[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 1893 Referred in House (RFH)]

<DOC>






114th CONGRESS
  2d Session
                                S. 1893


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 5, 2016

            Referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 AN ACT


 
   To reauthorize and improve programs related to mental health and 
                        substance use disorders.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the Mental Health Awareness and 
Improvement Act of 2015.

SEC. 2. GARRETT LEE SMITH MEMORIAL ACT REAUTHORIZATION.

    (a) Suicide Prevention Technical Assistance Center.--Section 520C 
of the Public Health Service Act (42 U.S.C. 290bb-34) is amended--
            (1) in the section heading, by striking the section heading 
        and inserting ``suicide prevention technical assistance 
        center.'';
            (2) in subsection (a), by striking ``and in consultation 
        with'' and all that follows through the period at the end of 
        paragraph (2) and inserting ``shall establish a research, 
        training, and technical assistance resource center to provide 
        appropriate information, training, and technical assistance to 
        States, political subdivisions of States, federally recognized 
        Indian tribes, tribal organizations, institutions of higher 
        education, public organizations, or private nonprofit 
        organizations regarding the prevention of suicide among all 
        ages, particularly among groups that are at high risk for 
        suicide.'';
            (3) by striking subsections (b) and (c);
            (4) by redesignating subsection (d) as subsection (b);
            (5) in subsection (b), as so redesignated--
                    (A) by striking the subsection heading and 
                inserting ``Responsibilities of the Center.'';
                    (B) in the matter preceding paragraph (1), by 
                striking ``The additional research'' and all that 
                follows through ``nonprofit organizations for'' and 
                inserting ``The center established under subsection (a) 
                shall conduct activities for the purpose of'';
                    (C) by striking ``youth suicide'' each place such 
                term appears and inserting ``suicide'';
                    (D) in paragraph (1)--
                            (i) by striking ``the development or 
                        continuation of'' and inserting ``developing 
                        and continuing''; and
                            (ii) by inserting ``for all ages, 
                        particularly among groups that are at high risk 
                        for suicide'' before the semicolon at the end;
                    (E) in paragraph (2), by inserting ``for all ages, 
                particularly among groups that are at high risk for 
                suicide'' before the semicolon at the end;
                    (F) in paragraph (3), by inserting ``and tribal'' 
                after ``statewide'';
                    (G) in paragraph (5), by inserting ``and 
                prevention'' after ``intervention'';
                    (H) in paragraph (8), by striking ``in youth'';
                    (I) in paragraph (9), by striking ``and behavioral 
                health'' and inserting ``health and substance use 
                disorder''; and
                    (J) in paragraph (10), by inserting ``conducting'' 
                before ``other''; and
            (6) by striking subsection (e) and inserting the following:
    ``(c) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $6,000,000 
for each of fiscal years 2016 through 2020.
    ``(d) Annual Report.--Not later than 2 years after the date of 
enactment of this subsection, the Secretary shall submit to Congress a 
report on the activities carried out by the center established under 
subsection (a) during the year involved, including the potential 
impacts of such activities, and the States, organizations, and 
institutions that have worked with the center.''.
    (b) Youth Suicide Early Intervention and Prevention Strategies.--
Section 520E of the Public Health Service Act (42 U.S.C. 290bb-36) is 
amended--
            (1) in paragraph (1) of subsection (a) and in subsection 
        (c), by striking ``substance abuse'' each place such term 
        appears and inserting ``substance use disorder'';
            (2) in subsection (b)(2)--
                    (A) by striking ``each State is awarded only 1 
                grant or cooperative agreement under this section'' and 
                inserting ``a State does not receive more than 1 grant 
                or cooperative agreement under this section at any 1 
                time''; and
                    (B) by striking ``been awarded'' and inserting 
                ``received''; and
    (3) in subsection (g)(2), by striking ``2 years after the date of 
enactment of this section,'' and insert ``2 years after the date of 
enactment of the Mental Health Awareness and Improvement Act of 
2015,''.
            (4) by striking subsection (m) and inserting the following:
    ``(m) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $30,000,000 
for each of fiscal years 2016 through 2020.''.
    (c) Mental Health and Substance Use Disorder Services.--Section 
520E-2 of the Public Health Service Act (42 U.S.C. 290bb-36b) is 
amended--
            (1) in the section heading, by striking ``and behavioral 
        health'' and inserting ``health and substance use disorder'';
            (2) in subsection (a)--
                    (A) by striking ``Services,'' and inserting 
                ``Services and'';
                    (B) by striking ``and behavioral health problems'' 
                and inserting ``health or substance use disorders''; 
                and
                    (C) by striking ``substance abuse'' and inserting 
                ``substance use disorders'';
            (3) in subsection (b)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``for--'' and inserting ``for one or more of 
                the following:''; and
                    (B) by striking paragraphs (1) through (6) and 
                inserting the following:
            ``(1) Educating students, families, faculty, and staff to 
        increase awareness of mental health and substance use 
        disorders.
            ``(2) The operation of hotlines.
            ``(3) Preparing informational material.
            ``(4) Providing outreach services to notify students about 
        available mental health and substance use disorder services.
            ``(5) Administering voluntary mental health and substance 
        use disorder screenings and assessments.
            ``(6) Supporting the training of students, faculty, and 
        staff to respond effectively to students with mental health and 
        substance use disorders.
            ``(7) Creating a network infrastructure to link colleges 
        and universities with health care providers who treat mental 
        health and substance use disorders.'';
            (4) in subsection (c)(5), by striking ``substance abuse'' 
        and inserting ``substance use disorder'';
            (5) in subsection (d)--
                    (A) in the matter preceding paragraph (1), by 
                striking ``An institution of higher education desiring 
                a grant under this section'' and inserting ``To be 
                eligible to receive a grant under this section, an 
                institution of higher education'';
                    (B) in paragraph (1)--
                            (i) by striking ``and behavioral health'' 
                        and inserting ``health and substance use 
                        disorder''; and
                            (ii) by inserting ``, including veterans 
                        whenever possible and appropriate,'' after 
                        ``students''; and
                    (C) in paragraph (2), by inserting ``, which may 
                include, as appropriate and in accordance with 
                subsection (b)(7), a plan to seek input from relevant 
                stakeholders in the community, including appropriate 
                public and private entities, in order to carry out the 
                program under the grant'' before the period at the end;
            (6) in subsection (e)(1), by striking ``and behavioral 
        health problems'' and inserting ``health and substance use 
        disorders'';
            (7) in subsection (f)(2)--
                    (A) by striking ``and behavioral health'' and 
                inserting ``health and substance use disorder''; and
                    (B) by striking ``suicide and substance abuse'' and 
                inserting ``suicide and substance use disorders''; and
            (8) in subsection (h), by striking ``$5,000,000 for fiscal 
        year 2005'' and all that follows through the period at the end 
        and inserting ``$6,500,000 for each of fiscal years 2016 
        through 2020.''.

