[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4199 Introduced in House (IH)]

<DOC>






116th CONGRESS
  1st Session
                                H. R. 4199

  To protect individuals by strengthening the Nation's mental health 
infrastructure, improving the understanding of violence, strengthening 
   firearm prohibitions and protections for at-risk individuals, and 
 improving and expanding the reporting of mental health records to the 
           National Instant Criminal Background Check System.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            August 20, 2019

Mr. Thompson of California (for himself and Mr. Perlmutter) introduced 
    the following bill; which was referred to the Committee on the 
Judiciary, and in addition to the Committee on Energy and Commerce, for 
a period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
  To protect individuals by strengthening the Nation's mental health 
infrastructure, improving the understanding of violence, strengthening 
   firearm prohibitions and protections for at-risk individuals, and 
 improving and expanding the reporting of mental health records to the 
           National Instant Criminal Background Check System.

    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 ``Safer Communities Act of 2019''.

SEC. 2. TABLE OF CONTENTS.

    The table of contents of this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.
Sec. 3. Statement of purpose.
       TITLE I--STRENGTHENING AND IMPROVING INTERVENTION EFFORTS

Sec. 101. Mental health crisis assessment, prevention, and education 
                            grant program.
Sec. 102. School-based mental health programs.
Sec. 103. High utilizers.
                TITLE II--IMPROVING RESEARCH ON VIOLENCE

Sec. 201. Research with respect to violence.
         TITLE III--UNDERSTANDING THE EPIDEMIC OF GUN VIOLENCE

Sec. 301. National violent death reporting system.
Sec. 302. Reaffirming Centers for Disease Control and Prevention's 
                            authority.
Sec. 303. Protecting confidential doctor-patient relationship.
                  TITLE IV--ENSURING SAFE COMMUNITIES

Sec. 401. Ban on firearm possession by person committed involuntarily 
                            to mental institution on an outpatient 
                            basis.
Sec. 402. Grant program regarding firearms.
Sec. 403. Notification of State and local law enforcement authorities 
                            of attempt to purchase firearm by 
                            ineligible person.
                          TITLE V--RESTORATION

Sec. 501. Federal agency relief program.
Sec. 502. State relief programs.
Sec. 503. Ineligibility due to disqualifying mental status.
TITLE VI--SUBMISSION OF RECORDS TO NATIONAL INSTANT CRIMINAL BACKGROUND 
                              CHECK SYSTEM

Sec. 601. Reports relating to submission of information to NICS.
Sec. 602. Reauthorization of the National Criminal History Records 
                            Improvement Program.
Sec. 603. Improvement of metrics and incentives.
Sec. 604. Grants to States to improve coordination and automation of 
                            NICS record reporting.
Sec. 605. Sharing of records by Federal departments and agencies with 
                            NICS.

SEC. 3. STATEMENT OF PURPOSE.

    The purpose of this Act is to ensure the public safety and welfare 
of communities by promoting evidence-based approaches that will prevent 
the tragic toll of gun violence on families and communities. This 
purpose can be accomplished by--
            (1) strengthening and improving intervention efforts by 
        increasing investments in programs designed to appropriately 
        identify, respond to, treat, and mitigate future behavioral 
        health crises;
            (2) prioritizing research on reducing the threat of gun 
        violence to self or others and identifying further risk factors 
        for violence, including gender, culture, substance abuse, and 
        history of violence; and
            (3) restricting gun access by individuals found to be at an 
        elevated risk of committing future acts of violence against 
        self or others.

       TITLE I--STRENGTHENING AND IMPROVING INTERVENTION EFFORTS

SEC. 101. MENTAL HEALTH CRISIS ASSESSMENT, PREVENTION, AND EDUCATION 
              GRANT PROGRAM.

    (a) Definitions.--For purposes of this section, the following 
definitions shall apply:
            (1) Eligible entity.--The term ``eligible entity'' means a 
        State, political subdivision of a State, or nonprofit private 
        entity.
            (2) Secretary.--The term ``Secretary'' means the Secretary 
        of Health and Human Services.
            (3) State.--The term ``State'' means each State of the 
        United States, the District of Columbia, each commonwealth, 
        territory, or possession of the United States, and each 
        federally recognized Indian tribe.
    (b) Establishment of Grant Program.--
            (1) Establishment.--The Secretary shall establish a program 
        to award grants to eligible entities to carry out the 
        activities described in paragraph (2).
            (2) Use of funds.--
                    (A) In general.--Grants under this section may be 
                used to carry out programs that--
                            (i) expand early invention and treatment 
                        services to improve access to mental health 
                        crisis assistance and address unmet mental 
                        health care needs;
                            (ii) expand the continuum of services to 
                        address crisis intervention and crisis 
                        stabilization;
                            (iii) reduce recidivism due to mental 
                        health crises and mitigate unnecessary 
                        expenditures by local law enforcement; and
                            (iv) reduce unnecessary hospitalizations by 
                        appropriately utilizing community-based 
                        services and improving access to timely mental 
                        health crisis assistance.
                    (B) Authorized activities.--The programs described 
                in subparagraph (A) may include any or all of the 
                following activities:
                            (i) Mental health crisis intervention and 
                        response training for law enforcement (to 
                        increase officers' understanding and 
                        recognition of mental illnesses).
                            (ii) Mobile support that provides field-
                        based behavioral health assistance to law 
                        enforcement and members of the community and 
                        links individuals in crisis to appropriate 
                        services.
                            (iii) School and community-based early 
                        intervention and prevention programs that 
                        provide mobile response, screening and 
                        assessment, training and education, and peer-
                        based and family services.
            (3) Application.--To be considered for a grant under this 
        section, an eligible entity shall submit an application to the 
        Secretary at such time, in such manner, and containing such 
        information as the Secretary may require. At minimum, such 
        application shall include a description of--
                    (A) the activities to be funded with the grant;
                    (B) community needs;
                    (C) the population to be served; and
                    (D) the interaction between the activities 
                described in subparagraph (A) and public systems of 
                health and mental health care, law enforcement, social 
                services, and related assistance programs.
            (4) Selecting among applicants.--
                    (A) In general.--Grants shall be awarded to 
                eligible entities on a competitive basis.
                    (B) Selection criteria.--The Secretary shall 
                evaluate applicants based on such criteria as the 
                Secretary determines to be appropriate, including the 
                ability of an applicant to carry out the activities 
                described in paragraph (2).
            (5) Reports.--
                    (A) Annual reports.--
                            (i) Eligible entities.--As a condition of 
                        receiving a grant under this section, an 
                        eligible entity shall agree to submit a report 
                        to the Secretary, on an annual basis, 
                        describing the activities carried out with the 
                        grant and assessing the effectiveness of such 
                        activities.
                            (ii) Secretary.--The Secretary shall, on an 
                        annual basis, and using the reports received 
                        under clause (i), report to Congress on the 
                        overall impact and effectiveness of the grant 
                        program under this section.
                    (B) Final report.--Not later than January 15, 2024, 
                the Secretary shall submit to Congress a final report 
                that includes recommendations with respect to the 
                feasibility and advisability of extending or expanding 
                the grant program.
            (6) Collection of data.--
                    (A) In general.--The Secretary shall collect data 
                on the grant program to determine its effectiveness in 
                reducing the social impact of mental health crises and 
                the feasibility and advisability of extending the grant 
                program.
                    (B) Manner of collection.--Data described in 
                subparagraph (A) shall be collected and analyzed using 
                a scientific peer-reviewed system and valid and 
                reliable results-based research methodologies.
    (c) Funding.--
            (1) Grant amount.--A grant under this section shall be in 
        an amount that is not more than $100,000 for each of fiscal 
        years 2020 through 2024. Subject to the preceding sentence, the 
        Secretary shall determine the amount of each grant.
            (2) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this section $10,000,000 for 
        each of fiscal years 2020 though 2024.

