[Congressional Bills 106th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4365 Engrossed Amendment Senate (EAS)]
In the Senate of the United States,
September 22, 2000.
Resolved, That the bill from the House of Representatives (H.R.
4365) entitled ``An Act to amend the Public Health Service Act with
respect to children's health.'', do pass with the following
AMENDMENT:
Strike out all after the enacting clause and insert:
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Children's Health Act of 2000''.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
DIVISION A--CHILDREN'S HEALTH
TITLE I--AUTISM
Sec. 101. Expansion, intensification, and coordination of activities of
National Institutes of Health with respect
to research on autism.
Sec. 102. Developmental disabilities surveillance and research
programs.
Sec. 103. Information and education.
Sec. 104. Inter-agency Autism Coordinating Committee.
Sec. 105. Report to Congress.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
Sec. 201. National Institute of Child Health and Human Development;
research on fragile X.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
Sec. 301. National Institute of Arthritis and Musculoskeletal and Skin
Diseases; research on juvenile arthritis
and related conditions.
Sec. 302. Information clearinghouse.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
Sec. 401. Programs of Centers for Disease Control and Prevention.
Sec. 402. Programs of National Institutes of Health.
TITLE V--ASTHMA SERVICES FOR CHILDREN
Subtitle A--Asthma Services
Sec. 501. Grants for children's asthma relief.
Sec. 502. Technical and conforming amendments.
Subtitle B--Prevention Activities
Sec. 511. Preventive health and health services block grant; systems
for reducing asthma-related illnesses
through integrated pest management.
Subtitle C--Coordination of Federal Activities
Sec. 521. Coordination through National Institutes of Health.
Subtitle D--Compilation of Data
Sec. 531. Compilation of data by Centers for Disease Control and
Prevention.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
Sec. 601. Program regarding effects of folic acid in prevention of
birth defects.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
Sec. 611. National Center on Birth Defects and Developmental
Disabilities.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
Sec. 701. Purposes.
Sec. 702. Programs of Health Resources and Services Administration,
Centers for Disease Control and Prevention,
and National Institutes of Health.
TITLE VIII--CHILDREN AND EPILEPSY
Sec. 801. National public health campaign on epilepsy; seizure disorder
demonstration projects in medically
underserved areas.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Prevention Research
Sec. 901. Prevention research and other activities.
Subtitle B--Pregnant Women and Infants Health Promotion
Sec. 911. Programs regarding prenatal and postnatal health.
TITLE X--PEDIATRIC RESEARCH INITIATIVE
Sec. 1001. Establishment of pediatric research initiative.
Sec. 1002. Investment in tomorrow's pediatric researchers.
Sec. 1003. Review of regulations.
Sec. 1004. Long-term child development study.
TITLE XI--CHILDHOOD MALIGNANCIES
Sec. 1101. Programs of Centers for Disease Control and Prevention and
National Institutes of Health.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
Sec. 1201. Grants regarding infant adoption awareness.
Subtitle B--Special Needs Adoption Awareness
Sec. 1211. Special needs adoption programs; public awareness campaign
and other activities.
TITLE XIII--TRAUMATIC BRAIN INJURY
Sec. 1301. Programs of Centers for Disease Control and Prevention.
Sec. 1302. Study and monitor incidence and prevalence.
Sec. 1303. Programs of National Institutes of Health.
Sec. 1304. Programs of Health Resources and Services Administration.
Sec. 1305. State grants for protection and advocacy services.
Sec. 1306. Authorization of appropriations for certain programs.
TITLE XIV--CHILD CARE SAFETY AND HEALTH GRANTS
Sec. 1401. Definitions.
Sec. 1402. Authorization of appropriations.
Sec. 1403. Programs.
Sec. 1404. Amounts reserved; allotments.
Sec. 1405. State applications.
Sec. 1406. Use of funds.
Sec. 1407. Reports.
TITLE XV--HEALTHY START INITIATIVE
Sec. 1501. Continuation of healthy start program.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
Sec. 1601. Identification of interventions that reduce the burden and
transmission of oral, dental, and
craniofacial diseases in high risk
populations; development of approaches for
pediatric oral and craniofacial assessment.
Sec. 1602. Oral health promotion and disease prevention.
Sec. 1603. Coordinated program to improve pediatric oral health.
TITLE XVII--VACCINE-RELATED PROGRAMS
Subtitle A--Vaccine Compensation Program
Sec. 1701. Content of petitions.
Subtitle B-- Childhood Immunizations
Sec. 1711. Childhood immunizations.
TITLE XVIII--HEPATITIS C
Sec. 1801. Surveillance and education regarding hepatitis C.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec. 1901. Autoimmune diseases; initiative through Director of National
Institutes of Health.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
Sec. 2001. Provisions to revise and extend program.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
Sec. 2101. Organ Procurement and Transplantation Network; amendments
regarding needs of children.
TITLE XXII--MUSCULAR DYSTROPHY RESEARCH
Sec. 2201. Muscular dystrophy research.
TITLE XXIII--CHILDREN AND TOURETTE SYNDROME AWARENESS
Sec. 2301. Grants regarding Tourette Syndrome.
TITLE XXIV--CHILDHOOD OBESITY PREVENTION
Sec. 2401. Programs operated through the Centers for Disease Control
and Prevention.
TITLE XXV--EARLY DETECTION AND TREATMENT REGARDING CHILDHOOD LEAD
POISONING
Sec. 2501. Centers for Disease Control and Prevention efforts to combat
childhood lead poisoning.
Sec. 2502. Grants for lead poisoning related activities.
Sec. 2503. Training and reports by the Health Resources and Services
Administration.
Sec. 2504. Screenings, referrals, and education regarding lead
poisoning.
TITLE XXVI--SCREENING FOR HERITABLE DISORDERS
Sec. 2601. Program to improve the ability of States to provide newborn
and child screening for heritable
disorders.
TITLE XXVII--PEDIATRIC RESEARCH PROTECTIONS
Sec. 2701. Requirement for additional protections for children involved
in research.
TITLE XXVIII--MISCELLANEOUS PROVISIONS
Sec. 2801. Report regarding research on rare diseases in children.
Sec. 2802. Study on metabolic disorders.
TITLE XXIX--EFFECTIVE DATE
Sec. 2901. Effective date.
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES
Sec. 3001. Short title.
TITLE XXXI--PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
Sec. 3101. Children and violence.
Sec. 3102. Emergency response.
Sec. 3103. High risk youth reauthorization.
Sec. 3104. Substance abuse treatment services for children and
adolescents.
Sec. 3105. Comprehensive community services for children with serious
emotional disturbance.
Sec. 3106. Services for children of substance abusers.
Sec. 3107. Services for youth offenders.
Sec. 3108. Grants for strengthening families through community
partnerships.
Sec. 3109. Programs to reduce underage drinking.
Sec. 3110. Services for individuals with fetal alcohol syndrome.
Sec. 3111. Suicide prevention.
Sec. 3112. General provisions.
TITLE XXXII--PROVISIONS RELATING TO MENTAL HEALTH
Sec. 3201. Priority mental health needs of regional and national
significance.
Sec. 3202. Grants for the benefit of homeless individuals.
Sec. 3203. Projects for assistance in transition from homelessness.
Sec. 3204. Community mental health services performance partnership
block grant.
Sec. 3205. Determination of allotment.
Sec. 3206. Protection and Advocacy for Mentally Ill Individuals Act of
1986.
Sec. 3207. Requirement relating to the rights of residents of certain
facilities.
Sec. 3208. Requirement relating to the rights of residents of certain
non-medical, community-based facilities for
children and youth.
Sec. 3209. Emergency mental health centers.
Sec. 3210. Grants for jail diversion programs.
Sec. 3211. Improving outcomes for children and adolescents through
services integration between child welfare
and mental health services.
Sec. 3212. Grants for the integrated treatment of serious mental
illness and co-occurring substance abuse.
Sec. 3213. Training grants.
TITLE XXXIII--PROVISIONS RELATING TO SUBSTANCE ABUSE
Sec. 3301. Priority substance abuse treatment needs of regional and
national significance.
Sec. 3302. Priority substance abuse prevention needs of regional and
national significance.
Sec. 3303. Substance abuse prevention and treatment performance
partnership block grant.
Sec. 3304. Determination of allotments.
Sec. 3305. Nondiscrimination and institutional safeguards for religious
providers.
Sec. 3306. Alcohol and drug prevention or treatment services for
Indians and Native Alaskans.
Sec. 3307. Establishment of commission.
TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND ACCOUNTABILITY
Sec. 3401. General authorities and peer review.
Sec. 3402. Advisory councils.
Sec. 3403. General provisions for the performance partnership block
grants.
Sec. 3404. Data infrastructure projects.
Sec. 3405. Repeal of obsolete addict referral provisions.
Sec. 3406. Individuals with co-occurring disorders.
Sec. 3407. Services for individuals with co-occurring disorders.
TITLE XXXV--WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR PRESCRIBE
CERTAIN NARCOTIC DRUGS FOR MAINTENANCE TREATMENT OR DETOXIFICATION
TREATMENT
Sec. 3501. Short title.
Sec. 3502. Amendment to Controlled Substances Act.
TITLE XXXVI--METHAMPHETAMINE AND OTHER CONTROLLED SUBSTANCES
Sec. 3601. Short title.
Subtitle A--Methamphetamine Production, Trafficking, and Abuse
Part I--Criminal Penalties
Sec. 3611. Enhanced punishment of amphetamine laboratory operators.
Sec. 3612. Enhanced punishment of amphetamine or methamphetamine
laboratory operators.
Sec. 3613. Mandatory restitution for violations of Controlled
Substances Act and Controlled Substances
Import and Export Act relating to
amphetamine and methamphetamine.
Sec. 3614. Methamphetamine paraphernalia.
Part II--Enhanced Law Enforcement
Sec. 3621. Environmental hazards associated with illegal manufacture of
amphetamine and methamphetamine.
Sec. 3622. Reduction in retail sales transaction threshold for non-safe
harbor products containing pseudoephedrine
or phenylpropanolamine.
Sec. 3623. Training for Drug Enforcement Administration and State and
local law enforcement personnel relating to
clandestine laboratories.
Sec. 3624. Combating methamphetamine and amphetamine in high intensity
drug trafficking areas.
Sec. 3625. Combating amphetamine and methamphetamine manufacturing and
trafficking.
Part III--Abuse Prevention and Treatment
Sec. 3631. Expansion of methamphetamine research.
Sec. 3632. Methamphetamine and amphetamine treatment initiative by
Center for Substance Abuse Treatment.
Sec. 3633. Study of methamphetamine treatment.
Part IV--Reports
Sec. 3641. Reports on consumption of methamphetamine and other illicit
drugs in rural areas, metropolitan areas,
and consolidated metropolitan areas.
Sec. 3642. Report on diversion of ordinary, over-the-counter
pseudoephedrine and phenylpropanolamine
products.
Subtitle B--Controlled Substances Generally
Sec. 3651. Enhanced punishment for trafficking in list I chemicals.
Sec. 3652. Mail order requirements.
Sec. 3653. Theft and transportation of anhydrous ammonia for purposes
of illicit production of controlled
substances.
Subtitle C--Ecstasy Anti-Proliferation Act of 2000
Sec. 3661. Short title.
Sec. 3662. Findings.
Sec. 3663. Enhanced punishment of Ecstasy traffickers.
Sec. 3664. Emergency authority to United States Sentencing Commission.
Sec. 3665. Expansion of Ecstasy and club drugs abuse prevention
efforts.
Subtitle D--Miscellaneous
Sec. 3671. Antidrug messages on Federal Government Internet websites.
Sec. 3672. Reimbursement by Drug Enforcement Administration of expenses
incurred to remediate methamphetamine
laboratories.
Sec. 3673. Severability.
DIVISION A--CHILDREN'S HEALTH
TITLE I--AUTISM
SEC. 101. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF
NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH ON
AUTISM.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284
et seq.) is amended by adding at the end the following section:
``expansion, intensification, and coordination of activities of
national institutes of health with respect to research on autism
``Sec. 409C. (a) In General.--
``(1) Expansion of activities.--The Director of NIH (in
this section referred to as the `Director') shall expand,
intensify, and coordinate the activities of the National
Institutes of Health with respect to research on autism.
``(2) Administration of program; collaboration among
agencies.--The Director shall carry out this section acting
through the Director of the National Institute of Mental Health
and in collaboration with any other agencies that the Director
determines appropriate.
``(b) Centers of Excellence.--
``(1) In general.--The Director shall under subsection
(a)(1) make awards of grants and contracts to public or
nonprofit private entities to pay all or part of the cost of
planning, establishing, improving, and providing basic
operating support for centers of excellence regarding research
on autism.
``(2) Research.--Each center under paragraph (1) shall
conduct basic and clinical research into autism. Such research
should include investigations into the cause, diagnosis, early
detection, prevention, control, and treatment of autism. The
centers, as a group, shall conduct research including the
fields of developmental neurobiology, genetics, and
psychopharmacology.
``(3) Services for patients.--
``(A) In general.--A center under paragraph (1) may
expend amounts provided under such paragraph to carry
out a program to make individuals aware of
opportunities to participate as subjects in research
conducted by the centers.
``(B) Referrals and costs.--A program under
subparagraph (A) may, in accordance with such criteria
as the Director may establish, provide to the subjects
described in such subparagraph, referrals for health
and other services, and such patient care costs as are
required for research.
``(C) Availability and access.--The extent to which
a center can demonstrate availability and access to
clinical services shall be considered by the Director
in decisions about awarding grants to applicants which
meet the scientific criteria for funding under this
section.
``(4) Coordination of centers; reports.--The Director
shall, as appropriate, provide for the coordination of
information among centers under paragraph (1) and ensure
regular communication between such centers, and may require the
periodic preparation of reports on the activities of the
centers and the submission of the reports to the Director.
``(5) Organization of centers.--Each center under paragraph
(1) shall use the facilities of a single institution, or be
formed from a consortium of cooperating institutions, meeting
such requirements as may be prescribed by the Director.
``(6) Number of centers; duration of support.--
``(A) In general.--The Director shall provide for
the establishment of not less than 5 centers under
paragraph (1).
``(B) Duration.--Support for a center established
under paragraph (1) may be provided under this section
for a period of not to exceed 5 years. Such period may
be extended for 1 or more additional periods not
exceeding 5 years if the operations of such center have
been reviewed by an appropriate technical and
scientific peer review group established by the
Director and if such group has recommended to the
Director that such period should be extended.
``(c) Facilitation of Research.--The Director shall under
subsection (a)(1) provide for a program under which samples of tissues
and genetic materials that are of use in research on autism are
donated, collected, preserved, and made available for such research.
The program shall be carried out in accordance with accepted scientific
and medical standards for the donation, collection, and preservation of
such samples.
``(d) Public Input.--The Director shall under subsection (a)(1)
provide for means through which the public can obtain information on
the existing and planned programs and activities of the National
Institutes of Health with respect to autism and through which the
Director can receive comments from the public regarding such programs
and activities.
``(e) Funding.--There are authorized to be appropriated such sums
as may be necessary to carry out this section. Amounts appropriated
under this subsection are in addition to any other amounts appropriated
for such purpose.''.
SEC. 102. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH
PROGRAMS.
(a) National Autism and Pervasive Developmental Disabilities
Surveillance Program.--
(1) In general.--The Secretary of Health and Human Services
(in this section referred to as the ``Secretary''), acting
through the Director of the Centers for Disease Control and
Prevention, may make awards of grants and cooperative
agreements for the collection, analysis, and reporting of data
on autism and pervasive developmental disabilities. In making
such awards, the Secretary may provide direct technical
assistance in lieu of cash.
(2) Eligibility.--To be eligible to receive an award under
paragraph (1) an entity shall be a public or nonprofit private
entity (including health departments of States and political
subdivisions of States, and including universities and other
educational entities).
(b) Centers of Excellence in Autism and Pervasive Developmental
Disabilities Epidemiology.--
(1) In general.--The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, shall
establish not less than 3 regional centers of excellence in
autism and pervasive developmental disabilities epidemiology
for the purpose of collecting and analyzing information on the
number, incidence, correlates, and causes of autism and related
developmental disabilities.
(2) Recipients of awards for establishment of centers.--
Centers under paragraph (1) shall be established and operated
through the awarding of grants or cooperative agreements to
public or nonprofit private entities that conduct research,
including health departments of States and political
subdivisions of States, and including universities and other
educational entities.
(3) Certain requirements.--An award for a center under
paragraph (1) may be made only if the entity involved submits
to the Secretary an application containing such agreements and
information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report
autism and pervasive developmental disabilities data
according to guidelines prescribed by the Director,
after consultation with relevant State and local public
health officials, private sector developmental
disability researchers, and advocates for those with
developmental disabilities.
(B) The center will assist with the development and
coordination of State autism and pervasive
developmental disabilities surveillance efforts within
a region.
(C) The center will identify eligible cases and
controls through its surveillance systems and conduct
research into factors which may cause autism and
related developmental disabilities.
(D) The center will develop or extend an area of
special research expertise (including genetics,
environmental exposure to contaminants, immunology, and
other relevant research specialty areas).
(c) Clearinghouse.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall carry out the
following:
(1) The Secretary shall establish a clearinghouse within
the Centers for Disease Control and Prevention for the
collection and storage of data generated from the monitoring
programs established by this title. Through the clearinghouse,
such Centers shall serve as the coordinating agency for autism
and pervasive developmental disabilities surveillance
activities. The functions of such a clearinghouse shall include
facilitating the coordination of research and policy
development relating to the epidemiology of autism and other
pervasive developmental disabilities.
(2) The Secretary shall coordinate the Federal response to
requests for assistance from State health department officials
regarding potential or alleged autism or developmental
disability clusters.
(d) Definition.--In this title, the term ``State'' means each of
the several States, the District of Columbia, the Commonwealth of
Puerto Rico, American Samoa, Guam, the Commonwealth of the Northern
Mariana Islands, the Virgin Islands, and the Trust Territory of the
Pacific Islands.
(e) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 103. INFORMATION AND EDUCATION.
(a) In General.--The Secretary shall establish and implement a
program to provide information and education on autism to health
professionals and the general public, including information and
education on advances in the diagnosis and treatment of autism and
training and continuing education through programs for scientists,
physicians, and other health professionals who provide care for
patients with autism.
(b) Stipends.--The Secretary may use amounts made available under
this section to provide stipends for health professionals who are
enrolled in training programs under this section.
(c) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 104. INTER-AGENCY AUTISM COORDINATING COMMITTEE.
(a) Establishment.--The Secretary shall establish a committee to be
known as the ``Autism Coordinating Committee'' (in this section
referred to as the ``Committee'') to coordinate all efforts within the
Department of Health and Human Services concerning autism, including
activities carried out through the National Institutes of Health and
the Centers for Disease Control and Prevention under this title (and
the amendment made by this title).
(b) Membership.--
(1) In general.--The Committee shall be composed of the
Directors of such national research institutes, of the Centers
for Disease Control and Prevention, and of such other agencies
and such other officials as the Secretary determines
appropriate.
(2) Additional members.--If determined appropriate by the
Secretary, the Secretary may appoint to the Committee--
(A) parents or legal guardians of individuals with
autism or other pervasive developmental disorders; and
(B) representatives of other governmental agencies
that serve children with autism such as the Department
of Education.
(c) Administrative Support; Terms of Service; Other Provisions.--
The following shall apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and Human
Services.
(2) Members of the Committee appointed under subsection
(b)(2)(A) shall serve for a term of 3 years, and may serve for
an unlimited number of terms if reappointed.
(3) The Committee shall meet not less than 2 times each
year.
SEC. 105. REPORT TO CONGRESS.
Not later than January 1, 2001, and each January 1 thereafter, the
Secretary shall prepare and submit to the appropriate committees of
Congress, a report concerning the implementation of this title and the
amendments made by this title.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
SEC. 201. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT;
RESEARCH ON FRAGILE X.
Subpart 7 of part C of title IV of the Public Health Service Act is
amended by adding at the end the following section:
``fragile x
``Sec. 452E. (a) Expansion and Coordination of Research
Activities.--The Director of the Institute, after consultation with the
advisory council for the Institute, shall expand, intensify, and
coordinate the activities of the Institute with respect to research on
the disease known as fragile X.
``(b) Research Centers.--
``(1) In general.--The Director of the Institute shall make
grants or enter into contracts for the development and
operation of centers to conduct research for the purposes of
improving the diagnosis and treatment of, and finding the cure
for, fragile X.
``(2) Number of centers.--
``(A) In general.--In carrying out paragraph (1),
the Director of the Institute shall, to the extent that
amounts are appropriated, and subject to subparagraph
(B), provide for the establishment of at least three
fragile X research centers.
``(B) Peer review requirement.--The Director of the
Institute shall make a grant to, or enter into a
contract with, an entity for purposes of establishing a
center under paragraph (1) only if the grant or
contract has been recommended after technical and
scientific peer review required by regulations under
section 492.
``(3) Activities.--The Director of the Institute, with the
assistance of centers established under paragraph (1), shall
conduct and support basic and biomedical research into the
detection and treatment of fragile X.
``(4) Coordination among centers.--The Director of the
Institute shall, as appropriate, provide for the coordination
of the activities of the centers assisted under this section,
including providing for the exchange of information among the
centers.
``(5) Certain administrative requirements.--Each center
assisted under paragraph (1) shall use the facilities of a
single institution, or be formed from a consortium of
cooperating institutions, meeting such requirements as may be
prescribed by the Director of the Institute.
``(6) Duration of support.--Support may be provided to a
center under paragraph (1) for a period not exceeding 5 years.
Such period may be extended for one or more additional periods,
each of which may not exceed 5 years, if the operations of such
center have been reviewed by an appropriate technical and
scientific peer review group established by the Director and if
such group has recommended to the Director that such period be
extended.
``(7) Authorization of appropriations.--For the purpose of
carrying out this subsection, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.''.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
SEC. 301. NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN
DISEASES; RESEARCH ON JUVENILE ARTHRITIS AND RELATED
CONDITIONS.
(a) In General.--Subpart 4 of part C of title IV of the Public
Health Service Act (42 U.S.C. 285d et seq.) is amended by inserting
after section 442 the following section:
``juvenile arthritis and related conditions
``Sec. 442A. (a) Expansion and Coordination of Activities.--The
Director of the Institute, in coordination with the Director of the
National Institute of Allergy and Infectious Diseases, shall expand and
intensify the programs of such Institutes with respect to research and
related activities concerning juvenile arthritis and related
conditions.
``(b) Coordination.--The Directors referred to in subsection (a)
shall jointly coordinate the programs referred to in such subsection
and consult with the Arthritis and Musculoskeletal Diseases Interagency
Coordinating Committee.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
(b) Pediatric Rheumatology.--Subpart 1 of part E of title VII of
the Public Health Service Act (42 U.S.C. 294n et seq.) is amended by
adding at the end the following:
``SEC. 763. PEDIATRIC RHEUMATOLOGY.
``(a) In General.--The Secretary, acting through the appropriate
agencies, shall evaluate whether the number of pediatric
rheumatologists is sufficient to address the health care needs of
children with arthritis and related conditions, and if the Secretary
determines that the number is not sufficient, shall develop strategies
to help address the shortfall.
``(b) Report to Congress.--Not later than October 1, 2001, the
Secretary shall submit to the Congress a report describing the results
of the evaluation under subsection (a), and as applicable, the
strategies developed under such subsection.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
SEC. 302. INFORMATION CLEARINGHOUSE.
Section 438(b) of the Public Health Service Act (42 U.S.C. 285d-
3(b)) is amended by inserting ``, including juvenile arthritis and
related conditions,'' after ``diseases''.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
Part B of title III of the Public Health Service Act (42 U.S.C. 243
et seq.) is amended by inserting after section 317G the following
section:
``diabetes in children and youth
``Sec. 317H. (a) Surveillance on Juvenile Diabetes.--The Secretary,
acting through the Director of the Centers for Disease Control and
Prevention, shall develop a sentinel system to collect data on juvenile
diabetes, including with respect to incidence and prevalence, and shall
establish a national database for such data.
``(b) Type 2 Diabetes in Youth.--The Secretary shall implement a
national public health effort to address type 2 diabetes in youth,
including--
``(1) enhancing surveillance systems and expanding research
to better assess the prevalence and incidence of type 2
diabetes in youth and determine the extent to which type 2
diabetes is incorrectly diagnosed as type 1 diabetes among
children; and
``(2) developing and improving laboratory methods to assist
in diagnosis, treatment, and prevention of diabetes including,
but not limited to, developing noninvasive ways to monitor
blood glucose to prevent hypoglycemia and improving existing
glucometers that measure blood glucose.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
SEC. 402. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
Subpart 3 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285c et seq.) is amended by inserting after section 434 the
following section:
``juvenile diabetes
``Sec. 434A. (a) Long-Term Epidemiology Studies.--The Director of
the Institute shall conduct or support long-term epidemiology studies
in which individuals with or at risk for type 1, or juvenile, diabetes
are followed for 10 years or more. Such studies shall investigate the
causes and characteristics of the disease and its complications.
``(b) Clinical Trial Infrastructure/Innovative Treatments for
Juvenile Diabetes.--The Secretary, acting through the Director of the
National Institutes of Health, shall support regional clinical research
centers for the prevention, detection, treatment, and cure of juvenile
diabetes.
``(c) Prevention of Type 1 Diabetes.--The Secretary, acting through
the appropriate agencies, shall provide for a national effort to
prevent type 1 diabetes. Such effort shall provide for a combination of
increased efforts in research and development of prevention strategies,
including consideration of vaccine development, coupled with
appropriate ability to test the effectiveness of such strategies in
large clinical trials of children and young adults.
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE V--ASTHMA SERVICES FOR CHILDREN
Subtitle A--Asthma Services
SEC. 501. GRANTS FOR CHILDREN'S ASTHMA RELIEF.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended by adding at the end the following part:
``PART P--ADDITIONAL PROGRAMS
``SEC. 399L. CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.
``(a) Authority To Make Grants.--
``(1) In general.--In addition to any other payments made
under this Act or title V of the Social Security Act, the
Secretary shall award grants to eligible entities to carry out
the following purposes:
``(A) To provide access to quality medical care for
children who live in areas that have a high prevalence
of asthma and who lack access to medical care.
``(B) To provide on-site education to parents,
children, health care providers, and medical teams to
recognize the signs and symptoms of asthma, and to
train them in the use of medications to treat asthma
and prevent its exacerbations.
``(C) To decrease preventable trips to the
emergency room by making medication available to
individuals who have not previously had access to
treatment or education in the management of asthma.
``(D) To provide other services, such as smoking
cessation programs, home modification, and other direct
and support services that ameliorate conditions that
exacerbate or induce asthma.
``(2) Certain projects.--In making grants under paragraph
(1), the Secretary may make grants designed to develop and
expand the following projects:
``(A) Projects to provide comprehensive asthma
services to children in accordance with the guidelines
of the National Asthma Education and Prevention Program
(through the National Heart, Lung and Blood Institute),
including access to care and treatment for asthma in a
community-based setting.
``(B) Projects to fully equip mobile health care
clinics that provide preventive asthma care including
diagnosis, physical examinations, pharmacological
therapy, skin testing, peak flow meter testing, and
other asthma-related health care services.
``(C) Projects to conduct validated asthma
management education programs for patients with asthma
and their families, including patient education
regarding asthma management, family education on asthma
management, and the distribution of materials,
including displays and videos, to reinforce concepts
presented by medical teams.
``(2) Award of grants.--
``(A) Application.--
``(i) In general.--An eligible entity shall
submit an application to the Secretary for a
grant under this section in such form and
manner as the Secretary may require.
``(ii) Required information.--An
application submitted under this subparagraph
shall include a plan for the use of funds
awarded under the grant and such other
information as the Secretary may require.
``(B) Requirement.--In awarding grants under this
section, the Secretary shall give preference to
eligible entities that demonstrate that the activities
to be carried out under this section shall be in
localities within areas of known or suspected high
prevalence of childhood asthma or high asthma-related
mortality or high rate of hospitalization or emergency
room visits for asthma (relative to the average asthma
prevalence rates and associated mortality rates in the
United States). Acceptable data sets to demonstrate a
high prevalence of childhood asthma or high asthma-
related mortality may include data from Federal, State,
or local vital statistics, claims data under title XIX
or XXI of the Social Security Act, other public health
statistics or surveys, or other data that the
Secretary, in consultation with the Director of the
Centers for Disease Control and Prevention, deems
appropriate.
``(3) Definition of eligible entity.--For purposes of this
section, the term `eligible entity' means a public or nonprofit
private entity (including a State or political subdivision of a
State), or a consortium of any of such entities.
``(b) Coordination With Other Children's Programs.--An eligible
entity shall identify in the plan submitted as part of an application
for a grant under this section how the entity will coordinate
operations and activities under the grant with--
``(1) other programs operated in the State that serve
children with asthma, including any such programs operated
under titles V, XIX, or XXI of the Social Security Act; and
``(2) one or more of the following--
``(A) the child welfare and foster care and
adoption assistance programs under parts B and E of
title IV of such Act;
``(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
``(C) the program of assistance under the special
supplemental nutrition program for women, infants and
children (WIC) under section 17 of the Child Nutrition
Act of 1966 (42 U.S.C. 1786);
``(D) local public and private elementary or
secondary schools; or
``(E) public housing agencies, as defined in
section 3 of the United States Housing Act of 1937 (42
U.S.C. 1437a).
``(c) Evaluation.--An eligible entity that receives a grant under
this section shall submit to the Secretary an evaluation of the
operations and activities carried out under the grant that includes--
``(1) a description of the health status outcomes of
children assisted under the grant;
``(2) an assessment of the utilization of asthma-related
health care services as a result of activities carried out
under the grant;
``(3) the collection, analysis, and reporting of asthma
data according to guidelines prescribed by the Director of the
Centers for Disease Control and Prevention; and
``(4) such other information as the Secretary may require.
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
SEC. 502. TECHNICAL AND CONFORMING AMENDMENTS.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.)
is amended--
(1) in part L, by redesignating section 399D as section
399A;
(2) in part M--
(A) by redesignating sections 399H through 399L as
sections 399B through 399F, respectively;
(B) in section 399B (as so redesignated), in
subsection (e)--
(i) by striking ``section 399K(b)'' and
inserting ``subsection (b) of section 399E'';
and
(ii) by striking ``section 399C'' and
inserting ``such section'';
(C) in section 399E (as so redesignated), in
subsection (c), by striking ``section 399H(a)'' and
inserting ``section 399B(a)''; and
(D) in section 399F (as so redesignated)--
(i) in subsection (a), by striking
``section 399I'' and inserting ``section
399C'';
(ii) in subsection (a), by striking
``subsection 399J'' and inserting ``section
399D''; and
(iii) in subsection (b), by striking
``subsection 399K'' and inserting ``section
399E'';
(3) in part N, by redesignating section 399F as section
399G; and
(4) in part O--
(A) by redesignating sections 399G through 399J as
sections 399H through 399K, respectively;
(B) in section 399H (as so redesignated), in
subsection (b), by striking ``section 399H'' and
inserting ``section 399I'';
(C) in section 399J (as so redesignated), in
subsection (b), by striking ``section 399G(d)'' and
inserting ``section 399H(d)''; and
(D) in section 399K (as so redesignated), by
striking ``section 399G(d)(1)'' and inserting ``section
399H(d)(1)''.
Subtitle B--Prevention Activities
SEC. 511. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT; SYSTEMS
FOR REDUCING ASTHMA-RELATED ILLNESSES THROUGH INTEGRATED
PEST MANAGEMENT.
Section 1904(a)(1) of the Public Health Service Act (42 U.S.C.
300w-3(a)(1)) is amended--
(1) by redesignating subparagraphs (E) and (F) as
subparagraphs (F) and (G), respectively;
(2) by adding a period at the end of subparagraph (G) (as
so redesignated);
(3) by inserting after subparagraph (D), the following:
``(E) The establishment, operation, and coordination of
effective and cost-efficient systems to reduce the prevalence
of illness due to asthma and asthma-related illnesses,
especially among children, by reducing the level of exposure to
cockroach allergen or other known asthma triggers through the
use of integrated pest management, as applied to cockroaches or
other known allergens. Amounts expended for such systems may
include the costs of building maintenance and the costs of
programs to promote community participation in the carrying out
at such sites of integrated pest management, as applied to
cockroaches or other known allergens. For purposes of this
subparagraph, the term `integrated pest management' means an
approach to the management of pests in public facilities that
combines biological, cultural, physical, and chemical tools in
a way that minimizes economic, health, and environmental
risks.'';
(4) in subparagraph (F) (as so redesignated), by striking
``subparagraphs (A) through (D)'' and inserting ``subparagraphs
(A) through (E)''; and
(5) in subparagraph (G) (as so redesignated), by striking
``subparagraphs (A) through (E)'' and inserting ``subparagraphs
(A) through (F)''.
Subtitle C--Coordination of Federal Activities
SEC. 521. COORDINATION THROUGH NATIONAL INSTITUTES OF HEALTH.
Subpart 2 of part C of title IV of the Public Health Service Act
(42 U.S.C. 285b et seq.) is amended by inserting after section 424A the
following section:
``coordination of federal asthma activities
``Sec. 424B (a) In General.--The Director of Institute shall,
through the National Asthma Education Prevention Program Coordinating
Committee--
``(1) identify all Federal programs that carry out asthma-
related activities;
``(2) develop, in consultation with appropriate Federal
agencies and professional and voluntary health organizations, a
Federal plan for responding to asthma; and
``(3) not later than 12 months after the date of the
enactment of the Children's Health Act of 2000, submit
recommendations to the appropriate committees of the Congress
on ways to strengthen and improve the coordination of asthma-
related activities of the Federal Government.
``(b) Representation of the Department of Housing and Urban
Development.--A representative of the Department of Housing and Urban
Development shall be included on the National Asthma Education
Prevention Program Coordinating Committee for the purpose of performing
the tasks described in subsection (a).
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
Subtitle D--Compilation of Data
SEC. 531. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 401 of this Act, is amended by inserting after section 317H the
following section:
``compilation of data on asthma
``Sec. 317I. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall--
``(1) conduct local asthma surveillance activities to
collect data on the prevalence and severity of asthma and the
quality of asthma management;
``(2) compile and annually publish data on the prevalence
of children suffering from asthma in each State; and
``(3) to the extent practicable, compile and publish data
on the childhood mortality rate associated with asthma
nationally.
``(b) Surveillance Activities.--The Director of the Centers for
Disease Control and Prevention, acting through the representative of
the Director on the National Asthma Education Prevention Program
Coordinating Committee, shall, in carrying out subsection (a), provide
an update on surveillance activities at each Committee meeting.
``(c) Collaborative Efforts.--The activities described in
subsection (a)(1) may be conducted in collaboration with eligible
entities awarded a grant under section 399L.
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
SEC. 601. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVENTION OF
BIRTH DEFECTS.
Part B of title III of the Public Health Service Act, as amended by
section 531 of this Act, is amended by inserting after section 317I the
following section:
``effects of folic acid in prevention of birth defects
``Sec. 317J. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
expand and intensify programs (directly or through grants or contracts)
for the following purposes:
``(1) To provide education and training for health
professionals and the general public for purposes of explaining
the effects of folic acid in preventing birth defects and for
purposes of encouraging each woman of reproductive capacity
(whether or not planning a pregnancy) to consume on a daily
basis a dietary supplement that provides an appropriate level
of folic acid.
``(2) To conduct research with respect to such education
and training, including identifying effective strategies for
increasing the rate of consumption of folic acid by women of
reproductive capacity.
``(3) To conduct research to increase the understanding of
the effects of folic acid in preventing birth defects,
including understanding with respect to cleft lip, cleft
palate, and heart defects.
``(4) To provide for appropriate epidemiological activities
regarding folic acid and birth defects, including
epidemiological activities regarding neural tube defects.
``(b) Consultations With States and Private Entities.--In carrying
out subsection (a), the Secretary shall consult with the States and
with other appropriate public or private entities, including national
nonprofit private organizations, health professionals, and providers of
health insurance and health plans.
``(c) Technical Assistance.--The Secretary may (directly or through
grants or contracts) provide technical assistance to public and
nonprofit private entities in carrying out the activities described in
subsection (a).
``(d) Evaluations.--The Secretary shall (directly or through grants
or contracts) provide for the evaluation of activities under subsection
(a) in order to determine the extent to which such activities have been
effective in carrying out the purposes of the program under such
subsection, including the effects on various demographic populations.
Methods of evaluation under the preceding sentence may include surveys
of knowledge and attitudes on the consumption of folic acid and on
blood folate levels. Such methods may include complete and timely
monitoring of infants who are born with neural tube defects.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES.
Section 317C of the Public Health Service Act (42 U.S.C. 247b-4) is
amended--
(1) by striking the heading for the section and inserting
the following:
``national center on birth defects and developmental disabilities'';
(2) by striking ``Sec. 317C. (a)'' and all that follows
through the end of subsection (a) and inserting the following:
``Sec. 317C. (a) In General.--
``(1) National center.--There is established within the
Centers for Disease Control and Prevention a center to be known
as the National Center on Birth Defects and Developmental
Disabilities (referred to in this section as the `Center'),
which shall be headed by a director appointed by the Director
of the Centers for Disease Control and Prevention.
``(2) General duties.--The Secretary shall carry out
programs--
(A) to collect, analyze, and make available data on
birth defects and developmental disabilities (in a
manner that facilitates compliance with subsection
(d)(2)), including data on the causes of such defects
and disabilities and on the incidence and prevalence of
such defects and disabilities;
(B) to operate regional centers for the conduct of
applied epidemiological research on the prevention of
such defects and disabilities; and
(C) to provide information and education to the
public on the prevention of such defects and
disabilities.
``(3) Folic acid.--The Secretary shall carry out section
317J through the Center.
``(4) Certain programs.--
``(A) Transfers.--All programs and functions
described in subparagraph (B) are transferred to the
Center, effective upon the expiration of the 180-day
period beginning on the date of the enactment of the
Children's Health Act of 2000.
``(B) Relevant programs.--The programs and
functions described in this subparagraph are all
programs and functions that--
``(i) relate to birth defects; folic acid;
cerebral palsy; mental retardation; child
development; newborn screening; autism; fragile
X syndrome; fetal alcohol syndrome; pediatric
genetic disorders; disability prevention; or
other relevant diseases, disorders, or
conditions as determined the Secretary; and
``(ii) were carried out through the
National Center for Environmental Health as of
the day before the date of the enactment of the
Act referred to in subparagraph (A).
