PUBLIC HEALTH SERVICE ACT
119–44
Statute Compilation
United States House of Representatives
Office of the Legislative Counsel
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Public Health Service Act-TITLE V (Substance Abuse and Mental Health Services Administration)
Public Health Service Act
Helping Families in Mental Health Crisis Reform Act of 2016
SUPPORT for Patients and Communities Reauthorization Act of 2025
Donald J. Cohen National Child Traumatic Stress Initiative
8776
78
1944-07-01
PUBLIC HEALTH SERVICE ACT
[As Amended Through P.L. 119–44, Enacted December 1, 2025]
[Currency: This publication is a compilation of the text of title V of Chapter 373 of the 78th Congress. It was last amended by the public law listed in the As Amended Through note above and below at the bottom of each page of the pdf version and reflects current law through the date of the enactment of the public law listed at https://www.govinfo.gov/app/collection/comps/]
[Note: While this publication does not represent an official version of any Federal statute, substantial efforts have been made to ensure the accuracy of its contents. The official version of Federal law is found in the United States Statutes at Large and in the United States Code. The legal effect to be given to the Statutes at Large and the United States Code is established by statute (1 U.S.C. 112, 204).]
[References in brackets[] are to title 42, United States Code]
TITLE V—

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Part A—

Organization and General Authorities
SEC. 501.
[290aa]

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION.
(a)

Establishment.—
The Substance Abuse and Mental Health Services Administration (hereafter referred to in this title as the “Administration”) is an agency of the Service.
(b)

Centers.—
The following Centers are agencies of the Administration:
(1)
The Center for Substance Abuse Treatment.
(2)
The Center for Substance Abuse Prevention.
(3)
The Center for Mental Health Services.
(c)

Assistant Secretary and Deputy Assistant Secretary.—
(1)

Assistant secretary.—
The Administration shall be headed by an official to be known as the Assistant Secretary for Mental Health and Substance Use (hereinafter in this title referred to as the “Assistant Secretary”) who shall be appointed by the President, by and with the advice and consent of the Senate.
(2)

Deputy assistant secretary.—
The Assistant Secretary, with the approval of the Secretary, may appoint a Deputy Assistant Secretary and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration.
(d)