SEC. 102. SCHOOL-BASED MENTAL HEALTH PROGRAMS.

    (a) Technical Amendments.--The second part G (relating to services 
provided through religious organizations) of title V of the Public 
Health Service Act (42 U.S.C. 290kk et seq.) is amended--
            (1) by redesignating such part as part J; and
            (2) by redesignating sections 581 through 584 as sections 
        596 through 596C, respectively.
    (b) School-Based Mental Health and Children and Violence.--Section 
581 of the Public Health Service Act (42 U.S.C. 290hh) is amended to 
read as follows:

``SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHILDREN AND VIOLENCE.

    ``(a) In General.--The Secretary, in collaboration with the 
Secretary of Education and in consultation with the Attorney General, 
shall, directly or through grants, contracts, or cooperative agreements 
awarded to public entities and local education agencies, assist local 
communities and schools in applying a public health approach to mental 
health services both in schools and in the community. Such approach 
should provide comprehensive age-appropriate services and supports, be 
linguistically and culturally appropriate, be trauma-informed, and 
incorporate age-appropriate strategies of positive behavioral 
interventions and supports. A comprehensive school mental health 
program funded under this section shall assist children in dealing with 
trauma and violence.
    ``(b) Activities.--Under the program under subsection (a), the 
Secretary may--
            ``(1) provide financial support to enable local communities 
        to implement a comprehensive culturally and linguistically 
        appropriate, trauma-informed, and age-appropriate, school 
        mental health program that incorporates positive behavioral 
        interventions, client treatment, and supports 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 child and adolescent trauma 
        and mental health issues and violence when and if it occurs;
            ``(4) facilitate community partnerships among families, 
        students, law enforcement agencies, education systems, mental 
        health and substance use disorder service systems, family-based 
        mental health service systems, welfare agencies, health care 
        service systems (including physicians), faith-based programs, 
        trauma networks, and other community-based systems; and
            ``(5) establish mechanisms for children and adolescents to 
        report incidents of violence or plans by other children, 
        adolescents, or adults to commit violence.
    ``(c) Requirements.--
            ``(1) In general.--To be eligible for a grant, contract, or 
        cooperative agreement under subsection (a), an entity shall--
                    ``(A) be a partnership between a local education 
                agency and at least one community program or agency 
                that is involved in mental health; and
                    ``(B) submit an application, that is endorsed by 
                all members of the partnership, that contains the 
                assurances described in paragraph (2).
            ``(2) Required assurances.--An application under paragraph 
        (1) shall contain assurances as follows:
                    ``(A) That the applicant will ensure that, in 
                carrying out activities under this section, the local 
                educational agency involved will enter into a 
                memorandum of understanding--
                            ``(i) with at least one public or private 
                        mental health entity, health care entity, law 
                        enforcement or juvenile justice entity, child 
                        welfare agency, family-based mental health 
                        entity, family or family organization, trauma 
                        network, or other community-based entity; and
                            ``(ii) that clearly states--
                                    ``(I) how school-employed mental 
                                health professionals (such as school 
                                psychologists, school counselors, and 
                                school social workers) will be utilized 
                                in the comprehensive school mental 
                                health program;
                                    ``(II) the responsibilities of each 
                                partner with respect to the activities 
                                to be carried out;
                                    ``(III) how each such partner will 
                                be accountable for carrying out such 
                                responsibilities; and
                                    ``(IV) the amount of non-Federal 
                                funding or in-kind contributions that 
                                each such partner will contribute in 
                                order to sustain the program.
                    ``(B) That the comprehensive school-based mental 
                health program carried out under this section supports 
                the flexible use of funds to address--
                            ``(i) the promotion of the social, 
                        emotional, mental, and behavioral health and 
                        wellness of all students in an environment that 
                        is conducive to learning;
                            ``(ii) the reduction in the likelihood of 
                        at-risk students developing social, emotional, 
                        mental, and behavioral health problems, or 
                        substance use disorders;
                            ``(iii) the early identification of social, 
                        emotional, mental, and behavioral problems, or 
                        substance use disorders and the provision of 
                        early intervention services;
                            ``(iv) the treatment or referral for 
                        treatment of students with existing social, 
                        emotional, mental, and behavioral health 
                        problems, or substance use disorders; and
                            ``(v) the development and implementation of 
                        programs to assist children in dealing with 
                        trauma and violence.
                    ``(C) That the comprehensive school-based mental 
                health program carried out under this section will 
                provide for in-service training of all school 
                personnel, including ancillary staff and volunteers, 
                in--
                            ``(i) the techniques and supports needed to 
                        identify early children with trauma histories 
                        and children with, or at risk of, mental 
                        illness;
                            ``(ii) the use of referral mechanisms that 
                        effectively link such children to appropriate 
                        treatment and intervention services in the 
                        school and in the community and to follow-up 
                        when services are not available;
                            ``(iii) strategies for promoting the 
                        social, emotional, mental, and behavioral 
                        health of all students; and
                            ``(iv) strategies to increase the knowledge 
                        and skills of school and community leaders 
                        about the impact of trauma and violence and on 
                        the application of a public health approach to 
                        comprehensive school-based mental health 
                        programs.
                    ``(D) That the comprehensive school-based mental 
                health program carried out under this section will 
                include comprehensive training for parents, siblings, 
                and other family members of children with mental health 
                disorders, and for concerned members of the community 
                in--
                            ``(i) the techniques and supports needed to 
                        identify early children with trauma histories, 
                        and children with, or at risk of, mental 
                        illness;
                            ``(ii) the use of referral mechanisms that 
                        effectively link such children to appropriate 
                        treatment and intervention services in the 
                        school and in the community and follow-up when 
                        such services are not available; and
                            ``(iii) strategies that promote a school-
                        wide positive environment.
                    ``(E) That the comprehensive school-based mental 
                health program carried out under this section will 
                demonstrate the measures to be taken to sustain the 
                program after funding under this section terminates.
                    ``(F) That the local education agency partnership 
                involved is supported by the State educational and 
                mental health system to ensure that the sustainability 
                of the programs is established after funding under this 
                section terminates.
                    ``(G) That the comprehensive school-based mental 