``(C) Related transfers.--Personnel employed in
connection with the programs and functions specified in
subparagraph (B), and amounts available for carrying
out the programs and functions, are transferred to the
Center, effective upon the expiration of the 180-day
period beginning on the date of the enactment of the
Act referred to in subparagraph (A). Such transfer of
amounts does not affect the period of availability of
the amounts, or the availability of the amounts with
respect to the purposes for which the amounts may be
expended.''; and
(3) in subsection (b)(1), in the matter preceding
subparagraph (A), by striking ``(a)(1)'' and inserting
``(a)(2)(A)''.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
SEC. 701. PURPOSES.
The purposes of this title are to clarify the authority within the
Public Health Service Act to authorize statewide newborn and infant
hearing screening, evaluation and intervention programs and systems,
technical assistance, a national applied research program, and
interagency and private sector collaboration for policy development, in
order to assist the States in making progress toward the following
goals:
(1) All babies born in hospitals in the United States and
its territories should have a hearing screening before leaving
the birthing facility. Babies born in other countries and
residing in the United States via immigration or adoption
should have a hearing screening as early as possible.
(2) All babies who are not born in hospitals in the United
States and its territories should have a hearing screening
within the first 3 months of life.
(3) Appropriate audiologic and medical evaluations should
be conducted by 3 months for all newborns and infants suspected
of having hearing loss to allow appropriate referral and
provisions for audiologic rehabilitation, medical and early
intervention before the age of 6 months.
(4) All newborn and infant hearing screening programs and
systems should include a component for audiologic
rehabilitation, medical and early intervention options that
ensures linkage to any new and existing state-wide systems of
intervention and rehabilitative services for newborns and
infants with hearing loss.
(5) Public policy in regard to newborn and infant hearing
screening and intervention should be based on applied research
and the recognition that newborns, infants, toddlers, and
children who are deaf or hard-of-hearing have unique language,
learning, and communication needs, and should be the result of
consultation with pertinent public and private sectors.
SEC. 702. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION,
CENTERS FOR DISEASE CONTROL AND PREVENTION, AND NATIONAL
INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as added by
section 501 of this Act, is amended by adding at the end the following
section:
``SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING
HEARING LOSS IN INFANTS.
``(a) Statewide Newborn and Infant Hearing Screening, Evaluation
and Intervention Programs and Systems.--The Secretary, acting through
the Administrator of the Health Resources and Services Administration,
shall make awards of grants or cooperative agreements to develop
statewide newborn and infant hearing screening, evaluation and
intervention programs and systems for the following purposes:
``(1) To develop and monitor the efficacy of state-wide
newborn and infant hearing screening, evaluation and
intervention programs and systems. Early intervention includes
referral to schools and agencies, including community,
consumer, and parent-based agencies and organizations and other
programs mandated by part C of the Individuals with
Disabilities Education Act, which offer programs specifically
designed to meet the unique language and communication needs of
deaf and hard of hearing newborns, infants, toddlers, and
children.
``(2) To collect data on statewide newborn and infant
hearing screening, evaluation and intervention programs and
systems that can be used for applied research, program
evaluation and policy development.
``(b) Technical Assistance, Data Management, and Applied
Research.--
``(1) Centers for disease control and prevention.--The
Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall make awards of grants or
cooperative agreements to provide technical assistance to State
agencies to complement an intramural program and to conduct
applied research related to newborn and infant hearing
screening, evaluation and intervention programs and systems.
The program shall develop standardized procedures for data
management and program effectiveness and costs, such as--
``(A) to ensure quality monitoring of newborn and
infant hearing loss screening, evaluation, and
intervention programs and systems;
``(B) to provide technical assistance on data
collection and management;
``(C) to study the costs and effectiveness of
newborn and infant hearing screening, evaluation and
intervention programs and systems conducted by State-
based programs in order to answer issues of importance
to state and national policymakers;
``(D) to identify the causes and risk factors for
congenital hearing loss;
``(E) to study the effectiveness of newborn and
infant hearing screening, audiologic and medical
evaluations and intervention programs and systems by
assessing the health, intellectual and social
developmental, cognitive, and language status of these
children at school age; and
``(F) to promote the sharing of data regarding
early hearing loss with State-based birth defects and
developmental disabilities monitoring programs for the
purpose of identifying previously unknown causes of
hearing loss.
``(2) National institutes of health.--The Director of the
National Institutes of Health, acting through the Director of
the National Institute on Deafness and Other Communication
Disorders, shall for purposes of this section, continue a
program of research and development on the efficacy of new
screening techniques and technology, including clinical studies
of screening methods, studies on efficacy of intervention, and
related research.
``(c) Coordination and Collaboration.--
``(1) In general.--In carrying out programs under this
section, the Administrator of the Health Resources and Services
Administration, the Director of the Centers for Disease Control
and Prevention, and the Director of the National Institutes of
Health shall collaborate and consult with other Federal
agencies; State and local agencies, including those responsible
for early intervention services pursuant to title XIX of the
Social Security Act (Medicaid Early and Periodic Screening,
Diagnosis and Treatment Program); title XXI of the Social
Security Act (State Children's Health Insurance Program); title
V of the Social Security Act (Maternal and Child Health Block
Grant Program); and part C of the Individuals with Disabilities
Education Act; consumer groups of and that serve individuals
who are deaf and hard-of-hearing and their families;
appropriate national medical and other health and education
specialty organizations; persons who are deaf and hard-of-
hearing and their families; other qualified professional
personnel who are proficient in deaf or hard-of-hearing
children's language and who possess the specialized knowledge,
skills, and attributes needed to serve deaf and hard-of-hearing
newborns, infants, toddlers, children, and their families;
third-party payers and managed care organizations; and related
commercial industries.
``(2) Policy development.--The Administrator of the Health
Resources and Services Administration, the Director of the
Centers for Disease Control and Prevention, and the Director of
the National Institutes of Health shall coordinate and
collaborate on recommendations for policy development at the
Federal and State levels and with the private sector, including
consumer, medical and other health and education professional-
based organizations, with respect to newborn and infant hearing
screening, evaluation and intervention programs and systems.
``(3) State early detection, diagnosis, and intervention
programs and systems; data collection.--The Administrator of
the Health Resources and Services Administration and the
Director of the Centers for Disease Control and Prevention
shall coordinate and collaborate in assisting States to
establish newborn and infant hearing screening, evaluation and
intervention programs and systems under subsection (a) and to
develop a data collection system under subsection (b).
``(d) Rule of Construction; Religious Accommodation.--Nothing in
this section shall be construed to preempt or prohibit any State law,
including State laws which do not require the screening for hearing
loss of newborn infants or young children of parents who object to the
screening on the grounds that such screening conflicts with the
parents' religious beliefs.
``(e) Definitions.--For purposes of this section:
``(1) The term `audiologic evaluation' refers to procedures
to assess the status of the auditory system; to establish the
site of the auditory disorder; the type and degree of hearing
loss, and the potential effects of hearing loss on
communication; and to identify appropriate treatment and
referral options. Referral options should include linkage to
State coordinating agencies under part C of the Individuals
with Disabilities Education Act or other appropriate agencies,
medical evaluation, hearing aid/sensory aid assessment,
audiologic rehabilitation treatment, national and local
consumer, self-help, parent, and education organizations, and
other family-centered services.
``(2) The terms `audiologic rehabilitation' and `audiologic
intervention' refer to procedures, techniques, and technologies
to facilitate the receptive and expressive communication
abilities of a child with hearing loss.
``(3) The term `early intervention' refers to providing
appropriate services for the child with hearing loss, including
nonmedical services, and ensuring that families of the child
are provided comprehensive, consumer-oriented information about
the full range of family support, training, information
services, communication options and are given the opportunity
to consider the full range of educational and program
placements and options for their child.
``(4) The term `medical evaluation by a physician' refers
to key components including history, examination, and medical
decision making focused on symptomatic and related body systems
for the purpose of diagnosing the etiology of hearing loss and
related physical conditions, and for identifying appropriate
treatment and referral options.
``(5) The term `medical intervention' refers to the process
by which a physician provides medical diagnosis and direction
for medical and/or surgical treatment options of hearing loss
and/or related medical disorder associated with hearing loss.
``(6) The term `newborn and infant hearing screening'
refers to objective physiologic procedures to detect possible
hearing loss and to identify newborns and infants who, after
rescreening, require further audiologic and medical
evaluations.
``(f) Authorization of Appropriations.--
``(1) Statewide newborn and infant hearing screening,
evaluation and intervention programs and systems.--For the
purpose of carrying out subsection (a), there are authorized to
be appropriated to the Health Resources and Services
Administration such sums as may be necessary for fiscal year
2002.
``(2) Technical assistance, data management, and applied
research; centers for disease control and prevention.--For the
purpose of carrying out subsection (b)(1), there are authorized
to be appropriated to the Centers for Disease Control and
Prevention such sums as may be necessary for fiscal year 2002.
``(3) Technical assistance, data management, and applied
research; national institute on deafness and other
communication disorders.--For the purpose of carrying out
subsection (b)(2), there are authorized to be appropriated to
the National Institute on Deafness and Other Communication
Disorders such sums as may be necessary for fiscal year
2002.''.
TITLE VIII--CHILDREN AND EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY; SEIZURE DISORDER
DEMONSTRATION PROJECTS IN MEDICALLY UNDERSERVED AREAS.
Subpart I of part D of title III of the Public Health Service Act
(42 U.S.C. 254b) is amended by adding at the end the following section:
``SEC. 330E. EPILEPSY; SEIZURE DISORDER.
``(a) National Public Health Campaign.--
``(1) In general.--The Secretary shall develop and
implement public health surveillance, education, research, and
intervention strategies to improve the lives of persons with
epilepsy, with a particular emphasis on children. Such projects
may be carried out by the Secretary directly and through awards
of grants or contracts to public or nonprofit private entities.
The Secretary may directly or through such awards provide
technical assistance with respect to the planning, development,
and operation of such projects.
``(2) Certain activities.--Activities under paragraph (1)
shall include--
``(A) expanding current surveillance activities
through existing monitoring systems and improving
registries that maintain data on individuals with
epilepsy, including children;
``(B) enhancing research activities on the
diagnosis, treatment, and management of epilepsy;
``(C) implementing public and professional
information and education programs regarding epilepsy,
including initiatives which promote effective
management of the disease through children's programs
which are targeted to parents, schools, daycare
providers, patients;
``(D) undertaking educational efforts with the
media, providers of health care, schools and others
regarding stigmas and secondary disabilities related to
epilepsy and seizures, and its effects on youth;
``(E) utilizing and expanding partnerships with
organizations with experience addressing the health and
related needs of people with disabilities; and
``(F) other activities the Secretary deems
appropriate.
``(3) Coordination of activities.--The Secretary shall
ensure that activities under this subsection are coordinated as
appropriate with other agencies of the Public Health Service
that carry out activities regarding epilepsy and seizure.
``(b) Seizure Disorder; Demonstration Projects in Medically
Underserved Areas.--
``(1) In general.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, may make grants for the purpose of carrying out
demonstration projects to improve access to health and other
services regarding seizures to encourage early detection and
treatment in children and others residing in medically
underserved areas.
``(2) Application for grant.--A grant may not be awarded
under paragraph (1) unless an application therefore is
submitted to the Secretary and the Secretary approves such
application. Such application shall be submitted in such form
and manner and shall contain such information as the Secretary
may prescribe.
``(c) Definitions.--For purposes of this section:
``(1) The term ``epilepsy'' refers to a chronic and serious
neurological condition characterized by excessive electrical
discharges in the brain causing recurring seizures affecting
all life activities. The Secretary may revise the definition of
such term to the extent the Secretary determines necessary.
``(2) The term ``medically underserved'' has the meaning
applicable under section 799B(6).
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Prevention Research
SEC. 901. PREVENTION RESEARCH AND OTHER ACTIVITIES.
Part B of title III of the Public Health Service Act, as amended by
section 601 of this Act, is amended by inserting after section 317J the
following section:
``safe motherhood
``Sec. 317K. (a) Surveillance.--
``(1) Purpose.--The purpose of this subsection is to
develop surveillance systems at the local, State, and national
level to better understand the burden of maternal complications
and mortality and to decrease the disparities among population
at risk of death and complications from pregnancy.
``(2) Activities.--For the purpose described in paragraph
(1), the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may carry out the following
activities:
``(A) The Secretary may establish and implement a
national surveillance program to identify and promote
the investigation of deaths and severe complications
that occur during pregnancy.
``(B) The Secretary may expand the Pregnancy Risk
Assessment Monitoring System to provide surveillance
and collect data in each State.
``(C) The Secretary may expand the Maternal and
Child Health Epidemiology Program to provide technical
support, financial assistance, or the time-limited
assignment of senior epidemiologists to maternal and
child health programs in each State.
``(b) Prevention Research.--
``(1) Purpose.--The purpose of this subsection is to
provide the Secretary with the authority to further expand
research concerning risk factors, prevention strategies, and
the roles of the family, health care providers and the
community in safe motherhood.
``(2) Research.--The Secretary may carry out activities to
expand research relating to--
``(A) encouraging preconception counseling,
especially for at risk populations such as diabetics;
``(B) the identification of critical components of
prenatal delivery and postpartum care;
``(C) the identification of outreach and support
services, such as folic acid education, that are
available for pregnant women;
``(D) the identification of women who are at high
risk for complications;
``(E) preventing preterm delivery;
``(F) preventing urinary tract infections;
``(G) preventing unnecessary caesarean sections;
``(H) an examination of the higher rates of
maternal mortality among African American women;
``(I) an examination of the relationship between
domestic violence and maternal complications and
mortality;
``(J) preventing and reducing adverse health
consequences that may result from smoking, alcohol and
illegal drug use before, during and after pregnancy;
``(K) preventing infections that cause maternal and
infant complications; and
``(L) other areas determined appropriate by the
Secretary.
``(c) Prevention Programs.--
``(1) In general.--The Secretary may carry out activities
to promote safe motherhood, including--
``(A) public education campaigns on healthy
pregnancies and the building of partnerships with
outside organizations concerned about safe motherhood;
``(B) education programs for physicians, nurses and
other health care providers; and
``(C) activities to promote community support
services for pregnant women.
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
Subtitle B--Pregnant Women and Infants Health Promotion
SEC. 911. PROGRAMS REGARDING PRENATAL AND POSTNATAL HEALTH.
Part B of title III of the Public Health Service Act, as amended by
section 901 of this Act, is amended by inserting after section 317K the
following section:
``prenatal and postnatal health
``Sec. 317L. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall carry
out programs--
``(1) to collect, analyze, and make available data on
prenatal smoking, alcohol and illegal drug use, including data
on the implications of such activities and on the incidence and
prevalence of such activities and their implications;
``(2) to conduct applied epidemiological research on the
prevention of prenatal and postnatal smoking, alcohol and
illegal drug use;
``(3) to support, conduct, and evaluate the effectiveness
of educational and cessation programs; and
``(4) to provide information and education to the public on
the prevention and implications of prenatal and postnatal
smoking, alcohol and illegal drug use.
``(b) Grants.--In carrying out subsection (a), the Secretary may
award grants to and enter into contracts with States, local
governments, scientific and academic institutions, Federally qualified
health centers, and other public and nonprofit entities, and may
provide technical and consultative assistance to such entities.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE X-- PEDIATRIC RESEARCH INITIATIVE
SEC. 1001. ESTABLISHMENT OF PEDIATRIC RESEARCH INITIATIVE.
Part B of title IV of the Public Health Service Act, as amended by
section 101 of this Act, is amended by adding at the end the following:
``pediatric research initiative
``Sec. 409D. (a) Establishment.--The Secretary shall establish
within the Office of the Director of NIH a Pediatric Research
Initiative (referred to in this section as the `Initiative') to conduct
and support research that is directly related to diseases, disorders,
and other conditions in children. The Initiative shall be headed by the
Director of NIH.
``(b) Purpose.--The purpose of the Initiative is to provide funds
to enable the Director of NIH--
``(1) to increase support for pediatric biomedical research
within the National Institutes of Health to realize the
expanding opportunities for advancement in scientific
investigations and care for children;
``(2) to enhance collaborative efforts among the Institutes
to conduct and support multidisciplinary research in the areas
that the Director deems most promising; and
``(3) in coordination with the Food and Drug
Administration, to increase the development of adequate
pediatric clinical trials and pediatric use information to
promote the safer and more effective use of prescription drugs
in the pediatric population.
``(c) Duties.--In carrying out subsection (b), the Director of NIH
shall--
``(1) consult with the Director of the National Institute
of Child Health and Human Development and the other national
research institutes, in considering their requests for new or
expanded pediatric research efforts, and consult with the
Administrator of the Health Resources and Services
Administration and other advisors as the Director determines to
be appropriate;
``(2) have broad discretion in the allocation of any
Initiative assistance among the Institutes, among types of
grants, and between basic and clinical research so long as the
assistance is directly related to the illnesses and conditions
of children; and
``(3) be responsible for the oversight of any newly
appropriated Initiative funds and annually report to Congress
and the public on the extent of the total funds obligated to
conduct or support pediatric research across the National
Institutes of Health, including the specific support and
research awards allocated through the Initiative.
``(d) Authorization.--For the purpose of carrying out this section,
there are authorized to be appropriated $50,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years
2002 through 2005.
``(e) Transfer of Funds.--The Director of NIH may transfer amounts
appropriated under this section to any of the Institutes for a fiscal
year to carry out the purposes of the Initiative under this section.''.
SEC. 1002. INVESTMENT IN TOMORROW'S PEDIATRIC RESEARCHERS.
(a) In General.--Subpart 7 of part C of title IV of the Public
Health Service Act, as amended by section 921 of this Act, is amended
by adding at the end the following:
``investment in tomorrow's pediatric researchers
``Sec. 452G. (a) Enhanced Support.--In order to ensure the future
supply of researchers dedicated to the care and research needs of
children, the Director of the Institute, after consultation with the
Administrator of the Health Resources and Services Administration,
shall support activities to provide for--
``(1) an increase in the number and size of institutional
training grants to institutions supporting pediatric training;
and
``(2) an increase in the number of career development
awards for health professionals who intend to build careers in
pediatric basic and clinical research.
``(b) Authorization.--For the purpose of carrying out subsection
(a), there are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2001 through 2005.''.
(b) Pediatric Research Loan Repayment Program.--Part G of title IV
of the Public Health Service Act (42 U.S.C. 288 et seq.) is amended by
inserting after section 487E the following section:
``pediatric research loan repayment program
``Sec. 487F. (a) In General.--The Secretary, in consultation with
the Director of NIH, may establish a pediatric research loan repayment
program. Through such program--
``(1) the Secretary shall enter into contracts with
qualified health professionals under which such professionals
will agree to conduct pediatric research, in consideration of
the Federal government agreeing to repay, for each year of such
service, not more than $35,000 of the principal and interest of
the educational loans of such professionals; and
``(2) the Secretary shall, for the purpose of providing
reimbursements for tax liability resulting from payments made
under paragraph (1) on behalf of an individual, make payments,
in addition to payments under such paragraph, to the individual
in an amount equal to 39 percent of the total amount of loan
repayments made for the taxable year involved.
``(b) Application of other provisions.--The provisions of sections
338B, 338C, and 338E shall, except as inconsistent with paragraph (1),
apply to the program established under such paragraph to the same
extent and in the same manner as such provisions apply to the National
Health Service Corps Loan Repayment Program established under subpart
III of part D of title III.
``(c) Funding.--
``(1) In general.--For the purpose of carrying out this
section with respect to a national research institute the
Secretary may reserve, from amounts appropriated for such
institute for the fiscal year involved, such amounts as the
Secretary determines to be appropriate.
``(2) Availability of funds.--Amounts made available to
carry out this section shall remain available until the
expiration of the second fiscal year beginning after the fiscal
year for which such amounts were made available.''.
SEC. 1003. REVIEW OF REGULATIONS.
(a) Review.--By not later than 6 months after the date of enactment
of this Act, the Secretary of Health and Human Services shall conduct a
review of the regulations under subpart D of part 46 of title 45, Code
of Federal Regulations, consider any modifications necessary to ensure
the adequate and appropriate protection of children participating in
research, and report the findings of the Secretary to Congress.
(b) Areas of Review.--In conducting the review under subsection
(a), the Secretary of Health and Human Services shall consider--
(1) the appropriateness of the regulations for children of
differing ages and maturity levels, including legal status;
(2) the definition of ``minimal risk'' for a healthy child
or for a child with an illness;
(3) the definitions of ``assent'' and ``permission'' for
child clinical research participants and their parents or
guardians and of ``adequate provisions'' for soliciting assent
or permission in research as such definitions relate to the
process of obtaining the agreement of children participating in
research and the parents or guardians of such children;
(4) the definitions of ``direct benefit to the individual
subjects'' and ``generalizable knowledge about the subject's
disorder or condition'';
(5) whether payment (financial or otherwise) may be
provided to a child or his or her parent or guardian for the
participation of the child in research, and if so, the amount
and type given;
(6) the expectations of child research participants and
their parent or guardian for the direct benefits of the child's
research involvement;
(7) safeguards for research involving children conducted in
emergency situations with a waiver of informed assent;
(8) parent and child notification in instances in which the
regulations have not been complied with;
(9) compliance with the regulations in effect on the date
of enactment of this Act, the monitoring of such compliance,
and enforcement actions for violations of such regulations; and
(10) the appropriateness of current practices for
recruiting children for participation in research.
(c) Consultation.--In conducting the review under subsection (a),
the Secretary of Health and Human Services shall consult broadly with
experts in the field, including pediatric pharmacologists,
pediatricians, pediatric professional societies, bioethics experts,
clinical investigators, institutional review boards, industry experts,
appropriate Federal agencies, and children who have participated in
research studies and the parents, guardians, or families of such
children.
(d) Consideration of Additional Provisions.--In conducting the
review under subsection (a), the Secretary of Health and Human Services
shall consider and, not later than 6 months after the date of enactment
of this Act, report to Congress concerning--
(1) whether the Secretary should establish data and safety
monitoring boards or other mechanisms to review adverse events
associated with research involving children; and
(2) whether the institutional review board oversight of
clinical trials involving children is adequate to protect
children.
SEC. 1004. LONG-TERM CHILD DEVELOPMENT STUDY.
(a) Purpose.--It is the purpose of this section to authorize the
National Institute of Child Health and Human Development to conduct a
national longitudinal study of environmental influences (including
physical, chemical, biological, and psychosocial) on children's health
and development.
(b) In General.--The Director of the National Institute of Child
Health and Human Development shall establish a consortium of
representatives from appropriate Federal agencies (including the
Centers for Disease Control and Prevention, the Environmental
Protection Agency) to--
(1) plan, develop, and implement a prospective cohort
study, from birth to adulthood, to evaluate the effects of both
chronic and intermittent exposures on child health and human
development; and
(2) investigate basic mechanisms of developmental disorders
and environmental factors, both risk and protective, that
influence health and developmental processes.
(c) Requirement.--The study under subsection (b) shall--
(1) incorporate behavioral, emotional, educational, and
contextual consequences to enable a complete assessment of the
physical, chemical, biological and psychosocial environmental
influences on children's well-being;
(2) gather data on environmental influences and outcomes on
diverse populations of children, which may include the
consideration of prenatal exposures;
(3) consider health disparities among children which may
include the consideration of prenatal exposures.
(d) Report.--Beginning not later than 3 years after the date of
enactment of this Act, and periodically thereafter for the duration of
the study under this section, the Director of the National Institute of
Child Health and Human Development shall prepare and submit to the
appropriate committees of Congress a report on the implementation and
findings made under the planning and feasibility study conducted under
this section.
(e) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $18,000,000 for fiscal year
2001, and such sums as may be necessary for each the fiscal years 2002
through 2005.
TITLE XI--CHILDHOOD MALIGNANCIES
SEC. 1101. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION AND
NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as amended by
section 702 of this Act, is amended by adding at the end the following
section:
``SEC. 399N. CHILDHOOD MALIGNANCIES.
``(a) In General.--The Secretary, acting as appropriate through the
Director of the Centers for Disease Control and Prevention and the
Director of the National Institutes of Health, shall study
environmental and other risk factors for childhood cancers (including
skeletal malignancies, leukemias, malignant tumors of the central
nervous system, lymphomas, soft tissue sarcomas, and other malignant
neoplasms) and carry out projects to improve outcomes among children
with childhood cancers and resultant secondary conditions, including
limb loss, anemia, rehabilitation, and palliative care. Such projects
shall be carried out by the Secretary directly and through awards of
grants or contracts.
``(b) Certain Activities.--Activities under subsection (a)
include--
``(1) the expansion of current demographic data collection
and population surveillance efforts to include childhood
cancers nationally;
``(2) the development of a uniform reporting system under
which treating physicians, hospitals, clinics, and states
report the diagnosis of childhood cancers, including relevant
associated epidemiological data; and
``(3) support for the National Limb Loss Information Center
to address, in part, the primary and secondary needs of persons
who experience childhood cancers in order to prevent or
minimize the disabling nature of these cancers.
``(c) Coordination of Activities.--The Secretary shall assure that
activities under this section are coordinated as appropriate with other
agencies of the Public Health Service that carry out activities focused
on childhood cancers and limb loss.
``(d) Definition.--For purposes of this section, the term
`childhood cancer' refers to a spectrum of different malignancies that
vary by histology, site of disease, origin, race, sex, and age. The
Secretary may for purposes of this section revise the definition of
such term to the extent determined by the Secretary to be appropriate.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
SEC. 1201. GRANTS REGARDING INFANT ADOPTION AWARENESS.
Subpart I of part D of title III of the Public Health Service Act,
as amended by section 801 of this Act, is amended by adding at the end
the following section:
``SEC. 330F. CERTAIN SERVICES FOR PREGNANT WOMEN.
``(a) Infant Adoption Awareness.--
``(1) In general.--The Secretary shall make grants to
national, regional, or local adoption organizations for the
purpose of developing and implementing programs to train the
designated staff of eligible health centers in providing
adoption information and referrals to pregnant women on an
equal basis with all other courses of action included in
nondirective counseling to pregnant women.
``(2) Best-practices guidelines.--
``(A) In general.--A condition for the receipt of a
grant under paragraph (1) is that the adoption
organization involved agree that, in providing training
under such paragraph, the organization will follow the
guidelines developed under subparagraph (B).
``(B) Process for development of guidelines.--
``(i) In general.--The Secretary shall
establish and supervise a process described in
clause (ii) in which the participants are--
``(I) an appropriate number and
variety of adoption organizations that,
as a group, have expertise in all
models of adoption practice and that
represent all members of the adoption
triad (birth mother, infant, and
adoptive parent); and
``(II) affected public health
entities.
``(ii) Description of process.--The process
referred to in clause (i) is a process in which
the participants described in such clause
collaborate to develop best-practices
guidelines on the provision of adoption
information and referrals to pregnant women on
an equal basis with all other courses of action
included in nondirective counseling to pregnant
women.
``(iii) Date certain for development.--The
Secretary shall ensure that the guidelines
described in clause (ii) are developed not
later than 180 days after the date of the
enactment of the Children's Health Act of 2000.
``(C) Relation to authority for grants.--The
Secretary may not make any grant under paragraph (1)
before the date on which the guidelines under
subparagraph (B) are developed.
``(3) Use of grant.--
``(A) In general.--With respect to a grant under
paragraph (1)--
``(i) an adoption organization may expend
the grant to carry out the programs directly or
through grants to or contracts with other
adoption organizations;
``(ii) the purposes for which the adoption
organization expends the grant may include the
development of a training curriculum,
consistent with the guidelines developed under
paragraph (2)(B); and
``(iii) a condition for the receipt of the
grant is that the adoption organization agree
that, in providing training for the designated
staff of eligible health centers, such
organization will make reasonable efforts to
ensure that the individuals who provide the
training are individuals who are knowledgeable
in all elements of the adoption process and are
experienced in providing adoption information
and referrals in the geographic areas in which
the eligible health centers are located, and
that the designated staff receive the training
in such areas.
``(B) Rule of construction regarding training of
trainers.--With respect to individuals who under a
grant under paragraph (1) provide training for the
designated staff of eligible health centers (referred
to in this subparagraph as `trainers'), subparagraph
(A)(iii) may not be construed as establishing any
limitation regarding the geographic area in which the
trainers receive instruction in being such trainers. A
trainer may receive such instruction in a different
geographic area than the area in which the trainer
trains (or will train) the designated staff of eligible
health centers.
``(4) Adoption organizations; eligible health centers;
other definitions.--For purposes of this section:
``(A) The term `adoption organization' means a
national, regional, or local organization--
``(i) among whose primary purposes are
adoption;
``(ii) that is knowledgeable in all
elements of the adoption process and on
providing adoption information and referrals to
pregnant women; and
``(iii) that is a nonprofit private entity.
``(B) The term `designated staff', with respect to
an eligible health center, means staff of the center
who provide pregnancy or adoption information and
referrals (or will provide such information and
referrals after receiving training under a grant under
paragraph (1)).
``(C) The term `eligible health centers' means
public and nonprofit private entities that provide
health services to pregnant women.
``(5) Training for certain eligible health centers.--A
condition for the receipt of a grant under paragraph (1) is
that the adoption organization involved agree to make
reasonable efforts to ensure that the eligible health centers
with respect to which training under the grant is provided
include--
``(A) eligible health centers that receive grants
under section 1001 (relating to voluntary family
planning projects);
``(B) eligible health centers that receive grants
under section 330 (relating to community health
centers, migrant health centers, and centers regarding
homeless individuals and residents of public housing);
and
``(C) eligible health centers that receive grants
under this Act for the provision of services in
schools.
``(6) Participation of certain eligible health clinics.--In
the case of eligible health centers that receive grants under
section 330 or 1001:
``(A) Within a reasonable period after the
Secretary begins making grants under paragraph (1), the
Secretary shall provide eligible health centers with
complete information about the training available from
organizations receiving grants under such paragraph.
The Secretary shall make reasonable efforts to
encourage eligible health centers to arrange for
designated staff to participate in such training. Such
efforts shall affirm Federal requirements, if any, that
the eligible health center provide nondirective
counseling to pregnant women.
``(B) All costs of such centers in obtaining the
training shall be reimbursed by the organization that
provides the training, using grants under paragraph
(1).
``(C) Not later than one year after the date of the
enactment of the Children's Health Act of 2000, the
Secretary shall submit to the appropriate committees of
the Congress a report evaluating the extent to which
adoption information and referral, upon request, are
provided by eligible health centers. Within a
reasonable time after training under this section is
initiated, the Secretary shall submit to the
appropriate committees of the Congress a report
evaluating the extent to which adoption information and
referral, upon request, are provided by eligible health
centers in order to determine the effectiveness of such
training and the extent to which such training complies
with subsection (a)(1). In preparing the reports
required by this subparagraph, the Secretary shall in
no respect interpret the provisions of this section to
allow any interference in the provider-patient
relationship, any breach of patient confidentiality, or
any monitoring or auditing of the counseling process or
patient records which breaches patient confidentiality
or reveals patient identity. The reports required by
this subparagraph shall be conducted by the Secretary
acting through the Administrator of the Health
Resources and Services Administration and in
collaboration with the Director of the Agency for
Healthcare Research and Quality.
``(b) Application for Grant.--The Secretary may make a grant under
subsection (a) only if an application for the grant is submitted to the
Secretary and the application is in such form, is made in such manner,
and contains such agreements, assurances, and information as the
Secretary determines to be necessary to carry out this section.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
Subtitle B--Special Needs Adoption Awareness
SEC. 1211. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN
AND OTHER ACTIVITIES.
Subpart I of part D of title III of the Public Health Service Act,
as amended by section 1201 of this Act, is amended by adding at the end
the following section:
``SEC. 330G. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN
AND OTHER ACTIVITIES.
``(a) Special Needs Adoption Awareness Campaign.--
``(1) In general.--The Secretary shall, through making
grants to nonprofit private entities, provide for the planning,
development, and carrying out of a national campaign to provide
information to the public regarding the adoption of children
with special needs.
``(2) Input on planning and development.--In providing for
the planning and development of the national campaign under
paragraph (1), the Secretary shall provide for input from a
number and variety of adoption organizations throughout the
States in order that the full national diversity of interests
among adoption organizations is represented in the planning and
development of the campaign.
``(3) Certain features.--With respect to the national
campaign under paragraph (1):
``(A) The campaign shall be directed at various
populations, taking into account as appropriate
differences among geographic regions, and shall be
carried out in the language and cultural context that
is most appropriate to the population involved.
``(B) The means through which the campaign may be
carried out include--
``(i) placing public service announcements
on television, radio, and billboards; and
``(ii) providing information through means
that the Secretary determines will reach
individuals who are most likely to adopt
children with special needs.
``(C) The campaign shall provide information on the
subsidies and supports that are available to
individuals regarding the adoption of children with
special needs.
``(D) The Secretary may provide that the placement
of public service announcements, and the dissemination
of brochures and other materials, is subject to review
by the Secretary.
``(4) Matching Requirement.--
``(A) In general.--With respect to the costs of the
activities to be carried out by an entity pursuant to
paragraph (1), a condition for the receipt of a grant
under such paragraph is that the entity agree to make
available (directly or through donations from public or
private entities) non-Federal contributions toward such
costs in an amount that is not less than 25 percent of
such costs.
``(B) Determination of amount contributed.--Non-
Federal contributions under subparagraph (A) may be in
cash or in kind, fairly evaluated, including plant,
equipment, or services. Amounts provided by the Federal
Government, or services assisted or subsidized to any
significant extent by the Federal Government, may not
be included in determining the amount of such
contributions.
``(b) National Resources Program.--The Secretary shall (directly or
through grant or contract) carry out a program that, through toll-free
telecommunications, makes available to the public information regarding
the adoption of children with special needs. Such information shall
include the following:
``(1) A list of national, State, and regional organizations
that provide services regarding such adoptions, including
exchanges and other information on communicating with the
organizations. The list shall represent the full national
diversity of adoption organizations.
``(2) Information beneficial to individuals who adopt such
children, including lists of support groups for adoptive
parents and other postadoptive services.
``(c) Other Programs.--With respect to the adoption of children
with special needs, the Secretary shall make grants--
``(1) to provide assistance to support groups for adoptive
parents, adopted children, and siblings of adopted children;
and
``(2) to carry out studies to identify--
``(A) the barriers to completion of the adoption
process; and
``(B) those components that lead to favorable long-
term outcomes for families that adopt children with
special needs.
``(d) Application for Grant.--The Secretary may make an award of a
grant or contract under this section only if an application for the
award is submitted to the Secretary and the application is in such
form, is made in such manner, and contains such agreements, assurances,
and information as the Secretary determines to be necessary to carry
out this section.
``(e) Funding.--For the purpose of carrying out this section, there
are authorized to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.''.
TITLE XIII--TRAUMATIC BRAIN INJURY
SEC. 1301. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
(a) In General.--Section 393A of the Public Health Service Act (42
U.S.C. 280b-1b) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by striking ``and'' at the
end;
(B) in paragraph (2), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(3) the implementation of a national education and
awareness campaign regarding such injury (in conjunction with
the program of the Secretary regarding health-status goals for
2010, commonly referred to as Healthy People 2010), including--
``(A) the national dissemination of information
on--
``(i) incidence and prevalence; and
``(ii) information relating to traumatic
brain injury and the sequelae of secondary
conditions arising from traumatic brain injury
upon discharge from hospitals and trauma
centers; and
``(B) the provision of information in primary care
settings, including emergency rooms and trauma centers,
concerning the availability of State level services and
resources.'';
(2) in subsection (d)--
(A) in the second sentence, by striking ``anoxia
due to near drowning.'' and inserting ``anoxia due to
trauma.''; and
(B) in the third sentence, by inserting before the
period the following: ``, after consultation with
States and other appropriate public or nonprofit
private entities''.
(b) National Registry.--Part J of title III of the Public Health
Service Act (42 U.S.C. 280b et seq.) is amended by inserting after
section 393A the following section:
``national program for traumatic brain injury registries
``Sec. 393B. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may make
grants to States or their designees to operate the State's traumatic
brain injury registry, and to academic institutions to conduct applied
research that will support the development of such registries, to
collect data concerning--
``(1) demographic information about each traumatic brain
injury;
``(2) information about the circumstances surrounding the
injury event associated with each traumatic brain injury;
``(3) administrative information about the source of the
collected information, dates of hospitalization and treatment,
and the date of injury; and
``(4) information characterizing the clinical aspects of
the traumatic brain injury, including the severity of the
injury, outcomes of the injury, the types of treatments
received, and the types of services utilized.''.
SEC. 1302. STUDY AND MONITOR INCIDENCE AND PREVALENCE.
Section 4 of Public Law 104-166 (42 U.S.C. 300d-61 note) is
amended--
(1) in subsection (a)(1)(A)--
(A) by striking clause (i) and inserting the
following:
``(i)(I) determine the incidence and
prevalence of traumatic brain injury in all age
groups in the general population of the United
States, including institutional settings; and
``(II) determine appropriate methodological
strategies to obtain data on the incidence and
prevalence of mild traumatic brain injury and
report to Congress concerning such within 18
months of the date of enactment of the
Children's Health Act of 2000; and''; and
(B) in clause (ii), by striking ``, if the
Secretary determines that such a system is
appropriate'';
(2) in subsection (a)(1)(B)(i), by inserting ``, including
return to work or school and community participation,'' after
``functioning''; and
(3) in subsection (d), to read as follows:
``(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.''.
SEC. 1303. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
(a) Interagency Program.--Section 1261(d)(4) of the Public Health
Service Act (42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (A), by striking ``degree of injury''
and inserting ``degree of brain injury'';
(2) in subparagraph (B), by striking ``acute injury'' and
inserting ``acute brain injury''; and
(3) in subparagraph (D), by striking ``injury treatment''
and inserting ``brain injury treatment''.
(b) Definition.--Section 1261(h)(4) of the Public Health Service
Act (42 U.S.C. 300d-61(h)(4)) is amended--
(1) in the second sentence, by striking ``anoxia due to
near drowning.'' and inserting ``anoxia due to trauma.''; and
(2) in the third sentence, by inserting before the period
the following: ``, after consultation with States and other
appropriate public or nonprofit private entities''.
(c) Research on Cognitive and Neurobehavioral Disorders Arising
From Traumatic Brain Injury.--Section 1261(d)(4) of the Public Health
Service Act (42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (C), by striking ``and'' after the
semicolon at the end;
(2) in subparagraph (D), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(E) carrying out subparagraphs (A) through (D)
with respect to cognitive disorders and neurobehavioral
consequences arising from traumatic brain injury,
including the development, modification, and evaluation
of therapies and programs of rehabilitation toward
reaching or restoring normal capabilities in areas such
as reading, comprehension, speech, reasoning, and
deduction.''.
(d) Authorization of Appropriations.--Section 1261 of the Public
Health Service Act (42 U.S.C. 300d-61) is amended by adding at the end
the following:
``(i) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
SEC. 1304. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION.