SEC. 3. MENTAL HEALTH AWARENESS TRAINING GRANTS.

    Section 520J of the Public Health Service Act (42 U.S.C. 290bb-41) 
is amended--
            (1) in the section heading, by inserting ``mental health 
        awareness'' before ``training''; and
            (2) in subsection (b)--
                    (A) in the subsection heading, by striking 
                ``Illness'' and inserting ``Health'';
                    (B) in paragraph (1), by inserting ``and other 
                categories of individuals, as determined by the 
                Secretary,'' after ``emergency services personnel'';
                    (C) in paragraph (5)--
                            (i) in the matter preceding subparagraph 
                        (A), by striking ``to'' and inserting ``for 
                        evidence-based programs for the purpose of''; 
                        and
                            (ii) by striking subparagraphs (A) through 
                        (C) and inserting the following:
                    ``(A) recognizing the signs and symptoms of mental 
                illness; and
                    ``(B)(i) providing education to personnel regarding 
                resources available in the community for individuals 
                with a mental illness and other relevant resources; or
                    ``(ii) the safe de-escalation of crisis situations 
                involving individuals with a mental illness.''; and
                    (D) in paragraph (7), by striking ``, $25,000,000'' 
                and all that follows through the period at the end and 
                inserting ``$15,000,000 for each of fiscal years 2016 
                through 2020.''.

SEC. 4. CHILDREN'S RECOVERY FROM TRAUMA.