                health program carried out under this section will be 
                based on trauma-informed and evidence-based practices.
                    ``(H) That the comprehensive school-based mental 
                health program carried out under this section will be 
                coordinated with early intervening activities carried 
                out under the Individuals with Disabilities Education 
                Act.
                    ``(I) That the comprehensive school-based mental 
                health program carried out under this section will be 
                trauma-informed and culturally and linguistically 
                appropriate.
                    ``(J) That the comprehensive school-based mental 
                health program carried out under this section will 
                include a broad needs assessment of youth who drop out 
                of school due to policies of `zero tolerance' with 
                respect to drugs, alcohol, or weapons and an inability 
                to obtain appropriate services.
                    ``(K) That the mental health services provided 
                through the comprehensive school-based mental health 
                program carried out under this section will be provided 
                by qualified mental and behavioral health professionals 
                who are certified or licensed by the State involved and 
                practicing within their area of expertise.
            ``(3) Coordinator.--Any entity that is a member of a 
        partnership described in paragraph (1)(A) may serve as the 
        coordinator of funding and activities under the grant if all 
        members of the partnership agree.
            ``(4) Compliance with hipaa.--A grantee under this section 
        shall be deemed to be a covered entity for purposes of 
        compliance with the regulations promulgated under section 
        264(c) of the Health Insurance Portability and Accountability 
        Act of 1996 with respect to any patient records developed 
        through activities under the grant.
    ``(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 shall be 6 
years. An entity may receive only one award under this section, except 
that an entity that is providing services and supports on a regional 
basis may receive additional funding after the expiration of the 
preceding grant period.
    ``(f) Evaluation and Measures of Outcomes.--
            ``(1) Development of process.--The Administrator shall 
        develop a fiscally appropriate process for evaluating 
        activities carried out under this section. Such process shall 
        include--
                    ``(A) the development of guidelines for the 
                submission of program data by grant, contract, or 
                cooperative agreement recipients;
                    ``(B) the development of measures of outcomes (in 
                accordance with paragraph (2)) to be applied by such 
                recipients in evaluating programs carried out under 
                this section; and
                    ``(C) the submission of annual reports by such 
                recipients concerning the effectiveness of programs 
                carried out under this section.
            ``(2) Measures of outcomes.--
                    ``(A) In general.--The Administrator shall develop 
                measures of outcomes to be applied by recipients of 
                assistance under this section, and the Administrator, 
                in evaluating the effectiveness of programs carried out 
                under this section. Such measures shall include student 
                and family measures as provided for in subparagraph (B) 
                and local educational measures as provided for under 
                subparagraph (C).
                    ``(B) Student and family measures of outcomes.--The 
                measures of outcomes developed under paragraph (1)(B) 
                relating to students and families shall, with respect 
                to activities carried out under a program under this 
                section, at a minimum include provisions to evaluate 
                whether the program is effective in--
                            ``(i) improving social, emotional, mental, 
                        and behavioral health and wellness;
                            ``(ii) increasing academic competency (as 
                        defined by the Secretary);
                            ``(iii) reducing disruptive and aggressive 
                        behaviors;
                            ``(iv) improving child functioning;
                            ``(v) reducing substance use disorders;
                            ``(vi) reducing suspensions, truancy, 
                        expulsions, and violence;
                            ``(vii) increasing graduation rates 
                        (defined as the percentage of students who 
                        graduate from secondary school with a regular 
                        diploma in the standard number of years); and
                            ``(viii) improving access to care for 
                        mental health disorders.
                    ``(C) Local educational outcomes.--The outcome 
                measures developed under paragraph (1)(B) relating to 
                local educational systems shall, with respect to 
                activities carried out under a program under this 
                section, at a minimum include provisions to evaluate--
                            ``(i) the effectiveness of comprehensive 
                        school mental health programs established under 
                        this section;
                            ``(ii) the effectiveness of formal 
                        partnership linkages among child and family 
                        serving institutions, community support 
                        systems, and the educational system;
                            ``(iii) the progress made in sustaining the 
                        program once funding under the grant has 
                        expired;
                            ``(iv) the effectiveness of training and 
                        professional development programs for all 
                        school personnel that incorporate indicators 
                        that measure cultural and linguistic 
                        competencies under the program in a manner that 
                        incorporates appropriate cultural and 
                        linguistic training;
                            ``(v) the improvement in perception of a 
                        safe and supportive learning environment among 
                        school staff, students, and parents;
                            ``(vi) the improvement in case-finding of 
                        students in need of more intensive services and 
                        referral of identified students to early 
                        intervention and clinical services;
                            ``(vii) the improvement in the immediate 
                        availability of clinical assessment and 
                        treatment services within the context of the 
                        local community to students posing a danger to 
                        themselves or others;
                            ``(viii) the increased successful 
                        matriculation to postsecondary school; and
                            ``(ix) reduced referrals to juvenile 
                        justice.
            ``(3) Submission of annual data.--An entity that receives a 
        grant, contract, or cooperative agreement under this section 
        shall annually submit to the Administrator a report that 
        includes data to evaluate the success of the program carried 
        out by the entity based on whether such program is achieving 
        the purposes of the program. Such reports shall utilize the 
        measures of outcomes under paragraph (2) in a reasonable manner 
        to demonstrate the progress of the program in achieving such 
        purposes.
            ``(4) Evaluation by administrator.--Based on the data 
        submitted under paragraph (3), the Administrator shall annually 
        submit to Congress a report concerning the results and 
        effectiveness of the programs carried out with assistance 
        received under this section.
            ``(5) Limitation.--A grantee shall use not to exceed 10 
        percent of amounts received under a grant under this section to 
        carry out evaluation activities under this subsection.
    ``(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) Amount of Grants and Authorization of Appropriations.--
            ``(1) Amount of grants.--A grant under this section shall 
        be in an amount that is not more than $1,000,000 for each of 
        grant years 2020 though 2024. The Secretary shall determine the 
        amount of each such grant based on the population of children 
        up to age 21 of the area to be served under the grant.
            ``(2) Authorization of appropriations.--There is authorized 
        to be appropriated to carry out this section, $200,000,000 for 
        each of fiscal years 2020 though 2024.''.
    (c) Conforming Amendment.--Part G of title V of the Public Health 
Service Act (42 U.S.C. 290hh et seq.), as amended by this section, is 
further amended by striking the part heading and inserting the 
following:

                ``PART G--SCHOOL-BASED MENTAL HEALTH''.

SEC. 103. HIGH UTILIZERS.

    Section 2991 of the Omnibus Crime Control and Safe Streets Act of 
1968 (34 U.S.C. 10651) is amended--
            (1) by redesignating subsections (m) through (o) as 
        subsections (n) through (p), respectively; and
            (2) by inserting after subsection (l) the following:
    ``(m) Demonstration Grants Responding to High Utilizers.--
            ``(1) Definition.--In this subsection, the term `high 
        utilizer' means an individual who--
                    ``(A) manifests obvious signs of mental illness or 
                has been diagnosed by a qualified mental health 
                professional as having a mental illness; and
                    ``(B) consumes a significantly disproportionate 
                quantity of public resources, such as emergency, 
                housing, judicial, corrections, and law enforcement 
                services.
            ``(2) Demonstration grants responding to high utilizers.--
                    ``(A) In general.--The Attorney General may award 
                not more than 6 grants per year under this subsection 
                to applicants for the purpose of reducing the use of 
                public services by high utilizers.
                    ``(B) Use of grants.--A recipient of a grant 
                awarded under this subsection may use the grant--
                            ``(i) to develop or support 
                        multidisciplinary teams that coordinate, 
                        implement, and administer community-based 
                        crisis responses and long-term plans for high 
                        utilizers;
                            ``(ii) to provide training on how to 
                        respond appropriately to the unique issues 
                        involving high utilizers for public service 
                        personnel, including criminal justice, mental 
                        health, substance abuse, emergency room, 
                        healthcare, law enforcement, corrections, and 
                        housing personnel;
                            ``(iii) to develop or support alternatives 
                        to hospital and jail admissions for high 
                        utilizers that provide treatment, 
                        stabilization, and other appropriate supports 
                        in the least restrictive, yet appropriate, 
                        environment; or
                            ``(iv) to develop protocols and systems 
                        among law enforcement, mental health, substance 
                        abuse, housing, corrections, and emergency 
                        medical service operations to provide 
                        coordinated assistance to high utilizers.
                    ``(C) Report.--Not later than the last day of the 
                first year following the fiscal year in which a grant 
                is awarded under this subsection, the recipient of the 
                grant shall submit to the Attorney General a report 
                that--
                            ``(i) measures the performance of the grant 
                        recipient in reducing the use of public 
                        services by high utilizers; and
                            ``(ii) provides a model set of practices, 
                        systems, or procedures that other jurisdictions 
                        can adopt to reduce the use of public services 
                        by high utilizers.''.

                TITLE II--IMPROVING RESEARCH ON VIOLENCE

SEC. 201. RESEARCH WITH RESPECT TO VIOLENCE.

    (a) In General.--The Secretary of Health and Human Services, in 
consultation with the Director of the National Institutes of Health, 
shall expand and intensify research on self-directed and other-directed 
violence associated with mental illness and substance abuse disorders.
    (b) Limitations on Authorization of Appropriations.--To carry out 
subsection (a), there are authorized to be appropriated $100,000,000 
without fiscal year limitation, which is authorized to remain available 
until expended.

         TITLE III--UNDERSTANDING THE EPIDEMIC OF GUN VIOLENCE

SEC. 301. NATIONAL VIOLENT DEATH REPORTING SYSTEM.

    The Secretary of Health and Human Services, acting through the 
Director of the Centers for Disease Control and Prevention, shall 
improve the National Violent Death Reporting System, as authorized by 
title III of the Public Health Service Act (42 U.S.C. 241 et seq.), 
particularly through the expansion of the application of such system to 
include the 50 States. Participation in the system by the States shall 
be voluntary.