Section 1252 of the Public Health Service Act (42 U.S.C. 300d-51)
is amended--
(1) in the section heading by striking ``demonstration'';
(2) in subsection (a), by striking ``demonstration'';
(3) in subsection (b)(3)--
(A) in subparagraph (A)(iv), by striking
``representing traumatic brain injury survivors'' and
inserting ``representing individuals with traumatic
brain injury''; and
(B) in subparagraph (B), by striking ``who are
survivors of'' and inserting ``with'';
(4) in subsection (c)--
(A) in paragraph (1), by striking ``, in cash,'';
and
(B) in paragraph (2), by amending the paragraph to
read as follows:
``(2) Determination of amount contributed.--Non-Federal
contributions under paragraph (1) may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount of
such contributions.'';
(5) by redesignating subsections (e) through (h) as
subsections (g) through (j), respectively; and
(6) by inserting after subsection (d) the following
subsections:
``(e) Continuation of Previously Awarded Demonstration Projects.--A
State that received a grant under this section prior to the date of the
enactment of the Children's Health Act of 2000 may compete for new
project grants under this section after such date of enactment.
``(f) Use of State Grants.--
``(1) Community services and supports.--A State shall
(directly or through awards of contracts to nonprofit private
entities) use amounts received under a grant under this section
for the following:
``(A) To develop, change, or enhance community-
based service delivery systems that include timely
access to comprehensive appropriate services and
supports. Such service and supports--
``(i) shall promote full participation by
individuals with brain injury and their
families in decision making regarding the
services and supports; and
``(ii) shall be designed for children and
other individuals with traumatic brain injury.
``(B) To focus on outreach to underserved and
inappropriately served individuals, such as individuals
in institutional settings, individuals with low
socioeconomic resources, individuals in rural
communities, and individuals in culturally and
linguistically diverse communities.
``(C) To award contracts to nonprofit entities for
consumer or family service access training, consumer
support, peer mentoring, and parent to parent programs.
``(D) To develop individual and family service
coordination or case management systems.
``(E) To support other needs identified by the
advisory board under subsection (b) for the State
involved.
``(2) Best practices.--
``(A) In general.--State services and supports
provided under a grant under this section shall reflect
the best practices in the field of traumatic brain
injury, shall be in compliance with title II of the
Americans with Disabilities Act of 1990, and shall be
supported by quality assurance measures as well as
state-of-the-art health care and integrated community
supports, regardless of the severity of injury.
``(B) Demonstration by state agency.--The State
agency responsible for administering amounts received
under a grant under this section shall demonstrate that
it has obtained knowledge and expertise of traumatic
brain injury and the unique needs associated with
traumatic brain injury.
``(3) State capacity building.--A State may use amounts
received under a grant under this section to--
``(A) educate consumers and families;
``(B) train professionals in public and private
sector financing (such as third party payers, State
agencies, community-based providers, schools, and
educators);
``(C) develop or improve case management or service
coordination systems;
``(D) develop best practices in areas such as
family or consumer support, return to work, housing or
supportive living personal assistance services,
assistive technology and devices, behavioral health
services, substance abuse services, and traumatic brain
injury treatment and rehabilitation;
``(E) tailor existing State systems to provide
accommodations to the needs of individuals with brain
injury (including systems administered by the State
departments responsible for health, mental health,
labor/employment, education, mental retardation/
developmental disorders, transportation, and
correctional systems);
``(F) improve data sets coordinated across systems
and other needs identified by a State plan supported by
its advisory council; and
``(G) develop capacity within targeted
communities.'';
(5) in subsection (g) (as so redesignated), by striking
``agencies of the Public Health Service'' and inserting
``Federal agencies'';
(6) in subsection (i) (as redesignated by paragraph (3))--
(A) in the second sentence, by striking ``anoxia
due to near drowning.'' and inserting ``anoxia due to
trauma.''; and
(B) in the third sentence, by inserting before the
period the following: ``, after consultation with
States and other appropriate public or nonprofit
private entities''; and
(7) in subsection (j) (as so redesignated), by amending the
subsection to read as follows:
``(j) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
SEC. 1305. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.
Part E of title XII of the Public Health Service Act (42 U.S.C.
300d-51 et seq.) is amended by adding at the end the following:
``SEC. 1253. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.
``(a) In General.--The Secretary, acting through the Administrator
of the Health Resources and Services Administration (referred to in
this section as the `Administrator'), shall make grants to protection
and advocacy systems for the purpose of enabling such systems to
provide services to individuals with traumatic brain injury.
``(b) Services Provided.--Services provided under this section may
include the provision of--
``(1) information, referrals, and advice;
``(2) individual and family advocacy;
``(3) legal representation; and
``(4) specific assistance in self-advocacy.
``(c) Application.--To be eligible to receive a grant under this
section, a protection and advocacy system shall submit an application
to the Administrator at such time, in such form and manner, and
accompanied by such information and assurances as the Administrator may
require.
``(d) Appropriations Less Than $2,700,000.--
``(1) In general.--With respect to any fiscal year in which
the amount appropriated under subsection (i) to carry out this
section is less than $2,700,000, the Administrator shall make
grants from such amount to individual protection and advocacy
systems within States to enable such systems to plan for,
develop outreach strategies for, and carry out services
authorized under this section for individuals with traumatic
brain injury.
``(2) Amount.--The amount of each grant provided under
paragraph (1) shall be determined as set forth in paragraphs
(2) and (3) of subsection (e).
``(e) Appropriations of $2,700,000 or More.--
``(1) Population basis.--Except as provided in paragraph
(2), with respect to each fiscal year in which the amount
appropriated under subsection (i) to carry out this section is
$2,700,000 or more, the Administrator shall make a grant to a
protection and advocacy system within each State.
``(2) Amount.--The amount of a grant provided to a system
under paragraph (1) shall be equal to an amount bearing the
same ratio to the total amount appropriated for the fiscal year
involved under subsection (i) as the population of the State in
which the grantee is located bears to the population of all
States.
``(3) Minimums.--Subject to the availability of
appropriations, the amount of a grant a protection and advocacy
system under paragraph (1) for a fiscal year shall--
``(A) in the case of a protection and advocacy
system located in American Samoa, Guam, the United
States Virgin Islands, or the Commonwealth of the
Northern Mariana Islands, and the protection and
advocacy system serving the American Indian consortium,
not be less than $20,000; and
``(B) in the case of a protection and advocacy
system in a State not described in subparagraph (A),
not be less than $50,000.
``(4) Inflation adjustment.--For each fiscal year in which
the total amount appropriated under subsection (i) to carry out
this section is $5,000,000 or more, and such appropriated
amount exceeds the total amount appropriated to carry out this
section in the preceding fiscal year, the Administrator shall
increase each of the minimum grants amount described in
subparagraphs (A) and (B) of paragraph (3) by a percentage
equal to the percentage increase in the total amount
appropriated under subsection (i) to carry out this section
between the preceding fiscal year and the fiscal year involved.
``(f) Carryover.--Any amount paid to a protection and advocacy
system that serves a State or the American Indian consortium for a
fiscal year under this section that remains unobligated at the end of
such fiscal year shall remain available to such system for obligation
during the next fiscal year for the purposes for which such amount was
originally provided.
``(g) Direct Payment.--Notwithstanding any other provision of law,
the Administrator shall pay directly to any protection and advocacy
system that complies with the provisions of this section, the total
amount of the grant for such system, unless the system provides
otherwise for such payment.
``(h) Annual Report.--Each protection and advocacy system that
receives a payment under this section shall submit an annual report to
the Administrator concerning the services provided to individuals with
traumatic brain injury by such system.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $5,000,000 for fiscal year 2001,
and such sums as may be necessary for each the fiscal years 2002
through 2005.
``(j) Definitions.--In this section:
``(1) American indian consortium.--The term `American
Indian consortium' means a consortium established under part C
of the Developmental Disabilities Assistance Bill of Rights Act
(42 U.S.C. 6042 et seq.).
``(2) Protection and advocacy system.--The term `protection
and advocacy system' means a protection and advocacy system
established under part C of the Developmental Disabilities
Assistance and Bill of Rights Act (42 U.S.C. 6042 et seq.).
``(3) State.--The term `State', unless otherwise specified,
means the several States of the United States, the District of
Columbia, the Commonwealth of Puerto Rico, the United States
Virgin Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands.''.
SEC. 1306. AUTHORIZATION OF APPROPRIATIONS FOR CERTAIN PROGRAMS.
Section 394A of the Public Health Service Act (42 U.S.C. 280b-3) is
amended by striking ``and'' after ``1994'' and by inserting before the
period the following: ``, and such sums as may be necessary for each of
the fiscal years 2001 through 2005.''.
TITLE XIV--CHILD CARE SAFETY AND HEALTH GRANTS
SEC. 1401. DEFINITIONS.
In this title:
(1) Child with a disability; infant or toddler with a
disability.--The terms ``child with a disability'' and ``infant
or toddler with a disability'' have the meanings given the
terms in sections 602 and 632 of the Individuals with
Disabilities Education Act (20 U.S.C. 1401 and 1431).
(2) Eligible child care provider.--The term ``eligible
child care provider'' means a provider of child care services
for compensation, including a provider of care for a school-age
child during non-school hours, that--
(A) is licensed, regulated, registered, or
otherwise legally operating, under State and local law;
and
(B) satisfies the State and local requirements,
applicable to the child care services the provider provides.
(3) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(4) State.--The term ``State'' means any of the several
States of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, the United States Virgin Islands,
Guam, American Samoa, and the Commonwealth of the Northern
Mariana Islands.
SEC. 1402. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated to carry out this title
$200,000,000 for fiscal year 2001, and such sums as may be necessary
for each subsequent fiscal year.
SEC. 1403. PROGRAMS.
The Secretary shall make allotments to eligible States under
section 1404. The Secretary shall make the allotments to enable the
States to establish programs to improve the health and safety of
children receiving child care outside the home, by preventing illnesses
and injuries associated with that care and promoting the health and
well-being of children receiving that care.
SEC. 1404. AMOUNTS RESERVED; ALLOTMENTS.
(a) Amounts Reserved.--The Secretary shall reserve not more than
\1/2\ of 1 percent of the amount appropriated under section 1402 for
each fiscal year to make allotments to Guam, American Samoa, the United
States Virgin Islands, and the Commonwealth of the Northern Mariana
Islands to be allotted in accordance with their respective needs.
(b) State Allotments.--
(1) General rule.--From the amounts appropriated under
section 1402 for each fiscal year and remaining after
reservations are made under subsection (a), the Secretary shall
allot to each State an amount equal to the sum of--
(A) an amount that bears the same ratio to 50
percent of such remainder as the product of the young
child factor of the State and the allotment percentage
of the State bears to the sum of the corresponding
products for all States; and
(B) an amount that bears the same ratio to 50
percent of such remainder as the product of the school
lunch factor of the State and the allotment percentage
of the State bears to the sum of the corresponding
products for all States.
(2) Young child factor.--In this subsection, the term
``young child factor'' means the ratio of the number of
children under 5 years of age in a State to the number of such
children in all States, as provided by the most recent annual
estimates of population in the States by the Census Bureau of
the Department of Commerce.
(3) School lunch factor.--In this subsection, the term
``school lunch factor'' means the ratio of the number of
children who are receiving free or reduced price lunches under
the school lunch program established under the National School
Lunch Act (42 U.S.C. 1751 et seq.) in the State to the number
of such children in all States, as determined annually by the
Department of Agriculture.
(4) Allotment percentage.--
(A) In general.--For purposes of this subsection,
the allotment percentage for a State shall be
determined by dividing the per capita income of all
individuals in the United States, by the per capita
income of all individuals in the State.
(B) Limitations.--If an allotment percentage
determined under subparagraph (A) for a State--
(i) is more than 1.2 percent, the allotment
percentage of the State shall be considered to
be 1.2 percent; and
(ii) is less than 0.8 percent, the
allotment percentage of the State shall be
considered to be 0.8 percent.
(C) Per capita income.--For purposes of
subparagraph (A), per capita income shall be--
(i) determined at 2-year intervals;
(ii) applied for the 2-year period
beginning on October 1 of the first fiscal year
beginning after the date such determination is
made; and
(iii) equal to the average of the annual
per capita incomes for the most recent period
of 3 consecutive years for which satisfactory
data are available from the Department of
Commerce on the date such determination is
made.
(c) Data and Information.--The Secretary shall obtain from each
appropriate Federal agency, the most recent data and information
necessary to determine the allotments provided for in subsection (b).
(d) Definition.--In this section, the term ``State'' includes only
the several States of the United States, the District of Columbia, and
the Commonwealth of Puerto Rico.
SEC. 1405. STATE APPLICATIONS.
To be eligible to receive an allotment under section 1404, a State
shall submit an application to the Secretary at such time, in such
manner, and containing such information as the Secretary may require.
The application shall contain information assessing the needs of the
State with regard to child care health and safety, the goals to be
achieved through the program carried out by the State under this title,
and the measures to be used to assess the progress made by the State
toward achieving the goals.
SEC. 1406. USE OF FUNDS.
(a) In General.--A State that receives an allotment under section
1404 shall use the funds made available through the allotment to carry
out 2 or more activities consisting of--
(1) providing training and education to eligible child care
providers on preventing injuries and illnesses in children, and
promoting health-related practices;
(2) strengthening licensing, regulation, or registration
standards for eligible child care providers;
(3) assisting eligible child care providers in meeting
licensing, regulation, or registration standards, including
rehabilitating the facilities of the providers, in order to
bring the facilities into compliance with the standards;
(4) enforcing licensing, regulation, or registration
standards for eligible child care providers, including holding
increased unannounced inspections of the facilities of those
providers;
(5) providing health consultants to provide advice to
eligible child care providers;
(6) assisting eligible child care providers in enhancing
the ability of the providers to serve children with
disabilities and infants and toddlers with disabilities;
(7) conducting criminal background checks for eligible
child care providers and other individuals who have contact
with children in the facilities of the providers;
(8) providing information to parents on what factors to
consider in choosing a safe and healthy child care setting; or
(9) assisting in improving the safety of transportation
practices for children enrolled in child care programs with
eligible child care providers.
(b) Supplement, Not Supplant.--Funds appropriated pursuant to the
authority of this title shall be used to supplement and not supplant
other Federal, State, and local public funds expended to provide
services for eligible individuals.
SEC. 1407. REPORTS.
Each State that receives an allotment under section 1404 shall
annually prepare and submit to the Secretary a report that describes--
(1) the activities carried out with funds made available
through the allotment; and
(2) the progress made by the State toward achieving the
goals described in the application submitted by the State under
section 1405.
TITLE XV--HEALTHY START INITIATIVE
SEC. 1501. CONTINUATION OF HEALTHY START PROGRAM.
Subpart I of part D of title III of the Public Health Service Act,
as amended by section 1211 of this Act, is amended by adding at the end
the following section:
``SEC. 330H. HEALTHY START FOR INFANTS.
``(a) In General.--
``(1) Continuation and expansion of program.--The
Secretary, acting through the Administrator of the Health
Resources and Services Administration, Maternal and Child
Health Bureau, shall under authority of this section continue
in effect the Healthy Start Initiative and may, during fiscal
year 2001 and subsequent years, carry out such program on a
national basis.
``(2) Definition.--For purposes of paragraph (1), the term
`Healthy Start Initiative' is a reference to the program that,
as an initiative to reduce the rate of infant mortality and
improve perinatal outcomes, makes grants for project areas with
high annual rates of infant mortality and that, prior to the
effective date of this section, was a demonstration program
carried out under section 301.
``(3) Additional grants.-- Effective upon increased funding
beyond fiscal year 1999 for such Initiative, additional grants
may be made to States to assist communities with technical
assistance, replication of successful projects, and State
policy formation to reduce infant and maternal mortality and
morbidity.
``(b) Requirements for Making Grants.--In making grants under
subsection (a), the Secretary shall require that applicants (in
addition to meeting all eligibility criteria established by the
Secretary) establish, for project areas under such subsection,
community-based consortia of individuals and organizations (including
agencies responsible for administering block grant programs under title
V of the Social Security Act, consumers of project services, public
health departments, hospitals, health centers under section 330, and
other significant sources of health care services) that are appropriate
for participation in projects under subsection (a).
``(c) Coordination.--Recipients of grants under subsection (a)
shall coordinate their services and activities with the State agency or
agencies that administer block grant programs under title V of the
Social Security Act in order to promote cooperation, integration, and
dissemination of information with Statewide systems and with other
community services funded under the Maternal and Child Health Block
Grant.
``(d) Rule of Construction.--Except to the extent inconsistent with
this section, this section may not be construed as affecting the
authority of the Secretary to make modifications in the program carried
out under subsection (a).
``(e) Additional Services for At-Risk Pregnant Women and Infants.--
``(1) In general.--The Secretary may make grants to conduct
and support research and to provide additional health care
services for pregnant women and infants, including grants to
increase access to prenatal care, genetic counseling,
ultrasound services, and fetal or other surgery.
``(2) Eligible project area.--The Secretary may make a
grant under paragraph (1) only if the geographic area in which
services under the grant will be provided is a geographic area
in which a project under subsection (a) is being carried out,
and if the Secretary determines that the grant will add to or
expand the level of health services available in such area to
pregnant women and infants.
``(3) Evaluation by general accounting office.--
``(A) In general.--During fiscal year 2004, the
Comptroller General of the United States shall conduct
an evaluation of activities under grants under
paragraph (1) in order to determine whether the
activities have been effective in serving the needs of
pregnant women with respect to services described in
such paragraph. The evaluation shall include an
analysis of whether such activities have been effective
in reducing the disparity in health status between the
general population and individuals who are members of
racial or ethnic minority groups. Not later than
January 10, 2004, the Comptroller General shall submit
to the Committee on Commerce in the House of
Representatives, and to the Committee on Health,
Education, Labor, and Pensions in the Senate, a report
describing the findings of the evaluation.
``(B) Relation to grants regarding additional
services for at-risk pregnant women and infants.--
Before the date on which the evaluation under
subparagraph (A) is submitted in accordance with such
subparagraph--
``(i) the Secretary shall ensure that there
are not more than five grantees under paragraph
(1); and
``(ii) an entity is not eligible to receive
grants under such paragraph unless the entity
has substantial experience in providing the
health services described in such paragraph.
``(f) Funding.--
``(1) General program.--
``(A) Authorization of appropriations.--For the
purpose of carrying out this section (other than
subsection (e)), there are authorized to be
appropriated such sums as may be necessary for each of
the fiscal years 2001 through 2005.
``(B) Allocations.--
``(i) Program administration.--Of the
amounts appropriated under subparagraph (A) for
a fiscal year, the Secretary may reserve up to
5 percent for coordination, dissemination,
technical assistance, and data activities that
are determined by the Secretary to be
appropriate for carrying out the program under
this section.
``(ii) Evaluation.--Of the amounts
appropriated under subparagraph (A) for a
fiscal year, the Secretary may reserve up to 1
percent for evaluations of projects carried out
under subsection (a). Each such evaluation
shall include a determination of whether such
projects have been effective in reducing the
disparity in health status between the general
population and individuals who are members of
racial or ethnic minority groups.
``(2) Additional services for at-risk pregnant women and
infants.--
``(A) Authorization of appropriations.--For the
purpose of carrying out subsection (e), there are
authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2001 through
2005.
``(B) Allocation for community-based mobile health
units.--Of the amounts appropriated under subparagraph
(A) for a fiscal year, the Secretary shall make
available not less than 10 percent for providing
services under subsection (e) (including ultrasound
services) through visits by mobile units to communities
that are eligible for services under subsection (a).''.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
SEC. 1601. IDENTIFICATION OF INTERVENTIONS THAT REDUCE THE BURDEN AND
TRANSMISSION OF ORAL, DENTAL, AND CRANIOFACIAL DISEASES
IN HIGH RISK POPULATIONS; DEVELOPMENT OF APPROACHES FOR
PEDIATRIC ORAL AND CRANIOFACIAL ASSESSMENT.
(a) In General.--The Secretary of Health and Human Services,
through the Maternal and Child Health Bureau, the Indian Health
Service, and in consultation with the National Institutes of Health and
the Centers for Disease Control and Prevention, shall--
(1) support community-based research that is designed to
improve understanding of the etiology, pathogenesis, diagnosis,
prevention, and treatment of pediatric oral, dental,
craniofacial diseases and conditions and their sequelae in high
risk populations;
(2) support demonstrations of preventive interventions in
high risk populations including nutrition, parenting, and
feeding techniques; and
(3) develop clinical approaches to assess individual
patients for the risk of pediatric dental disease.
(b) Compliance With State Practice Laws.--Treatment and other
services shall be provided pursuant to this section by licensed dental
health professionals in accordance with State practice and licensing
laws.
(c) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for each the fiscal years 2001 through 2005.
SEC. 1602. ORAL HEALTH PROMOTION AND DISEASE PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 911 of this Act, is amended by inserting after section 317L the
following section:
``oral health promotion and disease prevention
``Sec. 317M. (a) Grants to Increase Resources for Community Water
Fluoridation.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
make grants to States and Indian tribes for the purpose of
increasing the resources available for community water
fluoridation.
``(2) Use of funds.--A State shall use amounts provided
under a grant under paragraph (1)--
``(A) to purchase fluoridation equipment;
``(B) to train fluoridation engineers;
``(C) to develop educational materials on the
benefits of fluoridation; or
``(D) to support the infrastructure necessary to
monitor and maintain the quality of water fluoridation.
``(b) Community Water Fluoridation.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and
in collaboration with the Director of the Indian Health
Service, shall establish a demonstration project that is
designed to assist rural water systems in successfully
implementing the water fluoridation guidelines of the Centers
for Disease Control and Prevention that are entitled
``Engineering and Administrative Recommendations for Water
Fluoridation, 1995'' (referred to in this subsection as the
`EARWF').
``(2) Requirements.--
``(A) Collaboration.--In collaborating under
paragraph (1), the Directors referred to in such
paragraph shall ensure that technical assistance and
training are provided to tribal programs located in
each of the 12 areas of the Indian Health Service. The
Director of the Indian Health Service shall provide
coordination and administrative support to tribes under
this section.
``(B) General use of funds.--Amounts made available
under paragraph (1) shall be used to assist small water
systems in improving the effectiveness of water
fluoridation and to meet the recommendations of the
EARWF.
``(C) Fluoridation specialists.--
``(i) In general.--In carrying out this
subsection, the Secretary shall provide for the
establishment of fluoridation specialist
engineering positions in each of the Dental
Clinical and Preventive Support Centers through
which technical assistance and training will be
provided to tribal water operators, tribal
utility operators and other Indian Health
Service personnel working directly with
fluoridation projects.
``(ii) Liaison.--A fluoridation specialist
shall serve as the principal technical liaison
between the Indian Health Service and the
Centers for Disease Control and Prevention with
respect to engineering and fluoridation issues.
``(iii) CDC.--The Director of the Centers
for Disease Control and Prevention shall
appoint individuals to serve as the
fluoridation specialists.
``(D) Implementation.--The project established
under this subsection shall be planned, implemented and
evaluated over the 5-year period beginning on the date
on which funds are appropriated under this section and
shall be designed to serve as a model for improving the
effectiveness of water fluoridation systems of small
rural communities.
``(3) Evaluation.--In conducting the ongoing evaluation as
provided for in paragraph (2)(D), the Secretary shall ensure
that such evaluation includes--
``(A) the measurement of changes in water
fluoridation compliance levels resulting from
assistance provided under this section;
``(B) the identification of the administrative,
technical and operational challenges that are unique to
the fluoridation of small water systems;
``(C) the development of a practical model that may
be easily utilized by other tribal, state, county or
local governments in improving the quality of water
fluoridation with emphasis on small water systems; and
``(D) the measurement of any increased percentage
of Native Americans or Alaskan Natives who receive the
benefits of optimally fluoridated water.
``(c) School-Based Dental Sealant Program.--
``(1) In general.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention and
in collaboration with the Administrator of the Health Resources
and Services Administration, may award grants to States and
Indian tribes to provide for the development of school-based
dental sealant programs to improve the access of children to
sealants.
``(2) Use of funds.--A State shall use amounts received
under a grant under paragraph (1) to provide funds to eligible
school-based entities or to public elementary or secondary
schools to enable such entities or schools to provide children
with access to dental care and dental sealant services. Such
services shall be provided by licensed dental health
professionals in accordance with State practice licensing laws.
``(3) Eligibility.--To be eligible to receive funds under
paragraph (1), an entity shall--
``(A) prepare and submit to the State an
application at such time, in such manner and containing
such information as the state may require; and
``(B) be a public elementary or secondary school--
``(i) that is located in an urban area in
which and more than 50 percent of the student
population is participating in federal or state
free or reduced meal programs; or
``(ii) that is located in a rural area and,
with respect to the school district in which
the school is located, the district involved
has a median income that is at or below 235
percent of the poverty line, as defined in
section 673(2) of the Community Services Block
Grant Act (42 U.S.C. 9902(2)).
``(d) Definitions.--For purposes of this section, the term `Indian
tribe' means an Indian tribe or tribal organization as defined in
section 4(b) and section 4(c) of the Indian Self-Determination and
Education Assistance Act.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
SEC. 1603. COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL HEALTH.
Part B of the Public Health Service Act (42 U.S.C. 243 et seq.) is
amended by adding at the end the following:
``coordinated program to improve pediatric oral health
``Sec. 320A. (a) In General.--The Secretary, acting through the
Administrator of the Health Resources and Services Administration,
shall establish a program to fund innovative oral health activities
that improve the oral health of children under 6 years of age who are
eligible for services provided under a Federal health program, to
increase the utilization of dental services by such children, and to
decrease the incidence of early childhood and baby bottle tooth decay.
``(b) Grants.--The Secretary shall award grants to or enter into
contracts with public or private nonprofit schools of dentistry or
accredited dental training institutions or programs, community dental
programs, and programs operated by the Indian Health Service (including
federally recognized Indian tribes that receive medical services from
the Indian Health Service, urban Indian health programs funded under
title V of the Indian Health Care Improvement Act, and tribes that
contract with the Indian Health Service pursuant to the Indian Self-
Determination and Education Assistance Act) to enable such schools,
institutions, and programs to develop programs of oral health
promotion, to increase training of oral health services providers in
accordance with State practice laws, or to increase the utilization of
dental services by eligible children.
``(c) Distribution.--In awarding grants under this section, the
Secretary shall, to the extent practicable, ensure an equitable
national geographic distribution of the grants, including areas of the
United States where the incidence of early childhood caries is highest.
``(d) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $10,000,000 for each the fiscal
years 2001 through 2005.''.
TITLE XVII--VACCINE-RELATED PROGRAMS
Subtitle A--Vaccine Compensation Program
SEC. 1701. CONTENT OF PETITIONS.
(a) In General.--Section 2111(c)(1)(D) of the Public Health Service
Act (42 U.S.C. 300aa-11(c)(1)(D)) is amended by striking ``and'' at the
end and inserting ``or (iii) suffered such illness, disability, injury,
or condition from the vaccine which resulted in inpatient
hospitalization and surgical intervention, and''.
(b) Effective Date.--The amendment made by subsection (a) takes
effect upon the date of the enactment of this Act, including with
respect to petitions under section 2111 of the Public Health Service
Act that are pending on such date.
Subtitle B--Childhood Immunizations
SEC. 1711. CHILDHOOD IMMUNIZATIONS.
Section 317(j)(1) of the Public Health Service Act (42 U.S.C.
247b(j)(1)) is amended in the first sentence by striking ``1998'' and
all that follows and inserting ``1998 through 2005.''.
TITLE XVIII--HEPATITIS C
SEC. 1801. SURVEILLANCE AND EDUCATION REGARDING HEPATITIS C.
Part B of title III of the Public Health Service Act, as amended by
section 1602 of this Act, is amended by inserting after section 317M
the following section:
``surveillance and education regarding hepatitis c virus
``Sec. 317N. (a) In General.--The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, may
(directly and through grants to public and nonprofit private entities)
provide for programs to carry out the following:
``(1) To cooperate with the States in implementing a
national system to determine the incidence of hepatitis C virus
infection (in this section referred to as `HCV infection') and
to assist the States in determining the prevalence of such
infection, including the reporting of chronic HCV cases.
``(2) To identify, counsel, and offer testing to
individuals who are at risk of HCV infection as a result of
receiving blood transfusions prior to July 1992, or as a result
of other risk factors.
``(3) To provide appropriate referrals for counseling,
testing, and medical treatment of individuals identified under
paragraph (2) and to ensure, to the extent practicable, the
provision of appropriate follow-up services.
``(4) To develop and disseminate public information and
education programs for the detection and control of HCV
infection, with priority given to high risk populations as
determined by the Secretary.
``(5) To improve the education, training, and skills of
health professionals in the detection and control of HCV
infection, with priority given to pediatricians and other
primary care physicians, and obstetricians and gynecologists.
``(b) Laboratory Procedures.--The Secretary may (directly and
through grants to public and nonprofit private entities) carry out
programs to provide for improvements in the quality of clinical-
laboratory procedures regarding hepatitis C, including reducing
variability in laboratory results on hepatitis C antibody and PCR
testing.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
SEC. 1901. AUTOIMMUNE DISEASES; INITIATIVE THROUGH DIRECTOR OF NATIONAL
INSTITUTES OF HEALTH.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284
et seq.), as amended by section 1001 of this Act, is amended by adding
at the end the following:
``SEC. 409E. AUTOIMMUNE DISEASES.
``(a) Expansion, Intensification, and Coordination of Activities.--
``(1) In general.--The Director of NIH shall expand,
intensify, and coordinate research and other activities of the
National Institutes of Health with respect to autoimmune
diseases.
``(2) Allocations by director of nih.--With respect to
amounts appropriated to carry out this section for a fiscal
year, the Director of NIH shall allocate the amounts among the
national research institutes that are carrying out paragraph
(1).
``(3) Definition.--The term `autoimmune disease' includes,
for purposes of this section such diseases or disorders with
evidence of autoimmune pathogensis as the Secretary determines
to be appropriate.
``(b) Coordinating Committee.--
``(1) In general.--The Secretary shall ensure that the
Autoimmune Diseases Coordinating Committee (referred to in this
section as the `Coordinating Committee') coordinates activities
across the National Institutes and with other Federal health
programs and activities relating to such diseases.
``(2) Composition.--The Coordinating Committee shall be
composed of the directors or their designees of each of the
national research institutes involved in research with respect
to autoimmune diseases and representatives of all other Federal
departments and agencies whose programs involve health
functions or responsibilities relevant to such diseases,
including the Centers for Disease Control and Prevention and
the Food and Drug Administration.
``(3) Chair.--
``(A) In general.--With respect to autoimmune
diseases, the Chair of the Committee shall serve as the
principal advisor to the Secretary, the Assistant
Secretary for Health, and the Director of NIH, and
shall provide advice to the Director of the Centers for
Disease Control and Prevention, the Commissioner of
Food and Drugs, and other relevant agencies.
``(B) Director of nih.--The Chair of the Committee
shall be directly responsible to the Director of NIH.
``(c) Plan for NIH Activities.--
``(1) In general.--Not later than 1 year after the date of
enactment of this section, the Coordinating Committee shall
develop a plan for conducting and supporting research and
education on autoimmune diseases through the national research
institutes and shall periodically review and revise the plan.
The plan shall--
``(A) provide for a broad range of research and
education activities relating to biomedical,
psychosocial, and rehabilitative issues, including
studies of the disproportionate impact of such diseases
on women;
``(B) identify priorities among the programs and
activities of the National Institutes of Health
regarding such diseases; and
``(C) reflect input from a broad range of
scientists, patients, and advocacy groups.
``(2) Certain elements of plan.--The plan under paragraph
(1) shall, with respect to autoimmune diseases, provide for the
following as appropriate:
``(A) Research to determine the reasons underlying
the incidence and prevalence of the diseases.
``(B) Basic research concerning the etiology and
causes of the diseases.
``(C) Epidemiological studies to address the
frequency and natural history of the diseases,
including any differences among the sexes and among
racial and ethnic groups.
``(D) The development of improved screening
techniques.
``(E) Clinical research for the development and
evaluation of new treatments, including new biological
agents.
``(F) Information and education programs for health
care professionals and the public.
``(3) Implementation of plan.--The Director of NIH shall
ensure that programs and activities of the National Institutes
of Health regarding autoimmune diseases are implemented in
accordance with the plan under paragraph (1).
``(d) Reports to Congress.--The Coordinating Committee under
subsection (b)(1) shall biennially submit to the Committee on Commerce
of the House of Representatives, and the Committee on Health,
Education, Labor and Pensions of the Senate, a report that describes
the research, education, and other activities on autoimmune diseases
being conducted or supported through the national research institutes,
and that in addition includes the following:
``(1) The plan under subsection (c)(1) (or revisions to the
plan, as the case may be).
``(2) Provisions specifying the amounts expended by the
National Institutes of Health with respect to each of the
autoimmune diseases included in the plan.
``(3) Provisions identifying particular projects or types
of projects that should in the future be considered by the
national research institutes or other entities in the field of
research on autoimmune diseases.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005. The
authorization of appropriations established in the preceding sentence
is in addition to any other authorization of appropriations that is
available for conducting or supporting through the National Institutes
of Health research and other activities with respect to autoimmune
diseases.''.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
SEC. 2001. PROVISIONS TO REVISE AND EXTEND PROGRAM.
(a) Payments.--Section 340E(a) of the Public Health Service Act (42
U.S.C. 256e(a)) is amended--
(1) by striking ``and 2001'' and inserting ``through
2005''; and
(2) by adding at the end the following: ``The Secretary
shall promulgate regulations pursuant to the rulemaking
requirements of title 5, United States Code, which shall govern
payments made under this subpart.''.
(b) Updating Rates.--Section 340E(c)(2)(F) of the Public Health
Service Act (42 U.S.C. 256e(c)(2)(F)) is amended by striking
``hospital's cost reporting period that begins during fiscal year
2000'' and inserting ``Federal fiscal year for which payments are
made''.
(c) Resident Count for Interim Payments.--Section 340E(e)(1) of the
Public Health Service Act (42 U.S.C. 256e(e)(1)) is amended by adding
at the end the following: ``Such interim payments to each individual
hospital shall be based on the number of residents reported in the
hospital's most recently filed medicare cost report prior to the
application date for the Federal fiscal year for which the interim
payment amounts are established. In the case of a hospital that does
not report residents on a medicare cost report, such interim payments
shall be based on the number of residents trained during the hospital's
most recently completed medicare cost report filing period.''.
(d) Withholding.--Section 340E(e)(2) of the Public Health Service
Act (42 U.S.C. 256e(e)(2)) is amended--
(1) by adding ``and indirect'' after ``direct'';
(2) by adding at the end the following: ``The Secretary
shall withhold up to 25 percent from each interim installment
for direct and indirect graduate medical education paid under
paragraph (1) as necessary to ensure a hospital will not be
overpaid on an interim basis.''.
(e) Reconciliation.--Section 340E(e)(3) of the Public Health
Service Act (42 U.S.C. 256e(e)(3)) is amended to read as follows:
``(3) Reconciliation.--Prior to the end of each fiscal
year, the Secretary shall determine any changes to the number
of residents reported by a hospital in the application of the
hospital for the current fiscal year to determine the final
amount payable to the hospital for the current fiscal year for
both direct expense and indirect expense amounts. Based on such
determination, the Secretary shall recoup any overpayments made
to pay any balance due to the extent possible. The final amount
so determined shall be considered a final intermediary
determination for the purposes of section 1878 of the Social
Security Act and shall be subject to administrative and
judicial review under that section in the same manner as the
amount of payment under section 1186(d) of such Act is subject
to review under such section.''.
(f) Authorization of Appropriations.--Section 340E(f) of the Public
Health Service Act (42 U.S.C. 256e(f)) is amended--
(1) in paragraph (1)(A)--
(A) in clause (i), by striking ``and'' at the end;
(B) in clause (ii), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(iii) for each of the fiscal years 2002
through 2005, such sums as may be necessary.'';
and
(2) in paragraph (2)--
(A) in subparagraph (A), by striking ``and'' at the
end;
(B) in subparagraph (B), by striking the period and
inserting ``; and''; and
(C) by adding at the end the following:
``(C) for each of the fiscal years 2002 through
2005, such sums as may be necessary.''.
(g) Definition of Children's Hospital.--Section 340E(g)(2) of the
Public Health Service Act (42 U.S.C. 256e(g)(2)) is amended by striking
``described in'' and all that follows and inserting the following:
``with a medicare payment agreement and which is excluded from the
medicare inpatient prospective payment system pursuant to section
1886(d)(1)(B)(iii) of the Social Security Act and its accompanying
regulations.''.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
SEC. 2101. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK; AMENDMENTS
REGARDING NEEDS OF CHILDREN.
(a) In General.--Section 372(b)(2) of the Public Health Service Act
(42 U.S.C. 274(b)(2)) is amended--
(1) in subparagraph (J), by striking ``and'' at the end;
(2) in each of subparagraphs (K) and (L), by striking the
period and inserting a comma; and
(3) by adding at the end the following subparagraphs:
``(M) recognize the differences in health and in
organ transplantation issues between children and
adults throughout the system and adopt criteria,
polices, and procedures that address the unique health
care needs of children,
``(N) carry out studies and demonstration projects
for the purpose of improving procedures for organ
donation procurement and allocation, including but not
limited to projects to examine and attempt to increase
transplantation among populations with special needs,
including children and individuals who are members of
racial or ethnic minority groups, and among populations
with limited access to transportation, and
``(O) provide that for purposes of this paragraph,
the term `children' refers to individuals who are under
the age of 18.''.
(b) Study Regarding Immunosuppressive Drugs.--
(1) In general.--The Secretary of Health and Human Services
(referred to in this subsection as the ``Secretary'') shall
provide for a study to determine the costs of immunosuppressive
drugs that are provided to children pursuant to organ
transplants and to determine the extent to which health plans
and health insurance cover such costs. The Secretary may carry
out the study directly or through a grant to the Institute of
Medicine (or other public or nonprofit private entity).
(2) Recommendations regarding certain issues.--The
Secretary shall ensure that, in addition to making
determinations under paragraph (1), the study under such
paragraph makes recommendations regarding the following issues:
(A) The costs of immunosuppressive drugs that are
provided to children pursuant to organ transplants and
to determine the extent to which health plans, health
insurance and government programs cover such costs.
(B) The extent of denial of organs to be released
for transplant by coroners and medical examiners.
(C) The special growth and developmental issues
that children have pre- and post- organ
transplantation.
(D) Other issues that are particular to the special
health and transplantation needs of children.
(3) Report.--The Secretary shall ensure that, not later
than December 31, 2001, the study under paragraph (1) is
completed and a report describing the findings of the study is
submitted to the Congress.
TITLE XXII--MUSCULAR DYSTROPHY RESEARCH
SEC. 2201. MUSCULAR DYSTROPHY RESEARCH.