    Section 582 of the Public Health Service Act (42 U.S.C. 290hh-1) is 
amended--
            (1) in subsection (a), by striking ``developing programs'' 
        and all that follows through the period at the end and 
        inserting ``developing and maintaining programs that provide 
        for--
            ``(1) the continued operation of the National Child 
        Traumatic Stress Initiative (referred to in this section as the 
        `NCTSI'), which includes a cooperative agreement with a 
        coordinating center, that focuses on the mental, behavioral, 
        and biological aspects of psychological trauma response, 
        prevention of the long-term consequences of child trauma, and 
        early intervention services and treatment to address the long-
        term consequences of child trauma; and
            ``(2) the development of knowledge with regard to evidence-
        based practices for identifying and treating mental, 
        behavioral, and biological disorders of children and youth 
        resulting from witnessing or experiencing a traumatic event.'';
            (2) in subsection (b)--
                    (A) by striking ``subsection (a) related'' and 
                inserting ``subsection (a)(2) (related'';
                    (B) by striking ``treating disorders associated 
                with psychological trauma'' and inserting ``treating 
                mental, behavioral, and biological disorders associated 
                with psychological trauma)''; and
                    (C) by striking ``mental health agencies and 
                programs that have established clinical and basic 
                research'' and inserting ``universities, hospitals, 
                mental health agencies, and other programs that have 
                established clinical expertise and research'';
            (3) by redesignating subsections (c) through (g) as 
        subsections (g) through (k), respectively;
            (4) by inserting after subsection (b), the following:
    ``(c) Child Outcome Data.--The NCTSI coordinating center shall 
collect, analyze, and report NCTSI-wide child treatment process and 
outcome data regarding the early identification and delivery of 
evidence-based treatment and services for children and families served 
by the NCTSI grantees.
    ``(d) Training.--The NCTSI coordinating center shall facilitate the 
coordination of training initiatives in evidence-based and trauma-
informed treatments, interventions, and practices offered to NCTSI 
grantees, providers, and partners.
    ``(e) Dissemination and Collaboration.--The NCTSI coordinating 
center shall, as appropriate, collaborate with--
            ``(1) the Secretary, in the dissemination of evidence-based 
        and trauma-informed interventions, treatments, products, and 
        other resources to appropriate stakeholders; and
            ``(2) appropriate agencies that conduct or fund research 
        within the Department of Health and Human Services, for 
        purposes of sharing NCTSI expertise, evaluation data, and other 
        activities, as appropriate.
    ``(f) Review.--The Secretary shall, consistent with the peer review 
process, ensure that NCTSI applications are reviewed by appropriate 
experts in the field as part of a consensus review process. The 
Secretary shall include review criteria related to expertise and 
experience in child trauma and evidence-based practices.'';
            (5) in subsection (g) (as so redesignated), by striking 
        ``with respect to centers of excellence are distributed 
        equitably among the regions of the country'' and inserting 
        ``are distributed equitably among the regions of the United 
        States'';
            (6) in subsection (i) (as so redesignated), by striking 
        ``recipient may not exceed 5 years'' and inserting ``recipient 
        shall not be less than 4 years, but shall not exceed 5 years''; 
        and
            (7) in subsection (j) (as so redesignated), by striking 
        ``$50,000,000'' and all that follows through ``2006'' and 
        inserting ``$46,000,000 for each of fiscal years 2016 through 
        2020''.

SEC. 5. ASSESSING BARRIERS TO BEHAVIORAL HEALTH INTEGRATION.

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

SEC. 6. INCREASING EDUCATION AND AWARENESS OF TREATMENTS FOR OPIOID USE 
              DISORDERS.

    (a) In General.--In order to improve the quality of care delivery 
and treatment outcomes among patients with opioid use disorders, the 
Secretary of Health and Human Services (referred to in this section as 
the ``Secretary''), acting through the Administrator for the Substance 
Abuse and Mental Health Services Administration, may advance, through 
existing programs as appropriate, the education and awareness of 
providers, patients, and other appropriate stakeholders regarding all 
products approved by the Food and Drug Administration to treat opioid 
use disorders.
    (b) Activities.--The activities described in subsection (a) may 
include--
            (1) disseminating evidence-based practices for the 
        treatment of opioid use disorders;
            (2) facilitating continuing education programs for health 
        professionals involved in treating opioid use disorders;
            (3) increasing awareness among relevant stakeholders of the 
        treatment of opioid use disorders;
            (4) assessing current barriers to the treatment of opioid 
        use disorders for patients and providers and development and 
        implementation of strategies to mitigate such barriers; and
            (5) continuing innovative approaches to the treatment of 
        opioid use disorders in various treatment settings, such as 
        prisons, community mental health centers, primary care, and 
        hospitals.
    (c) Report.--Not later than 1 year after the date of enactment of 
this Act, if the Secretary carries out the activities under this 
section, the Secretary shall submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives a report that 
examines--
            (1) the activities the Substance Abuse and Mental Health 
        Services Administration conducts under this section, including 
        any potential impacts on health care costs associated with such 
        activities;
            (2) the role of adherence in the treatment of opioid use 
        disorders and methods to reduce opioid use disorders; and
            (3) recommendations on priorities and strategies to address 
        co-occurring substance use disorders and mental illnesses.