SEC. 302. REAFFIRMING CENTERS FOR DISEASE CONTROL AND PREVENTION'S 
              AUTHORITY.

    (a) In General.--Section 391 of the Public Health Service Act (42 
U.S.C. 280b) is amended--
            (1) in subsection (a)(1), by striking ``research relating 
        to the causes, mechanisms, prevention, diagnosis, treatment of 
        injuries, and rehabilitation from injuries;'' and inserting 
        ``research, including data collection, relating to--
            ``(A) the causes, mechanisms, prevention, diagnosis, and 
        treatment of injuries, including with respect to gun violence; 
        and
            ``(B) rehabilitation from such injuries;''; and
            (2) by adding at the end the following new subsection:
    ``(c) No Advocacy or Promotion of Gun Control.--Nothing in this 
section shall be construed to--
            ``(1) authorize the Secretary to give assistance, make 
        grants, or enter into cooperative agreements or contracts for 
        the purpose of advocating or promoting gun control; or
            ``(2) permit a recipient of any assistance, grant, 
        cooperative agreement, or contract under this section to use 
        such assistance, grant, agreement, or contract for the purpose 
        of advocating or promoting gun control.''.
    (b) Authorization of Appropriations.--Section 394A of the Public 
Health Service Act (42 U.S.C. 280b-3) is amended by striking 
``authorized to be appropriated'' and all that follows through the end 
and inserting the following: ``authorized to be appropriated such sums 
as may be necessary for each of fiscal years 2020 though 2024.''.

SEC. 303. PROTECTING CONFIDENTIAL DOCTOR-PATIENT RELATIONSHIP.

    Section 2717(c) of the Public Health Service Act (42 U.S.C. 300gg-
17(c)) is amended by adding at the end the following new paragraph:
            ``(6) Rule of construction.--Notwithstanding the previous 
        provisions of this subsection, none of the authorities provided 
        to the Secretary under this subsection, Public Law 111-148, or 
        an amendment made by such Public Law shall be construed to 
        prohibit a physician or other health care provider from--
                    ``(A) asking a patient about the ownership, 
                possession, use, or storage of a firearm or ammunition 
                in the home of such patient;
                    ``(B) speaking to a patient about gun safety; or
                    ``(C) reporting to the authorities a patient's 
                threat of violence.''.

                  TITLE IV--ENSURING SAFE COMMUNITIES

SEC. 401. BAN ON FIREARM POSSESSION BY PERSON COMMITTED INVOLUNTARILY 
              TO MENTAL INSTITUTION ON AN OUTPATIENT BASIS.

    Subsections (d)(4) and (g)(4) of section 922 of title 18, United 
States Code, are each amended by inserting ``on an involuntary 
inpatient or involuntary outpatient basis'' before the semicolon.

SEC. 402. GRANT PROGRAM REGARDING FIREARMS.

    Section 506(b) of the Omnibus Crime Control and Safe Streets Act of 
1968 (34 U.S.C. 10157(b)) is amended--
            (1) by striking ``1 or more States or units of local 
        government, for 1 or more of the purposes specified in section 
        501, pursuant to his determination that the same is 
        necessary'';
            (2) by inserting before paragraph (1) the following:
            ``(1) one or more States or units of local government, for 
        one or more of the purposes specified in section 501, pursuant 
        to his determination that the same is necessary--'';
            (3) by redesignating the second paragraph (1) as 
        subparagraph (A);
            (4) in paragraph (2)--
                    (A) by striking the period at the end and inserting 
                ``; or''; and
                    (B) by redesignating paragraph (2) as subparagraph 
                (B); and
            (5) by adding at the end the following:
            ``(2) one or more States, if that State has demonstrated, 
        in the determination of the Attorney General, that the State 
        has adopted policies, procedures, protocols, laws or 
        regulations pertaining to the possession or transfer of 
        firearms or ammunition that--
                    ``(A)(i) give State and local law enforcement the 
                authority, to the extent allowable under Federal laws 
                and the United States Constitution, to seize firearms 
                or ammunition from an individual pursuant to a warrant, 
                where there is probable cause to believe that the 
                individual in possession of such firearms or ammunition 
                poses an elevated risk of harm to himself or herself or 
                to another individual, which may be determined by 
                considering whether the individual has caused harm to 
                himself or herself or another individual, has detailed 
                plans to cause harm to himself or herself or another 
                individual, has a history of substance abuse, or lacks 
                impulse control; and
                    ``(ii) provide that not later than 14 days after 
                such a seizure, an individual from whom a firearm or 
                ammunition was so seized shall be given an opportunity 
                to contest such seizure in court, and any firearm or 
                ammunition so seized shall be returned to the 
                individual, unless a State or local law enforcement 
                officer demonstrates in court by a preponderance of the 
                evidence that the individual from whom a firearm or 
                ammunition was seized poses an elevated risk of harm to 
                himself or herself or to another individual; or
                    ``(B) temporarily prohibit an individual who has 
                been involuntarily hospitalized for a period of not 
                less than 48 hours for mental illness on an emergency 
                basis, from possessing a firearm or ammunition;''.

SEC. 403. NOTIFICATION OF STATE AND LOCAL LAW ENFORCEMENT AUTHORITIES 
              OF ATTEMPT TO PURCHASE FIREARM BY INELIGIBLE PERSON.

    (a) In General.--The Attorney General shall establish a system for 
the prompt notification of the relevant State and local enforcement 
agencies when the National Instant Criminal Background Check System 
established under section 103 of the Brady Handgun Violence Prevention 
Act notifies a licensed dealer that the information available to the 
system indicates that the possession of a firearm by an individual 
attempting to obtain a firearm from the licensed dealer would violate 
subsection (g) or (n) of section 922 of title 18, United States Code, 
or State law, except when it is determined, on a case-by-case basis, 
that law enforcement purposes would best be served by not providing 
such a notice.
    (b) Definitions.--In this section, the terms ``firearm'' and 
``licensed dealer'' shall have the meanings given such terms in section 
921(a) of title 18, United States Code.

                          TITLE V--RESTORATION

SEC. 501. FEDERAL AGENCY RELIEF PROGRAM.