Part B of title IV of the Public Health Service Act, as amended by
section 1901 of this Act, is amended by adding at the end the
following:
``muscular dystrophy research
``Sec. 409F. (a) Coordination of Activities.--The Director of NIH
shall expand and increase coordination in the activities of the
National Institutes of Health with respect to research on muscular
dystrophies, including Duchenne muscular dystrophy.
``(b) Administration of Program; Collaboration Among Agencies.--The
Director of NIH shall carry out this section through the appropriate
institutes, including the National Institute of Neurological Disorders
and Stroke and in collaboration with any other agencies that the
Director determines appropriate.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated such sums as may be necessary to carry out this section
for each of the fiscal years 2001 through 2005. Amounts appropriated
under this subsection shall be in addition to any other amounts
appropriated for such purpose.''.
TITLE XXIII--CHILDREN AND TOURETTE SYNDROME AWARENESS
SEC. 2301. GRANTS REGARDING TOURETTE SYNDROME.
Part A of title XI of the Public Health Service Act is amended by
adding at the end the following section:
``tourette syndrome
``Sec. 1108. (a) In General.--The Secretary shall develop and
implement outreach programs to educate the public, health care
providers, educators and community based organizations about the
etiology, symptoms, diagnosis and treatment of Tourette Syndrome, with
a particular emphasis on children with Tourette Syndrome. Such programs
may be carried out by the Secretary directly and through awards of
grants or contracts to public or nonprofit private entities.
``(b) Certain Activities.--Activities under subsection (a) shall
include--
``(1) the production and translation of educational
materials, including public service announcements;
``(2) the development of training material for health care
providers, educators and community based organizations; and
``(3) outreach efforts directed at the misdiagnosis and
underdiagnosis of Tourette Syndrome in children and in minority
groups.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001 through 2005.''.
TITLE XXIV--CHILDHOOD OBESITY PREVENTION
SEC. 2401. PROGRAMS OPERATED THROUGH THE CENTERS FOR DISEASE CONTROL
AND PREVENTION.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.),
as amended by section 1101 of this Act, is amended by adding at the end
the following part:
``PART Q--PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN
``SEC. 399W. GRANTS TO PROMOTE CHILDHOOD NUTRITION AND PHYSICAL
ACTIVITY.
``(a) In General.--The Secretary, acting though the Director of the
Centers for Disease Control and Prevention, shall award competitive
grants to States and political subdivisions of States for the
development and implementation of State and community-based
intervention programs to promote good nutrition and physical activity
in children and adolescents.
``(b) Eligibility.--To be eligible to receive a grant under this
section a State or political subdivision of a State shall prepare and
submit to the Secretary an application at such time, in such manner,
and containing such information as the Secretary may require, including
a plan that describes--
``(1) how the applicant proposes to develop a comprehensive
program of school- and community-based approaches to encourage
and promote good nutrition and appropriate levels of physical
activity with respect to children or adolescents in local
communities;
``(2) the manner in which the applicant shall coordinate
with appropriate State and local authorities, such as State and
local school departments, State departments of health, chronic
disease directors, State directors of programs under section 17
of the Child Nutrition Act of 1966, 5-a-day coordinators,
governors councils for physical activity and good nutrition,
and State and local parks and recreation departments; and
``(3) the manner in which the applicant will evaluate the
effectiveness of the program carried out under this section.
``(c) Use of Funds.--A State or political subdivision of a State
shall use amount received under a grant under this section to--
``(1) develop, implement, disseminate, and evaluate school-
and community-based strategies in States to reduce inactivity
and improve dietary choices among children and adolescents;
``(2) expand opportunities for physical activity programs
in school- and community-based settings; and
``(3) develop, implement, and evaluate programs that
promote good eating habits and physical activity including
opportunities for children with cognitive and physical
disabilities.
``(d) Technical Assistance.--The Secretary may set-aside an amount
not to exceed 10 percent of the amount appropriated for a fiscal year
under subsection (h) to permit the Director of the Centers for Disease
Control and Prevention to--
``(1) provide States and political subdivisions of States
with technical support in the development and implementation of
programs under this section; and
``(2) disseminate information about effective strategies
and interventions in preventing and treating obesity through
the promotion of good nutrition and physical activity.
``(e) Limitation on Administrative Costs.--Not to exceed 10 percent
of the amount of a grant awarded to the State or political subdivision
under subsection (a) for a fiscal year may be used by the State or
political subdivision for administrative expenses.
``(f) Term.--A grant awarded under subsection (a) shall be for a
term of 3 years.
``(g) Definition.--In this section, the term `children and
adolescents' means individuals who do not exceed 18 years of age.
``(h) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.
``SEC. 399X. APPLIED RESEARCH PROGRAM.
``(a) In General.--The Secretary, acting through the Centers for
Disease Control and Prevention and in consultation with the Director of
the National Institutes of Health, shall--
``(1) conduct research to better understand the
relationship between physical activity, diet, and health and
factors that influence health-related behaviors;
``(2) develop and evaluate strategies for the prevention
and treatment of obesity to be used in community-based
interventions and by health professionals;
``(3) develop and evaluate strategies for the prevention
and treatment of eating disorders, such as anorexia and
bulimia;
``(4) conduct research to establish the prevalence,
consequences, and costs of childhood obesity and its effects in
adulthood;
``(5) identify behaviors and risk factors that contribute
to obesity;
``(6) evaluate materials and programs to provide nutrition
education to parents and teachers of children in child care or
pre-school and the food service staff of such child care and
pre-school entities; and
``(7) evaluate materials and programs that are designed to
educate and encourage physical activity in child care and pre-
school facilities.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.
``SEC. 399Y. EDUCATION CAMPAIGN.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, and in collaboration
with national, State, and local partners, physical activity
organizations, nutrition experts, and health professional
organizations, shall develop a national public campaign to promote and
educate children and their parents concerning--
``(1) the health risks associated with obesity, inactivity,
and poor nutrition;
``(2) ways in which to incorporate physical activity into
daily living; and
``(3) the benefits of good nutrition and strategies to
improve eating habits.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.
``SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND TRAINING.
``(a) In General.--The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, in collaboration with
the Administrator of the Health Resources and Services Administration
and the heads of other agencies, and in consultation with appropriate
health professional associations, shall develop and carry out a program
to educate and train health professionals in effective strategies to--
``(1) better identify and assess patients with obesity or
an eating disorder or patients at-risk of becoming obese or
developing an eating disorder;
``(2) counsel, refer, or treat patients with obesity or an
eating disorder; and
``(3) educate patients and their families about effective
strategies to improve dietary habits and establish appropriate
levels of physical activity.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.''.
TITLE XXV--EARLY DETECTION AND TREATMENT REGARDING CHILDHOOD LEAD
POISONING
SEC. 2501. CENTERS FOR DISEASE CONTROL AND PREVENTION EFFORTS TO COMBAT
CHILDHOOD LEAD POISONING.
(a) Requirements for Lead Poisoning Prevention Grantees.--Section
317A of the Public Health Service Act (42 U.S.C. 247b-1) is amended--
(1) in subsection (d)--
(A) by redesignating paragraph (7) as paragraph
(8); and
(B) by inserting after paragraph (6) the following:
``(7) Assurances satisfactory to the Secretary that the
applicant will ensure complete and consistent reporting of all
blood lead test results from laboratories and health care
providers to State and local health departments in accordance
with guidelines of the Centers for Disease Control and
Prevention for standardized reporting as described in
subsection (m).''; and
(2) in subsection (j)(2)--
(A) in subparagraph (F) by striking ``(E)'' and
inserting ``(F)'';
(B) by redesignating subparagraph (F) as
subparagraph (G); and
(C) by inserting after subparagraph (E) the
following:
``(F) The number of grantees that have established
systems to ensure mandatory reporting of all blood lead
tests from laboratories and health care providers to
State and local health departments.''.
(b) Guidelines for Standardized Reporting.--Section 317A of the
Public Health Service Act (42 U.S.C. 247b-1) is amended by adding at
the end the following:
``(m) Guidelines for Standardized Reporting.--The Secretary, acting
through the Director of the Centers for Disease Control and Prevention,
shall develop national guidelines for the uniform reporting of all
blood lead test results to State and local health departments.''.
(c) Development and Implementation of Effective Data Management by
the Centers for Disease Control and Prevention.--
(1) In general.--The Director of the Centers for Disease
Control and Prevention shall--
(A) assist with the improvement of data linkages
between State and local health departments and between
State health departments and the Centers for Disease
Control and Prevention;
(B) assist States with the development of flexible,
comprehensive State-based data management systems for
the surveillance of children with lead poisoning that
have the capacity to contribute to a national data set;
(C) assist with the improvement of the ability of
State-based data management systems and federally-
funded means-tested public benefit programs (including
the special supplemental food program for women,
infants and children (WIC) under section 17 of the
Child Nutrition Act of 1966 (42 U.S.C. 1786) and the
early head start program under section 645A of the Head
Start Act (42 U.S.C. 9840a(h)) to respond to ad hoc
inquiries and generate progress reports regarding the
lead blood level screening of children enrolled in
those programs;
(D) assist States with the establishment of a
capacity for assessing how many children enrolled in
the medicaid, WIC, early head start, and other
federally-funded means-tested public benefit programs
are being screened for lead poisoning at age-
appropriate intervals;
(E) use data obtained as result of activities under
this section to formulate or revise existing lead blood
screening and case management policies; and
(F) establish performance measures for evaluating
State and local implementation of the requirements and
improvements described in subparagraphs (A) through
(E).
(2) Authorization of appropriations.--There are authorized
to be appropriated to carry out this subsection such sums as
may be necessary for each the fiscal years 2001 through 2005.
(3) Effective date.--This subsection takes effect on the
date of enactment of this Act.
SEC. 2502. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.
(a) In General.--Part B of title III of the Public Health Service
Act (42 U.S.C. 243 et seq.), as amended by section 1801 of this Act, is
amended by inserting after section 317N the following section:
``grants for lead poisoning related activities
``Sec. 317O. (a) Authority To Make Grants.--
``(1) In general.--The Secretary shall make grants to
States to support public health activities in States and
localities where data suggests that at least 5 percent of
preschool-age children have an elevated blood lead level
through--
``(A) effective, ongoing outreach and community
education targeted to families most likely to be at
risk for lead poisoning;
``(B) individual family education activities that
are designed to reduce ongoing exposures to lead for
children with elevated blood lead levels, including
through home visits and coordination with other
programs designed to identify and treat children at
risk for lead poisoning; and
``(C) the development, coordination and
implementation of community-based approaches for
comprehensive lead poisoning prevention from
surveillance to lead hazard control.
``(2) State match.--A State is not eligible for a grant
under this section unless the State agrees to expend (through
State or local funds) $1 for every $2 provided under the grant
to carry out the activities described in paragraph (1).
``(3) Application.--To be eligible to receive a grant under
this section, a State shall submit an application to the
Secretary in such form and manner and containing such
information as the Secretary may require.
``(b) Coordination With Other Children's Programs.--A State shall
identify in the application for a grant under this section how the
State will coordinate operations and activities under the grant with--
``(1) other programs operated in the State that serve
children with elevated blood lead levels, including any such
programs operated under titles V, XIX, or XXI of the Social
Security Act; and
``(2) one or more of the following--
``(A) the child welfare and foster care and
adoption assistance programs under parts B and E of
title IV of such Act;
``(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
``(C) the program of assistance under the special
supplemental nutrition program for women, infants and
children (WIC) under section 17 of the Child Nutrition
Act of 1966 (42 U.S.C. 1786);
``(D) local public and private elementary or
secondary schools; or
``(E) public housing agencies, as defined in
section 3 of the United States Housing Act of 1937 (42
U.S.C. 1437a).
``(c) Performance Measures.--The Secretary shall establish needs
indicators and performance measures to evaluate the activities carried
out under grants awarded under this section. Such indicators shall be
commensurate with national measures of maternal and child health
programs and shall be developed in consultation with the Director of
the Centers for Disease Control and Prevention.
``(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.''.
(b) Conforming Amendment.--Section 340D(c)(1) of the Public Health
Service Act (42 U.S.C. 256d(c)(1)) is amended by striking ``317E'' and
inserting ``317F''.
SEC. 2503. TRAINING AND REPORTS BY THE HEALTH RESOURCES AND SERVICES
ADMINISTRATION.
(a) Training.--The Secretary of Health and Human Services, acting
through the Administrator of the Health Resources and Services
Administration and in collaboration with the Administrator of the
Health Care Financing Administration and the Director of the Centers
for Disease Control and Prevention, shall conduct education and
training programs for physicians and other health care providers
regarding childhood lead poisoning, current screening and treatment
recommendations and requirements, and the scientific, medical, and
public health basis for those policies.
(b) Report.--The Secretary of Health and Human Services, acting
through the Administrator of the Health Resources and Services
Administration, annually shall report to Congress on the number of
children who received services through health centers established under
section 330 of the Public Health Service Act (42 U.S.C. 254b) and
received a blood lead screening test during the prior fiscal year,
noting the percentage that such children represent as compared to all
children who received services through such health centers.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each the fiscal years 2001 through 2005.
SEC. 2504. SCREENINGS, REFERRALS, AND EDUCATION REGARDING LEAD
POISONING.
Section 317A(l)(1) of the Public Health Service Act (42 U.S.C.
247b-1(l)(1)) is amended by striking ``1994'' and all that follows and
inserting ``1994 through 2005.''.
TITLE XXVI--SCREENING FOR HERITABLE DISORDERS
SEC. 2601. PROGRAM TO IMPROVE THE ABILITY OF STATES TO PROVIDE NEWBORN
AND CHILD SCREENING FOR HERITABLE DISORDERS.
Part A of title XI of the Public Health Service Act, as amended by
section 2301 of this Act, is amended by adding at the end the
following:
``SEC. 1109. IMPROVED NEWBORN AND CHILD SCREENING FOR HERITABLE
DISORDERS.
``(a) In General.--The Secretary shall award grants to eligible
entities to enhance, improve or expand the ability of State and local
public health agencies to provide screening, counseling or health care
services to newborns and children having or at risk for heritable
disorders.
``(b) Use of Funds.--Amounts provided under a grant awarded under
subsection (a) shall be used to--
``(1) establish, expand, or improve systems or programs to
provide screening, counseling, testing or specialty services
for newborns and children at risk for heritable disorders;
``(2) establish, expand, or improve programs or services to
reduce mortality or morbidity from heritable disorders;
``(3) establish, expand, or improve systems or programs to
provide information and counseling on available therapies for
newborns and children with heritable disorders;
``(4) improve the access of medically underserved
populations to screening, counseling, testing and specialty
services for newborns and children having or at risk for
heritable disorders; or
``(5) conduct such other activities as may be necessary to
enable newborns and children having or at risk for heritable
disorders to receive screening, counseling, testing or
specialty services, regardless of income, race, color,
religion, sex, national origin, age, or disability.
``(c) Eligible Entities.--To be eligible to receive a grant under
subsection (a) an entity shall--
``(1) be a State or political subdivision of a State, or a
consortium of 2 or more States or political subdivisions of
States; and
``(2) prepare and submit to the Secretary an application
that includes--
``(A) a plan to use amounts awarded under the grant
to meet specific health status goals and objectives
relative to heritable disorders, including attention to
needs of medically underserved populations;
``(B) a plan for the collection of outcome data or
other methods of evaluating the degree to which amounts
awarded under this grant will be used to achieve the
goals and objectives identified under subparagraph (A);
``(C) a plan for monitoring and ensuring the
quality of services provided under the grant;
``(D) an assurance that amounts awarded under the
grant will be used only to implement the approved plan
for the State;
``(E) an assurance that the provision of services
under the plan is coordinated with services provided
under programs implemented in the State under titles V,
XVIII, XIX, XX, or XXI of the Social Security Act
(subject to Federal regulations applicable to such
programs) so that the coverage of services under such
titles is not substantially diminished by the use of
granted funds; and
``(F) such other information determined by the
Secretary to be necessary.
``(d) Limitation.--An eligible entity may not use amounts received
under this section to--
``(1) provide cash payments to or on behalf of affected
individuals;
``(2) provide inpatient services;
``(3) purchase land or make capital improvements to
property; or
``(4) provide for proprietary research or training.
``(e) Voluntary Participation.--The participation by any individual
in any program or portion thereof established or operated with funds
received under this section shall be wholly voluntary and shall not be
a prerequisite to eligibility for or receipt of any other service or
assistance from, or to participation in, another Federal or State
program.
``(f) Supplement Not Supplant.--Funds appropriated under this
section shall be used to supplement and not supplant other Federal,
State, and local public funds provided for activities of the type
described in this section.
``(g) Publication.
``(1) In general.--An application submitted under
subsection (c)(2) shall be made public by the State in such a
manner as to facilitate comment from any person, including
through hearings and other methods used to facilitate comments
from the public.
``(2) Comments.--Comments received by the State after the
publication described in paragraph (1) shall be addressed in
the application submitted under subsection (c)(2).
``(h) Technical Assistance.--The Secretary shall provide to
entities receiving grants under subsection (a) such technical
assistance as may be necessary to ensure the quality of programs
conducted under this section.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2005.
``SEC. 1110. EVALUATING THE EFFECTIVENESS OF NEWBORN AND CHILD
SCREENING PROGRAMS.
``(a) In General.--The Secretary shall award grants to eligible
entities to provide for the conduct of demonstration programs to
evaluate the effectiveness of screening, counseling or health care
services in reducing the morbidity and mortality caused by heritable
disorders in newborns and children.
``(b) Demonstration Programs.--A demonstration program conducted
under a grant under this section shall be designed to evaluate and
assess, within the jurisdiction of the entity receiving such grant--
``(1) the effectiveness of screening, counseling, testing
or specialty services for newborns and children at risk for
heritable disorders in reducing the morbidity and mortality
associated with such disorders;
``(2) the effectiveness of screening, counseling, testing
or specialty services in accurately and reliably diagnosing
heritable disorders in newborns and children; or
``(3) the availability of screening, counseling, testing or
specialty services for newborns and children at risk for
heritable disorders.
``(c) Eligible Entities.--To be eligible to receive a grant under
subsection (a) an entity shall be a State or political subdivision of a
State, or a consortium of 2 or more States or political subdivisions of
States.
``SEC. 1111. ADVISORY COMMITTEE ON HERITABLE DISORDERS IN NEWBORNS AND
CHILDREN.
``(a) Establishment.--The Secretary shall establish an advisory
committee to be known as the 'Advisory Committee on Heritable Disorders
in Newborns and Children' (referred to in this section as the 'Advisory
Committee').
``(b) Duties.--The Advisory Committee shall--
``(1) provide advice and recommendations to the Secretary
concerning grants and projects awarded or funded under section
1109;
``(2) provide technical information to the Secretary for
the development of policies and priorities for the
administration of grants under section 1109; and
``(3) provide such recommendations, advice or information
as may be necessary to enhance, expand or improve the ability
of the Secretary to reduce the mortality or morbidity from
heritable disorders.
``(c) Membership.--
``(1) In general.--The Secretary shall appoint not to
exceed 15 members to the Advisory Committee. In appointing such
members, the Secretary shall ensure that the total membership
of the Advisory Committee is an odd number.
``(2) Required members.--The Secretary shall appoint to the
Advisory Committee under paragraph (1)--
``(A) the Administrator of the Health Resources and
Services Administration;
``(B) the Director of the Centers for Disease
Control and Prevention;
``(C) the Director of the National Institutes of
Health;
``(D) the Director of the Agency for Healthcare
Research and Quality;
``(E) medical, technical, or scientific
professionals with special expertise in heritable
disorders, or in providing screening, counseling,
testing or specialty services for newborns and children
at risk for heritable disorders;
``(F) members of the public having special
expertise about or concern with heritable disorders;
and
``(G) representatives from such Federal agencies,
public health constituencies, and medical professional
societies as determined to be necessary by the
Secretary, to fulfill the duties of the Advisory
Committee, as established under subsection (b).''.
TITLE XXVII--PEDIATRIC RESEARCH PROTECTIONS
SEC. 2701. REQUIREMENT FOR ADDITIONAL PROTECTIONS FOR CHILDREN INVOLVED
IN RESEARCH.
Notwithstanding any other provision of law, not later than 6 months
after the date of enactment of this Act, the Secretary of Health and
Human Services shall require that all research involving children that
is conducted, supported, or regulated by the Department of Health and
Human Services be in compliance with subpart D of part 45 of title 46,
Code of Federal Regulations.
TITLE XXVIII--MISCELLANEOUS PROVISIONS
SEC. 2801. REPORT REGARDING RESEARCH ON RARE DISEASES IN CHILDREN.
Not later than 180 days after the date of the enactment of this
Act, the Director of the National Institutes of Health shall submit to
the Congress a report on--
(1) the activities that, during fiscal year 2000, were
conducted and supported by such Institutes with respect to rare
diseases in children, including Friedreich's ataxia and
Hutchinson-Gilford progeria syndrome; and
(2) the activities that are planned to be conducted and
supported by such Institutes with respect to such diseases
during the fiscal years 2001 through 2005.
SEC. 2802. STUDY ON METABOLIC DISORDERS.
(a) In General.--The Secretary of Health and Human Services (in
this section referred to as the ``Secretary'') shall, in consultation
with relevant experts or through the Institute of Medicine, study
issues related to treatment of PKU and other metabolic disorders for
children, adolescents, and adults, and mechanisms to assure access to
effective treatment, including special diets, for children and others
with PKU and other metabolic disorders. Such mechanisms shall be
evidence-based and reflect the best scientific knowledge regarding
effective treatment and prevention of disease progression.
(b) Dissemination of Results.--Upon completion of the study
referred to in subsection (a), the Secretary shall disseminate and
otherwise make available the results of the study to interested groups
and organizations, including insurance commissioners, employers,
private insurers, health care professionals, State and local public
health agencies, and State agencies that carry out the medicaid program
under title XIX of the Social Security Act or the State children's
health insurance program under title XXI of such Act.
(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of the fiscal years 2001 through 2003.
TITLE XXIX--EFFECTIVE DATE
SEC. 2901. EFFECTIVE DATE.
This division and the amendments made by this division take effect
October 1, 2000, or upon the date of the enactment of this Act,
whichever occurs later.
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES
SEC. 3001. SHORT TITLE.
This division may be cited as the ``Youth Drug and Mental Health
Services Act''.
TITLE XXXI--PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
SEC. 3101. CHILDREN AND VIOLENCE.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended by adding at the end the following:
``Part G--Projects for Children and Violence
``SEC. 581. CHILDREN AND VIOLENCE.
``(a) In General.--The Secretary, in consultation with the
Secretary of Education and the Attorney General, shall carry out
directly or through grants, contracts or cooperative agreements with
public entities a program to assist local communities in developing
ways to assist children in dealing with violence.
``(b) Activities.--Under the program under subsection (a), the
Secretary may--
``(1) provide financial support to enable local communities
to implement programs to foster the health and development of
children;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address violence when and if it
occurs;
``(4) assist in the creation of community partnerships
among law enforcement, education systems and mental health and
substance abuse service systems; and
``(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children or
adolescents to commit violence.
``(c) Requirements.--An application for a grant, contract or
cooperative agreement under subsection (a) shall demonstrate that--
``(1) the applicant will use amounts received to create a
partnership described in subsection (b)(4) to address issues of
violence in schools;
``(2) the activities carried out by the applicant will
provide a comprehensive method for addressing violence, that
will include--
``(A) security;
``(B) educational reform;
``(C) the review and updating of school policies;
``(D) alcohol and drug abuse prevention and early
intervention services;
``(E) mental health prevention and treatment
services; and
``(F) early childhood development and psychosocial
services; and
``(3) the applicant will use amounts received only for the
services described in subparagraphs (D), (E), and (F) of
paragraph (2).
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient may not
exceed 5 years.
``(f) Evaluation.--The Secretary shall conduct an evaluation of
each project carried out under this section and shall disseminate the
results of such evaluations to appropriate public and private entities.
``(g) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application under this
section to the general public and to health care professionals.
``(h) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $100,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
and 2003.
``SEC. 582. GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO EXPERIENCE
VIOLENCE RELATED STRESS.
``(a) In General.--The Secretary shall award grants, contracts or
cooperative agreements to public and nonprofit private entities, as
well as to Indian tribes and tribal organizations, for the purpose of
developing programs focusing on the behavioral and biological aspects
of psychological trauma response and for developing knowledge with
regard to evidence-based practices for treating psychiatric disorders
of children and youth resulting from witnessing or experiencing a
traumatic event.
``(b) Priorities.--In awarding grants, contracts or cooperative
agreements under subsection (a) related to the development of knowledge
on evidence-based practices for treating disorders associated with
psychological trauma, the Secretary shall give priority to mental
health agencies and programs that have established clinical and basic
research experience in the field of trauma-related mental disorders.
``(c) Geographical Distribution.--The Secretary shall ensure that
grants, contracts or cooperative agreements under subsection (a) with
respect to centers of excellence are distributed equitably among the
regions of the country and among urban and rural areas.
``(d) Evaluation.--The Secretary, as part of the application
process, shall require that each applicant for a grant, contract or
cooperative agreement under subsection (a) submit a plan for the
rigorous evaluation of the activities funded under the grant, contract
or agreement, including both process and outcomes evaluation, and the
submission of an evaluation at the end of the project period.
``(e) Duration of Awards.--With respect to a grant, contract or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient may not
exceed 5 years. Such grants, contracts or agreements may be renewed.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $50,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
and 2003.''.
SEC. 3102. EMERGENCY RESPONSE.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa) is
amended--
(1) by redesignating subsection (m) as subsection (o);
(2) by inserting after subsection (l) the following:
``(m) Emergency Response.--
``(1) In general.--Notwithstanding section 504 and except
as provided in paragraph (2), the Secretary may use not to
exceed 2.5 percent of all amounts appropriated under this title
for a fiscal year to make noncompetitive grants, contracts or
cooperative 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
emergency exists and publish such criteria in the Federal
Register prior to providing funds under this subsection.
``(n) Limitation on the Use of Certain Information.--No
information, 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.''; and
(3) in subsection (o) (as so redesignated), by striking
``1993'' and all that follows through the period and inserting
``2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.''.
SEC. 3103. HIGH RISK YOUTH REAUTHORIZATION.
Section 517(h) of the Public Health Service Act (42 U.S.C. 290bb-
23(h)) is amended by striking ``$70,000,000'' and all that follows
through ``1994'' and inserting ``such sums as may be necessary for each
of the fiscal years 2001 through 2003''.
SEC. 3104. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN AND
ADOLESCENTS.
(a) Substance Abuse Treatment Services.--Subpart 1 of part B of
title V of the Public Health Service Act (42 U.S.C. 290bb et seq.) is
amended by adding at the end the following:
``SEC. 514. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN AND
ADOLESCENTS.
``(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
organizations, for the purpose of providing substance abuse treatment
services for children and adolescents.
``(b) Priority.--In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority to
applicants who propose to--
``(1) apply evidenced-based and cost effective methods for
the treatment of substance abuse among children and
adolescents;
``(2) coordinate the provision of treatment services with
other social service agencies in the community, including
educational, juvenile justice, child welfare, and mental health
agencies;
``(3) provide a continuum of integrated treatment services,
including case management, for children and adolescents with
substance abuse disorders and their families;
``(4) provide treatment that is gender-specific and
culturally appropriate;
``(5) involve and work with families of children and
adolescents receiving treatment;
``(6) provide aftercare services for children and
adolescents and their families after completion of substance
abuse treatment; and
``(7) address the relationship between substance abuse and
violence.
``(c) Duration of Grants.--The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for periods
not to exceed 5 fiscal years.
``(d) Application.--An entity desiring a grant, contract, or
cooperative 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
cooperative agreement under subsection (a) shall submit, in the
application 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 evaluation at the
completion of such project as the Secretary determines to be
appropriate.
``(f) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $40,000,000 for fiscal year
2001, and such sums as may be necessary for fiscal years 2002 and 2003.
``SEC. 514A. EARLY INTERVENTION SERVICES FOR CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary shall award grants, contracts, or
cooperative agreements to public and private nonprofit entities,
including local educational agencies (as defined in section 14101 of
the Elementary and Secondary Education Act of 1965 (20 U.S.C. 8801)),
for the purpose of providing early intervention substance abuse
services for children and adolescents.
``(b) Priority.--In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority to
applicants who demonstrate an ability to--
``(1) screen for and assess substance use and abuse by
children and adolescents;
``(2) make appropriate referrals for children and
adolescents who are in need of treatment for substance abuse;
``(3) provide early intervention services, including
counseling and ancillary services, that are designed to meet
the developmental needs of children and adolescents who are at
risk for substance abuse; and
``(4) develop networks with the educational, juvenile
justice, social services, and other agencies and organizations
in the State or local community involved that will work to
identify children and adolescents who are in need of substance
abuse treatment services.
``(c) Condition.--In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall ensure that such
grants, contracts, or cooperative agreements are allocated, subject to
the availability of qualified applicants, among the principal
geographic regions of the United States, to Indian tribes and tribal
organizations, and to urban and rural areas.
``(d) Duration of Grants.--The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for periods
not to exceed 5 fiscal years.
``(e) Application.--An entity desiring a grant, contract, or
cooperative 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.
``(f) Evaluation.--An entity that receives a grant, contract, or
cooperative agreement under subsection (a) shall submit, in the
application 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 evaluation at the
completion of such project as the Secretary determines to be
appropriate.
``(g) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $20,000,000 for fiscal year
2001, and such sums as may be necessary for fiscal years 2002 and
2003.''.
(b) Youth Interagency Centers.--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 the following:
``SEC. 520C. YOUTH INTERAGENCY RESEARCH, TRAINING, AND TECHNICAL
ASSISTANCE CENTERS.
``(a) Program Authorized.--The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration, and in consultation with the Administrator of the
Office of Juvenile Justice and Delinquency Prevention, the Director of
the Bureau of Justice Assistance and the Director of the National
Institutes of Health, shall award grants or contracts to public or
nonprofit private entities to establish not more than 4 research,
training, and technical assistance centers to carry out the activities
described in subsection (c).
``(b) Application.--A public or private nonprofit entity desiring a
grant or contract under subsection (a) shall prepare and submit an
application to the Secretary at such time, in such manner, and
containing such information as the Secretary may require.
``(c) Authorized Activities.--A center established under a grant or
contract under subsection (a) shall--
``(1) provide training with respect to state-of-the-art
mental health and justice-related services and successful
mental health and substance abuse-justice collaborations that
focus on children and adolescents, to public policymakers, law
enforcement administrators, public defenders, police, probation
officers, judges, parole officials, jail administrators and
mental health and substance abuse providers and administrators;
``(2) engage in research and evaluations concerning State
and local justice and mental health systems, including system
redesign initiatives, and disseminate information concerning
the results of such evaluations;
``(3) provide direct technical assistance, including
assistance provided through toll-free telephone numbers,
concerning issues such as how to accommodate individuals who
are being processed through the courts under the Americans with
Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), what types
of mental health or substance abuse service approaches are
effective within the judicial system, and how community-based
mental health or substance abuse services can be more
effective, including relevant regional, ethnic, and gender-
related considerations; and
``(4) provide information, training, and technical
assistance to State and local governmental officials to enhance
the capacity of such officials to provide appropriate services
relating to mental health or substance abuse.
``(d) Authorization of Appropriations.--For the purpose of carrying
out this section, there is authorized to be appropriated $4,000,000 for
fiscal year 2001, and such sums as may be necessary for fiscal years
2002 and 2003.''.
(c) Prevention of Abuse and Addiction.--Subpart 2 of part B of
title V of the Public Health Service Act (42 U.S.C. 290bb-21 et seq.)
is amended by adding the following:
``SEC. 519E. PREVENTION OF METHAMPHETAMINE AND INHALANT ABUSE AND
ADDICTION.
``(a) Grants.--The Director of the Center for Substance Abuse
Prevention (referred to in this section as the `Director') may make
grants to and enter into contracts and cooperative agreements with
public and nonprofit private entities to enable such entities--
``(1) to carry out school-based programs concerning the
dangers of methamphetamine or inhalant abuse and addiction,
using methods that are effective and evidence-based, including
initiatives that give students the responsibility to create
their own anti-drug abuse education programs for their schools;
and
``(2) to carry out community-based methamphetamine or
inhalant abuse and addiction prevention programs that are
effective and evidence-based.
``(b) Use of Funds.--Amounts made available under a grant, contract
or cooperative agreement under subsection (a) shall be used for
planning, establishing, or administering methamphetamine or inhalant
prevention programs in accordance with subsection (c).
``(c) Prevention Programs and Activities.--
``(1) In general.--Amounts provided under this section may
be used--
``(A) to carry out school-based programs that are
focused on those districts with high or increasing
rates of methamphetamine or inhalant abuse and
addiction and targeted at populations which are most at
risk to start methamphetamine or inhalant abuse;
``(B) to carry out community-based prevention
programs that are focused on those populations within
the community that are most at-risk for methamphetamine
or inhalant abuse and addiction;
``(C) to assist local government entities to
conduct appropriate methamphetamine or inhalant
prevention activities;
``(D) to train and educate State and local law
enforcement officials, prevention and education
officials, members of community anti-drug coalitions
and parents on the signs of methamphetamine or inhalant
abuse and addiction and the options for treatment and
prevention;
``(E) for planning, administration, and educational
activities related to the prevention of methamphetamine
or inhalant abuse and addiction;
``(F) for the monitoring and evaluation of
methamphetamine or inhalant prevention activities, and
reporting and disseminating resulting information to
the public; and
``(G) for targeted pilot programs with evaluation
components to encourage innovation and experimentation
with new methodologies.
``(2) Priority.--The Director shall give priority in making
grants under this section to rural and urban areas that are
experiencing a high rate or rapid increases in methamphetamine
or inhalant abuse and addiction.
``(d) Analyses and Evaluation.--
``(1) In general.--Up to $500,000 of the amount available
in each fiscal year to carry out this section shall be made
available to the Director, acting in consultation with other
Federal agencies, to support and conduct periodic analyses and
evaluations of effective prevention programs for
methamphetamine or inhalant abuse and addiction and the
development of appropriate strategies for disseminating
information about and implementing these programs.
``(2) Annual reports.--The Director shall submit to the
Committee on Health, Education, Labor, and Pensions and the
Committee on Appropriations of the Senate and the Committee on
Commerce and Committee on Appropriations of the House of
Representatives, an annual report with the results of the
analyses and evaluation under paragraph (1).
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out subsection (a), $10,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
and 2003.''.
SEC. 3105. COMPREHENSIVE COMMUNITY SERVICES FOR CHILDREN WITH SERIOUS
EMOTIONAL DISTURBANCE.
(a) Matching Funds.--Section 561(c)(1)(D) of the Public Health
Service Act (42 U.S.C. 290ff(c)(1)(D)) is amended by striking ``fifth''
and inserting ``fifth and sixth''.
(b) Flexibility for Indian Tribes and Territories.--Section 562 of
the Public Health Service Act (42 U.S.C. 290ff-1) is amended by adding
at the end the following:
``(g) Waivers.--The Secretary may waive 1 or more of the
requirements of subsection (c) 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 United States
Virgin Islands if the Secretary determines, after peer review, that the
system of care is family-centered and uses the least restrictive
environment that is clinically appropriate.''.
(c) Duration of Grants.--Section 565(a) of the Public Health
Service Act (42 U.S.C. 290ff-4(a)) is amended by striking ``5 fiscal''
and inserting ``6 fiscal''.
(d) Authorization of Appropriations.--Section 565(f)(1) of the
Public Health Service Act (42 U.S.C. 290ff-4(f)(1)) is amended by
striking ``1993'' and all that follows and inserting ``2001, and such
sums as may be necessary for each of the fiscal years 2002 and 2003.''.
(e) Current Grantees.--
(1) In general.--Entities with active grants under section
561 of the Public Health Service Act (42 U.S.C. 290ff) on the
date of enactment of this Act shall be eligible to receive a
6th year of funding under the grant in an amount not to exceed
the amount that such grantee received in the 5th year of
funding under such grant. Such 6th year may be funded without
requiring peer and Advisory Council review as required under
section 504 of such Act (42 U.S.C. 290aa-3).
(2) Limitation.--Paragraph (1) shall apply with respect to
a grantee only if the grantee agrees to comply with the
provisions of section 561 as amended by subsection (a).
SEC. 3106. SERVICES FOR CHILDREN OF SUBSTANCE ABUSERS.
(a) Administration and Activities.--
(1) Administration.--Section 399D(a) of the Public Health
Service Act (42 U.S.C. 280d(a)(1)) is amended--
(A) in paragraph (1), by striking ``Administrator''
and all that follows through ``Administration'' and
insert ``Administrator of the Substance Abuse and
Mental Health Services Administration''; and
(B) in paragraph (2), by striking ``Administrator
of the Substance Abuse and Mental Health Services
Administration'' and inserting ``Administrator of the
Health Resources and Services Administration''.
(2) Activities.--Section 399D(a)(1) of the Public Health
Service Act (42 U.S.C. 280d(a)(1)) is amended--
(A) in subparagraph (B), by striking ``and'' at the
end;
(B) in subparagraph (C), by striking the period and
inserting the following: ``through youth service
agencies, family social services, child care providers,
Head Start, schools and after-school programs, early
childhood development programs, community-based family
resource and support centers, the criminal justice
system, health, substance abuse and mental health
providers through screenings conducted during regular
childhood examinations and other examinations, self and
family member referrals, substance abuse treatment
services, and other providers of services to children
and families; and''; and
(C) by adding at the end the following:
``(D) to provide education and training to health,
substance abuse and mental health professionals, and
other providers of services to children and families
through youth service agencies, family social services,
child care, Head Start, schools and after-school
programs, early childhood development programs,
community-based family resource and support centers,
the criminal justice system, and other providers of
services to children and families.''.
(3) Identification of certain children.--Section
399D(a)(3)(A) of the Public Health Service Act (42 U.S.C.
280d(a)(3)(A)) is amended--
(A) in clause (i), by striking ``(i) the entity''
and inserting ``(i)(I) the entity'';
(B) in clause (ii)--
(i) by striking ``(ii) the entity'' and
inserting ``(II) the entity''; and
(ii) by striking the period and inserting
``; and''; and
(C) by adding at the end the following:
``(ii) the entity will identify children
who may be eligible for medical assistance
under a State program under title XIX or XXI of
the Social Security Act.''.
(b) Services for Children.--Section 399D(b) of the Public Health
Service Act (42 U.S.C. 280d(b)) is amended--
(1) in paragraph (1), by inserting ``alcohol and drug,''
after ``psychological,'';
(2) by striking paragraph (5) and inserting the following:
``(5) Developmentally and age-appropriate drug and alcohol
early intervention, treatment and prevention services.''; and
(3) by inserting after paragraph (8), the following:
``Services shall be provided under paragraphs (2) through (8) by a
public health nurse, social worker, or similar professional, or by a
trained worker from the community who is supervised by a professional,
or by an entity, where the professional or entity provides assurances
that the professional or entity is licensed or certified by the State
if required and is complying with applicable licensure or certification
requirements.''.