Authorities.—
The Secretary, acting through the Assistant Secretary, shall—
(1)
supervise the functions of the Centers of the Administration in order to assure that the programs carried out through each such Center receive appropriate and equitable support and that there is cooperation among the Centers in the implementation of such programs;
(2)
establish and implement, through the respective Centers, a comprehensive program to improve the provision of treatment and related services to individuals with respect to substance use disorders and mental illness and to improve prevention services, promote mental health and protect the legal rights of individuals with mental illnesses and individuals with substance use disorders;
(3)
carry out the administrative and financial management, policy development and planning, evaluation, knowledge dissemination, and public information functions that are required for the implementation of this title;
(4)
assure that the Administration conduct and coordinate demonstration projects, evaluations, and service system assessments and other activities necessary to improve the availability and quality of treatment, prevention and related services;
(5)
support activities that will improve the provision of treatment, prevention and related services, including the development of national mental health and substance use disorder goals and model programs;
(6)
in cooperation with the National Institutes of Health, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration, develop educational materials and intervention strategies to reduce the risks of HIV, hepatitis, tuberculosis, and other communicable diseases among individuals with mental or substance use disorders, and to develop appropriate mental health services for individuals with such diseases or disorders;
(7)
coordinate Federal policy with respect to the provision of treatment services for substance use disorders, including services that utilize drugs or devices approved or cleared by the Food and Drug Administration for the treatment of substance use disorders;
(8)
conduct programs, and assure the coordination of such programs with activities of the National Institutes of Health and the Agency for Healthcare Research and Quality, as appropriate, to evaluate the process, outcomes and community impact of prevention and treatment services and systems of care in order to identify the manner in which such services can most effectively be provided;
(9)
collaborate with the Director of the National Institutes of Health in the development and maintenance of a system by which the relevant research findings of the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health, and, as appropriate, the Agency for Healthcare Research and Quality are disseminated to service providers in a manner designed to improve the delivery and effectiveness of prevention, treatment, and recovery support services and are appropriately incorporated into programs carried out by the Administration;
(10)
encourage public and private entities that provide health insurance to provide benefits for substance use disorder and mental health services;
(11)
work with relevant agencies of the Department of Health and Human Services on integrating mental health promotion and substance use disorder prevention with general health promotion and disease prevention and integrating mental and substance use disorders treatment services with physical health treatment services;
(12)
monitor compliance by hospitals and other facilities with the requirements of sections 542 and 543;
(13)
with respect to grant programs authorized under this title or part B of title XIX, or grant programs otherwise funded by the Administration—
(A)
require that all grants that are awarded for the provision of services are subject to performance and outcome evaluations;
(B)
ensure that the director of each Center of the Administration consistently documents the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded;
(C)
require that all grants that are awarded to entities other than States are awarded only after the State in which the entity intends to provide services—
(i)
is notified of the pendency of the grant application; and
(ii)
is afforded an opportunity to comment on the merits of the application; and
(D)
inform a State when any funds are awarded through such a grant to any entity within such State;
(14)
assure that services provided with amounts appropriated under this title are provided bilingually, if appropriate;
(15)
improve coordination among prevention programs, treatment facilities and nonhealth care systems such as employers, labor unions, and schools, and encourage the adoption of employee assistance programs and student assistance programs;
(16)
maintain a clearinghouse for substance use disorder information, including evidence-based and promising best practices for prevention, treatment, and recovery support services for individuals with mental and substance use disorders, to assure the widespread dissemination of such information to States, political subdivisions, educational agencies and institutions, treatment providers, and the general public;
(17)
in collaboration with the National Institute on Aging, and in consultation with the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism and the National Institute of Mental Health, as appropriate, promote and evaluate substance use disorder services for older Americans in need of such services, and mental health services for older Americans who are seriously mentally ill;
(18)
promote the coordination of service programs conducted by other departments, agencies, organizations and individuals that are or may be related to the problems of individuals suffering from mental illness or substance abuse, including liaisons with the Social Security Administration, Centers for Medicare & Medicaid Services, and other programs of the Department, as well as liaisons with the Department of Education, Department of Justice, and other Federal Departments and offices, as appropriate;
(19)
consult with State, local, and tribal governments, nongovernmental entities, and individuals with mental illness, particularly adults with a serious mental illness, children with a serious emotional disturbance, and the family members of such adults and children, with respect to improving community-based and other mental health services;
(20)
collaborate with the Secretary of Defense and the Secretary of Veterans Affairs to improve the provision of mental and substance use disorder services provided by the Department of Defense and the Department of Veterans Affairs to members of the Armed Forces, veterans, and the family members of such members and veterans, including through the provision of services using the telehealth capabilities of the Department of Defense and the Department of Veterans Affairs;
(21)
collaborate with the heads of relevant Federal agencies and departments, States, communities, and nongovernmental experts to improve mental and substance use disorders services for chronically homeless individuals, including by designing strategies to provide such services in supportive housing;
(22)
work with States and other stakeholders to develop and support activities to recruit and retain a workforce addressing mental and substance use disorders;
(23)
collaborate with the Attorney General and representatives of the criminal justice system to improve mental and substance use disorders services for individuals who have been arrested or incarcerated;
(24)
support the continued access to, or availability of, mental health and substance use disorder services during, or in response to, a public health emergency declared under section 319, including in consultation with, as appropriate, the Assistant Secretary for Preparedness and Response, the Director of the Centers for Disease Control and Prevention, and the heads of other relevant agencies, in preparing for, and responding to, a public health emergency;
(25)
after providing an opportunity for public input, set standards for grant programs under this title for mental and substance use disorders services and prevention programs, which standards may address—
(A)
the capacity of the grantee to implement the award;
(B)
requirements for the description of the program implementation approach;
(C)
the extent to which the grant plan submitted by the grantee as part of its application must explain how the grantee will reach the population of focus and provide a statement of need, which may include information on how the grantee will increase access to services and a description of measurable objectives for improving outcomes;
(D)
the extent to which the grantee must collect and report on required performance measures; and
(E)
the extent to which the grantee is proposing to use evidence-based practices;
(26)
advance, through existing programs, the use of performance metrics, including those based on the recommendations on performance metrics from the Assistant Secretary for Planning and Evaluation under section 6021(d) of the Helping Families in Mental Health Crisis Reform Act of 2016; and
(26)1
collaborate with national accrediting entities, recovery housing providers, organizations or individuals with established expertise in delivery of recovery housing services, States, Federal agencies (including the Department of Health and Human Services, the Department of Housing and Urban Development, and the agencies listed in section 550(e)(2)(B)), and other relevant stakeholders, to promote the availability of high-quality recovery housing and services for individuals with a substance use disorder.
^1
Section 1231(3) of division FF of Public Law 117-328 inserted a new paragraph (26) which resulted in two paragraph (26)’s.
(e)