    Section 101(c) of the NICS Improvement Amendments Act of 2007 (34 
U.S.C. 40911) is amended--
            (1) in paragraph (2)(A)(i), by inserting after ``imposed by 
        such subsections'' the following: ``if such person is a person 
        described in subparagraph (C) and submits the opinion (and 
        records and information supporting the opinion) of a 
        psychiatrist, a clinical psychologist, or a licensed or 
        qualified mental health professional who can provide adequate 
        information who has personally evaluated the person''; and
            (2) by adding at the end of paragraph (2) the following:
                    ``(C) Person described.--A person is described in 
                this subparagraph if, beginning not earlier than 1 year 
                after the person is subject to the disabilities imposed 
                by subsection (d)(4) or (g)(4) of section 922 of title 
                18, United States Code, and after affording the Federal 
                department or agency the opportunity to request an 
                additional evaluation, by a psychiatrist, a clinical 
                psychologist, or a licensed or qualified mental health 
                professional who can provide adequate information 
                appointed by the department or agency, the department 
                or agency determines by a preponderance of the evidence 
                received that--
                            ``(i) the person no longer manifests the 
                        symptoms of mental disorder that resulted in 
                        that person's adjudication as ineligible due to 
                        disqualifying mental status or involuntary 
                        commitment or that otherwise significantly 
                        elevate the risk of harm to self or others;
                            ``(ii) the person has adhered consistently 
                        to any prescribed treatment for a substantial 
                        period of time preceding the date of the 
                        application and has expressed a willingness to 
                        continue treatment under an appropriate mental 
                        health professional;
                            ``(iii) if ongoing treatment is required, 
                        that adherence to that treatment is likely to 
                        minimize the risk that the person will revert 
                        to a mental state that would present a danger 
                        to self or others; and
                            ``(iv) the granting of the relief would not 
                        be contrary to the public interest.''.

SEC. 502. STATE RELIEF PROGRAMS.

    (a) In General.--Section 105 of the NICS Improvement Amendments Act 
of 2007 (34 U.S.C. 40915) is amended--
            (1) in subsection (a)(2), by striking ``if the 
        circumstances'' and all that follows through ``public 
        interest'' and inserting ``beginning not earlier than 1 year 
        after the person is first adjudicated as described in 
        subsection (g)(4) of section 922 of title 18, United States 
        Code, if the person submits the opinion (and records and 
        information supporting the opinion) of a psychiatrist, a 
        clinical psychologist, or a licensed or qualified mental health 
        professional who can provide adequate information who has 
        personally evaluated the person, and after affording the State 
        the opportunity to request an additional evaluation, by a 
        psychiatrist, clinical psychologist, or other licensed or 
        qualified mental health professional who can provide adequate 
        information appointed by the court, board, commission, or other 
        lawful authority, only if the court, board, commission, or 
        other lawful authority determines by a preponderance of the 
        evidence received that the person is a person described in 
        subsection (c)''; and
            (2) by adding at the end the following:
    ``(c) Eligible Person Described.--A person described in this 
subsection is any person who submits with the application for relief 
under subsection (a)(1), the opinion (and records and information 
supporting the opinion) of a psychiatrist, a clinical psychologist, or 
a licensed or qualified mental health professional who can provide 
adequate information who has personally evaluated the petitioner and 
which attests that--
            ``(1) the person no longer manifests the symptoms of 
        disqualifying mental status that resulted in that person's 
        adjudication as ineligible due to disqualifying mental status 
        or involuntary commitment;
            ``(2) the person appears to have adhered consistently to 
        any prescribed treatment for a substantial period of time 
        preceding the date of the application and has expressed a 
        willingness to continue treatment under an appropriate mental 
        health professional;
            ``(3) if ongoing treatment is required, that adherence to 
        that treatment is likely to minimize the risk that the person 
        will revert to a mental state that would present a danger to 
        self or others; and
            ``(4) the granting of the relief would not be contrary to 
        the public interest.
    ``(d) Definitions.--The Attorney General may, by rule, define terms 
used in this section to ensure conformity with Federal programs 
providing relief from disabilities imposed under subsections (d) and 
(g) of section 922 of title 18, United States Code.''.
    (b) Transition Rule.--The amendment made by subsection (a) shall 
apply only beginning on the date that is 5 years after the date of 
enactment of this Act, in the case of any State that has a program 
described in section 105 of the NICS Improvement Amendments Act of 2007 
(34 U.S.C. 40915) in effect on the date of enactment of this Act.

SEC. 503. INELIGIBILITY DUE TO DISQUALIFYING MENTAL STATUS.

    (a) Section 922(d)(4) of title 18, United States Code, is amended 
by striking ``adjudicated as a mental defective'' and inserting 
``adjudicated as ineligible due to disqualifying mental status''.
    (b) Section 922(g)(4) of title 18, United States Code, is amended 
by striking ``adjudicated as a mental defective'' and inserting 
``adjudicated as ineligible due to disqualifying mental status''.
    (c) Section 922(s)(3)(B)(iv) of title 18, United States Code, is 
amended by striking ``adjudicated as a mental defective'' and inserting 
``adjudicated as ineligible due to disqualifying mental status''.
    (d) Section 175b(d)(2)(F) of title 18, United States Code, is 
amended by striking ``adjudicated as a mental defective'' and inserting 
``adjudicated as ineligible due to disqualifying mental status''.
    (e) Section 842(d)(6) of title 18, United States Code, is amended 
by striking ``adjudicated a mental defective'' and inserting 
``adjudicated as ineligible due to disqualifying mental status''.
    (f) Section 842(i)(4) of title 18, United States Code, is amended 
by striking ``adjudicated as a mental defective'' and inserting 
``adjudicated as ineligible due to disqualifying mental status''.
    (g) Section 3(2) of the NICS Improvement Amendments Act of 2007 (34 
U.S.C. 40903) is amended by striking ``adjudicated as a mental 
defective'' and inserting ``adjudicated as ineligible due to 
disqualifying mental status''.
    (h) Section 101(b)(2)(C)(ii) of the NICS Improvement Amendments Act 
of 2007 (34 U.S.C. 40911) is amended by striking ``adjudicated as a 
mental defective'' and inserting ``adjudicated as ineligible due to 
disqualifying mental status''.
    (i) Section 101(c)(1)(C) of the NICS Improvement Amendments Act of 
2007 (34 U.S.C. 40911) is amended by striking ``adjudicated as a mental 
defective'' and inserting ``adjudicated as ineligible due to 
disqualifying mental status''.
    (j) Section 101(c)(3) of the NICS Improvement Amendments Act of 
2007 (34 U.S.C. 40911) is amended in the matter preceding subparagraph 
(A), by striking ``adjudicate a person as a mental defective'' and 
inserting ``adjudicate a person as ineligible due to disqualifying 
mental status''.
    (k) Section 101(c)(3)(A) of the NICS Improvement Amendments Act of 
2007 (34 U.S.C. 40911) is amended by striking ``adjudicate the person 
as a mental defective,'' and inserting ``adjudicate the person as 
ineligible due to disqualifying mental status''.
    (l) Section 102(b)(1)(C)(iv) of the NICS Improvement Amendments Act 
of 2007 (34 U.S.C. 40912) is amended by striking ``adjudicated as a 
mental defective'' and inserting ``adjudicated as ineligible due to 
disqualifying mental status''.