(c) Services for Affected Families.--Section 399D(c) of the Public
Health Service Act (42 U.S.C. 280d(c)) is amended--
(1) in paragraph (1)--
(A) in the matter preceding subparagraph (A), by
inserting before the colon the following: ``, or by an
entity, where the professional or entity provides
assurances that the professional or entity is licensed
or certified by the State if required and is complying
with applicable licensure or certification
requirements''; and
(B) by adding at the end the following:
``(D) Aggressive outreach to family members with
substance abuse problems.
``(E) Inclusion of consumer in the development,
implementation, and monitoring of Family Services
Plan.'';
(2) in paragraph (2)--
(A) by striking subparagraph (A) and inserting the
following:
``(A) Alcohol and drug treatment services,
including screening and assessment, diagnosis,
detoxification, individual, group and family
counseling, relapse prevention, pharmacotherapy
treatment, after-care services, and case management.'';
(B) in subparagraph (C), by striking ``, including
educational and career planning'' and inserting ``and
counseling on the human immunodeficiency virus and
acquired immune deficiency syndrome'';
(C) in subparagraph (D), by striking ``conflict
and''; and
(D) in subparagraph (E), by striking ``Remedial''
and inserting ``Career planning and''; and
(3) in paragraph (3)(D), by inserting ``which include child
abuse and neglect prevention techniques'' before the period.
(d) Eligible Entities.--Section 399D(d) of the Public Health
Service Act (42 U.S.C. 280d(d)) is amended--
(1) by striking the matter preceding paragraph (1) and
inserting:
``(d) Eligible Entities.--The Secretary shall distribute the grants
through the following types of entities:'';
(2) in paragraph (1), by striking ``drug treatment'' and
inserting ``drug early intervention, prevention or treatment;
and
(3) in paragraph (2)--
(A) in subparagraph (A), by striking ``; and'' and
inserting ``; or''; and
(B) in subparagraph (B), by inserting ``or
pediatric health or mental health providers and family
mental health providers'' before the period.
(e) Submission of Information.--Section 399D(h) of the Public
Health Service Act (42 U.S.C. 280d(h)) is amended--
(1) in paragraph (2)--
(A) by inserting ``including maternal and child
health'' before ``mental'';
(B) by striking ``treatment programs''; and
(C) by striking ``and the State agency responsible
for administering public maternal and child health
services'' and inserting ``, the State agency
responsible for administering alcohol and drug
programs, the State lead agency, and the State
Interagency Coordinating Council under part H of the
Individuals with Disabilities Education Act; and''; and
(2) by striking paragraph (3) and redesignating paragraph
(4) as paragraph (3).
(f) Reports to the Secretary.--Section 399D(i)(6) of the Public
Health Service Act (42 U.S.C. 280d(i)(6)) is amended--
(1) in subparagraph (B), by adding ``and'' at the end; and
(2) by striking subparagraphs (C), (D), and (E) and
inserting the following:
``(C) the number of case workers or other
professionals trained to identify and address substance
abuse issues.''.
(g) Evaluations.--Section 399D(l) of the Public Health Service Act
(42 U.S.C. 280d(l)) is amended--
(1) in paragraph (3), by adding ``and'' at the end;
(2) in paragraph (4), by striking the semicolon and
inserting the following: ``, including increased participation
in work or employment-related activities and decreased
participation in welfare programs.''; and
(3) by striking paragraphs (5) and (6).
(h) Report to Congress.--Section 399D(m) of the Public Health
Service Act (42 U.S.C. 280d(m)) is amended--
(1) in paragraph (2), by adding ``and'' at the end;
(2) in paragraph (3)--
(A) in subparagraph (A), by adding ``and'' at the
end;
(B) in subparagraph (B), by striking the semicolon
and inserting a period; and
(C) by striking subparagraphs (C), (D), and (E);
and
(3) by striking paragraphs (4) and (5).
(i) Data Collection.--Section 399D(n) of the Public Health Service
Act (42 U.S.C. 280d(n)) is amended by adding at the end the following:
``The periodic report shall include a quantitative estimate of the
prevalence of alcohol and drug problems in families involved in the
child welfare system, the barriers to treatment and prevention services
facing these families, and policy recommendations for removing the
identified barriers, including training for child welfare workers.''.
(j) Definition.--Section 399D(o)(2)(B) of the Public Health Service
Act (42 U.S.C. 280d(o)(2)(B)) is amended by striking ``dangerous''.
(k) Authorization of Appropriations.--Section 399D(p) of the Public
Health Service Act (42 U.S.C. 280d(p)) is amended to read as follows:
``(p) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $50,000,000
for fiscal year 2001, and such sums as may be necessary for each of
fiscal years 2002 and 2003.''.
(l) Grants for Training and Conforming Amendments.--Section 399D of
the Public Health Service Act (42 U.S.C. 280d) is amended--
(1) by striking subsection (f);
(2) by striking subsection (k);
(3) by redesignating subsections (d), (e), (g), (h), (i),
(j), (l), (m), (n), (o), and (p) as subsections (e) through
(o), respectively;
(4) by inserting after subsection (c), the following:
``(d) Training for Providers of Services to Children and
Families.--The Secretary may make a grant under subsection (a) for the
training of health, substance abuse and mental health professionals and
other providers of services to children and families through youth
service agencies, family social services, child care providers, Head
Start, schools and after-school programs, early childhood development
programs, community-based family resource centers, the criminal justice
system, and other providers of services to children and families. Such
training shall be to assist professionals in recognizing the drug and
alcohol problems of their clients and to enhance their skills in
identifying and understanding the nature of substance abuse, and
obtaining substance abuse early intervention, prevention and treatment
resources.'';
(5) in subsection (k)(2) (as so redesignated), by striking
``(h)'' and inserting ``(i)''; and
(6) in paragraphs (3)(E) and (5) of subsection (m) (as so
redesignated), by striking ``(d)'' and inserting ``(e)''.
(m) Transfer and Redesignation.--Section 399D of the Public Health
Service Act (42 U.S.C. 280d), as amended by this section--
(1) is transferred to title V;
(2) is redesignated as section 519; and
(3) is inserted after section 518.
(n) Conforming Amendment.--Title III of the Public Health Service
Act (42 U.S.C. 241 et seq.) is amended by striking the heading of part
L.
SEC. 3107. SERVICES FOR YOUTH OFFENDERS.
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 3104(b), is further
amended by adding at the end the following:
``SEC. 520D. SERVICES FOR YOUTH OFFENDERS.
``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, and in consultation with the
Director of the Center for Substance Abuse Treatment, the Administrator
of the Office of Juvenile Justice and Delinquency Prevention, and the
Director of the Special Education Programs, shall award grants on a
competitive basis to State or local juvenile justice agencies to enable
such agencies to provide aftercare services for youth offenders who
have been discharged from facilities in the juvenile or criminal
justice system and have serious emotional disturbances or are at risk
of developing such disturbances.
``(b) Use of Funds.--A State or local juvenile justice agency
receiving a grant under subsection (a) shall use the amounts provided
under the grant--
``(1) to develop a plan describing the manner in which the
agency will provide services for each youth offender who has a
serious emotional disturbance and has been detained or
incarcerated in facilities within the juvenile or criminal
justice system;
``(2) to provide a network of core or aftercare services or
access to such services for each youth offender, including
diagnostic and evaluation services, substance abuse treatment
services, outpatient mental health care services, medication
management services, intensive home-based therapy, intensive
day treatment services, respite care, and therapeutic foster
care;
``(3) to establish a program that coordinates with other
State and local agencies providing recreational, social,
educational, vocational, or operational services for youth, to
enable the agency receiving a grant under this section to
provide community-based system of care services for each youth
offender that addresses the special needs of the youth and
helps the youth access all of the aforementioned services; and
``(4) using not more than 20 percent of funds received, to
provide planning and transition services as described in
paragraph (3) for youth offenders while such youth are
incarcerated or detained.
``(c) Application.--A State or local juvenile justice agency that
desires a grant 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.
``(d) Report.--Not later than 3 years after the date of enactment
of this section and annually thereafter, the Secretary shall prepare
and submit, to the Committee on Health, Education, Labor, and Pensions
of the Senate and the Committee on Commerce of the House of
Representatives, a report that describes the services provided pursuant
to this section.
``(e) Definitions.--In this section:
``(1) Serious emotional disturbance.--The term `serious
emotional disturbance' with respect to a youth offender means
an offender who currently, or at any time within the 1-year
period ending on the day on which services are sought under
this section, has a diagnosable mental, behavioral, or
emotional disorder that functionally impairs the offender's
life by substantially limiting the offender's role in family,
school, or community activities, and interfering with the
offender's ability to achieve or maintain 1 or more
developmentally-appropriate social, behavior, cognitive,
communicative, or adaptive skills.
``(2) Community-based system of care.--The term `community-
based system of care' means the provision of services for the
youth offender by various State or local agencies that in an
interagency fashion or operating as a network addresses the
recreational, social, educational, vocational, mental health,
substance abuse, and operational needs of the youth offender.
``(3) Youth offender.--The term `youth offender' means an
individual who is 21 years of age or younger who has been
discharged from a State or local juvenile or criminal justice
system, except that if the individual is between the ages of 18
and 21 years, such individual has had contact with the State or
local juvenile or criminal justice system prior to attaining 18
years of age and is under the jurisdiction of such a system at
the time services are sought.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $40,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
and 2003.''.
SEC. 3108. GRANTS FOR STRENGTHENING FAMILIES THROUGH COMMUNITY
PARTNERSHIPS.
Subpart 2 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-21 et seq) is amended by adding at the end the following:
``SEC. 519A. GRANTS FOR STRENGTHENING FAMILIES.
``(a) Program Authorized.--The Secretary, acting through the
Director of the Prevention Center, may make grants to public and
nonprofit private entities to develop and implement model substance
abuse prevention programs to provide early intervention and substance
abuse prevention services for individuals of high-risk families and the
communities in which such individuals reside.
``(b) Priority.--In awarding grants under subsection (a), the
Secretary shall give priority to applicants that--
``(1) have proven experience in preventing substance abuse
by individuals of high-risk families and reducing substance
abuse in communities of such individuals;
``(2) have demonstrated the capacity to implement
community-based partnership initiatives that are sensitive to
the diverse backgrounds of individuals of high-risk families
and the communities of such individuals;
``(3) have experience in providing technical assistance to
support substance abuse prevention programs that are community-
based;
``(4) have demonstrated the capacity to implement research-
based substance abuse prevention strategies; and
``(5) have implemented programs that involve families,
residents, community agencies, and institutions in the
implementation and design of such programs.
``(c) Duration of Grants.--The Secretary shall award grants under
subsection (a) for a period not to exceed 5 years.
``(d) Use of Funds.--An applicant that is awarded a grant under
subsection (a) shall--
``(1) in the first fiscal year that such funds are received
under the grant, use such funds to develop a model substance
abuse prevention program; and
``(2) in the fiscal year following the first fiscal year
that such funds are received, use such funds to implement the
program developed under paragraph (1) to provide early
intervention and substance abuse prevention services to--
``(A) strengthen the environment of children of
high risk families by targeting interventions at the
families of such children and the communities in which
such children reside;
``(B) strengthen protective factors, such as--
``(i) positive adult role models;
``(ii) messages that oppose substance
abuse;
``(iii) community actions designed to
reduce accessibility to and use of illegal
substances; and
``(iv) willingness of individuals of
families in which substance abuse occurs to
seek treatment for substance abuse;
``(C) reduce family and community risks, such as
family violence, alcohol or drug abuse, crime, and
other behaviors that may effect healthy child
development and increase the likelihood of substance
abuse; and
``(D) build collaborative and formal partnerships
between community agencies, institutions, and
businesses to ensure that comprehensive high quality
services are provided, such as early childhood
education, health care, family support programs, parent
education programs, and home visits for infants.
``(e) Application.--To be eligible to receive a grant under
subsection (a), an applicant shall prepare and submit to the Secretary
an application that--
``(1) describes a model substance abuse prevention program
that such applicant will establish;
``(2) describes the manner in which the services described
in subsection (d)(2) will be provided; and
``(3) describe in as much detail as possible the results
that the entity expects to achieve in implementing such a
program.
``(f) Matching Funding.--The Secretary may not make a grant to a
entity under subsection (a) unless that entity agrees that, with
respect to the costs to be incurred by the entity in carrying out the
program for which the grant was awarded, the entity will make available
non-Federal contributions in an amount that is not less than 40 percent
of the amount provided under the grant.
``(g) Report to Secretary.--An applicant that is awarded a grant
under subsection (a) shall prepare and submit to the Secretary a report
in such form and containing such information as the Secretary may
require, including an assessment of the efficacy of the model substance
abuse prevention program implemented by the applicant and the short,
intermediate, and long term results of such program.
``(h) Evaluations.--The Secretary shall conduct evaluations, based
in part on the reports submitted under subsection (g), to determine the
effectiveness of the programs funded under subsection (a) in reducing
substance use in high-risk families and in making communities in which
such families reside in stronger. The Secretary shall submit such
evaluations to the appropriate committees of Congress.
``(i) High-Risk Families.--In this section, the term `high-risk
family' means a family in which the individuals of such family are at a
significant risk of using or abusing alcohol or any illegal substance.
``(j) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $3,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years
2002 and 2003.''.
SEC. 3109. PROGRAMS TO REDUCE UNDERAGE DRINKING.
Subpart 2 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-21 et seq), as amended by section 3108, is further amended
by adding at the end the following:
``SEC. 519B. PROGRAMS TO REDUCE UNDERAGE DRINKING.
``(a) In General.--The Secretary shall make awards of grants,
cooperative agreements, or contracts to public and nonprofit private
entities, including Indian tribes and tribal organizations, to enable
such entities to develop plans for and to carry out school-based
(including institutions of higher education) and community-based
programs for the prevention of alcoholic-beverage consumption by
individuals who have not attained the legal drinking age.
``(b) Eligibility Requirements.--To be eligible to receive an award
under subsection (a), an entity shall provide any assurances to the
Secretary which the Secretary may require, including that the entity
will--
``(1) annually report to the Secretary on the effectiveness
of the prevention approaches implemented by the entity;
``(2) use science based and age appropriate approaches; and
``(3) involve local public health officials and community
prevention program staff in the planning and implementation of
the program.
``(c) Evaluation.--The Secretary shall evaluate each project under
subsection (a) and shall disseminate the findings with respect to each
such evaluation to appropriate public and private entities.
``(d) Geographical Distribution.--The Secretary shall ensure that
awards will be distributed equitably among the regions of the country
and among urban and rural areas.
``(e) Duration of Award.--With respect to an award under subsection
(a), the period during which payments under such award are made to the
recipient may not exceed 5 years. The preceding sentence may not be
construed as establishing a limitation on the number of awards under
such subsection that may be made to the recipient.
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $25,000,000
for fiscal year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.''.
SEC. 3110. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.
Subpart 2 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-21 et seq), as amended by sections 3108 and 3109, is
further amended by adding at the end the following:
``SEC. 519C. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.
``(a) In General.--The Secretary shall make awards of grants,
cooperative agreements, or contracts to public and nonprofit private
entities, including Indian tribes and tribal organizations, to provide
services to individuals diagnosed with fetal alcohol syndrome or
alcohol-related birth defects.
``(b) Use of Funds.--An award under subsection (a) may, subject to
subsection (d), be used to--
``(1) screen and test individuals to determine the type and
level of services needed;
``(2) develop a comprehensive plan for providing services
to the individual;
``(3) provide mental health counseling;
``(4) provide substance abuse prevention services and
treatment, if needed;
``(5) coordinate services with other social programs
including social services, justice system, educational
services, health services, mental health and substance abuse
services, financial assistance programs, vocational services
and housing assistance programs;
``(6) provide vocational services;
``(7) provide health counseling;
``(8) provide housing assistance;
``(9) parenting skills training;
``(10) overall case management;
``(11) supportive services for families of individuals with
Fetal Alcohol Syndrome; and
``(12) provide other services and programs, to the extent
authorized by the Secretary after consideration of
recommendations made by the National Task Force on Fetal
Alcohol Syndrome.
``(c) Requirements.--To be eligible to receive an award under
subsection (a), an applicant shall--
``(1) demonstrate that the program will be part of a
coordinated, comprehensive system of care for such individuals;
``(2) demonstrate an established communication with other
social programs in the community including social services,
justice system, financial assistance programs, health services,
educational services, mental health and substance abuse
services, vocational services and housing assistance services;
``(3) show a history of working with individuals with fetal
alcohol syndrome or alcohol-related birth defects;
``(4) provide assurance that the services will be provided
in a culturally and linguistically appropriate manner; and
``(5) provide assurance that at the end of the 5-year award
period, other mechanisms will be identified to meet the needs
of the individuals and families served under such award.
``(d) Relationship to Payments Under Other Programs.--An award may
be made under subsection (a) only if the applicant involved agrees that
the award will not be expended to pay the expenses of providing any
service under this section to an individual to the extent that payment
has been made, or can reasonably be expected to be made, with respect
to such expenses--
``(1) under any State compensation program, under an
insurance policy, or under any Federal or State health benefits
program; or
``(2) by an entity that provides health services on a
prepaid basis.
``(e) Duration of Awards.--With respect to an award under
subsection (a), the period during which payments under such award are
made to the recipient may not exceed 5 years.
``(f) Evaluation.--The Secretary shall evaluate each project
carried out under subsection (a) and shall disseminate the findings
with respect to each such evaluation to appropriate public and private
entities.
``(g) Funding.--
``(1) Authorization of appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $25,000,000 for fiscal year 2001, and such sums as
may be necessary for each of the fiscal years 2002 and 2003.
``(2) Allocation.--Of the amounts appropriated under
paragraph (1) for a fiscal year, not less than $300,000 shall,
for purposes relating to fetal alcohol syndrome and alcohol-
related birth defects, be made available for collaborative,
coordinated interagency efforts with the National Institute on
Alcohol Abuse and Alcoholism, the National Institute on Child
Health and Human Development, the Health Resources and Services
Administration, the Agency for Healthcare Research and Quality,
the Centers for Disease Control and Prevention, the Department
of Education, and the Department of Justice.
``SEC. 519D. CENTERS OF EXCELLENCE ON SERVICES FOR INDIVIDUALS WITH
FETAL ALCOHOL SYNDROME AND ALCOHOL-RELATED BIRTH DEFECTS
AND TREATMENT FOR INDIVIDUALS WITH SUCH CONDITIONS AND
THEIR FAMILIES.
``(a) In General.--The Secretary shall make awards of grants,
cooperative agreements, or contracts to public or nonprofit private
entities for the purposes of establishing not more than 4 centers of
excellence to study techniques for the prevention of fetal alcohol
syndrome and alcohol-related birth defects and adaptations of
innovative clinical interventions and service delivery improvements for
the provision of comprehensive services to individuals with fetal
alcohol syndrome or alcohol-related birth defects and their families
and for providing training on such conditions.
``(b) Use of Funds.--An award under subsection (a) may be used to--
``(1) study adaptations of innovative clinical
interventions and service delivery improvements strategies for
children and adults with fetal alcohol syndrome or alcohol-
related birth defects and their families;
``(2) identify communities which have an exemplary
comprehensive system of care for such individuals so that they
can provide technical assistance to other communities
attempting to set up such a system of care;
``(3) provide technical assistance to communities who do
not have a comprehensive system of care for such individuals
and their families;
``(4) train community leaders, mental health and substance
abuse professionals, families, law enforcement personnel,
judges, health professionals, persons working in financial
assistance programs, social service personnel, child welfare
professionals, and other service providers on the implications
of fetal alcohol syndrome and alcohol-related birth defects,
the early identification of and referral for such conditions;
``(5) develop innovative techniques for preventing alcohol
use by women in child bearing years;
``(6) perform other functions, to the extent authorized by
the Secretary after consideration of recommendations made by
the National Task Force on Fetal Alcohol Syndrome.
``(c) Report.--
``(1) In general.--A recipient of an award under subsection
(a) shall at the end of the period of funding report to the
Secretary on any innovative techniques that have been
discovered for preventing alcohol use among women of child
bearing years.
``(2) Dissemination of findings.--The Secretary shall upon
receiving a report under paragraph (1) disseminate the findings
to appropriate public and private entities.
``(d) Duration of Awards.--With respect to an award under
subsection (a), the period during which payments under such award are
made to the recipient may not exceed 5 years.
``(e) Evaluation.--The Secretary shall evaluate each project
carried out under subsection (a) and shall disseminate the findings
with respect to each such evaluation to appropriate public and private
entities.
``(f) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $5,000,000
for fiscal year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.''.
SEC. 3111. SUICIDE PREVENTION.
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 3107, is further amended
by adding at the end the following:
``SEC. 520E. SUICIDE PREVENTION FOR CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary shall award grants, contracts, or
cooperative agreements to States, political subdivisions of States,
Indian tribes, tribal organizations, public organizations, or private
nonprofit organizations to establish programs to reduce suicide deaths
in the United States among children and adolescents.
``(b) Collaboration.--In carrying out subsection (a), the Secretary
shall ensure that activities under this section are coordinated among
the Substance Abuse and Mental Health Services Administration, the
relevant institutes at the National Institutes of Health, the Centers
for Disease Control and Prevention, the Health Resources and Services
Administration, and the Administration on Children and Families.
``(c) Requirements.--A State, political subdivision of a State,
Indian tribe, tribal organization, public organization, or private
nonprofit organization desiring a grant, contract, or cooperative
agreement under this section shall demonstrate that the suicide
prevention program such entity proposes will--
``(1) provide for the timely assessment, treatment, or
referral for mental health or substance abuse services of
children and adolescents at risk for suicide;
``(2) be based on best evidence-based, suicide prevention
practices and strategies that are adapted to the local
community;
``(3) integrate its suicide prevention program into the
existing health care system in the community including primary
health care, mental health services, and substance abuse
services;
``(4) be integrated into other systems in the community
that address the needs of children and adolescents including
the educational system, juvenile justice system, welfare and
child protection systems, and community youth support
organizations;
``(5) use primary prevention methods to educate and raise
awareness in the local community by disseminating evidence-
based information about suicide prevention;
``(6) include suicide prevention, mental health, and
related information and services for the families and friends
of those who completed suicide, as needed;
``(7) provide linguistically appropriate and culturally
competent services, as needed;
``(8) provide a plan for the evaluation of outcomes and
activities at the local level, according to standards
established by the Secretary, and agree to participate in a
national evaluation; and
``(9) ensure that staff used in the program are trained in
suicide prevention and that professionals involved in the
system of care have received training in identifying persons at
risk of suicide.
``(d) Use of Funds.--Amounts provided under grants, contracts, or
cooperative agreements under subsection (a) shall be used to supplement
and not supplant other Federal, State, and local public funds that are
expended to provide services for eligible individuals.
``(e) Condition.--An applicant for a grant, contract, or
cooperative agreement under subsection (a) shall demonstrate to the
Secretary that the applicant has the support of the local community and
relevant public health officials.
``(f) Special Populations.--In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary shall ensure
that such awards are made in a manner that will focus on the needs of
communities or groups that experience high or rapidly rising rates of
suicide.
``(g) Application.--A State, political subdivision of a State,
Indian tribe, tribal organization, public organization, or private
nonprofit organization receiving a grant, contract, or cooperative
agreement under subsection (a) shall prepare and submit an application
to the Secretary at such time, in such manner, and containing such
information as the Secretary may reasonably require. Such application
shall include a plan for the rigorous evaluation of activities funded
under the grant, contract, or cooperative agreement, including a
process and outcome evaluation.
``(h) Distribution of Awards.--In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary shall ensure
that such awards are distributed among the geographical regions of the
United States and between urban and rural settings.
``(i) Evaluation.--A State, political subdivision of a State,
Indian tribe, tribal organization, public organization, or private
nonprofit organization receiving a grant, contract, or cooperative
agreement under subsection (a) shall prepare and submit to the
Secretary at the end of the program period, an evaluation of all
activities funded under this section.
``(j) Dissemination and Education.--The Secretary shall ensure that
findings derived from activities carried out under this section are
disseminated to State, county and local governmental agencies and
public and private nonprofit organizations active in promoting suicide
prevention and family support activities.
``(k) Duration of Projects.--With respect to a grant, contract, or
cooperative agreement awarded under this section, the period during
which payments under such award may be made to the recipient may not
exceed 5 years.
``(l) Study.--Within 1 year after the date of enactment of this
section, the Secretary shall, directly or by grant or contract,
initiate a study to assemble and analyze data to identify--
``(1) unique profiles of children under 13 who attempt or
complete suicide;
``(2) unique profiles of youths between ages 13 and 21 who
attempt or complete suicide; and
``(3) a profile of services which might have been available
to these groups and the use of these services by children and
youths from paragraphs (1) and (2).
``(m) Authorization of Appropriation.--
``(1) In general.--For purposes of carrying out this
section, there is authorized to be appropriated $75,000,000 for
fiscal year 2001 and such sums as may be necessary for each of
the fiscal years 2002 through 2003.
``(2) Program management.--In carrying out this section,
the Secretary shall use 1 percent of the amount appropriated
under paragraph (1) for each fiscal year for managing programs
under this section.''.
SEC. 3112. GENERAL PROVISIONS.
(a) Duties of the Center for Substance Abuse Treatment.--Section
507(b) of the Public Health Service Act (42 U.S.C. 290bb(b)) is
amended--
(1) by redesignating paragraphs (2) through (12) as
paragraphs (4) through (14), respectively;
(2) by inserting after paragraph (1), the following:
``(2) ensure that emphasis is placed on children and
adolescents in the development of treatment programs;
``(3) collaborate with the Attorney General to develop
programs to provide substance abuse treatment services to
individuals who have had contact with the Justice system,
especially adolescents;'';
(3) in paragraph (7) (as so redesignated), by striking
``services, and monitor'' and all that follows through ``1925''
and inserting ``services'';
(4) in paragraph (13) (as so redesignated), by striking
``treatment, including'' and all that follows through ``which
shall'' and inserting ``treatment, which shall''; and
(5) in paragraph 14 (as so redesignated), by striking
``paragraph (11)'' and inserting ``paragraph (13)''.
(b) Office for Substance Abuse Prevention.--Section 515(b) of the
Public Health Service Act (42 U.S.C. 290bb-21(b)) is amended--
(1) by redesignating paragraphs (9) and (10) as (10) and
(11);
(2) by inserting after paragraph (8), the following:
``(9) collaborate with the Attorney General of the
Department of Justice to develop programs to prevent drug abuse
among high risk youth;''; and
(3) in paragraph (10) (as so redesignated), by striking
``public concerning'' and inserting ``public, especially
adolescent audiences, concerning''.
(c) Duties of the Center for Mental Health Services.--Section
520(b) of the Public Health Service Act (42 U.S.C. 290bb-3(b)) is
amended--
(1) by redesignating paragraphs (3) through (14) as
paragraphs (4) through (15), respectively;
(2) by inserting after paragraph (2), the following:
``(3) collaborate with the Department of Education and the
Department of Justice to develop programs to assist local
communities in addressing violence among children and
adolescents;'';
(3) in paragraph (8) (as so redesignated), by striking
``programs authorized'' and all that follows through
``Programs'' and inserting ``programs under part C''; and
(4) in paragraph (9) (as so redesignated), by striking
``program and programs'' and all that follows through ``303''
and inserting ``programs''.
TITLE XXXII--PROVISIONS RELATING TO MENTAL HEALTH
SEC. 3201. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
(a) In General.--Section 520A of the Public Health Service Act (42
U.S.C. 290bb-32) is amended to read as follows:
``SEC. 520A. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
``(a) Projects.--The Secretary shall address priority mental health
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
prevention, treatment, and rehabilitation, and the conduct or
support of evaluations of such projects;
``(2) training and technical assistance programs;
``(3) targeted capacity response programs; and
``(4) systems change grants including statewide family
network grants and client-oriented and consumer run self-help
activities.
The Secretary may carry out the activities described in this subsection
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal
organizations, other public or private nonprofit entities.
``(b) Priority Mental Health Needs.--
``(1) Determination of needs.--Priority mental health needs
of regional and national significance shall be determined by
the Secretary in consultation with States and other interested
groups. The Secretary shall meet with the States and interested
groups on an annual basis to discuss program priorities.
``(2) Special consideration.--In developing program
priorities described in paragraph (1), the Secretary shall give
special consideration to promoting the integration of mental
health services into primary health care systems.
``(c) Requirements.--
``(1) In general.--Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined appropriate
by the Secretary.
``(2) Duration of award.--With respect to a grant,
contract, or cooperative agreement awarded under this section,
the period during which payments under such award are made to
the recipient may not exceed 5 years.
``(3) Matching funds.--The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
this section provide non-Federal matching funds, as determined
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public 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
expenditures 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
carried out under subsection (a)(1) and shall disseminate the findings
with respect to each such evaluation to appropriate public and private
entities.
``(e) Information and Education.--
``(1) In general.--The Secretary shall establish
information and education programs to disseminate and apply the
findings of the knowledge development and application,
training, and technical assistance programs, and targeted
capacity response programs, under this section to the general
public, to health care professionals, and to interested groups.
The Secretary shall make every effort to provide linkages
between the findings of supported projects and State agencies
responsible for carrying out mental health services.
``(2) Rural and underserved areas.--In disseminating
information on evidence-based practices in the provision of
children's mental health services under this subsection, the
Secretary shall ensure that such information is distributed to
rural and medically underserved areas.
``(f) Authorization of Appropriation.--
``(1) In general.--There are authorized to be appropriated
to carry out this section, $300,000,000 for fiscal year 2001,
and such sums as may be necessary for each of the fiscal years
2002 and 2003.
``(2) Data infrastructure.--If amounts are not appropriated
for a fiscal year to carry out section 1971 with respect to
mental health, then the Secretary shall make available, from
the amounts appropriated for such fiscal year under paragraph
(1), an amount equal to the sum of $6,000,000 and 10 percent of
all amounts appropriated for such fiscal year under such
paragraph in excess of $100,000,000, to carry out such section
1971.''.
(b) Conforming Amendments.--
(1) Section 303 of the Public Health Service Act (42 U.S.C.
242a) is repealed.
(2) Section 520B of the Public Health Service Act (42
U.S.C. 290bb-33) is repealed.
(3) Section 612 of the Stewart B. McKinney Homeless
Assistance Act (42 U.S.C. 290aa-3 note) is repealed.
SEC. 3202. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
Section 506 of the Public Health Service Act (42 U.S.C. 290aa-5) is
amended to read as follows:
``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
abuse services for homeless individuals. In carrying out this section,
the Secretary shall consult with the Interagency 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 cooperative
agreements under subsection (a), the Secretary shall give a preference
to--
``(1) entities that provide integrated primary health,
substance abuse, and mental health services to homeless
individuals;
``(2) entities that demonstrate effectiveness in serving
runaway, homeless, and street youth;
``(3) entities that have experience in providing substance
abuse 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 illness or substance abuse; and
``(5) entities that demonstrate effectiveness in serving
homeless 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 abuse 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 substance
abuse; or
``(B) has a policy of excluding individuals from
substance abuse services due to the existence or
suspicion of mental illness.
``(d) Term of the Awards.--No entity may receive a grant, contract,
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, $50,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years
2002 and 2003.''.
SEC. 3203. PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS.
(a) Waivers for Territories.--Section 522 of the Public Health
Service Act (42 U.S.C. 290cc-22) is amended by adding at the end the
following:
``(i) Waiver for Territories.--With respect to the United States
Virgin Islands, Guam, American Samoa, Palau, the Marshall Islands, and
the Commonwealth of the Northern Mariana Islands, the Secretary may
waive the provisions of this part that the Secretary determines to be
appropriate.''.
(b) Authorization of Appropriation.--Section 535(a) of the Public
Health Service Act (42 U.S.C. 290cc-35(a)) is amended by striking
``1991 through 1994'' and inserting ``2001 through 2003''.
SEC. 3204. COMMUNITY MENTAL HEALTH SERVICES PERFORMANCE PARTNERSHIP
BLOCK GRANT.
(a) Criteria for Plan.--Section 1912(b) of the Public Health
Service Act (42 U.S.C. 300x-2(b)) is amended by striking paragraphs (1)
through (12) and inserting the following:
``(1) Comprehensive community-based mental health
systems.--The plan provides for an organized community-based
system of care for individuals with mental illness and
describes available services and resources in a comprehensive
system of care, including services for dually diagnosed
individuals. The description of the system of care shall
include health and mental health services, rehabilitation
services, employment services, housing services, educational
services, substance abuse services, medical and dental care,
and other support services to be provided to individuals with
Federal, State and local public and private resources to enable
such individuals to function outside of inpatient or
residential institutions to the maximum extent of their
capabilities, including services to be provided by local school
systems under the Individuals with Disabilities Education Act.
The plan shall include a separate description of case
management services and provide for activities leading to
reduction of hospitalization.
``(2) Mental health system data and epidemiology.--The plan
contains an estimate of the incidence and prevalence in the
State of serious mental illness among adults and serious
emotional disturbance among children and presents quantitative
targets to be achieved in the implementation of the system
described in paragraph (1).
``(3) Children's services.--In the case of children with
serious emotional disturbance, the plan--
``(A) subject to subparagraph (B), provides for a
system of integrated social services, educational
services, juvenile services, and substance abuse
services that, together with health and mental health
services, will be provided in order for such children
to receive care appropriate for their multiple needs
(such system to include services provided under the
Individuals with Disabilities Education Act);
``(B) provides that the grant under section 1911
for the fiscal year involved will not be expended to
provide any service under such system other than
comprehensive community mental health services; and
``(C) provides for the establishment of a defined
geographic area for the provision of the services of
such system.
``(4) Targeted services to rural and homeless
populations.--The plan describes the State's outreach to and
services for individuals who are homeless and how community-
based services will be provided to individuals residing in
rural areas.
``(5) Management systems.--The plan describes the financial
resources, staffing and training for mental health providers
that is necessary to implement the plan, and provides for the
training of providers of emergency health services regarding
mental health. The plan further describes the manner in which
the State intends to expend the grant under section 1911 for
the fiscal year involved.
Except as provided for in paragraph (3), the State plan shall contain
the information required under this subsection with respect to both
adults with serious mental illness and children with serious emotional
disturbance.''.
(b) Review of Planning Council of State's Report.--Section 1915(a)
of the Public Health Service Act (42 U.S.C. 300x-4(a)) is amended--
(1) in paragraph (1), by inserting ``and the report of the
State under section 1942(a) concerning the preceding fiscal
year'' after ``to the grant''; and
(2) in paragraph (2), by inserting before the period ``and
any comments concerning the annual report''.
(c) Maintenance of Effort.--Section 1915(b) of the Public Health
Service Act (42 U.S.C. 300x-4(b)) is amended--
(1) by redesignating paragraphs (2) and (3) as paragraphs
(3) and (4), respectively; and
(2) by inserting after paragraph (1), the following:
``(2) Exclusion of certain funds.--The Secretary may
exclude from the aggregate State expenditures under subsection
(a), funds appropriated to the principle agency for authorized
activities which are of a non-recurring nature and for a
specific purpose.''.
(d) Application for Grants.--Section 1917(a)(1) of the Public
Health Service Act (42 U.S.C. 300x-6(a)(1)) is amended to read as
follows:
``(1) the plan is received by the Secretary not later than
September 1 of the fiscal year prior to the fiscal year for
which a State is seeking funds, and the report from the
previous fiscal year as required under section 1941 is received
by December 1 of the fiscal year of the grant;''.
(e) Waivers for Territories.--Section 1917(b) of the Public Health
Service Act (42 U.S.C. 300x-6(b)) is amended by striking ``whose
allotment under section 1911 for the fiscal year is the amount
specified in section 1918(c)(2)(B)'' and inserting in its place
``except Puerto Rico''.
(f) Authorization of Appropriation.--Section 1920 of the Public
Health Service Act (42 U.S.C. 300x-9) is amended--
(1) in subsection (a), by striking ``$450,000,000'' and all
that follows through the end and inserting ``$450,000,000 for
fiscal year 2001, and such sums as may be necessary for each of
the fiscal years 2002 and 2003.''; and
(2) in subsection (b)(2), by striking ``section 505'' and
inserting ``sections 505 and 1971''.
SEC. 3205. DETERMINATION OF ALLOTMENT.
Section 1918(b) of the Public Health Service Act (42 U.S.C. 300x-
7(b)) is amended to read as follows:
``(b) Minimum Allotments for States.--With respect to fiscal year
2000, and subsequent fiscal years, the amount of the allotment of a
State under section 1911 shall not be less than the amount the State
received under such section for fiscal year 1998.''.
SEC. 3206. PROTECTION AND ADVOCACY FOR MENTALLY ILL INDIVIDUALS ACT OF
1986.
(a) Short Title.--The first section of the Protection and Advocacy
for Mentally Ill Individuals Act of 1986 (Public Law 99-319) is amended
to read as follows:
``SECTION 1. SHORT TITLE.
``This Act may be cited as the `Protection and Advocacy for
Individuals with Mental Illness Act'.''.
(b) Definitions.--Section 102 of the Protection and Advocacy for
Individuals with Mental Illness Act (as amended by subsection (a)) (42
U.S.C. 10802) is amended--
(1) in paragraph (4)--
(A) in the matter preceding subparagraph (A), by
inserting ``, except as provided in section 104(d),''
after ``means'';
(B) in subparagraph (B)--
(i) by striking ``(i)'' who'' and inserting
``(i)(I) who'';
(ii) by redesignating clauses (ii) and
(iii) as subclauses (II) and (III);
(iii) in subclause (III) (as so
redesignated), by striking the period and
inserting ``; or''; and
(iv) by adding at the end the following:
``(ii) who satisfies the requirements of
subparagraph (A) and lives in a community setting,
including their own home.''; and
(2) by adding at the end the following:
``(8) The term `American Indian consortium' means a
consortium established under part C of the Developmental
Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6042
et seq.).''.
(c) Use of Allotments.--Section 104 of the Protection and Advocacy
for Individuals with Mental Illness Act (as amended by subsection (a))
(42 U.S.C. 10804) is amended by adding at the end the following:
``(d) The definition of `individual with a mental illness'
contained in section 102(4)(B)(iii) shall apply, and thus an eligible
system may use its allotment under this title to provide representation
to such individuals, only if the total allotment under this title for
any fiscal year is $30,000,000 or more, and in such case, an eligible
system must give priority to representing persons with mental illness
as defined in subparagraphs (A) and (B)(i) of section 102(4).''.