Associate Administrator for Alcohol Prevention and Treatment Policy.—
(1)

In general.—
There may be in the Administration an Associate Administrator for Alcohol Prevention and Treatment Policy to whom the Assistant Secretary 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.
(2)

Plan.—
(A)
The Assistant Secretary, acting through the Associate Administrator for Alcohol Prevention and Treatment Policy, shall develop, and periodically review and as appropriate revise, a plan for programs and policies to treat and prevent alcoholism and alcohol abuse. The plan shall be developed (and reviewed and revised) in collaboration with the Directors of the Centers of the Administration and in consultation with members of other Federal agencies and public and private entities.
(B)
Not later than 1 year after the date of the enactment of the ADAMHA Reorganization Act, the Assistant Secretary shall submit to the Congress the first plan developed under subparagraph (A).
(3)

Report.—
(A)
Not less than once during each 2 years, the Assistant Secretary, acting through the Associate Administrator for Alcohol Prevention and Treatment Policy, shall prepare a report describing the alcoholism and alcohol abuse prevention and treatment programs undertaken by the Administration and its agencies, and the report shall include a detailed statement of the expenditures made for the activities reported on and the personnel used in connection with such activities.
(B)
Each report under subparagraph (A) shall include a description of any revisions in the plan under paragraph (2) made during the preceding 2 years.
(C)
Each report under subparagraph (A) shall be submitted to the Assistant Secretary for inclusion in the biennial report under subsection (m).
(f)

Associate Administrator for Women's Services.—
(1)

Appointment.—
The Assistant Secretary, with the approval of the Secretary, shall appoint an Associate Administrator for Women's Services who shall report directly to the Assistant Secretary.
(2)

Duties.—
The Associate Administrator appointed under paragraph (1) shall—
(A)
establish a committee to be known as the Coordinating Committee for Women's Services (hereafter in this subparagraph referred to as the “Coordinating Committee”), which shall be composed of the Directors of the agencies of the Administration (or the designees of the Directors);
(B)
acting through the Coordinating Committee, with respect to women's substance abuse and mental health services—
(i)
identify the need for such services, and make an estimate each fiscal year of the funds needed to adequately support the services;
(ii)
identify needs regarding the coordination of services;
(iii)
encourage the agencies of the Administration to support such services; and
(iv)
assure that the unique needs of minority women, including Native American, Hispanic, African-American and Asian women, are recognized and addressed within the activities of the Administration; and
(C)
establish an advisory committee to be known as the Advisory Committee for Women's Services, which shall be composed of not more than 10 individuals, a majority of whom shall be women, who are not officers or employees of the Federal Government, to be appointed by the Assistant Secretary from among physicians, practitioners, treatment providers, and other health professionals, whose clinical practice, specialization, or professional expertise includes a significant focus on women's substance abuse and mental health conditions, that shall—
(i)
advise the Associate Administrator on appropriate activities to be undertaken by the agencies of the Administration with respect to women's substance abuse and mental health services, including services which require a multidisciplinary approach;
(ii)
collect and review data, including information provided by the Secretary (including the material referred to in paragraph (3)), and report biannually to the Assistant Secretary regarding the extent to which women are represented among senior personnel, and make recommendations regarding improvement in the participation of women in the workforce of the Administration; and
(iii)
prepare, for inclusion in the biennial report required pursuant to subsection (m), a description of activities of the Committee, including findings made by the Committee regarding—
(I)
the extent of expenditures made for women's substance abuse and mental health services by the agencies of the Administration; and
(II)
the estimated level of funding needed for substance abuse and mental health services to meet the needs of women;
(D)
improve the collection of data on women's health by—
(i)
reviewing the current data at the Administration to determine its uniformity and applicability;
(ii)
developing standards for all programs funded by the Administration so that data are, to the extent practicable, collected and reported using common reporting formats, linkages and definitions; and
(iii)
reporting to the Assistant Secretary a plan for incorporating the standards developed under clause (ii) in all Administration programs and a plan to assure that the data so collected are accessible to health professionals, providers, researchers, and members of the public; and
(E)
shall establish, maintain, and operate a program to provide information on women's substance abuse and mental health services.
(3)