TITLE VI--SUBMISSION OF RECORDS TO NATIONAL INSTANT CRIMINAL BACKGROUND 
                              CHECK SYSTEM

SEC. 601. REPORTS RELATING TO SUBMISSION OF INFORMATION TO NICS.

    Section 201 of the NICS Improvement Amendments Act of 2007 (34 
U.S.C. 40931) is amended--
            (1) by amending subsection (b) to read as follows:
    ``(b) Report on Persons Prohibited From Obtaining Firearms as a 
Result of a Conviction of a Misdemeanor Crime of Domestic Violence.--
Not later than January 31 of each year, the Director shall submit to 
Congress a report containing the number of persons reported by each 
State to the National Instant Criminal Background Check System who are 
prohibited from possessing or receiving a firearm under section 
922(g)(9) of title 18, United States Code.'';
            (2) by redesignating subsection (d) as (e); and
            (3) by inserting after subsection (c) the following:
    ``(d) Report on Promising Practices.--
            ``(1) In general.--Not later than 180 days after the date 
        of enactment of the Safer Communities Act of 2019, and annually 
        thereafter, the Director shall submit to Congress and to each 
        State participating in the National Criminal History 
        Improvement Program, a report of the practices of the States 
        that the Director considers to be promising practices.
            ``(2) Promising practice defined.--For purposes of this 
        subsection, the term `promising practice' means a program, 
        activity, or strategy of a State regarding the collection, 
        maintenance, automation, and transmittal of information 
        relevant to determining whether a person is prohibited from 
        possessing or receiving a firearm by Federal or State law, by 
        the State or any other agency, or any other records relevant to 
        the National Instant Criminal Background Check System, that the 
        Director determines--
                    ``(A) has been used by a State or other agency to 
                successfully increase or expand its ability to collect, 
                maintain, automate, and transmit the information 
                described in the matter preceding this subparagraph;
                    ``(B) shows promise in its early stages of becoming 
                a best practice under subsection (c), with long-term 
                sustainable impact; and
                    ``(C) may be replicated by other States or 
                agencies.''.

SEC. 602. REAUTHORIZATION OF THE NATIONAL CRIMINAL HISTORY RECORDS 
              IMPROVEMENT PROGRAM.

    Section 106(b) of Public Law 103-159 (34 U.S.C. 40302) is amended--
            (1) in paragraph (1), in the matter preceding subparagraph 
        (A), by striking ``Fix NICS Act of 2018'' and inserting ``Safer 
        Communities Act of 2019''; and
            (2) by striking paragraph (2) and inserting the following:
            ``(2) Authorization of appropriations.--There are 
        authorized to be appropriated for grants under this subsection 
        $100,000,000 for each of fiscal years 2020 though 2024.''.

SEC. 603. IMPROVEMENT OF METRICS AND INCENTIVES.

    Section 102(b) of the NICS Improvement Amendments Act of 2007 (34 
U.S.C. 40912) is amended to read as follows:
    ``(b) Implementation Plan.--
            ``(1) In general.--Not later than 1 year after the date of 
        enactment of the Safer Communities Act of 2019, the Attorney 
        General, in coordination with the States, shall establish for 
        each State or Indian Tribal government applying for a grant 
        under section 103 a 4-year implementation plan to ensure 
        maximum coordination and automation of the reporting of records 
        or making records available to the National Instant Criminal 
        Background Check System.
            ``(2) Benchmark requirements.--Each 4-year plan established 
        under paragraph (1) shall include annual benchmarks, including 
        both qualitative goals and quantitative measures, to assess 
        implementation of the 4-year plan.
            ``(3) Penalties for non-compliance.--
                    ``(A) In general.--During the 4-year period covered 
                by a 4-year plan established under paragraph (1), the 
                Attorney General shall withhold--
                            ``(i) 10 percent of the amount that would 
                        otherwise be allocated to a State under section 
                        505 of the Omnibus Crime Control and Safe 
                        Streets Act of 1968 (34 U.S.C. 10156) if the 
                        State does not meet the benchmark established 
                        under paragraph (2) for the first year in the 
                        4-year period;
                            ``(ii) 11 percent of the amount that would 
                        otherwise be allocated to a State under section 
                        505 of the Omnibus Crime Control and Safe 
                        Streets Act of 1968 (34 U.S.C. 10156) if the 
                        State does not meet the benchmark established 
                        under paragraph (2) for the second year in the 
                        4-year period;
                            ``(iii) 13 percent of the amount that would 
                        otherwise be allocated to a State under section 
                        505 of the Omnibus Crime Control and Safe 
                        Streets Act of 1968 (34 U.S.C. 10156) if the 
                        State does not meet the benchmark established 
                        under paragraph (2) for the third year in the 
                        4-year period; and
                            ``(iv) 15 percent of the amount that would 
                        otherwise be allocated to a State under section 
                        505 of the Omnibus Crime Control and Safe 
                        Streets Act of 1968 (34 U.S.C. 10156) if the 
                        State does not meet the benchmark established 
                        under paragraph (2) for the fourth year in the 
                        4-year period.
                    ``(B) Failure to establish a plan.--A State that 
                fails to establish a plan under paragraph (1) shall be 
                treated as having not met any benchmark established 
                under paragraph (2).''.