(d) Minimum Amount.--Paragraph (2) of section 112(a) of the
Protection and Advocacy for Individuals with Mental Illness Act (as
amended by subsection (a)) (42 U.S.C. 10822(a)(2)) 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) of
the appropriate base amount determined under subparagraph (B)
and the factor specified in subparagraph (C).
``(B) For purposes of subparagraph (A), the appropriate
base amount--
``(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, is $139,300;
and
``(ii) for any other State, is $260,000.
``(C) The factor specified in this subparagraph is the
ratio of the amount appropriated under section 117 for the
fiscal year for which the allotment is being made to the amount
appropriated under such section for fiscal year 1995.
``(D) If the total amount appropriated for a fiscal year is
at least $25,000,000, the Secretary shall make an allotment in
accordance with subparagraph (A) to the eligible system serving
the American Indian consortium.''.
(e) Technical Amendments.--Section 112(a) of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended by
subsection (a)) (42 U.S.C. 10822(a)) is amended--
(1) in paragraph (1)(B), by striking ``Trust Territory of
the Pacific Islands'' and inserting ``Marshall Islands, the
Federated States of Micronesia, the Republic of Palau''; and
(2) by striking paragraph (3).
(f) Reauthorization.--Section 117 of the Protection and Advocacy
for Individuals with Mental Illness Act (as amended by subsection (a))
(42 U.S.C. 10827) is amended by striking ``1995'' and inserting
``2003''.
SEC. 3207. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.)
is amended by adding at the end the following:
``PART H--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES
``SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES.
``(a) In General.--A public or private general hospital, nursing
facility, intermediate care facility, or other health care facility,
that receives support in any form from any program supported in whole
or in part with funds appropriated to any Federal department or agency
shall protect and promote the rights of each resident of the facility,
including the right to be free from physical or mental abuse, corporal
punishment, and any restraints or involuntary seclusions imposed for
purposes of discipline or convenience.
``(b) Requirements.--Restraints and seclusion may only be imposed
on a resident of a facility described in subsection (a) if--
``(1) the restraints or seclusion are imposed to ensure the
physical safety of the resident, a staff member, or others; and
``(2) the restraints or seclusion are imposed only upon the
written order of a physician, or other licensed practitioner
permitted by the State and the facility to order such restraint
or seclusion, that specifies the duration and circumstances
under which the restraints are to be used (except in emergency
circumstances specified by the Secretary until such an order
could reasonably be obtained).
``(c) Current Law.--This part shall not be construed to affect or
impede any Federal or State law or regulations that provide greater
protections than this part regarding seclusion and restraint.
``(d) Definitions.--In this section:
``(1) Restraints.--The term `restraints' means--
``(A) any physical restraint that is a mechanical
or personal restriction that immobilizes or reduces the
ability of an individual to move his or her arms, legs,
or head freely, not including devices, such as
orthopedically prescribed devices, surgical dressings
or bandages, protective helmets, or any other methods
that involves the physical holding of a resident for
the purpose of conducting routine physical examinations
or tests or to protect the resident from falling out of
bed or to permit the resident to participate in
activities without the risk of physical harm to the
resident (such term does not include a physical
escort); and
``(B) a drug or medication that is used as a
restraint to control behavior or restrict the
resident's freedom of movement that is not a standard
treatment for the resident's medical or psychiatric
condition.
``(2) Seclusion.--The term `seclusion' means a behavior
control technique involving locked isolation. Such term does
not include a time out.
``(3) Physical escort.--The term `physical escort' means
the temporary touching or holding of the hand, wrist, arm,
shoulder or back for the purpose of inducing a resident who is
acting out to walk to a safe location.
``(4) Time out.--The term `time out' means a behavior
management technique that is part of an approved treatment
program and may involve the separation of the resident from the
group, in a non-locked setting, for the purpose of calming.
Time out is not seclusion.
``SEC. 592. REPORTING REQUIREMENT.
``(a) In General.-- Each facility to which the Protection and
Advocacy for Mentally Ill Individuals Act of 1986 applies shall notify
the appropriate agency, as determined by the Secretary, of each death
that occurs at each such facility while a patient is restrained or in
seclusion, of each death occurring within 24 hours after the patient
has been removed from restraints and seclusion, or where it is
reasonable to assume that a patient's death is a result of such
seclusion or restraint. A notification under this section shall include
the name of the resident and shall be provided not later than 7 days
after the date of the death of the individual involved.
``(b) Facility.--In this section, the term `facility' has the
meaning given the term `facilities' in section 102(3) of the Protection
and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C.
10802(3)).''.
``SEC. 593. REGULATIONS AND ENFORCEMENT.
``(a) Training.--Not later than 1 year after the date of enactment
of this part, the Secretary, after consultation with appropriate State
and local protection and advocacy organizations, physicians,
facilities, and other health care professionals and patients, shall
promulgate regulations that require facilities to which the Protection
and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. 10801
et seq.) applies, to meet the requirements of subsection (b).
``(b) Requirements.--The regulations promulgated under subsection
(a) shall require that--
``(1) facilities described in subsection (a) ensure that
there is an adequate number of qualified professional and
supportive staff to evaluate patients, formulate written
individualized, comprehensive treatment plans, and to provide
active treatment measures;
``(2) appropriate training be provided for the staff of
such facilities in the use of restraints and any alternatives
to the use of restraints; and
``(3) such facilities provide complete and accurate
notification of deaths, as required under section 592(a).
``(c) Enforcement.--A facility to which this part applies that
fails to comply with any requirement of this part, including a failure
to provide appropriate training, shall not be eligible for
participation in any program supported in whole or in part by funds
appropriated to any Federal department or agency.''.
SEC. 3208. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND
YOUTH.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.),
as amended by section 3207, is further amended by adding at the end the
following:
``PART I--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH
``SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND
YOUTH.
``(a) Protection of Rights.--
``(1) In general.--A public or private non-medical,
community-based facility for children and youth (as defined in
regulations to be promulgated by the Secretary) that receives
support in any form from any program supported in whole or in
part with funds appropriated under this Act shall protect and
promote the rights of each resident of the facility, including
the right to be free from physical or mental abuse, corporal
punishment, and any restraints or involuntary seclusions
imposed for purposes of discipline or convenience.
``(2) Nonapplicability.--Notwithstanding this part, a
facility that provides inpatient psychiatric treatment services
for individuals under the age of 21, as authorized and defined
in subsections (a)(16) and (h) of section 1905 of the Social
Security Act, shall comply with the requirements of part H.
``(3) Applicability of medicaid provisions.--A non-medical,
community-based facility for children and youth funded under
the medicaid program under title XIX of the Social Security Act
shall continue to meet all existing requirements for
participation in such program that are not affected by this
part.
``(b) Requirements.--
``(1) In general.--Physical restraints and seclusion may
only be imposed on a resident of a facility described in
subsection (a) if--
``(A) the restraints or seclusion are imposed only
in emergency circumstances and only to ensure the
immediate physical safety of the resident, a staff
member, or others and less restrictive interventions
have been determined to be ineffective; and
``(B) the restraints or seclusion are imposed only
by an individual trained and certified, by a State-
recognized body (as defined in regulation promulgated
by the Secretary) and pursuant to a process determined
appropriate by the State and approved by the Secretary,
in the prevention and use of physical restraint and
seclusion, including the needs and behaviors of the
population served, relationship building, alternatives
to restraint and seclusion, de-escalation methods,
avoiding power struggles, thresholds for restraints and
seclusion, the physiological and psychological impact
of restraint and seclusion, monitoring physical signs
of distress and obtaining medical assistance, legal
issues, position asphyxia, escape and evasion
techniques, time limits, the process for obtaining
approval for continued restraints, procedures to
address problematic restraints, documentation,
processing with children, and follow-up with staff, and
investigation of injuries and complaints.
``(2) Interim procedures relating to training and
certification.--
``(A) In general.--Until such time as the State
develops a process to assure the proper training and
certification of facility personnel in the skills and
competencies referred in paragraph (1)(B), the facility
involved shall develop and implement an interim
procedure that meets the requirements of subparagraph
(B).
``(B) Requirements.--A procedure developed under
subparagraph (A) shall--
``(i) ensure that a supervisory or senior
staff person with training in restraint and
seclusion who is competent to conduct a face-
to-face assessment (as defined in regulations
promulgated by the Secretary), will assess the
mental and physical well-being of the child or
youth being restrained or secluded and assure
that the restraint or seclusion is being done
in a safe manner;
``(ii) ensure that the assessment required
under clause (i) take place as soon as
practicable, but in no case later than 1 hour
after the initiation of the restraint or
seclusion; and
``(iii) ensure that the supervisory or
senior staff person continues to monitor the
situation for the duration of the restraint and
seclusion.
``(3) Limitations.--
``(A) In general.--The use of a drug or medication
that is used as a restraint to control behavior or
restrict the resident's freedom of movement that is not
a standard treatment for the resident's medical or
psychiatric condition in nonmedical community-based
facilities for children and youth described in
subsection (a)(1) is prohibited.
``(B) Prohibition.--The use of mechanical
restraints in non-medical, community-based facilities
for children and youth described in subsection (a)(1)
is prohibited.
``(C) Limitation.--A non-medical, community-based
facility for children and youth described in subsection
(a)(1) may only use seclusion when a staff member is
continuously face-to-face monitoring the resident and
when strong licensing or accreditation and internal
controls are in place.
``(c) Rule of Construction.--
``(1) In general.--Nothing in this section shall be
construed as prohibiting the use of restraints for medical
immobilization, adaptive support, or medical protection.
``(2) Current law.--This part shall not be construed to
affect or impede any Federal or State law or regulations that
provide greater protections than this part regarding seclusion
and restraint.
``(d) Definitions.--In this section:
``(1) Mechanical restraint.--The term `mechanical
restraint' means the use of devices as a means of restricting a
resident's freedom of movement.
``(2) Physical escort.--The term `physical escort' means
the temporary touching or holding of the hand, wrist, arm,
shoulder or back for the purpose of inducing a resident who is
acting out to walk to a safe location.
``(3) Physical restraint.--The term `physical restraint'
means a personal restriction that immobilizes or reduces the
ability of an individual to move his or her arms, legs, or head
freely. Such term does not include a physical escort.
``(4) Seclusion.--The term `seclusion' means a behavior
control technique involving locked isolation. Such term does
not include a time out.
``(5) Time out.--The term `time out' means a behavior
management technique that is part of an approved treatment
program and may involve the separation of the resident from the
group, in a non-locked setting, for the purpose of calming.
Time out is not seclusion.
``SEC. 595A. REPORTING REQUIREMENT.
``Each facility to which this part applies shall notify the
appropriate State licensing or regulatory agency, as determined by the
Secretary--
``(1) of each death that occurs at each such facility. A
notification under this section shall include the name of the
resident and shall be provided not later than 24 hours after
the time of the individuals death; and
``(2) of the use of seclusion or restraints in accordance
with regulations promulgated by the Secretary, in consultation
with the States.
``SEC. 595B. REGULATIONS AND ENFORCEMENT.
``(a) Training.--Not later than 6 months after the date of
enactment of this part, the Secretary, after consultation with
appropriate State, local, public and private protection and advocacy
organizations, health care professionals, social workers, facilities,
and patients, shall promulgate regulations that--
``(1) require States that license non-medical, community-
based residential facilities for children and youth to develop
licensing rules and monitoring requirements concerning behavior
management practice that will ensure compliance with Federal
regulations and to meet the requirements of subsection (b);
``(2) require States to develop and implement such
licensing rules and monitoring requirements within 1 year after
the promulgation of the regulations referred to in the matter
preceding paragraph (1); and
``(3) support the development of national guidelines and
standards on the quality, quantity, orientation and training,
required under this part, as well as the certification or
licensure of those staff responsible for the implementation of
behavioral intervention concepts and techniques.
``(b) Requirements.--The regulations promulgated under subsection
(a) shall require--
``(1) that facilities described in subsection (a) ensure
that there is an adequate number of qualified professional and
supportive staff to evaluate residents, formulate written
individualized, comprehensive treatment plans, and to provide
active treatment measures;
``(2) the provision of appropriate training and
certification of the staff of such facilities in the prevention
and use of physical restraint and seclusion, including the
needs and behaviors of the population served, relationship
building, alternatives to restraint, de-escalation methods,
avoiding power struggles, thresholds for restraints, the
physiological impact of restraint and seclusion, monitoring
physical signs of distress and obtaining medical assistance,
legal issues, position asphyxia, escape and evasion techniques,
time limits for the use of restraint and seclusion, the process
for obtaining approval for continued restraints and seclusion,
procedures to address problematic restraints, documentation,
processing with children, and follow-up with staff, and
investigation of injuries and complaints; and
``(3) that such facilities provide complete and accurate
notification of deaths, as required under section 595A(1).
``(c) Enforcement.--A State to which this part applies that fails
to comply with any requirement of this part, including a failure to
provide appropriate training and certification, shall not be eligible
for participation in any program supported in whole or in part by funds
appropriated under this Act.''.
SEC. 3209. EMERGENCY MENTAL HEALTH CENTERS.
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 3111, is further
amended by adding at the end the following:
``SEC. 520F. GRANTS FOR EMERGENCY MENTAL HEALTH CENTERS.
``(a) Program Authorized.--The Secretary shall award grants to
States, political subdivisions of States, Indian tribes, and tribal
organizations to support the designation of hospitals and health
centers as Emergency Mental Health Centers.
``(b) Health Center.--In this section, the term `health center' has
the meaning given such term in section 330, and includes community
health centers and community mental health centers.
``(c) Distribution of Awards.--The Secretary shall ensure that such
grants awarded under subsection (a) are equitably distributed among the
geographical regions of the United States, between urban and rural
populations, and between different settings of care including health
centers, mental health centers, hospitals, and other psychiatric units
or facilities.
``(d) Application.--A State, political subdivision of a State,
Indian tribe, or tribal organization that desires a grant under
subsection (a) shall submit an application to the Secretary at such
time, in such manner, and containing such information as the Secretary
may require, including a plan for the rigorous evaluation of activities
carried out with funds received under this section.
``(e) Use of Funds.--
``(1) In general.--A State, political subdivision of a
State, Indian tribe, or tribal organization receiving a grant
under subsection (a) shall use funds from such grant to
establish or designate hospitals and health centers as
Emergency Mental Health Centers.
``(2) Emergency mental health centers.--Such Emergency
Mental Health Centers described in paragraph (1)--
``(A) shall--
``(i) serve as a central receiving point in
the community for individuals who may be in
need of emergency mental health services;
``(ii) purchase, if needed, any equipment
necessary to evaluate, diagnose and stabilize
an individual with a mental illness;
``(iii) provide training, if needed, to the
medical personnel staffing the Emergency Mental
Health Center to evaluate, diagnose, stabilize,
and treat an individual with a mental illness;
and
``(iv) provide any treatment that is
necessary for an individual with a mental
illness or a referral for such individual to
another facility where such treatment may be
received; and
``(B) may establish and train a mobile crisis
intervention team to respond to mental health
emergencies within the community.
``(f) Evaluation.--A State, political subdivision of a State,
Indian tribe, or tribal organization that receives a grant under
subsection (a) shall prepare and submit an evaluation to the Secretary
at such time, in such manner, and containing such information as the
Secretary may reasonably require, including an evaluation of activities
carried out with funds received under this section and a process and
outcomes evaluation.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $25,000,000 for fiscal year
2001 and such sums as may be necessary for each of the fiscal years
2002 through 2003.''.
SEC. 3210. GRANTS FOR JAIL DIVERSION PROGRAMS.
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 3209, is further
amended by adding at the end the following:
``SEC. 520G. GRANTS FOR JAIL DIVERSION PROGRAMS.
``(a) Program Authorized.--The Secretary shall make up to 125
grants to States, political subdivisions of States, Indian tribes, and
tribal organizations, acting directly or through agreements with other
public or nonprofit entities, to develop and implement programs to
divert individuals with a mental illness from the criminal justice
system to community-based services.
``(b) Administration.--
``(1) Consultation.--The Secretary shall consult with the
Attorney General and any other appropriate officials in
carrying out this section.
``(2) Regulatory authority.--The Secretary shall issue
regulations and guidelines necessary to carry out this section,
including methodologies and outcome measures for evaluating
programs carried out by States, political subdivisions of
States, Indian tribes, and tribal organizations receiving
grants under subsection (a).
``(c) Applications.--
``(1) In general.--To receive a grant under subsection (a),
the chief executive of a State, chief executive of a
subdivision of a State, Indian tribe or tribal organization
shall prepare and submit an application to the Secretary at
such time, in such manner, and containing such information as
the Secretary shall reasonably require.
``(2) Content.--Such application shall--
``(A) contain an assurance that--
``(i) community-based mental health
services will be available for the individuals
who are diverted from the criminal justice
system, and that such services are based on the
best known practices, reflect current research
findings, include case management, assertive
community treatment, medication management and
access, integrated mental health and co-
occurring substance abuse treatment, and
psychiatric rehabilitation, and will be
coordinated with social services, including
life skills training, housing placement,
vocational training, education job placement,
and health care;
``(ii) there has been relevant interagency
collaboration between the appropriate criminal
justice, mental health, and substance abuse
systems; and
``(iii) the Federal support provided will
be used to supplement, and not supplant, State,
local, Indian tribe, or tribal organization
sources of funding that would otherwise be
available;
``(B) demonstrate that the diversion program will
be integrated with an existing system of care for those
with mental illness;
``(C) explain the applicant's inability to fund the
program adequately without Federal assistance;
``(D) specify plans for obtaining necessary support
and continuing the proposed program following the
conclusion of Federal support; and
``(E) describe methodology and outcome measures
that will be used in evaluating the program.
``(d) Use of Funds.--A State, political subdivision of a State,
Indian tribe, or tribal organization that receives a grant under
subsection (a) may use funds received under such grant to--
``(1) integrate the diversion program into the existing
system of care;
``(2) create or expand community-based mental health and
co-occurring mental illness and substance abuse services to
accommodate the diversion program;
``(3) train professionals involved in the system of care,
and law enforcement officers, attorneys, and judges; and
``(4) provide community outreach and crisis intervention.
``(e) Federal Share.--
``(1) In general.--The Secretary shall pay to a State,
political subdivision of a State, Indian tribe, or tribal
organization receiving a grant under subsection (a) the Federal
share of the cost of activities described in the application.
``(2) Federal share.--The Federal share of a grant made
under this section shall not exceed 75 percent of the total
cost of the program carried out by the State, political
subdivision of a State, Indian tribe, or tribal organization.
Such share shall be used for new expenses of the program
carried out by such State, political subdivision of a State,
Indian tribe, or tribal organization.
``(3) Non-federal share.--The non-Federal share of payments
made under this section may be made in cash or in kind fairly
evaluated, including planned equipment or services. The
Secretary may waive the requirement of matching contributions.
``(f) Geographic Distribution.--The Secretary shall ensure that
such grants awarded under subsection (a) are equitably distributed
among the geographical regions of the United States and between urban
and rural populations.
``(g) Training and Technical Assistance.--Training and technical
assistance may be provided by the Secretary to assist a State,
political subdivision of a State, Indian tribe, or tribal organization
receiving a grant under subsection (a) in establishing and operating a
diversion program.
``(h) Evaluations.--The programs described in subsection (a) shall
be evaluated not less than 1 time in every 12-month period using the
methodology and outcome measures identified in the grant application.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for fiscal year
2001, and such sums as may be necessary for fiscal years 2002 through
2003.''.
SEC. 3211. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS THROUGH
SERVICES INTEGRATION BETWEEN CHILD WELFARE AND 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.), as amended by section 3210, is further
amended by adding at the end the following:
``SEC. 520H. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS THROUGH
SERVICES INTEGRATION BETWEEN CHILD WELFARE AND MENTAL
HEALTH SERVICES.
``(a) In General.--The Secretary shall award grants, contracts or
cooperative agreements to States, political subdivisions of States,
Indian tribes, and tribal organizations to provide integrated child
welfare and mental health services for children and adolescents under
19 years of age in the child welfare system or at risk for becoming
part of the system, and parents or caregivers with a mental illness or
a mental illness and a co-occurring substance abuse disorder.
``(b) Duration.--With respect to a grant, contract or cooperative
agreement awarded under this section, the period during which payments
under such award are made to the recipient may not exceed 5 years.
``(c) Application.--
``(1) In general.--To be eligible to receive an award under
subsection (a), a State, political subdivision of a State,
Indian tribe, or tribal organization shall submit an
application to the Secretary at such time, in such manner, and
accompanied by such information as the Secretary may reasonably
require.
``(2) Content.--An application submitted under paragraph
(1) shall--
``(A) describe the program to be funded under the
grant, contract or cooperative agreement;
``(B) explain how such program reflects best
practices in the provision of child welfare and mental
health services; and
``(C) provide assurances that--
``(i) persons providing services under the
grant, contract or cooperative agreement are
adequately trained to provide such services;
and
``(ii) the services will be provided in
accordance with subsection (d).
``(d) Use of Funds.--A State, political subdivision of a State,
Indian tribe, or tribal organization that receives a grant, contract,
or cooperative agreement under subsection (a) shall use amounts made
available through such grant, contract or cooperative agreement to--
``(1) provide family-centered, comprehensive, and
coordinated child welfare and mental health services, including
prevention, early intervention and treatment services for
children and adolescents, and for their parents or caregivers;
``(2) ensure a single point of access for such coordinated
services;
``(3) provide integrated mental health and substance abuse
treatment for children, adolescents, and parents or caregivers
with a mental illness and a co-occurring substance abuse
disorder;
``(4) provide training for the child welfare, mental health
and substance abuse professionals who will participate in the
program carried out under this section;
``(5) provide technical assistance to child welfare and
mental health agencies;
``(6) develop cooperative efforts with other service
entities in the community, including education, social
services, juvenile justice, and primary health care agencies;
``(7) coordinate services with services provided under the
medicaid program and the State Children's Health Insurance
Program under titles XIX and XXI of the Social Security Act;
``(8) provide linguistically appropriate and culturally
competent services; and
``(9) evaluate the effectiveness and cost-efficiency of the
integrated services that measure the level of coordination,
outcome measures for parents or caregivers with a mental
illness or a mental illness and a co-occurring substance abuse
disorder, and outcome measures for children.
``(e) Distribution of Awards.--The Secretary shall ensure that
grants, contracts, and cooperative agreements awarded under subsection
(a) are equitably distributed among the geographical regions of the
United States and between urban and rural populations.
``(f) Evaluation.--The Secretary shall evaluate each program
carried out by a State, political subdivision of a State, Indian tribe,
or tribal organization under subsection (a) and shall disseminate the
findings with respect to each such evaluation to appropriate public and
private entities.
``(g) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $10,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002
and 2003.''.
SEC. 3212. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS MENTAL
ILLNESS AND CO-OCCURRING SUBSTANCE ABUSE.
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 3211, is further
amended by adding at the end the following:
``SEC. 520I. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS MENTAL
ILLNESS AND CO-OCCURRING SUBSTANCE ABUSE.
``(a) In General.--The Secretary shall award grants, contracts, or
cooperative agreements to States, political subdivisions of States,
Indian tribes, tribal organizations, and private nonprofit
organizations for the development or expansion of programs to provide
integrated treatment services for individuals with a serious mental
illness and a co-occurring substance abuse disorder.
``(b) Priority.--In awarding grants, contracts, and cooperative
agreements under subsection (a), the Secretary shall give priority to
applicants that emphasize the provision of services for individuals
with a serious mental illness and a co-occurring substance abuse
disorder who--
``(1) have a history of interactions with law enforcement
or the criminal justice system;
``(2) have recently been released from incarceration;
``(3) have a history of unsuccessful treatment in either an
inpatient or outpatient setting;
``(4) have never followed through with outpatient services
despite repeated referrals; or
``(5) are homeless.
``(c) Use of Funds.--A State, political subdivision of a State,
Indian tribe, tribal organization, or private nonprofit organization
that receives a grant, contract, or cooperative agreement under
subsection (a) shall use funds received under such grant--
``(1) to provide fully integrated services rather than
serial or parallel services;
``(2) to employ staff that are cross-trained in the
diagnosis and treatment of both serious mental illness and
substance abuse;
``(3) to provide integrated mental health and substance
abuse services at the same location;
``(4) to provide services that are linguistically
appropriate and culturally competent;
``(5) to provide at least 10 programs for integrated
treatment of both mental illness and substance abuse at sites
that previously provided only mental health services or only
substance abuse services; and
``(6) to provide services in coordination with other
existing public and private community programs.
``(d) Condition.--The Secretary shall ensure that a State,
political subdivision of a State, Indian tribe, tribal organization, or
private nonprofit organization that receives a grant, contract, or
cooperative agreement under subsection (a) maintains the level of
effort necessary to sustain existing mental health and substance abuse
programs for other populations served by mental health systems in the
community.
``(e) Distribution of Awards.--The Secretary shall ensure that
grants, contracts, or cooperative agreements awarded under subsection
(a) are equitably distributed among the geographical regions of the
United States and between urban and rural populations.
``(f) Duration.--The Secretary shall award grants, contract, or
cooperative agreements under this subsection for a period of not more
than 5 years.
``(g) Application.--A State, political subdivision of a State,
Indian tribe, tribal organization, or private nonprofit organization
that desires a grant, contract, or cooperative agreement under this
subsection shall prepare and submit an application to the Secretary at
such time, in such manner, and containing such information as the
Secretary may require. Such application shall include a plan for the
rigorous evaluation of activities funded with an award under such
subsection, including a process and outcomes evaluation.
``(h) Evaluation.--A State, political subdivision of a State,
Indian tribe, tribal organization, or private nonprofit organization
that receives a grant, contract, or cooperative agreement under this
subsection shall prepare and submit a plan for the rigorous evaluation
of the program funded under such grant, contract, or agreement,
including both process and outcomes evaluation, and the submission of
an evaluation at the end of the project period.
``(i) Authorization of Appropriation.--There is authorized to be
appropriated to carry out this subsection $40,000,000 for fiscal year
2001, and such sums as may be necessary for fiscal years 2002 through
2003.''.
SEC. 3213. TRAINING GRANTS.
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 3212, is further
amended by adding at the end the following:
``SEC. 520J. TRAINING GRANTS.
``(a) In General.--The Secretary shall award grants in accordance
with the provisions of this section.
``(b) Mental Illness Awareness Training Grants.--
``(1) In general.--The Secretary shall award grants to
States, political subdivisions of States, Indian tribes, tribal
organizations, and nonprofit private entities to train teachers
and other relevant school personnel to recognize symptoms of
childhood and adolescent mental disorders, to refer family
members to the appropriate mental health services if necessary,
to train emergency services personnel to identify and
appropriately respond to persons with a mental illness, and to
provide education to such teachers and personnel regarding
resources that are available in the community for individuals
with a mental illness.
``(2) Emergency Services Personnel.--In this subsection,
the term `emergency services personnel' includes paramedics,
firefighters, and emergency medical technicians.
``(3) Distribution of Awards.--The Secretary shall ensure
that such grants awarded under this subsection are equitably
distributed among the geographical regions of the United States
and between urban and rural populations.
``(4) Application.--A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit private
entity that desires a grant under this subsection shall submit
an application to the Secretary at such time, in such manner,
and containing such information as the Secretary may require,
including a plan for the rigorous evaluation of activities that
are carried out with funds received under a grant under this
subsection.
``(5) Use of Funds.--A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit private
entity receiving a grant under this subsection shall use funds
from such grant to--
``(A) train teachers and other relevant school
personnel to recognize symptoms of childhood and
adolescent mental disorders and appropriately respond;
``(B) train emergency services personnel to
identify and appropriately respond to persons with a
mental illness; and
``(C) provide education to such teachers and
personnel regarding resources that are available in the
community for individuals with a mental illness.
``(6) Evaluation.--A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit private
entity that receives a grant under this subsection shall
prepare and submit an evaluation to the Secretary at such time,
in such manner, and containing such information as the
Secretary may reasonably require, including an evaluation of
activities carried out with funds received under the grant
under this subsection and a process and outcome evaluation.
``(7) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this subsection, $25,000,000
for fiscal year 2001 and such sums as may be necessary for each
of fiscal years 2002 through 2003.''.
TITLE XXXIII--PROVISIONS RELATING TO SUBSTANCE ABUSE
SEC. 3301. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
(a) Residential Treatment Programs for Pregnant and Postpartum
Women.--Section 508(r) of the Public Health Service Act (42 U.S.C.
290bb-1(r)) is amended to read as follows:
``(r) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary to fiscal years 2001 through 2003.''.
(b) Priority Substance Abuse Treatment.--Section 509 of the Public
Health Service Act (42 U.S.C. 290bb-1) is amended to read as follows:
``SEC. 509. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
``(a) Projects.--The Secretary shall address priority substance
abuse 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
treatment and rehabilitation and the conduct or support of
evaluations of such projects;
``(2) training and technical assistance; and
``(3) targeted capacity response programs.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal
organizations, other public or nonprofit private entities.
``(b) Priority Substance Abuse Treatment Needs.--
``(1) In general.--Priority substance abuse treatment needs
of regional and national significance shall be determined by
the Secretary after consultation with States and other
interested groups. The Secretary shall meet with the States and
interested groups on an annual basis to discuss program
priorities.
``(2) Special consideration.--In developing program
priorities under paragraph (1), the Secretary shall give
special consideration to promoting the integration of substance
abuse treatment services into primary health care systems.
``(c) Requirements.--
``(1) In general.--Recipients of grants, contracts, or
cooperative agreements under this section shall comply with
information and application requirements determined appropriate
by the Secretary.
``(2) Duration of award.--With respect to a grant,
contract, or cooperative agreement awarded under this section,
the period during which payments under such award are made to
the recipient may not exceed 5 years.
``(3) Matching funds.--The Secretary may, for projects
carried 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
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public 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 expenditures 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
carried out under subsection (a)(1) and shall disseminate the findings
with respect to each such evaluation to appropriate public and private
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 application,
training and technical assistance programs, and targeted capacity
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
abuse prevention and treatment programs.
``(f) Authorization of Appropriation.--There are authorized to be
appropriated to carry out this section, $300,000,000 for fiscal year
2001 and such sums as may be necessary for each of the fiscal years
2002 and 2003.''.
(c) Conforming Amendments.--The following sections of the Public
Health Service Act are repealed:
(1) Section 510 (42 U.S.C. 290bb-3).
(2) Section 511 (42 U.S.C. 290bb-4).
(3) Section 512 (42 U.S.C. 290bb-5).
(4) Section 571 (42 U.S.C. 290gg).
SEC. 3302. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
(a) In General.--Section 516 of the Public Health Service Act (42
U.S.C. 290bb-1) is amended to read as follows:
``SEC. 516. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
``(a) Projects.--The Secretary shall address priority substance
abuse prevention 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
prevention and the conduct or support of evaluations of such
projects;
``(2) training and technical assistance; and
``(3) targeted capacity response programs.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal
organizations, or other public or nonprofit private entities.
``(b) Priority Substance Abuse Prevention Needs.--
``(1) In general.--Priority substance abuse prevention
needs of regional and national significance shall be determined
by the Secretary in consultation with the States and other
interested groups. The Secretary shall meet with the States and
interested groups on an annual basis to discuss program
priorities.
``(2) Special consideration.--In developing program
priorities under paragraph (1), the Secretary shall give
special consideration to--
``(A) applying the most promising strategies and
research-based primary prevention approaches; and
``(B) promoting the integration of substance abuse
prevention information and activities into primary
health care systems.
``(c) Requirements.--
``(1) In general.--Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined appropriate
by the Secretary.
``(2) Duration of award.--With respect to a grant,
contract, or cooperative agreement awarded under this section,
the period during which payments under such award are made to
the recipient may not exceed 5 years.
``(3) Matching funds.--The Secretary may, for projects
carried 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
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public 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 expenditures 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
carried out under subsection (a)(1) and shall disseminate the findings
with respect to each such evaluation to appropriate public and private
entities.
``(e) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application, training and
technical assistance programs, and targeted capacity response programs
under this section to the general public and to health professionals.
The Secretary shall make every effort to provide linkages between the
findings of supported projects and State agencies responsible for
carrying out substance abuse prevention and treatment programs.
``(f) Authorization of Appropriation.--There are authorized to be
appropriated to carry out this section, $300,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years
2002 and 2003.''.
(b) Conforming Amendments.--Section 518 of the Public Health
Service Act (42 U.S.C. 290bb-24) is repealed.
SEC. 3303. SUBSTANCE ABUSE PREVENTION AND TREATMENT PERFORMANCE
PARTNERSHIP BLOCK GRANT.
(a) Allocation Regarding Alcohol and Other Drugs.--Section 1922 of
the Public Health Service Act (42 U.S.C. 300x-22) is amended by--
(1) striking subsection (a); and
(2) redesignating subsections (b) and (c) as subsections
(a) and (b).
(b) Group Homes for Recovering Substance Abusers.--Section 1925(a)
of the Public Health Service Act (42 U.S.C. 300x-25(a)) is amended by
striking ``For fiscal year 1993'' and all that follows through the
colon and inserting the following: ``A State, using funds available
under section 1921, may establish and maintain the ongoing operation of
a revolving fund in accordance with this section to support group homes
for recovering substance abusers as follows:''.
(c) Maintenance of Effort.--Section 1930 of the Public Health
Service Act (42 U.S.C. 300x-30) is amended--
(1) by redesignating subsections (b) and (c) as subsections
(c) and (d) respectively; and
(2) by inserting after subsection (a), the following:
``(b) Exclusion of Certain Funds.--The Secretary may exclude from
the aggregate State expenditures under subsection (a), funds
appropriated to the principle agency for authorized activities which
are of a non-recurring nature and for a specific purpose.''.
(d) Applications for Grants.--Section 1932(a)(1) of the Public
Health Service Act (42 U.S.C. 300x-32(a)(1)) is amended to read as
follows:
``(1) the application is received by the Secretary not
later than October 1 of the fiscal year for which the State is
seeking funds;''.
(e) Waiver for Territories.--Section 1932(c) of the Public Health
Service Act (42 U.S.C. 300x-32(c)) is amended by striking ``whose
allotment under section 1921 for the fiscal year is the amount
specified in section 1933(c)(2)(B)'' and inserting ``except Puerto
Rico''.
(f) Waiver Authority for Certain Requirements.--
(1) In general.--Section 1932 of the Public Health Service
Act (42 U.S.C. 300x-32) is amended by adding at the end the
following:
``(e) Waiver Authority for Certain Requirements.--
``(1) In general.--Upon the request of a State, the
Secretary may waive the requirements of all or part of the
sections described in paragraph (2) using objective criteria
established by the Secretary by regulation after consultation
with the States and other interested parties including
consumers and providers.
``(2) Sections.--The sections described in paragraph (1)
are sections 1922(c), 1923, 1924 and 1928.
``(3) Date certain for acting upon request.--The Secretary
shall approve or deny a request for a waiver under paragraph
(1) and inform the State of that decision not later than 120
days after the date on which the request and all the
information needed to support the request are submitted.
``(4) Annual reporting requirement.--The Secretary shall
annually report to the general public on the States that
receive a waiver under this subsection.''.
(2) Conforming amendments.--Effective upon the publication
of the regulations developed in accordance with section
1932(e)(1) of the Public Health Service Act (42 U.S.C. 300x-
32(d))--
(A) section 1922(c) of the Public Health Service
Act (42 U.S.C. 300x-22(c)) is amended by--
(i) striking paragraph (2); and
(ii) redesignating paragraph (3) as
paragraph (2); and
(B) section 1928(d) of the Public Health Service
Act (42 U.S.C. 300x-28(d)) is repealed.
(g) Authorization of Appropriation.--Section 1935 of the Public
Health Service Act (42 U.S.C. 300x-35) is amended--
(1) in subsection (a), by striking ``$1,500,000,000'' and
all that follows through the end and inserting ``$2,000,000,000
for fiscal year 2001, and such sums as may be necessary for
each of the fiscal years 2002 and 2003.'';
(2) in subsection (b)(1), by striking ``section 505'' and
inserting ``sections 505 and 1971'';
(3) in subsection (b)(2), by striking ``1949(a)'' and
inserting ``1948(a)''; and
(4) in subsection (b), by adding at the end the following:
``(3) Core data set.--A State that receives a new grant,
contract, or cooperative agreement from amounts available to
the Secretary under paragraph (1), for the purposes of
improving the data collection, analysis and reporting
capabilities of the State, shall be required, as a condition of
receipt of funds, to collect, analyze, and report to the
Secretary for each fiscal year subsequent to receiving such
funds a core data set to be determined by the Secretary in
conjunction with the States.''.
SEC. 3304. DETERMINATION OF ALLOTMENTS.
Section 1933(b) of the Public Health Service Act (42 U.S.C. 300x-
33(b)) is amended to read as follows:
``(b) Minimum Allotments for States.--
``(1) In general.--With respect to fiscal year 2000, and
each subsequent fiscal year, the amount of the allotment of a
State under section 1921 shall not be less than the amount the
State received under such section for the previous fiscal year
increased by an amount equal to 30.65 percent of the percentage
by which the aggregate amount allotted to all States for such
fiscal year exceeds the aggregate amount allotted to all States
for the previous fiscal year.
``(2) Limitations.--
``(A) In general.--Except as provided in
subparagraph (B), a State shall not receive an
allotment under section 1921 for a fiscal year in an
amount that is less than an amount equal to 0.375
percent of the amount appropriated under section
1935(a) for such fiscal year.
``(B) Exception.--In applying subparagraph (A), the
Secretary shall ensure that no State receives an
increase in its allotment under section 1921 for a
fiscal year (as compared to the amount allotted to the
State in the prior fiscal year) that is in excess of an
amount equal to 300 percent of the percentage by which
the amount appropriated under section 1935(a) for such
fiscal year exceeds the amount appropriated for the
prior fiscal year.
``(3) Decrease in or equal appropriations.--If the amount
appropriated under section 1935(a) for a fiscal year is equal
to or less than the amount appropriated under such section for
the prior fiscal year, the amount of the State allotment under
section 1921 shall be equal to the amount that the State
received under section 1921 in the prior fiscal year decreased
by the percentage by which the amount appropriated for such
fiscal year is less than the amount appropriated or such
section for the prior fiscal year.''.
SEC. 3305. NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS FOR RELIGIOUS
PROVIDERS.
Subpart III of part B of title XIX of the Public Health Service Act
(42 U.S.C. 300x-51 et seq.) is amended by adding at the end the
following:
``SEC. 1955. SERVICES PROVIDED BY NONGOVERNMENTAL ORGANIZATIONS.
``(a) Purposes.--The purposes of this section are--
``(1) to prohibit discrimination against nongovernmental
organizations and certain individuals on the basis of religion
in the distribution of government funds to provide substance
abuse services under this title and title V, and the receipt of
services under such titles; and
``(2) to allow the organizations to accept the funds to
provide the services to the individuals without impairing the
religious character of the organizations or the religious
freedom of the individuals.