Study.—
(A)
The Secretary, acting through the Assistant Secretary for Personnel, shall conduct a study to evaluate the extent to which women are represented among senior personnel at the Administration.
(B)
Not later than 90 days after the date of the enactment of the ADAMHA Reorganization Act, the Assistant Secretary for Personnel shall provide the Advisory Committee for Women's Services with a study plan, including the methodology of the study and any sampling frames. Not later than 180 days after such date of enactment, the Assistant Secretary shall prepare and submit directly to the Advisory Committee a report concerning the results of the study conducted under subparagraph (A).
(C)
The Secretary shall prepare and provide to the Advisory Committee for Women's Services any additional data as requested.
(4)

Office.—
Nothing in this subsection shall be construed to preclude the Secretary from establishing within the Substance Abuse and Mental Health Administration an Office of Women's Health.
(5)

Definition.—
For purposes of this subsection, the term “women's substance abuse and mental health conditions”, with respect to women of all age, ethnic, and racial groups, means all aspects of substance abuse and mental illness—
(A)
unique to or more prevalent among women; or
(B)
with respect to which there have been insufficient services involving women or insufficient data.
(g)

Chief Medical Officer.—
(1)

In general.—
The Assistant Secretary, with the approval of the Secretary, shall appoint a Chief Medical Officer to serve within the Administration.
(2)

Eligible candidates.—
The Assistant Secretary shall select the Chief Medical Officer from among individuals who—
(A)
have a doctoral degree in medicine or osteopathic medicine;
(B)
have experience in the provision of mental or substance use disorder services;
(C)
have experience working with mental or substance use disorder programs;
(D)
have an understanding of biological, psychosocial, and pharmaceutical treatments of mental or substance use disorders; and
(E)
are licensed to practice medicine in one or more States.
(3)

Duties.—
The Chief Medical Officer shall—
(A)
serve as a liaison between the Administration and providers of mental and substance use disorders prevention, treatment, and recovery services;
(B)
assist the Assistant Secretary in the evaluation, organization, integration, and coordination of programs operated by the Administration;
(C)
promote evidence-based and promising best practices, including culturally and linguistically appropriate practices, as appropriate, for the prevention and treatment of, and recovery from, mental and substance use disorders, including serious mental illness and serious emotional disturbances;
(D)
participate in regular strategic planning with the Administration;
(E)
coordinate with the Assistant Secretary for Planning and Evaluation to assess the use of performance metrics to evaluate activities within the Administration related to mental and substance use disorders; and
(F)
coordinate with the Assistant Secretary to ensure mental and substance use disorders grant programs within the Administration consistently utilize appropriate performance metrics and evaluation designs.
(h)

Services of Experts.—
(1)

In general.—
The Assistant Secretary may obtain (in accordance with section 3109 of title 5, United States Code, but without regard to the limitation in such section on the number of days or the period of service) the services of not more than 20 experts or consultants who have professional qualifications. Such experts and consultants shall be obtained for the Administration and for each of its agencies.
(2)