SEC. 604. GRANTS TO STATES TO IMPROVE COORDINATION AND AUTOMATION OF 
              NICS RECORD REPORTING.

    (a) In General.--The NICS Improvement Amendments Act of 2007 (34 
U.S.C. 40901 et seq.) is amended--
            (1) by striking section 103 and inserting the following:

``SEC. 103. GRANTS TO STATES FOR IMPROVEMENT OF COORDINATION AND 
              AUTOMATION OF NICS RECORD REPORTING.

    ``(a) Authorization.--From amounts made available to carry out this 
section, the Attorney General shall make grants to States, Indian 
Tribal governments, and State court systems, in a manner consistent 
with the National Criminal History Improvement Program and consistent 
with State plans for integration, automation, and accessibility of 
criminal history records, for use by the State, or units of local 
government of the State, Indian Tribal government, or State court 
system to improve the automation and transmittal of mental health 
records and criminal history dispositions, records relevant to 
determining whether a person has been convicted of a misdemeanor crime 
of domestic violence, court orders, and mental health adjudications or 
commitments to Federal and State record repositories in accordance with 
section 102 and the National Criminal History Improvement Program.
    ``(b) Use of Grant Amounts.--Grants awarded to States, Indian 
Tribal governments, or State court systems under this section may only 
be used to--
            ``(1) carry out, as necessary, assessments of the 
        capabilities of the courts of the State or Indian Tribal 
        government for the automation and transmission of arrest and 
        conviction records, court orders, and mental health 
        adjudications or commitments to Federal and State record 
        repositories;
            ``(2) implement policies, systems, and procedures for the 
        automation and transmission of arrest and conviction records, 
        court orders, and mental health adjudications or commitments to 
        Federal and State record repositories;
            ``(3) create electronic systems that provide accurate and 
        up-to-date information which is directly related to checks 
        under the National Instant Criminal Background Check System, 
        including court disposition and corrections records;
            ``(4) assist States or Indian Tribal governments in 
        establishing or enhancing their own capacities to perform 
        background checks using the National Instant Criminal 
        Background Check System; and
            ``(5) develop and maintain the relief from disabilities 
        program in accordance with section 105.
    ``(c) Eligibility.--
            ``(1) In general.--To be eligible for a grant under this 
        section, a State, Indian Tribal government, or State court 
        system shall certify, to the satisfaction of the Attorney 
        General, that the State, Indian Tribal government, or State 
        court system--
                    ``(A) is not prohibited by State law or court order 
                from submitting mental health records to the National 
                Instant Criminal Background Check System; and
                    ``(B) subject to paragraph (2), has implemented a 
                relief from disabilities program in accordance with 
                section 105.
            ``(2) Relief from disabilities program.--For purposes of 
        obtaining a grant under this section, a State, Indian Tribal 
        government, or State court system shall not be required to meet 
        the eligibility requirement described in paragraph (1)(B) until 
        the date that is 2 years after the date of enactment of the 
        Safer Communities Act of 2019.
    ``(d) Federal Share.--
            ``(1) Studies, assessments, non-material activities.--The 
        Federal share of a study, assessment, creation of a task force, 
        or other non-material activity, as determined by the Attorney 
        General, carried out with a grant under this section shall be 
        not more than 25 percent.
            ``(2) Infrastructure or system development.--The Federal 
        share of an activity involving infrastructure or system 
        development, including labor-related costs, for the purpose of 
        improving State or Indian Tribal government record reporting to 
        the National Instant Criminal Background Check System carried 
        out with a grant under this section may amount to 100 percent 
        of the cost of the activity.
    ``(e) Grants to Indian Tribes.--Up to 5 percent of the grant 
funding available under this section may be reserved for Indian Tribal 
governments for use by Indian Tribal judicial systems.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $100,000,000 for each of fiscal 
years 2020 though 2023.'';
            (2) by striking title III; and
            (3) in section 401(b), by inserting after ``of this Act'' 
        the following: ``and 18 months after the date of enactment of 
        the Safer Communities Act of 2019''.
    (b) Technical and Conforming Amendment.--The table of sections in 
section 1(b) of the NICS Improvement Amendments Act of 2007 is amended 
by striking the item relating to section 103 and inserting the 
following:

``Sec. 103. Grants to States for improvement of coordination and 
                            automation of NICS record reporting.''.

SEC. 605. SHARING OF RECORDS BY FEDERAL DEPARTMENTS AND AGENCIES WITH 
              NICS.

    Section 101(b) of the NICS Improvement Amendments Act of 2007 (34 
U.S.C. 40911) is amended--
            (1) in paragraph (2)--
                    (A) in subparagraph (B), by striking ``and'' at the 
                end;
                    (B) in subparagraph (C), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by inserting at the end the following:
                    ``(D) not later than 180 days after the date of the 
                enactment of the Safer Communities Act of 2019, and 
                annually thereafter, submit a report to Congress on the 
                compliance of the heads of Federal departments and 
                agencies with the requirements of paragraphs (1) and 
                (3).''; and
            (2) by adding at the end the following:
            ``(3) Other federal departments and agencies.--The head of 
        each Federal department or agency in possession of records 
        which are relevant to a determination of whether a person is 
        disqualified from possessing or receiving a firearm under 
        subsection (g) or (n) of section 922 of title 18, United States 
        Code, shall make available to the Attorney General, such 
        records, updated not less than quarterly, for use in the 
        background checks performed by the National Instant Criminal 
        Background Check System.''.
                                 <all>