``(b) Religious Organizations Included as Nongovernmental
Providers.--
``(1) In general.--A State may administer and provide
substance abuse services under any program under this title or
title V through grants, contracts, or cooperative agreements to
provide assistance to beneficiaries under such titles with
nongovernmental organizations.
``(2) Requirement.--A State that elects to utilize
nongovernmental organizations as provided for under paragraph
(1) shall consider, on the same basis as other nongovernmental
organizations, religious organizations to provide services
under substance abuse programs under this title or title V, so
long as the programs under such titles are implemented in a
manner consistent with the Establishment Clause of the first
amendment to the Constitution. Neither the Federal Government
nor a State or local government receiving funds under such
programs shall discriminate against an organization that
provides services under, or applies to provide services under,
such programs, on the basis that the organization has a
religious character.
``(c) Religious Character and Independence.--
``(1) In general.--A religious organization that provides
services under any substance abuse program under this title or
title V shall retain its independence from Federal, State, and
local governments, including such organization's control over
the definition, development, practice, and expression of its
religious beliefs.
``(2) Additional safeguards.--Neither the Federal
Government nor a State or local government shall require a
religious organization--
``(A) to alter its form of internal governance; or
``(B) to remove religious art, icons, scripture, or
other symbols;
in order to be eligible to provide services under any substance
abuse program under this title or title V.
``(d) Employment Practices.--
``(1) Substance abuse.--A religious organization that
provides services under any substance abuse program under this
title or title V may require that its employees providing
services under such program adhere to rules forbidding the use
of drugs or alcohol.
``(2) Title vii exemption.--The exemption of a religious
organization provided under section 702 or 703(e)(2) of the
Civil Rights Act of 1964 (42 U.S.C. 2000e-1, 2000e-2(e)(2))
regarding employment practices shall not be affected by the
religious organization's provision of services under, or
receipt of funds from, any substance abuse program under this
title or title V.
``(e) Rights of Beneficiaries of Assistance.--
``(1) In general.--If an individual described in paragraph
(3) has an objection to the religious character of the
organization from which the individual receives, or would
receive, services funded under any substance abuse program
under this title or title V, the appropriate Federal, State, or
local governmental entity shall provide to such individual (if
otherwise eligible for such services) within a reasonable
period of time after the date of such objection, services
that--
``(A) are from an alternative provider that is
accessible to the individual; and
``(B) have a value that is not less than the value
of the services that the individual would have received
from such organization.
``(2) Notice.--The appropriate Federal, State, or local
governmental entity shall ensure that notice is provided to
individuals described in paragraph (3) of the rights of such
individuals under this section.
``(3) Individual described.--An individual described in
this paragraph is an individual who receives or applies for
services under any substance abuse program under this title or
title V.
``(f) Nondiscrimination Against Beneficiaries.--A religious
organization providing services through a grant, contract, or
cooperative agreement under any substance abuse program under this
title or title V shall not discriminate, in carrying out such program,
against an individual described in subsection (e)(3) on the basis of
religion, a religious belief, a refusal to hold a religious belief, or
a refusal to actively participate in a religious practice.
``(g) Fiscal Accountability.--
``(1) In general.--Except as provided in paragraph (2), any
religious organization providing services under any substance
abuse program under this title or title V shall be subject to
the same regulations as other nongovernmental organizations to
account in accord with generally accepted accounting principles
for the use of such funds provided under such program.
``(2) Limited audit.--Such organization shall segregate
government funds provided under such substance abuse program
into a separate account. Only the government funds shall be
subject to audit by the government.
``(h) Compliance.--Any party that seeks to enforce such party's
rights under this section may assert a civil action for injunctive
relief exclusively in an appropriate Federal or State court against the
entity, agency or official that allegedly commits such violation.
``(i) Limitations on Use of Funds for Certain Purposes.--No funds
provided through a grant or contract to a religious organization to
provide services under any substance abuse program under this title or
title V shall be expended for sectarian worship, instruction, or
proselytization.
``(j) Effect on State and Local Funds.--If a State or local
government contributes State or local funds to carry out any substance
abuse program under this title or title V, the State or local
government may segregate the State or local funds from the Federal
funds provided to carry out the program or may commingle the State or
local funds with the Federal funds. If the State or local government
commingles the State or local funds, the provisions of this section
shall apply to the commingled funds in the same manner, and to the same
extent, as the provisions apply to the Federal funds.
``(k) Treatment of Intermediate Contractors.--If a nongovernmental
organization (referred to in this subsection as an `intermediate
organization'), acting under a contract or other agreement with the
Federal Government or a State or local government, is given the
authority under the contract or agreement to select nongovernmental
organizations to provide services under any substance abuse program
under this title or title V, the intermediate organization shall have
the same duties under this section as the government but shall retain
all other rights of a nongovernmental organization under this
section.''.
SEC. 3306. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES FOR
INDIANS AND NATIVE ALASKANS.
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. 506A. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES FOR
INDIANS AND NATIVE ALASKANS.
``(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
organizations, for the purpose of providing alcohol and drug prevention
or treatment services for Indians and Native Alaskans.
``(b) Priority.--In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority to
applicants that--
``(1) propose to provide alcohol and drug prevention or
treatment services on reservations;
``(2) propose to employ culturally-appropriate approaches,
as determined by the Secretary, in providing such services; and
``(3) have provided prevention or treatment services to
Native Alaskan entities and Indian tribes and tribal
organizations for at least 1 year prior to applying for a grant
under this section.
``(c) Duration.--The Secretary shall award grants, contracts, or
cooperative agreements under subsection (a) for a period not to exceed
5 years.
``(d) Application.--An entity desiring a grant, contract, or
cooperative 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
cooperative agreement under subsection (a) shall submit, in the
application for such grant, 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 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.
``(f) Report.--Not later than 3 years after the date of enactment
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.
``(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. 3307. ESTABLISHMENT OF COMMISSION.
(a) In General.--There is established a commission to be known as
the Commission on Indian and Native Alaskan Health Care that shall
examine the health concerns of Indians and Native Alaskans who reside
on reservations and tribal lands (hereafter in this section referred to
as the `Commission').
(b) Membership.--
(1) In general.--The Commission established under
subsection (a) shall consist of--
(A) the Secretary;
(B) 15 members who are experts in the health care
field and issues that the Commission is established to
examine; and
(C) the Director of the Indian Health Service and
the Commissioner of Indian Affairs, who shall be
nonvoting members.
(2) Appointing authority.--Of the 15 members of the
Commission described in paragraph (1)(B)--
(A) 2 shall be appointed by the Speaker of the
House of Representatives;
(B) 2 shall be appointed by the Minority Leader of
the House of Representatives;
(C) 2 shall be appointed by the Majority Leader of
the Senate;
(D) 2 shall be appointed by the Minority Leader of
the Senate; and
(E) 7 shall be appointed by the Secretary.
(3) Limitation.--Not fewer than 10 of the members appointed
to the Commission shall be Indians or Native Alaskans.
(4) Chairperson.--The Secretary shall serve as the
Chairperson of the Commission.
(5) Experts.--The Commission may seek the expertise of any
expert in the health care field to carry out its duties.
(c) Period of Appointment.--Members shall be appointed for the life
of the Commission. Any vacancy in the Commission shall not affect its
powers, but shall be filed in the same manner as the original
appointment.
(d) Duties of the Commission.--The Commission shall--
(1) study the health concerns of Indians and Native
Alaskans; and
(2) prepare the reports described in subsection (i).
(e) Powers of the Commission.--
(1) Hearings.--The Commission may hold such hearings,
including hearings on reservations, sit and act at such times
and places, take such testimony, and receive such information
as the Commission considers advisable to carry out the purpose
for which the Commission was established.
(2) Information from federal agencies.--The Commission may
secure directly from any Federal department or agency such
information as the Commission considers necessary to carry out
the purpose for which the Commission was established. Upon
request of the Chairperson of the Commission, the head of such
department or agency shall furnish such information to the
Commission.
(f) Compensation of Members.--
(1) In general.--Except as provided in subparagraph (B),
each member of the Commission may be compensated at a rate not
to exceed the daily equivalent of the annual rate of basic pay
prescribed for level IV of the Executive Schedule under section
5315 of title 5, United States Code, for each day (including
travel time), during which that member is engaged in the actual
performance of the duties of the Commission.
(2) Limitation.--Members of the Commission who are officers
or employees of the United States shall receive no additional
pay on account of their service on the Commission.
(g) Travel Expenses of Members.--The members of the Commission
shall be allowed travel expenses, including per diem in lieu of
subsistence, at rates authorized for employees of agencies under
section 5703 of title 5, United States Code, while away from their
homes or regular places of business in the performance of services for
the Commission.
(h) Commission Personnel Matters.--
(1) In general.--The Secretary, in accordance with rules
established by the Commission, may select and appoint a staff
director and other personnel necessary to enable the Commission
to carry out its duties.
(2) Compensation of personnel.--The Secretary, in
accordance with rules established by the Commission, may set
the amount of compensation to be paid to the staff director and
any other personnel that serve the Commission.
(3) Detail of government employees.--Any Federal Government
employee may be detailed to the Commission without
reimbursement, and the detail shall be without interruption or
loss of civil service status or privilege.
(4) Consultant services.--The Chairperson of the Commission
is authorized to procure the temporary and intermittent
services of experts and consultants in accordance with section
3109 of title 5, United States Code, at rates not to exceed the
daily equivalent of the annual rate of basic pay prescribed for
level IV of the Executive Schedule under section 5315 of such
title.
(i) Report.--
(1) In general.--Not later than 3 years after the date of
enactment of the Youth Drug and Mental Health Services Act, the
Secretary shall prepare and submit, to the Committee on Health,
Education, Labor, and Pensions of the Senate, a report that
shall--
(A) detail the health problems faced by Indians and
Native Alaskans who reside on reservations;
(B) examine and explain the causes of such
problems;
(C) describe the health care services available to
Indians and Native Alaskans who reside on reservations
and the adequacy of such services;
(D) identify the reasons for the provision of
inadequate health care services for Indians and Native
Alaskans who reside on reservations, including the
availability of resources;
(E) develop measures for tracking the health status
of Indians and Native Americans who reside on
reservations; and
(F) make recommendations for improvements in the
health care services provided for Indians and Native
Alaskans who reside on reservations, including
recommendations for legislative change.
(2) Exception.--In addition to the report required under
paragraph (1), not later than 2 years after the date of
enactment of the Youth Drug and Mental Health Services Act, the
Secretary shall prepare and submit, to the Committee on Health,
Education, Labor, and Pensions of the Senate, a report that
describes any alcohol and drug abuse among Indians and Native
Alaskans who reside on reservations.
(j) Permanent Commission.--Section 14 of the Federal Advisory
Committee Act (5 U.S.C. App.) shall not apply to the Commission.
(k) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section $5,000,000 for fiscal year 2001,
and such sums as may be necessary for fiscal years 2002 and 2003.
TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND ACCOUNTABILITY
SEC. 3401. GENERAL AUTHORITIES AND PEER REVIEW.
(a) General Authorities.--Paragraph (1) of section 501(e) of the
Public Health Service Act (42 U.S.C. 290aa(e)) is amended to read as
follows:
``(1) In general.--There may be in the Administration an
Associate Administrator for Alcohol Prevention and Treatment
Policy to whom the Administrator may delegate the functions of
promoting, monitoring, and evaluating service programs for the
prevention and treatment of alcoholism and alcohol 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 ensure 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 Healthy People 2010
goals and the National Dietary Guidelines of the Department of
Health and Human Services and the Department of Agriculture
related to alcohol consumption.''.
(b) Peer Review.--Section 504 of the Public Health Service (42
U.S.C. 290aa-3) is amended as follows:
``SEC. 504. PEER REVIEW.
``(a) In General.--The Secretary, after consultation with the
Administrator, shall require appropriate peer review of grants,
cooperative agreements, and contracts to be administered through the
agency which exceed the simple acquisition threshold as defined in
section 4(11) of the Office of Federal Procurement Policy Act.
``(b) Members.--The members of any peer review group established
under subsection (a) shall be individuals who by virtue of their
training or experience are eminently qualified to perform the review
functions of the group. Not more than \1/4\ of the members of any such
peer review group shall be officers or employees of the United States.
``(c) Advisory Council Review.--If the direct cost of a grant or
cooperative agreement (described in subsection (a)) exceeds the simple
acquisition threshold as defined by section 4(11) of the Office of
Federal Procurement Policy Act, the Secretary may make such a grant or
cooperative agreement only if such grant or cooperative agreement is
recommended--
``(1) after peer review required under subsection (a); and
``(2) by the appropriate advisory council.
``(d) Conditions.--The Secretary may establish limited exceptions
to the limitations contained in this section regarding participation of
Federal employees and advisory council approval. The circumstances
under which the Secretary may make such an exception shall be made
public.''.
SEC. 3402. ADVISORY COUNCILS.
Section 502(e) of the Public Health Service Act (42 U.S.C. 290aa-
1(e)) is amended in the first sentence by striking ``3 times'' and
inserting ``2 times''.
SEC. 3403. GENERAL PROVISIONS FOR THE PERFORMANCE PARTNERSHIP BLOCK
GRANTS.
(a) Plans for Performance Partnerships.--Section 1949 of the Public
Health Service Act (42 U.S.C. 300x-59) is amended as follows:
``SEC. 1949. PLANS FOR PERFORMANCE PARTNERSHIPS.
``(a) Development.--The Secretary in conjunction with States and
other interested groups shall develop separate plans for the programs
authorized under subparts I and II for creating more flexibility for
States and accountability based on outcome and other performance
measures. The plans shall each include--
``(1) a description of the flexibility that would be given
to the States under the plan;
``(2) the common set of performance measures that would be
used for accountability, including measures that would be used
for the program under subpart II for pregnant addicts, HIV
transmission, tuberculosis, and those with a co-occurring
substance abuse and mental disorders, and for programs under
subpart I for children with serious emotional disturbance and
adults with serious mental illness and for individuals with co-
occurring mental health and substance abuse disorders;
``(3) the definitions for the data elements to be used
under the plan;
``(4) the obstacles to implementation of the plan and the
manner in which such obstacles would be resolved;
``(5) the resources needed to implement the performance
partnerships under the plan; and
``(6) an implementation strategy complete with
recommendations for any necessary legislation.
``(b) Submission.--Not later than 2 years after the date of
enactment of this Act, the plans developed under subsection (a) shall
be submitted to the Committee on Health, Education, Labor, and Pensions
of the Senate and the Committee on Commerce of the House of
Representatives.
``(c) Information.--As the elements of the plans described in
subsection (a) are developed, States are encouraged to provide
information to the Secretary on a voluntary basis.
``(d) Participants.--The Secretary shall include among those
interested groups that participate in the development of the plan
consumers of mental health or substance abuse services, providers,
representatives of political divisions of States, and representatives
of racial and ethnic groups including Native Americans.''.
(b) Availability to States of Grant Programs.--Section 1952 of the
Public Health Service Act (42 U.S.C. 300x-62) is amended as follows:
``SEC. 1952. AVAILABILITY TO STATES OF GRANT PAYMENTS.
``Any amounts paid to a State for a fiscal year under section 1911
or 1921 shall be available for obligation and expenditure until the end
of the fiscal year following the fiscal year for which the amounts were
paid.''.
SEC. 3404. DATA INFRASTRUCTURE PROJECTS.
Part C of title XIX of the Public Health Service Act (42 U.S.C.
300y et seq.) is amended--
(1) by striking the headings for part C and subpart I and
inserting the following:
``PART C--CERTAIN PROGRAMS REGARDING MENTAL HEALTH AND SUBSTANCE ABUSE
``Subpart I--Data Infrastructure Development'';
(2) by striking section 1971 (42 U.S.C. 300y) and inserting
the following:
``SEC. 1971. DATA INFRASTRUCTURE DEVELOPMENT.
``(a) In General.--The Secretary may make grants to, and enter into
contracts or cooperative agreements with States for the purpose of
developing and operating mental health or substance abuse data
collection, analysis, and reporting systems with regard to performance
measures including capacity, process, and outcomes measures.
``(b) Projects.--The Secretary shall establish criteria to ensure
that services will be available under this section to States that have
a fundamental basis for the collection, analysis, and reporting of
mental health and substance abuse performance measures and States that
do not have such basis. The Secretary will establish criteria for
determining whether a State has a fundamental basis for the collection,
analysis, and reporting of data.
``(c) Condition of Receipt of Funds.--As a condition of the receipt
of an award under this section a State shall agree to collect, analyze,
and report to the Secretary within 2 years of the date of the award on
a core set of performance measures to be determined by the Secretary in
conjunction with the States.
``(d) Matching Requirement.--
``(1) In general.--With respect to the costs of the program
to be carried out under subsection (a) by a State, the
Secretary may make an award under such subsection only if the
applicant agrees to make available (directly or through
donations from public or private entities) non-Federal
contributions toward such costs in an amount that is not less
than 50 percent of such costs.
``(2) Determination of amount contributed.--Non-Federal
contributions under paragraph (1) may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount of
such contributions.
``(e) Duration of Support.--The period during which payments may be
made for a project under subsection (a) may be not less than 3 years
nor more than 5 years.
``(f) Authorization of Appropriation.--
``(1) In general.--For the purpose of carrying out this
section, there are authorized to be appropriated such sums as
may be necessary for each of the fiscal years 2001, 2002 and
2003.
``(2) Allocation.--Of the amounts appropriated under
paragraph (1) for a fiscal year, 50 percent shall be expended
to support data infrastructure development for mental health
and 50 percent shall be expended to support data infrastructure
development for substance abuse.''.
SEC. 3405. REPEAL OF OBSOLETE ADDICT REFERRAL PROVISIONS.
(a) Repeal of Obsolete Public Health Service Act Authorities.--Part
E of title III (42 U.S.C. 257 et seq.) is repealed.
(b) Repeal of Obsolete NARA Authorities.--Titles III and IV of the
Narcotic Addict Rehabilitation Act of 1966 (Public Law 89-793) are
repealed.
(c) Repeal of Obsolete Title 28 Authorities.--
(1) In general.--Chapter 175 of title 28, United States
Code, is repealed.
(2) Table of contents.--The table of contents to part VI of
title 28, United States Code, is amended by striking the items
relating to chapter 175.
SEC. 3406. INDIVIDUALS WITH CO-OCCURRING DISORDERS.
The Public Health Service Act is amended by inserting after section
503 (42 U.S.C. 290aa-2) the following:
``SEC. 503A. REPORT ON INDIVIDUALS WITH CO-OCCURRING MENTAL ILLNESS AND
SUBSTANCE ABUSE DISORDERS.
``(a) In General.--Not later than 2 years after the date of
enactment of this section, the Secretary shall, after consultation with
organizations representing States, mental health and substance abuse
treatment providers, prevention specialists, individuals receiving
treatment services, and family members of such individuals, prepare and
submit to the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Commerce of the House of
Representatives, a report on prevention and treatment services for
individuals who have co-occurring mental illness and substance abuse
disorders.
``(b) Report Content.--The report under subsection (a) shall be
based on data collected from existing Federal and State surveys
regarding the treatment of co-occurring mental illness and substance
abuse disorders and shall include--
``(1) a summary of the manner in which individuals with co-
occurring disorders are receiving treatment, including the most
up-to-date information available regarding the number of
children and adults with co-occurring mental illness and
substance abuse disorders and the manner in which funds
provided under sections 1911 and 1921 are being utilized,
including the number of such children and adults served with
such funds;
``(2) a summary of improvements necessary to ensure that
individuals with co-occurring mental illness and substance
abuse disorders receive the services they need;
``(3) a summary of practices for preventing substance abuse
among individuals who have a mental illness and are at risk of
having or acquiring a substance abuse disorder; and
``(4) a summary of evidenced-based practices for treating
individuals with co-occurring mental illness and substance
abuse disorders and recommendations for implementing such
practices.
``(c) Funds for Report.--The Secretary may obligate funds to carry
out this section with such appropriations as are available.''.
SEC. 3407. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.
Subpart III of part B of title XIX of the Public Health Service Act
(42 U.S.C. 300x-51 et seq.) (as amended by section 3305) is further
amended by adding at the end the following:
``SEC. 1956. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.
``States may use funds available for treatment under sections 1911
and 1921 to treat persons with co-occurring substance abuse and mental
disorders as long as funds available under such sections are used for
the purposes for which they were authorized by law and can be tracked
for accounting purposes.''.
TITLE XXXV--WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR PRESCRIBE
CERTAIN NARCOTIC DRUGS FOR MAINTENANCE TREATMENT OR DETOXIFICATION
TREATMENT
SEC. 3501. SHORT TITLE.
This title may be cited as the ``Drug Addiction Treatment Act of
2000''.
SEC. 3502. AMENDMENT TO CONTROLLED SUBSTANCES ACT.
(a) In General.--Section 303(g) of the Controlled Substances Act
(21 U.S.C. 823(g)) is amended--
(1) in paragraph (2), by striking ``(A) security'' and
inserting ``(i) security'', and by striking ``(B) the
maintenance'' and inserting ``(ii) the maintenance'';
(2) by redesignating paragraphs (1) through (3) as
subparagraphs (A) through (C), respectively;
(3) by inserting ``(1)'' after ``(g)'';
(4) by striking ``Practitioners who dispense'' and
inserting ``Except as provided in paragraph (2), practitioners
who dispense''; and
(5) by adding at the end the following paragraph:
``(2)(A) Subject to subparagraphs (D) and (J), the requirements of
paragraph (1) are waived in the case of the dispensing (including the
prescribing), by a practitioner, of narcotic drugs in schedule III, IV,
or V or combinations of such drugs if the practitioner meets the
conditions specified in subparagraph (B) and the narcotic drugs or
combinations of such drugs meet the conditions specified in
subparagraph (C).
``(B) For purposes of subparagraph (A), the conditions specified in
this subparagraph with respect to a practitioner are that, before the
initial dispensing of narcotic drugs in schedule III, IV, or V or
combinations of such drugs to patients for maintenance or
detoxification treatment, the practitioner submit to the Secretary a
notification of the intent of the practitioner to begin dispensing the
drugs or combinations for such purpose, and that the notification
contain the following certifications by the practitioner:
``(i) The practitioner is a qualifying physician (as
defined in subparagraph (G)).
``(ii) With respect to patients to whom the practitioner
will provide such drugs or combinations of drugs, the
practitioner has the capacity to refer the patients for
appropriate counseling and other appropriate ancillary
services.
``(iii) In any case in which the practitioner is not in a
group practice, the total number of such patients of the
practitioner at any one time will not exceed the applicable
number. For purposes of this clause, the applicable number is
30, except that the Secretary may by regulation change such
total number.
``(iv) In any case in which the practitioner is in a group
practice, the total number of such patients of the group
practice at any one time will not exceed the applicable number.
For purposes of this clause, the applicable number is 30,
except that the Secretary may by regulation change such total
number, and the Secretary for such purposes may by regulation
establish different categories on the basis of the number of
practitioners in a group practice and establish for the various
categories different numerical limitations on the number of
such patients that the group practice may have.
``(C) For purposes of subparagraph (A), the conditions specified in
this subparagraph with respect to narcotic drugs in schedule III, IV,
or V or combinations of such drugs are as follows:
``(i) The drugs or combinations of drugs have, under the
Federal Food, Drug, and Cosmetic Act or section 351 of the
Public Health Service Act, been approved for use in maintenance
or detoxification treatment.
``(ii) The drugs or combinations of drugs have not been the
subject of an adverse determination. For purposes of this
clause, an adverse determination is a determination published
in the Federal Register and made by the Secretary, after
consultation with the Attorney General, that the use of the
drugs or combinations of drugs for maintenance or
detoxification treatment requires additional standards
respecting the qualifications of practitioners to provide such
treatment, or requires standards respecting the quantities of
the drugs that may be provided for unsupervised use.
``(D)(i) A waiver under subparagraph (A) with respect to a
practitioner is not in effect unless (in addition to conditions under
subparagraphs (B) and (C)) the following conditions are met:
``(I) The notification under subparagraph (B) is in writing
and states the name of the practitioner.
``(II) The notification identifies the registration issued
for the practitioner pursuant to subsection (f).
``(III) If the practitioner is a member of a group
practice, the notification states the names of the other
practitioners in the practice and identifies the registrations
issued for the other practitioners pursuant to subsection (f).
``(ii) Upon receiving a notification under subparagraph (B), the
Attorney General shall assign the practitioner involved an
identification number under this paragraph for inclusion with the
registration issued for the practitioner pursuant to subsection (f).
The identification number so assigned shall be appropriate to preserve
the confidentiality of patients for whom the practitioner has dispensed
narcotic drugs under a waiver under subparagraph (A).
``(iii) Not later than 45 days after the date on which the
Secretary receives a notification under subparagraph (B), the Secretary
shall make a determination of whether the practitioner involved meets
all requirements for a waiver under subparagraph (B). If the Secretary
fails to make such determination by the end of the such 45-day period,
the Attorney General shall assign the physician an identification
number described in clause (ii) at the end of such period.
``(E)(i) If a practitioner is not registered under paragraph (1)
and, in violation of the conditions specified in subparagraphs (B)
through (D), dispenses narcotic drugs in schedule III, IV, or V or
combinations of such drugs for maintenance treatment or detoxification
treatment, the Attorney General may, for purposes of section 304(a)(4),
consider the practitioner to have committed an act that renders the
registration of the practitioner pursuant to subsection (f) to be
inconsistent with the public interest.
``(ii)(I) Upon the expiration of 45 days from the date on which the
Secretary receives a notification under subparagraph (B), a
practitioner who in good faith submits a notification under
subparagraph (B) and reasonably believes that the conditions specified
in subparagraphs (B) through (D) have been met shall, in dispensing
narcotic drugs in schedule III, IV, or V or combinations of such drugs
for maintenance treatment or detoxification treatment, be considered to
have a waiver under subparagraph (A) until notified otherwise by the
Secretary, except that such a practitioner may commence to prescribe or
dispense such narcotic drugs for such purposes prior to the expiration
of such 45-day period if it facilitates the treatment of an individual
patient and both the Secretary and the Attorney General are notified by
the practitioner of the intent to commence prescribing or dispensing
such narcotic drugs.
``(II) For purposes of subclause (I), the publication in the
Federal Register of an adverse determination by the Secretary pursuant
to subparagraph (C)(ii) shall (with respect to the narcotic drug or
combination involved) be considered to be a notification provided by
the Secretary to practitioners, effective upon the expiration of the
30-day period beginning on the date on which the adverse determination
is so published.
``(F)(i) With respect to the dispensing of narcotic drugs in
schedule III, IV, or V or combinations of such drugs to patients for
maintenance or detoxification treatment, a practitioner may, in his or
her discretion, dispense such drugs or combinations for such treatment
under a registration under paragraph (1) or a waiver under subparagraph
(A) (subject to meeting the applicable conditions).
``(ii) This paragraph may not be construed as having any legal
effect on the conditions for obtaining a registration under paragraph
(1), including with respect to the number of patients who may be served
under such a registration.
``(G) For purposes of this paragraph:
``(i) The term `group practice' has the meaning given such
term in section 1877(h)(4) of the Social Security Act.
``(ii) The term `qualifying physician' means a physician
who is licensed under State law and who meets one or more of
the following conditions:
``(I) The physician holds a subspecialty board
certification in addiction psychiatry from the American
Board of Medical Specialties.
``(II) The physician holds an addiction
certification from the American Society of Addiction
Medicine.
``(III) The physician holds a subspecialty board
certification in addiction medicine from the American
Osteopathic Association.
``(IV) The physician has, with respect to the
treatment and management of opiate-dependent patients,
completed not less than eight hours of training
(through classroom situations, seminars at professional
society meetings, electronic communications, or
otherwise) that is provided by the American Society of
Addiction Medicine, the American Academy of Addiction
Psychiatry, the American Medical Association, the
American Osteopathic Association, the American
Psychiatric Association, or any other organization that
the Secretary determines is appropriate for purposes of
this subclause.
``(V) The physician has participated as an
investigator in one or more clinical trials leading to
the approval of a narcotic drug in schedule III, IV, or
V for maintenance or detoxification treatment, as
demonstrated by a statement submitted to the Secretary
by the sponsor of such approved drug.
``(VI) The physician has such other training or
experience as the State medical licensing board (of the
State in which the physician will provide maintenance
or detoxification treatment) considers to demonstrate
the ability of the physician to treat and manage
opiate-dependent patients.
``(VII) The physician has such other training or
experience as the Secretary considers to demonstrate
the ability of the physician to treat and manage
opiate-dependent patients. Any criteria of the
Secretary under this subclause shall be established by
regulation. Any such criteria are effective only for 3
years after the date on which the criteria are
promulgated, but may be extended for such additional
discrete 3-year periods as the Secretary considers
appropriate for purposes of this subclause. Such an
extension of criteria may only be effectuated through a
statement published in the Federal Register by the
Secretary during the 30-day period preceding the end of
the 3-year period involved.
``(H)(i) In consultation with the Administrator of the Drug
Enforcement Administration, the Administrator of the Substance Abuse
and Mental Health Services Administration, the Director of the National
Institute on Drug Abuse, and the Commissioner of Food and Drugs, the
Secretary shall issue regulations (through notice and comment
rulemaking) or issue practice guidelines to address the following:
``(I) Approval of additional credentialing bodies and the
responsibilities of additional credentialing bodies.
``(II) Additional exemptions from the requirements of this
paragraph and any regulations under this paragraph.
Nothing in such regulations or practice guidelines may authorize any
Federal official or employee to exercise supervision or control over
the practice of medicine or the manner in which medical services are
provided.
``(ii) Not later than 120 days after the date of the enactment of
the Drug Addiction Treatment Act of 2000, the Secretary shall issue a
treatment improvement protocol containing best practice guidelines for
the treatment and maintenance of opiate-dependent patients. The
Secretary shall develop the protocol in consultation with the Director
of the National Institute on Drug Abuse, the Administrator of the Drug
Enforcement Administration, the Commissioner of Food and Drugs, the
Administrator of the Substance Abuse and Mental Health Services
Administration and other substance abuse disorder professionals. The
protocol shall be guided by science.
``(I) During the 3-year period beginning on the date of the
enactment of the Drug Addiction Treatment Act of 2000, a State may not
preclude a practitioner from dispensing or prescribing drugs in
schedule III, IV, or V, or combinations of such drugs, to patients for
maintenance or detoxification treatment in accordance with this
paragraph unless, before the expiration of that 3-year period, the
State enacts a law prohibiting a practitioner from dispensing such
drugs or combinations of drug.
``(J)(i) This paragraph takes effect on the date of the enactment
of the Drug Addiction Treatment Act of 2000, and remains in effect
thereafter except as provided in clause (iii) (relating to a decision
by the Secretary or the Attorney General that this paragraph should not
remain in effect).
``(ii) For purposes relating to clause (iii), the Secretary and the
Attorney General may, during the 3-year period beginning on the date of
the enactment of the Drug Addiction Treatment Act of 2000, make
determinations in accordance with the following:
``(I) The Secretary may make a determination of whether
treatments provided under waivers under subparagraph (A) have
been effective forms of maintenance treatment and
detoxification treatment in clinical settings; may make a
determination of whether such waivers have significantly
increased (relative to the beginning of such period) the
availability of maintenance treatment and detoxification
treatment; and may make a determination of whether such waivers
have adverse consequences for the public health.
``(II) The Attorney General may make a determination of the
extent to which there have been violations of the numerical
limitations established under subparagraph (B) for the number
of individuals to whom a practitioner may provide treatment;
may make a determination of whether waivers under subparagraph
(A) have increased (relative to the beginning of such period)
the extent to which narcotic drugs in schedule III, IV, or V or
combinations of such drugs are being dispensed or possessed in
violation of this Act; and may make a determination of whether
such waivers have adverse consequences for the public health.
``(iii) If, before the expiration of the period specified in clause
(ii), the Secretary or the Attorney General publishes in the Federal
Register a decision, made on the basis of determinations under such
clause, that this paragraph should not remain in effect, this paragraph
ceases to be in effect 60 days after the date on which the decision is
so published. The Secretary shall in making any such decision consult
with the Attorney General, and shall in publishing the decision in the
Federal Register include any comments received from the Attorney
General for inclusion in the publication. The Attorney General shall in
making any such decision consult with the Secretary, and shall in
publishing the decision in the Federal Register include any comments
received from the Secretary for inclusion in the publication.''.
(b) Conforming Amendments.--Section 304 of the Controlled
Substances Act (21 U.S.C. 824) is amended--
(1) in subsection (a), in the matter after and below
paragraph (5), by striking ``section 303(g)'' each place such
term appears and inserting ``section 303(g)(1)''; and
(2) in subsection (d), by striking ``section 303(g)'' and
inserting ``section 303(g)(1)''.
(c) Additional Authorization of Appropriations.--For the purpose of
assisting the Secretary of Health and Human Services with the
additional duties established for the Secretary pursuant to the
amendments made by this section, there are authorized to be
appropriated, in addition to other authorizations of appropriations
that are available for such purpose, such sums as may be necessary for
each of fiscal years 2001 through 2003.
TITLE XXXVI--METHAMPHETAMINE AND OTHER CONTROLLED SUBSTANCES
SEC. 3601. SHORT TITLE.
This title may be cited as the ``Methamphetamine Anti-Proliferation
Act of 2000''.
Subtitle A--Methamphetamine Production, Trafficking, and Abuse
PART I--CRIMINAL PENALTIES
SEC. 3611. ENHANCED PUNISHMENT OF AMPHETAMINE LABORATORY OPERATORS.
(a) Amendment to Federal Sentencing Guidelines.--Pursuant to its
authority under section 994(p) of title 28, United States Code, the
United States Sentencing Commission shall amend the Federal sentencing
guidelines in accordance with this section with respect to any offense
relating to the manufacture, importation, exportation, or trafficking
in amphetamine (including an attempt or conspiracy to do any of the
foregoing) in violation of--
(1) the Controlled Substances Act (21 U.S.C. 801 et seq.);
(2) the Controlled Substances Import and Export Act (21
U.S.C. 951 et seq.); or
(3) the Maritime Drug Law Enforcement Act (46 U.S.C. App.
1901 et seq.).
(b) General Requirement.--In carrying out this section, the United
States Sentencing Commission shall, with respect to each offense
described in subsection (a) relating to amphetamine--
(1) review and amend its guidelines to provide for
increased penalties such that those penalties are comparable to
the base offense level for methamphetamine; and
(2) take any other action the Commission considers
necessary to carry out this subsection.
(c) Additional Requirements.--In carrying out this section, the
United States Sentencing Commission shall ensure that the sentencing
guidelines for offenders convicted of offenses described in subsection
(a) reflect the heinous nature of such offenses, the need for
aggressive law enforcement action to fight such offenses, and the
extreme dangers associated with unlawful activity involving
amphetamines, including--
(1) the rapidly growing incidence of amphetamine abuse and
the threat to public safety that such abuse poses;
(2) the high risk of amphetamine addiction;
(3) the increased risk of violence associated with
amphetamine trafficking and abuse; and
(4) the recent increase in the illegal importation of
amphetamine and precursor chemicals.
(d) Emergency Authority to Sentencing Commission.--The United
States Sentencing Commission shall promulgate amendments pursuant to
this section as soon as practicable after the date of enactment of this
Act in accordance with the procedure set forth in section 21(a) of the
Sentencing Act of 1987 (Public Law 100-182), as though the authority
under that Act had not expired.
SEC. 3612. ENHANCED PUNISHMENT OF AMPHETAMINE OR METHAMPHETAMINE
LABORATORY OPERATORS.
(a) Federal Sentencing Guidelines.--
(1) In general.--Pursuant to its authority under section
994(p) of title 28, United States Code, the United States
Sentencing Commission shall amend the Federal sentencing
guidelines in accordance with paragraph (2) with respect to any
offense relating to the manufacture, attempt to manufacture, or
conspiracy to manufacture amphetamine or methamphetamine in
violation of--
(A) the Controlled Substances Act (21 U.S.C. 801 et
seq.);
(B) the Controlled Substances Import and Export Act
(21 U.S.C. 951 et seq.); or
(C) the Maritime Drug Law Enforcement Act (46
U.S.C. App. 1901 et seq.).
(2) Requirements.--In carrying out this paragraph, the
United States Sentencing Commission shall--
(A) if the offense created a substantial risk of
harm to human life (other than a life described in
subparagraph (B)) or the environment, increase the base
offense level for the offense--
(i) by not less than 3 offense levels above
the applicable level in effect on the date of
enactment of this Act; or
(ii) if the resulting base offense level
after an increase under clause (i) would be
less than level 27, to not less than level 27;
or
(B) if the offense created a substantial risk of
harm to the life of a minor or incompetent, increase
the base offense level for the offense--
(i) by not less than 6 offense levels above
the applicable level in effect on the date of
enactment of this Act; or
(ii) if the resulting base offense level
after an increase under clause (i) would be
less than level 30, to not less than level 30.
(3) Emergency authority to sentencing commission.--The
United States Sentencing Commission shall promulgate amendments
pursuant to this subsection as soon as practicable after the
date of enactment of this Act in accordance with the procedure
set forth in section 21(a) of the Sentencing Act of 1987
(Public Law 100-182), as though the authority under that Act
had not expired.
(b) Effective Date.--The amendments made pursuant to this section
shall apply with respect to any offense occurring on or after the date
that is 60 days after the date of enactment of this Act.
SEC. 3613. MANDATORY RESTITUTION FOR VIOLATIONS OF CONTROLLED
SUBSTANCES ACT AND CONTROLLED SUBSTANCES IMPORT AND
EXPORT ACT RELATING TO AMPHETAMINE AND METHAMPHETAMINE.
(a) Mandatory Restitution.--Section 413(q) of the Controlled
Substances Act (21 U.S.C. 853(q)) is amended--
(1) in the matter preceding paragraph (1), by striking
``may'' and inserting ``shall'';
(2) by inserting ``amphetamine or'' before
``methamphetamine'' each place it appears;
(3) in paragraph (2)--
(A) by inserting ``, the State or local government
concerned, or both the United States and the State or
local government concerned'' after ``United States''
the first place it appears; and
(B) by inserting ``or the State or local government
concerned, as the case may be,'' after ``United
States'' the second place it appears; and
(4) in paragraph (3), by striking ``section 3663 of title
18, United States Code'' and inserting ``section 3663A of title
18, United States Code''.
(b) Deposit of Amounts in Department of Justice Assets Forfeiture
Fund.--Section 524(c)(4) of title 28, United States Code, is amended--
(1) by striking ``and'' at the end of subparagraph (B);
(2) by striking the period at the end of subparagraph (C)
and inserting ``; and''; and
(3) by adding at the end the following:
``(D) all amounts collected--
``(i) by the United States pursuant to a
reimbursement order under paragraph (2) of section
413(q) of the Controlled Substances Act (21 U.S.C.