SEC. 7. EXAMINING MENTAL HEALTH CARE FOR CHILDREN.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Comptroller General of the United States shall conduct 
an independent evaluation, and submit to the Committee on Health, 
Education, Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives, a report 
concerning the utilization of mental health services for children, 
including the usage of psychotropic medications.
    (b) Content.--The report submitted under subsection (a) shall 
review and assess--
            (1) the ways in which children access mental health care, 
        including information on whether children are treated by 
        primary care or specialty providers, what types of referrals 
        for additional care are recommended, and any barriers to 
        accessing this care;
            (2) the extent to which children are prescribed 
        psychotropic medications in the United States including the 
        frequency of concurrent medication usage; and
            (3) the tools, assessments, and medications that are 
        available and used to diagnose and treat children with mental 
        health disorders.

SEC. 8. EVIDENCE BASED PRACTICES FOR OLDER ADULTS.

    Section 520A(e) of the Public Health Service Act (42 U.S.C. 290bb-
32(e)) is amended by adding at the end the following:
            ``(3) Geriatric mental health disorders.--The Secretary 
        shall, as appropriate, provide technical assistance to grantees 
        regarding evidence-based practices for the prevention and 
        treatment of geriatric mental health disorders and co-occurring 
        mental health and substance use disorders among geriatric 
        populations, as well as disseminate information about such 
        evidence-based practices to States and nongrantees throughout 
        the United States.''.

SEC. 9. NATIONAL VIOLENT DEATH REPORTING SYSTEM.

    The Secretary of Health and Human Services, acting through the 
Director of the Centers for Disease Control and Prevention, is 
encouraged to improve, particularly through the inclusion of additional 
States, the National Violent Death Reporting System as authorized by 
title III of the Public Health Service Act (42 U.S.C. 241 et seq.). 
Participation in the system by the States shall be voluntary.

SEC. 10. GAO STUDY ON VIRGINIA TECH RECOMMENDATIONS.

    (a) In General.--Not later than 1 year after the date of enactment 
of this Act, the Comptroller General of the United States shall conduct 
an independent evaluation, and submit to the appropriate committees of 
Congress a report concerning the status of implementation of 
recommendations made in the report to the President, On Issues Raised 
by the Virginia Tech Tragedy, by the Secretaries of Health and Human 
Services and Education and the Attorney General of the United States, 
submitted to the President on June 13, 2007.
    (b) Content.--The report submitted to the committees of Congress 
under subsection (a) shall review and assess--
            (1) the extent to which the recommendations in the report 
        that include participation by the Department of Health and 
        Human Services were implemented;
            (2) whether there are any barriers to implementation of 
        such recommendations; and
            (3) identification of any additional actions the Federal 
        government can take to support States and local communities and 
        ensure that the Federal government and Federal law are not 
        obstacles to addressing at the community level--
                    (A) school violence; and
                    (B) mental illness.

SEC. 11. PERFORMANCE METRICS.

    (a) Evaluation of Current Programs.--
            (1) In general.--Not later than 180 days after the date of 
        enactment of this Act, the Assistant Secretary for Planning and 
        Evaluation of the Department of Health and Human Services shall 
        conduct an evaluation of the impact of activities related to 
        the prevention and treatment of mental illness and substance 
        use disorders conducted by the Substance Abuse and Mental 
        Health Services Administration.
            (2) Assessment of performance metrics.--The evaluation 
        conducted under paragraph (1) shall include an assessment of 
        the use of performance metrics to evaluate activities carried 
        out by entities receiving grants, contracts, or cooperative 
        agreements related to mental illness or substance use disorders 
        under title V or title XIX of the Public Health Service Act (42 
        U.S.C. 290aa et seq.; 42 U.S.C. 300w et seq.).
            (3) Recommendations.--The evaluation conducted under 
        paragraph (1) shall include recommendations for the use of 
        performance metrics to improve the quality of programs related 
        to the prevention and treatment of mental illness and substance 
        use disorders.
    (b) Use of Performance Metrics.--Not later than 1 year after the 
date of enactment of this Act, the Secretary of Health and Human 
Services, acting through the Administrator of the Substance Abuse and 
Mental Health Services Administration, shall advance, through existing 
programs, the use of performance metrics, taking into consideration the 
recommendations under subsection (a)(3), to improve programs related to 
the prevention and treatment of mental illness and substance use 
disorders.

            Passed the Senate December 18, 2015.

            Attest:

                                                JULIE E. ADAMS,

                                                             Secretary.