853(q)); and
``(ii) pursuant to a restitution order under
paragraph (1) or (3) of section 413(q) of the
Controlled Substances Act for injuries to the United
States.''.
(c) Clarification of Certain Orders of Restitution.--Section
3663(c)(2)(B) of title 18, United States Code, is amended by inserting
``which may be'' after ``the fine''.
(d) Expansion of Applicability of Mandatory Restitution.--Section
3663A(c)(1)(A)(ii) of title 18, United States Code, is amended by
inserting ``or under section 416(a) of the Controlled Substances Act
(21 U.S.C. 856(a)),'' after ``under this title,''.
(e) Treatment of Illicit Substance Manufacturing Operations as
Crimes Against Property.--Section 416 of the Controlled Substances Act
(21 U.S.C. 856) is amended by adding at the end the following new
subsection:
``(c) A violation of subsection (a) shall be considered an offense
against property for purposes of section 3663A(c)(1)(A)(ii) of title
18, United States Code.''.
SEC. 3614. METHAMPHETAMINE PARAPHERNALIA.
Section 422(d) of the Controlled Substances Act (21 U.S.C. 863(d))
is amended in the matter preceding paragraph (1) by inserting
``methamphetamine,'' after ``PCP,''.
PART II--ENHANCED LAW ENFORCEMENT
SEC. 3621. ENVIRONMENTAL HAZARDS ASSOCIATED WITH ILLEGAL MANUFACTURE OF
AMPHETAMINE AND METHAMPHETAMINE.
(a) Use of Amounts or Department of Justice Assets Forfeiture
Fund.--Section 524(c)(1)(E) of title 28, United States Code, is
amended--
(1) by inserting ``(i) for'' before ``disbursements'';
(2) by inserting ``and'' after the semicolon; and
(3) by adding at the end the following:
``(ii) for payment for--
``(I) costs incurred by or on behalf of the
Department of Justice in connection with the removal,
for purposes of Federal forfeiture and disposition, of
any hazardous substance or pollutant or contaminant
associated with the illegal manufacture of amphetamine
or methamphetamine; and
``(II) costs incurred by or on behalf of a State or
local government in connection with such removal in any
case in which such State or local government has
assisted in a Federal prosecution relating to
amphetamine or methamphetamine, to the extent such
costs exceed equitable sharing payments made to such
State or local government in such case;''.
(b) Grants Under Drug Control and System Improvement Grant
Program.--Section 501(b)(3) of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3751(b)(3)) is amended by inserting
before the semicolon the following: ``and to remove any hazardous
substance or pollutant or contaminant associated with the illegal
manufacture of amphetamine or methamphetamine''.
(c) Amounts Supplement and Not Supplant.--
(1) Assets forfeiture fund.--Any amounts made available
from the Department of Justice Assets Forfeiture Fund in a
fiscal year by reason of the amendment made by subsection (a)
shall supplement, and not supplant, any other amounts made
available to the Department of Justice in such fiscal year from
other sources for payment of costs described in section
524(c)(1)(E)(ii) of title 28, United States Code, as so
amended.
(2) Grant program.--Any amounts made available in a fiscal
year under the grant program under section 501(b)(3) of the
Omnibus Crime Control and Safe Streets Act of 1968 (42 U.S.C.
3751(b)(3)) for the removal of hazardous substances or
pollutants or contaminants associated with the illegal
manufacture of amphetamine or methamphetamine by reason of the
amendment made by subsection (b) shall supplement, and not
supplant, any other amounts made available in such fiscal year
from other sources for such removal.
SEC. 3622. REDUCTION IN RETAIL SALES TRANSACTION THRESHOLD FOR NON-SAFE
HARBOR PRODUCTS CONTAINING PSEUDOEPHEDRINE OR
PHENYLPROPANOLAMINE.
(a) Reduction in Transaction Threshold.--Section 102(39)(A)(iv)(II)
of the Controlled Substances Act (21 U.S.C. 802(39)(A)(iv)(II)) is
amended--
(1) by striking ``24 grams'' both places it appears and
inserting ``9 grams''; and
(2) by inserting before the semicolon at the end the
following: ``and sold in package sizes of not more than 3 grams
of pseudoephedrine base or 3 grams of phenylpropanolamine
base''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect 1 year after the date of enactment of this Act.
SEC. 3623. TRAINING FOR DRUG ENFORCEMENT ADMINISTRATION AND STATE AND
LOCAL LAW ENFORCEMENT PERSONNEL RELATING TO CLANDESTINE
LABORATORIES.
(a) In General.--
(1) Requirement.--The Administrator of the Drug Enforcement
Administration shall carry out the programs described in
subsection (b) with respect to the law enforcement personnel of
States and localities determined by the Administrator to have
significant levels of methamphetamine-related or amphetamine-
related crime or projected by the Administrator to have the
potential for such levels of crime in the future.
(2) Duration.--The duration of any program under that
subsection may not exceed 3 years.
(b) Covered Programs.--The programs described in this subsection
are as follows:
(1) Advanced mobile clandestine laboratory training
teams.--A program of advanced mobile clandestine laboratory
training teams, which shall provide information and training to
State and local law enforcement personnel in techniques
utilized in conducting undercover investigations and conspiracy
cases, and other information designed to assist in the
investigation of the illegal manufacturing and trafficking of
amphetamine and methamphetamine.
(2) Basic clandestine laboratory certification training.--A
program of basic clandestine laboratory certification training,
which shall provide information and training--
(A) to Drug Enforcement Administration personnel
and State and local law enforcement personnel for
purposes of enabling such personnel to meet any
certification requirements under law with respect to
the handling of wastes created by illegal amphetamine
and methamphetamine laboratories; and
(B) to State and local law enforcement personnel
for purposes of enabling such personnel to provide the
information and training covered by subparagraph (A) to
other State and local law enforcement personnel.
(3) Clandestine laboratory recertification and awareness
training.--A program of clandestine laboratory recertification
and awareness training, which shall provide information and
training to State and local law enforcement personnel for
purposes of enabling such personnel to provide recertification
and awareness training relating to clandestine laboratories to
additional State and local law enforcement personnel.
(c) Authorization of Appropriations.--There are authorized to be
appropriated for each of fiscal years 2000, 2001, and 2002 amounts as
follows:
(1) $1,500,000 to carry out the program described in
subsection (b)(1).
(2) $3,000,000 to carry out the program described in
subsection (b)(2).
(3) $1,000,000 to carry out the program described in
subsection (b)(3).
SEC. 3624. COMBATING METHAMPHETAMINE AND AMPHETAMINE IN HIGH INTENSITY
DRUG TRAFFICKING AREAS.
(a) In General.--
(1) In general.--The Director of National Drug Control
Policy shall use amounts available under this section to combat
the trafficking of methamphetamine and amphetamine in areas
designated by the Director as high intensity drug trafficking
areas.
(2) Activities.--In meeting the requirement in paragraph
(1), the Director shall transfer funds to appropriate Federal,
State, and local governmental agencies for employing additional
Federal law enforcement personnel, or facilitating the
employment of additional State and local law enforcement
personnel, including agents, investigators, prosecutors,
laboratory technicians, chemists, investigative assistants, and
drug-prevention specialists.
(b) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section--
(1) $15,000,000 for fiscal year 2000; and
(2) such sums as may be necessary for each of fiscal years
2001 through 2004.
(c) Apportionment of Funds.--
(1) Factors in apportionment.--The Director shall apportion
amounts appropriated for a fiscal year pursuant to the
authorization of appropriations in subsection (b) for
activities under subsection (a) among and within areas
designated by the Director as high intensity drug trafficking
areas based on the following factors:
(A) The number of methamphetamine manufacturing
facilities and amphetamine manufacturing facilities
discovered by Federal, State, or local law enforcement
officials in the previous fiscal year.
(B) The number of methamphetamine prosecutions and
amphetamine prosecutions in Federal, State, or local
courts in the previous fiscal year.
(C) The number of methamphetamine arrests and
amphetamine arrests by Federal, State, or local law
enforcement officials in the previous fiscal year.
(D) The amounts of methamphetamine, amphetamine, or
listed chemicals (as that term is defined in section
102(33) of the Controlled Substances Act (21 U.S.C.
802(33)) seized by Federal, State, or local law
enforcement officials in the previous fiscal year.
(E) Intelligence and predictive data from the Drug
Enforcement Administration and the Department of Health
and Human Services showing patterns and trends in
abuse, trafficking, and transportation in
methamphetamine, amphetamine, and listed chemicals (as
that term is so defined).
(2) Certification.--Before the Director apportions any
funds under this subsection to a high intensity drug
trafficking area, the Director shall certify that the law
enforcement entities responsible for clandestine
methamphetamine and amphetamine laboratory seizures in that
area are providing laboratory seizure data to the national
clandestine laboratory database at the El Paso Intelligence
Center.
(d) Limitation on Administrative Costs.--Not more than 5 percent of
the amount appropriated in a fiscal year pursuant to the authorization
of appropriations for that fiscal year in subsection (b) may be
available in that fiscal year for administrative costs associated with
activities under subsection (a).
SEC. 3625. COMBATING AMPHETAMINE AND METHAMPHETAMINE MANUFACTURING AND
TRAFFICKING.
(a) Activities.--In order to combat the illegal manufacturing and
trafficking in amphetamine and methamphetamine, the Administrator of
the Drug Enforcement Administration may--
(1) assist State and local law enforcement in small and
mid-sized communities in all phases of investigations related
to such manufacturing and trafficking, including assistance
with foreign-language interpretation;
(2) staff additional regional enforcement and mobile
enforcement teams related to such manufacturing and
trafficking;
(3) establish additional resident offices and posts of duty
to assist State and local law enforcement in rural areas in
combating such manufacturing and trafficking;
(4) provide the Special Operations Division of the
Administration with additional agents and staff to collect,
evaluate, interpret, and disseminate critical intelligence
targeting the command and control operations of major
amphetamine and methamphetamine manufacturing and trafficking
organizations;
(5) enhance the investigative and related functions of the
Chemical Control Program of the Administration to implement
more fully the provisions of the Comprehensive Methamphetamine
Control Act of 1996 (Public Law 104-237);
(6) design an effective means of requiring an accurate
accounting of the import and export of list I chemicals, and
coordinate investigations relating to the diversion of such
chemicals;
(7) develop a computer infrastructure sufficient to
receive, process, analyze, and redistribute time-sensitive
enforcement information from suspicious order reporting to
field offices of the Administration and other law enforcement
and regulatory agencies, including the continuing development
of the Suspicious Order Reporting and Tracking System (SORTS)
and the Chemical Transaction Database (CTRANS) of the
Administration;
(8) establish an education, training, and communication
process in order to alert the industry to current trends and
emerging patterns in the illegal manufacturing of amphetamine
and methamphetamine; and
(9) carry out such other activities as the Administrator
considers appropriate.
(b) Additional Positions and Personnel.--
(1) In general.--In carrying out activities under
subsection (a), the Administrator may establish in the
Administration not more than 50 full-time positions, including
not more than 31 special-agent positions, and may appoint
personnel to such positions.
(2) Particular positions.--In carrying out activities under
paragraphs (5) through (8) of subsection (a), the Administrator
may establish in the Administration not more than 15 full-time
positions, including not more than 10 diversion investigator
positions, and may appoint personnel to such positions. Any
positions established under this paragraph are in addition to
any positions established under paragraph (1).
(c) Authorization of Appropriations.--There are authorized to be
appropriated for the Drug Enforcement Administration for each fiscal
year after fiscal year 1999, $9,500,000 for purposes of carrying out
the activities authorized by subsection (a) and employing personnel in
positions established under subsection (b), of which $3,000,000 shall
be available for activities under paragraphs (5) through (8) of
subsection (a) and for employing personnel in positions established
under subsection (b)(2).
PART III--ABUSE PREVENTION AND TREATMENT
SEC. 3631. EXPANSION OF METHAMPHETAMINE RESEARCH.
Section 464N of the Public Health Service Act (42 U.S.C. 285o-2) is
amended by adding at the end the following:
``(c) Methamphetamine Research.--
``(1) Grants or cooperative agreements.--The Director of
the Institute may make grants or enter into cooperative
agreements to expand the current and on-going interdisciplinary
research and clinical trials with treatment centers of the
National Drug Abuse Treatment Clinical Trials Network relating
to methamphetamine abuse and addiction and other biomedical,
behavioral, and social issues related to methamphetamine abuse
and addiction.
``(2) Use of funds.--Amounts made available under a grant
or cooperative agreement under paragraph (1) for
methamphetamine abuse and addiction may be used for research
and clinical trials relating to--
``(A) the effects of methamphetamine abuse on the
human body, including the brain;
``(B) the addictive nature of methamphetamine and
how such effects differ with respect to different
individuals;
``(C) the connection between methamphetamine abuse
and mental health;
``(D) the identification and evaluation of the most
effective methods of prevention of methamphetamine
abuse and addiction;
``(E) the identification and development of the
most effective methods of treatment of methamphetamine
addiction, including pharmacological treatments;
``(F) risk factors for methamphetamine abuse;
``(G) effects of methamphetamine abuse and
addiction on pregnant women and their fetuses; and
``(H) cultural, social, behavioral, neurological
and psychological reasons that individuals abuse
methamphetamine, or refrain from abusing
methamphetamine.
``(3) Research results.--The Director shall promptly
disseminate research results under this subsection to Federal,
State and local entities involved in combating methamphetamine
abuse and addiction.
``(4) Authorization of appropriations.--
``(A) Authorization of appropriations.--There is
authorized to be appropriated to carry out paragraph
(1), such sums as may be necessary for each fiscal
year.
``(B) Supplement not supplant.--Amounts
appropriated pursuant to the authorization of
appropriations in subparagraph (A) for a fiscal year
shall supplement and not supplant any other amounts
appropriated in such fiscal year for research on
methamphetamine abuse and addiction.''.
SEC. 3632. METHAMPHETAMINE AND AMPHETAMINE TREATMENT INITIATIVE BY
CENTER FOR SUBSTANCE ABUSE TREATMENT.
Subpart 1 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb et seq.) is amended by adding at the end the following new
section:
``methamphetamine and amphetamine treatment initiative
``Sec. 514. (a) Grants.--
``(1) Authority to make grants.--The Director of the Center
for Substance Abuse Treatment may make grants to States and
Indian tribes recognized by the United States that have a high
rate, or have had a rapid increase, in methamphetamine or
amphetamine abuse or addiction in order to permit such States
and Indian tribes to expand activities in connection with the
treatment of methamphetamine or amphetamine abuser or addiction
in the specific geographical areas of such States or Indian
tribes, as the case may be, where there is such a rate or has
been such an increase.
``(2) Recipients.--Any grants under paragraph (1) shall be
directed to the substance abuse directors of the States, and of
the appropriate tribal government authorities of the Indian
tribes, selected by the Director to receive such grants.
``(3) Nature of activities.--Any activities under a grant
under paragraph (1) shall be based on reliable scientific
evidence of their efficacy in the treatment of methamphetamine
or amphetamine abuse or addiction.
``(b) Geographic Distribution.--The Director shall ensure that
grants under subsection (a) are distributed equitably among the various
regions of the country and among rural, urban, and suburban areas that
are affected by methamphetamine or amphetamine abuse or addiction.
``(c) Additional Activities.--The Director shall--
``(1) evaluate the activities supported by grants under
subsection (a);
``(2) disseminate widely such significant information
derived from the evaluation as the Director considers
appropriate to assist States, Indian tribes, and private
providers of treatment services for methamphetamine or
amphetamine abuser or addiction in the treatment of
methamphetamine or amphetamine abuse or addiction; and
``(3) provide States, Indian tribes, and such providers
with technical assistance in connection with the provision of
such treatment.
``(d) Authorization of Appropriations.--
``(1) In general.--There are authorized to be appropriated
to carry out this section $10,000,000 for fiscal year 2000 and
such sums as may be necessary for each of fiscal years 2001 and
2002.
``(2) Use of certain funds.--Of the funds appropriated to
carry out this section in any fiscal year, the lesser of 5
percent of such funds or $1,000,000 shall be available to the
Director for purposes of carrying out subsection (c).''.
SEC. 3633. STUDY OF METHAMPHETAMINE TREATMENT.
(a) Study.--
(1) Requirement.--The Secretary of Health and Human
Services shall, in consultation with the Institute of Medicine
of the National Academy of Sciences, conduct a study on the
development of medications for the treatment of addiction to
amphetamine and methamphetamine.
(2) Report.--Not later than 9 months after the date of
enactment of this Act, the Secretary shall submit to the
Committees on the Judiciary of the Senate and House of
Representatives a report on the results of the study conducted
under paragraph (1).
(b) Authorization of Appropriations.--There are hereby authorized
to be appropriated for the Department of Health and Human Services for
fiscal year 2000 such sums as may be necessary to meet the requirements
of subsection (a).
PART IV--REPORTS
SEC. 3641. REPORTS ON CONSUMPTION OF METHAMPHETAMINE AND OTHER ILLICIT
DRUGS IN RURAL AREAS, METROPOLITAN AREAS, AND
CONSOLIDATED METROPOLITAN AREAS.
The Secretary of Health and Human Services shall include in each
National Household Survey on Drug Abuse appropriate prevalence data and
information on the consumption of methamphetamine and other illicit
drugs in rural areas, metropolitan areas, and consolidated metropolitan
areas.
SEC. 3642. REPORT ON DIVERSION OF ORDINARY, OVER-THE-COUNTER
PSEUDOEPHEDRINE AND PHENYLPROPANOLAMINE PRODUCTS.
(a) Study.--The Attorney General shall conduct a study of the use
of ordinary, over-the-counter pseudoephedrine and phenylpropanolamine
products in the clandestine production of illicit drugs. Sources of
data for the study shall include the following:
(1) Information from Federal, State, and local clandestine
laboratory seizures and related investigations identifying the
source, type, or brand of drug products being utilized and how
they were obtained for the illicit production of
methamphetamine and amphetamine.
(2) Information submitted voluntarily from the
pharmaceutical and retail industries involved in the
manufacture, distribution, and sale of drug products containing
ephedrine, pseudoephedrine, and phenylpropanolamine, including
information on changes in the pattern, volume, or both, of
sales of ordinary, over-the-counter pseudoephedrine and
phenylpropanolamine products.
(b) Report.--
(1) Requirement.--Not later than 1 year after the date of
enactment of this Act, the Attorney General shall submit to
Congress a report on the study conducted under subsection (a).
(2) Elements.--The report shall include--
(A) the findings of the Attorney General as a
result of the study; and
(B) such recommendations on the need to establish
additional measures to prevent diversion of ordinary,
over-the-counter pseudoephedrine and
phenylpropanolamine (such as a threshold on ordinary,
over-the-counter pseudoephedrine and
phenylpropanolamine products) as the Attorney General
considers appropriate.
(3) Matters considered.--In preparing the report, the
Attorney General shall consider the comments and
recommendations including the comments on the Attorney
General's proposed findings and recommendations, of State and
local law enforcement and regulatory officials and of
representatives of the industry described in subsection (a)(2).
(c) Regulation of Retail Sales.--
(1) In general.--Notwithstanding section 401(d) of the
Comprehensive Methamphetamine Control Act of 1996 (21 U.S.C.
802 note) and subject to paragraph (2), the Attorney General
shall establish by regulation a single-transaction limit of not
less than 24 grams of ordinary, over-the-counter
pseudoephedrine or phenylpropanolamine (as the case may be) for
retail distributors, if the Attorney General finds, in the
report under subsection (b), that--
(A) there is a significant number of instances (as
set forth in paragraph (3)(A) of such section 401(d)
for purposes of such section) where ordinary, over-the-
counter pseudoephedrine products, phenylpropanolamine
products, or both such products that were purchased
from retail distributors were widely used in the
clandestine production of illicit drugs; and
(B) the best practical method of preventing such
use is the establishment of single-transaction limits
for retail distributors of either or both of such
products.
(2) Due process.--The Attorney General shall establish the
single-transaction limit under paragraph (1) only after notice,
comment, and an informal hearing.
Subtitle B--Controlled Substances Generally
SEC. 3651. ENHANCED PUNISHMENT FOR TRAFFICKING IN LIST I CHEMICALS.
(a) Amendments to Federal Sentencing Guidelines.--Pursuant to its
authority under section 994(p) of title 28, United States Code, the
United States Sentencing Commission shall amend the Federal sentencing
guidelines in accordance with this section with respect to any
violation of paragraph (1) or (2) of section 401(d) of the Controlled
Substances Act (21 U.S.C. 841(d)) involving a list I chemical and any
violation of paragraph (1) or (3) of section 1010(d) of the Controlled
Substance Import and Export Act (21 U.S.C. 960(d)) involving a list I
chemical.
(b) Ephedrine, Phenylpropanolamine, and Pseudoephedrine.--
(1) In general.--In carrying this section, the United
States Sentencing Commission shall, with respect to each
offense described in subsection (a) involving ephedrine,
phenylpropanolamine, or pseudoephedrine (including their salts,
optical isomers, and salts of optical isomers), review and
amend its guidelines to provide for increased penalties such
that those penalties corresponded to the quantity of controlled
substance that could reasonably have been manufactured using
the quantity of ephedrine, phenylpropanolamine, or
pseudoephedrine possessed or distributed.
(2) Conversion ratios.--For the purposes of the amendments
made by this subsection, the quantity of controlled substance
that could reasonably have been manufactured shall be
determined by using a table of manufacturing conversion ratios
for ephedrine, phenylpropanolamine, and pseudoephedrine, which
table shall be established by the Sentencing Commission based
on scientific, law enforcement, and other data the Sentencing
Commission considers appropriate.
(c) Other List I Chemicals.--In carrying this section, the United
States Sentencing Commission shall, with respect to each offense
described in subsection (a) involving any list I chemical other than
ephedrine, phenylpropanolamine, or pseudoephedrine, review and amend
its guidelines to provide for increased penalties such that those
penalties reflect the dangerous nature of such offenses, the need for
aggressive law enforcement action to fight such offenses, and the
extreme dangers associated with unlawful activity involving
methamphetamine and amphetamine, including--
(1) the rapidly growing incidence of controlled substance
manufacturing;
(2) the extreme danger inherent in manufacturing controlled
substances;
(3) the threat to public safety posed by manufacturing
controlled substances; and
(4) the recent increase in the importation, possession, and
distribution of list I chemicals for the purpose of
manufacturing controlled substances.
(d) Emergency Authority to Sentencing Commission.--The United
States Sentencing Commission shall promulgate amendments pursuant to
this section as soon as practicable after the date of enactment of this
Act in accordance with the procedure set forth in section 21(a) of the
Sentencing Act of 1987 (Public Law 100-182), as though the authority
under that Act had not expired.
SEC. 3652. MAIL ORDER REQUIREMENTS.
Section 310(b)(3) of the Controlled Substances Act (21 U.S.C.
830(b)(3)) is amended--
(1) by redesignating subparagraphs (A) and (B) as
subparagraphs (B) and (C), respectively;
(2) by inserting before subparagraph (B), as so
redesignated, the following new subparagraph (A):
``(A) As used in this paragraph:
``(i) The term `drug product' means an
active ingredient in dosage form that has been
approved or otherwise may be lawfully marketed
under the Food, Drug, and Cosmetic Act for
distribution in the United States.
``(ii) The term `valid prescription' means
a prescription which is issued for a legitimate
medical purpose by an individual practitioner
licensed by law to administer and prescribe the
drugs concerned and acting in the usual course
of the practitioner's professional practice.'';
(3) in subparagraph (B), as so redesignated, by inserting
``or who engages in an export transaction'' after
``nonregulated person''; and
(4) adding at the end the following:
``(D) Except as provided in subparagraph (E), the
following distributions to a nonregulated person, and
the following export transactions, shall not be subject
to the reporting requirement in subparagraph (B):
``(i) Distributions of sample packages of
drug products when such packages contain not
more than 2 solid dosage units or the
equivalent of 2 dosage units in liquid form,
not to exceed 10 milliliters of liquid per
package, and not more than one package is
distributed to an individual or residential
address in any 30-day period.
``(ii) Distributions of drug products by
retail distributors that may not include face-
to-face transactions to the extent that such
distributions are consistent with the
activities authorized for a retail distributor
as specified in section 102(46).
``(iii) Distributions of drug products to a
resident of a long term care facility (as that
term is defined in regulations prescribed by
the Attorney General) or distributions of drug
products to a long term care facility for
dispensing to or for use by a resident of that
facility.
``(iv) Distributions of drug products
pursuant to a valid prescription.
``(v) Exports which have been reported to
the Attorney General pursuant to section 1004
or 1018 or which are subject to a waiver
granted under section 1018(e)(2).
``(vi) Any quantity, method, or type of
distribution or any quantity, method, or type
of distribution of a specific listed chemical
(including specific formulations or drug
products) or of a group of listed chemicals
(including specific formulations or drug
products) which the Attorney General has
excluded by regulation from such reporting
requirement on the basis that such reporting is
not necessary for the enforcement of this title
or title III.
``(E) The Attorney General may revoke any or all of
the exemptions listed in subparagraph (D) for an
individual regulated person if he finds that drug
products distributed by the regulated person are being
used in violation of this title or title III. The
regulated person shall be notified of the revocation,
which will be effective upon receipt by the person of
such notice, as provided in section 1018(c)(1), and
shall have the right to an expedited hearing as
provided in section 1018(c)(2).''.
SEC. 3653. THEFT AND TRANSPORTATION OF ANHYDROUS AMMONIA FOR PURPOSES
OF ILLICIT PRODUCTION OF CONTROLLED SUBSTANCES.
(a) In General.--Part D of the Controlled Substances Act (21 U.S.C.
841 et seq.) is amended by adding at the end the following:
``anhydrous ammonia
``Sec. 423. (a) It is unlawful for any person--
``(1) to steal anhydrous ammonia, or
``(2) to transport stolen anhydrous ammonia across State
lines,
knowing, intending, or having reasonable cause to believe that such
anhydrous ammonia will be used to manufacture a controlled substance in
violation of this part.
``(b) Any person who violates subsection (a) shall be imprisoned or
fined, or both, in accordance with section 403(d) as if such violation
were a violation of a provision of section 403.''.
(b) Clerical Amendment.--The table of contents for that Act is
amended by inserting after the item relating to section 421 the
following new items:
``Sec. 422. Drug paraphernalia.
``Sec. 423. Anhydrous ammonia.''.
(c) Assistance for Certain Research.--
(1) Agreement.--The Administrator of the Drug Enforcement
Administration shall seek to enter into an agreement with Iowa
State University in order to permit the University to continue
and expand its current research into the development of inert
agents that, when added to anhydrous ammonia, eliminate the
usefulness of anhydrous ammonia as an ingredient in the
production of methamphetamine.
(2) Reimbursable provision of funds.--The agreement under
paragraph (1) may provide for the provision to Iowa State
University, on a reimbursable basis, of $500,000 for purposes
the activities specified in that paragraph.
(3) Authorization of appropriations.--There is hereby
authorized to be appropriated for the Drug Enforcement
Administration for fiscal year 2000, $500,000 for purposes of
carrying out the agreement under this subsection.
Subtitle C--Ecstasy Anti-Proliferation Act of 2000
SEC. 3661. SHORT TITLE.
This subtitle may be cited as the ``Ecstasy Anti-Proliferation Act
of 2000''.
SEC. 3662. FINDINGS.
Congress makes the following findings:
(1) The illegal importation of 3,4-methylenedioxy
methamphetamine, commonly referred to as ``MDMA'' or
``Ecstasy'' (referred to in this subtitle as ``Ecstasy''), has
increased in recent years, as evidenced by the fact that
Ecstasy seizures by the United States Customs Service have
increased from less than 500,000 tablets during fiscal year
1997 to more than 9,000,000 tablets during the first 9 months
of fiscal year 2000.
(2) Use of Ecstasy can cause long-lasting, and perhaps
permanent, damage to the serotonin system of the brain, which
is fundamental to the integration of information and emotion,
and this damage can cause long-term problems with learning and
memory.
(3) Due to the popularity and marketability of Ecstasy,
there are numerous Internet websites with information on the
effects of Ecstasy, the production of Ecstasy, and the
locations of Ecstasy use (often referred to as ``raves''). The
availability of this information targets the primary users of
Ecstasy, who are most often college students, young
professionals, and other young people from middle- to high-
income families.
(4) Greater emphasis needs to be placed on--
(A) penalties associated with the manufacture,
distribution, and use of Ecstasy;
(B) the education of young people on the negative
health effects of Ecstasy, since the reputation of
Ecstasy as a ``safe'' drug is the most dangerous
component of Ecstasy;
(C) the education of State and local law
enforcement agencies regarding the growing problem of
Ecstasy trafficking across the United States;
(D) reducing the number of deaths caused by Ecstasy
use and the combined use of Ecstasy with other ``club''
drugs and alcohol; and
(E) adequate funding for research by the National
Institute on Drug Abuse to--
(i) identify those most vulnerable to using
Ecstasy and develop science-based prevention
approaches tailored to the specific needs of
individuals at high risk;
(ii) understand how Ecstasy produces its
toxic effects and how to reverse neurotoxic
damage;
(iii) develop treatments, including new
medications and behavioral treatment
approaches;
(iv) better understand the effects that
Ecstasy has on the developing children and
adolescents; and
(v) translate research findings into useful
tools and ensure their effective dissemination.
SEC. 3663. ENHANCED PUNISHMENT OF ECSTASY TRAFFICKERS.
(a) Amendment to Federal Sentencing Guidelines.--Pursuant to its
authority under section 994(p) of title 28, United States Code, the
United States Sentencing Commission (referred to in this section as the
``Commission'') shall amend the Federal sentencing guidelines regarding
any offense relating to the manufacture, importation, or exportation
of, or trafficking in--
(1) 3,4-methylenedioxy methamphetamine;
(2) 3,4-methylenedioxy amphetamine;
(3) 3,4-methylenedioxy-N-ethylamphetamine;
(4) paramethoxymethamphetamine (PMA); or
(5) any other controlled substance, as determined by the
Commission in consultation with the Attorney General, that is
marketed as Ecstasy and that has either a chemical structure
substantially similar to that of 3,4-methylenedioxy
methamphetamine or an effect on the central nervous system
substantially similar to or greater than that of 3,4-
methylenedioxy methamphetamine;
including an attempt or conspiracy to commit an offense described in
paragraph (1), (2), (3), (4), or (5) in violation of the Controlled
Substances Act (21 U.S.C. 801 et seq.), the Controlled Substances
Import and Export Act (21 U.S.C. 951 et seq.), or the Maritime Drug Law
Enforcement Act (46 U.S.C. 1901 et seq.).
(b) General Requirements.--In carrying out this section, the
Commission shall, with respect to each offense described in subsection
(a)--
(1) review and amend the Federal sentencing guidelines to
provide for increased penalties such that those penalties
reflect the seriousness of these offenses and the need to deter
them; and
(2) take any other action the Commission considers to be
necessary to carry out this section.
(c) Additional Requirements.--In carrying out this section, the
Commission shall ensure that the Federal sentencing guidelines for
offenders convicted of offenses described in subsection (a) reflect--
(1) the need for aggressive law enforcement action with
respect to offenses involving the controlled substances
described in subsection (a); and
(2) the dangers associated with unlawful activity involving
such substances, including--
(A) the rapidly growing incidence of abuse of the
controlled substances described in subsection (a) and
the threat to public safety that such abuse poses;
(B) the recent increase in the illegal importation
of the controlled substances described in subsection
(a);
(C) the young age at which children are beginning
to use the controlled substances described in
subsection (a);
(D) the fact that the controlled substances
described in subsection (a) are frequently marketed to
youth;
(E) the large number of doses per gram of the
controlled substances described in subsection (a); and
(F) any other factor that the Commission determines
to be appropriate.
(d) Sense of Congress.--It is the sense of Congress that--
(1) the base offense levels for Ecstasy are too low,
particularly for high-level traffickers, and should be
increased, such that they are comparable to penalties for other
drugs of abuse; and
(2) based on the fact that importation of Ecstasy has
surged in the past few years, the traffickers are targeting the
Nation's youth, and the use of Ecstasy among youth in the
United States is increasing even as other drug use among this
population appears to be leveling off, the base offense levels
for importing and trafficking the controlled substances
described in subsection (a) should be increased.
(e) Report.--Not later than 60 days after the amendments pursuant
to this section have been promulgated, the Commission shall--
(1) prepare a report describing the factors and information
considered by the Commission in promulgating amendments
pursuant to this section; and
(2) submit the report to--
(A) the Committee on the Judiciary, the Committee
on Health, Education, Labor, and Pensions, and the
Committee on Appropriations of the Senate; and
(B) the Committee on the Judiciary, the Committee
on Commerce, and the Committee on Appropriations of the
House of Representatives.
SEC. 3664. EMERGENCY AUTHORITY TO UNITED STATES SENTENCING COMMISSION.
The United States Sentencing Commission shall promulgate amendments
under this subtitle as soon as practicable after the date of enactment
of this Act in accordance with the procedure set forth in section 21(a)
of the Sentencing Act of 1987 (Public Law 100-182), as though the
authority under that Act had not expired.
SEC. 3665. EXPANSION OF ECSTASY AND CLUB DRUGS ABUSE PREVENTION
EFFORTS.
(a) Public Health Service Act.--Part A of title V of the Public
Health Service Act (42 U.S.C. 290aa et seq.), as amended by section
3306, is further amended by adding at the end the following:
``SEC. 506B. GRANTS FOR ECSTASY AND OTHER CLUB DRUGS ABUSE PREVENTION.
``(a) Authority.--The Administrator may make grants to, and enter
into contracts and cooperative agreements with, public and nonprofit
private entities to enable such entities--
``(1) to carry out school-based programs concerning the
dangers of the abuse of and addiction to 3,4-methylenedioxy
methamphetamine, related drugs, and other drugs commonly
referred to as `club drugs' using methods that are effective
and science-based, including initiatives that give students the
responsibility to create their own anti-drug abuse education
programs for their schools; and
``(2) to carry out community-based abuse and addiction
prevention programs relating to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs that are
effective and science-based.
``(b) Use of Funds.--Amounts made available under a grant, contract
or cooperative agreement under subsection (a) shall be used for
planning, establishing, or administering prevention programs relating
to 3,4-methylenedioxy methamphetamine, related drugs, and other club
drugs.
``(c) Use of Funds.--
``(1) Discretionary functions.--Amounts provided to an
entity under this section may be used--
``(A) to carry out school-based programs that are
focused on those districts with high or increasing
rates of abuse and addiction to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs
and targeted at populations that are most at risk to
start abusing these drugs;
``(B) to carry out community-based prevention
programs that are focused on those populations within
the community that are most at-risk for abuse of and
addiction to 3,4-methylenedioxy methamphetamine,
related drugs, and other club drugs;
``(C) to assist local government entities to
conduct appropriate prevention activities relating to
3,4-methylenedioxy methamphetamine, related drugs, and
other club drugs;
``(D) to train and educate State and local law
enforcement officials, prevention and education
officials, health professionals, members of community
anti-drug coalitions and parents on the signs of abuse
of and addiction to 3,4-methylenedioxy methamphetamine,
related drugs, and other club drugs and the options for
treatment and prevention;
``(E) for planning, administration, and educational
activities related to the prevention of abuse of and
addiction to 3,4-methylenedioxy methamphetamine,
related drugs, and other club drugs;
``(F) for the monitoring and evaluation of
prevention activities relating to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs
and reporting and disseminating resulting information
to the public; and
``(G) for targeted pilot programs with evaluation
components to encourage innovation and experimentation
with new methodologies.
``(2) Priority.--The Administrator shall give priority in
awarding grants under this section to rural and urban areas
that are experiencing a high rate or rapid increases in abuse
and addiction to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs.
``(d) Allocation and Report.--
``(1) Prevention program allocation.--Not less than
$500,000 of the amount appropriated in each fiscal year to
carry out this section shall be made available to the
Administrator, acting in consultation with other Federal
agencies, to support and conduct periodic analyses and
evaluations of effective prevention programs for abuse of and
addiction to 3,4-methylenedioxy methamphetamine, related drugs,
and other club drugs and the development of appropriate
strategies for disseminating information about and implementing
such programs.
``(2) Report.--The Administrator shall annually prepare and
submit to the Committee on Health, Education, Labor, and
Pensions, the Committee on the Judiciary, and the Committee on
Appropriations of the Senate, and the Committee on Commerce,
the Committee on the Judiciary, and the Committee on
Appropriations of the House of Representatives, a report
containing the results of the analyses and evaluations
conducted under paragraph (1).
``(e) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section--
``(1) $10,000,000 for fiscal year 2001; and
``(2) such sums as may be necessary for each succeeding
fiscal year.''.
Subtitle D--Miscellaneous
SEC. 3671. ANTIDRUG MESSAGES ON FEDERAL GOVERNMENT INTERNET WEBSITES.
Not later than 90 days after the date of enactment of this Act, the
head of each department, agency, and establishment of the Federal
Government shall, in consultation with the Director of the Office of
National Drug Control Policy, place antidrug messages on appropriate
Internet websites controlled by such department, agency, or
establishment which messages shall, where appropriate, contain an
electronic hyperlink to the Internet website, if any, of the Office.
SEC. 3672. REIMBURSEMENT BY DRUG ENFORCEMENT ADMINISTRATION OF EXPENSES
INCURRED TO REMEDIATE METHAMPHETAMINE LABORATORIES.
(a) Reimbursement Authorized.--The Attorney General, acting through
the Administrator of the Drug Enforcement Administration, may reimburse
States, units of local government, Indian tribal governments, other
public entities, and multi-jurisdictional or regional consortia thereof
for expenses incurred to clean up and safely dispose of substances
associated with clandestine methamphetamine laboratories which may
present a danger to public health or the environment.
(b) Additional DEA Personnel.--From amounts appropriated or
otherwise made available to carry out this section, the Attorney
General may hire not more than 5 additional Drug Enforcement
Administration personnel to administer this section.
(c) Authorization of Appropriations.--There is authorized to be
appropriated to the Attorney General to carry out this section
$20,000,000 for fiscal year 2001.
SEC. 3673. SEVERABILITY.
Any provision of this title held to be invalid or unenforceable by
its terms, or as applied to any person or circumstance, shall be
construed as to give the maximum effect permitted by law, unless such
provision is held to be utterly invalid or unenforceable, in which
event such provision shall be severed from this title and shall not
affect the applicability of the remainder of this title, or of such
provision, to other persons not similarly situated or to other,
dissimilar circumstances.
Attest:
Secretary.
106th CONGRESS
2d Session
H. R. 4365
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AMENDMENT
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