Compensation and expenses.—
(A)
Experts and consultants whose services are obtained under paragraph (1) shall be paid or reimbursed for their expenses associated with traveling to and from their assignment location in accordance with sections 5724, 5724a(a), 5724a(c), and 5726(c) of title 5, United States Code.
(B)
Expenses specified in subparagraph (A) may not be allowed in connection with the assignment of an expert or consultant whose services are obtained under paragraph (1), unless and until the expert or consultant agrees in writing to complete the entire period of assignment or one year, whichever is shorter, unless separated or reassigned for reasons beyond the control of the expert or consultant that are acceptable to the Secretary. If the expert or consultant violates the agreement, the money spent by the United States for the expenses specified in subparagraph (A) is recoverable from the expert or consultant as a debt of the United States. The Secretary may waive in whole or in part a right of recovery under this subparagraph.
(i)

Peer Review Groups.—
The Assistant Secretary shall, without regard to the provisions of title 5, United States Code, governing appointments in the competitive service, and without regard to the provisions of chapter 51 and subchapter III of chapter 53 of such title, relating to classification and General Schedule pay rates, establish such peer review groups and program advisory committees as are needed to carry out the requirements of this title and appoint and pay members of such groups, except that officers and employees of the United States shall not receive additional compensation for services as members of such groups. The Federal Advisory Committee Act2 shall not apply to the duration of a peer review group appointed under this subsection.
^2
Section 4(a)(236) of Public Law 117–286 amends section 501(h) by striking “The Federal Advisory Committee Act” and inserting “Chapter 10 of title 5, United States Code”. The stricken phrase doesn’t appear in subsection (h) but does appear in subsection (i).
(j)

Voluntary Services.—
The Assistant Secretary may accept voluntary and uncompensated services.
(k)

Administration.—
The Assistant Secretary shall ensure that programs and activities assigned under this title to the Administration are fully administered by the respective Centers to which such programs and activities are assigned.
(l)

Strategic Plan.—
(1)

In general.—
Not later than September 30, 2018, and every 4 years thereafter, the Assistant Secretary shall develop and carry out a strategic plan in accordance with this subsection for the planning and operation of activities carried out by the Administration, including evidence-based programs.
(2)

Coordination.—
In developing and carrying out the strategic plan under this subsection, the Assistant Secretary shall take into consideration the findings and recommendations of the Assistant Secretary for Planning and Evaluation under section 6021(d) of the Helping Families in Mental Health Crisis Reform Act of 2016 and the report of the Interdepartmental Serious Mental Illness Coordinating Committee under section 501C.
(3)

Publication of plan.—
Not later than September 30, 2018, and every 4 years thereafter, the Assistant Secretary shall—
(A)
submit the strategic plan developed under paragraph (1) to the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate; and
(B)
post such plan on the Internet website of the Administration.
(4)

Contents.—
The strategic plan developed under paragraph (1) shall—
(A)
identify strategic priorities, goals, and measurable objectives for mental and substance use disorders activities and programs operated and supported by the Administration, including priorities to prevent or eliminate the burden of mental and substance use disorders;
(B)
identify ways to improve the quality of services for individuals with mental and substance use disorders, and to reduce homelessness, arrest, incarceration, violence, including self-directed violence, and unnecessary hospitalization of individuals with a mental or substance use disorder, including adults with a serious mental illness or children with a serious emotional disturbance;
(C)
ensure that programs provide, as appropriate, access to effective and evidence-based prevention, diagnosis, intervention, treatment, and recovery services, including culturally and linguistically appropriate services, as appropriate, for individuals with a mental or substance use disorder;
(D)
identify opportunities to collaborate with the Health Resources and Services Administration to develop or improve—
(i)
initiatives to encourage individuals to pursue careers (especially in rural and underserved areas and with rural and underserved populations) as psychiatrists, including child and adolescent psychiatrists, psychologists, psychiatric nurse practitioners, physician assistants, clinical social workers, certified peer support specialists, licensed professional counselors, or other licensed or certified mental health or substance use disorder professionals, including such professionals specializing in the diagnosis, evaluation, or treatment of adults with a serious mental illness or children with a serious emotional disturbance; and
(ii)
a strategy to improve the recruitment, training, and retention of a workforce for the treatment of individuals with mental or substance use disorders, or co-occurring disorders;
(E)
identify opportunities to improve collaboration with States, local governments, communities, and Indian tribes and tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act);
(F)
specify a strategy to disseminate evidence-based and promising best practices related to prevention, diagnosis, early intervention, treatment, and recovery services related to mental illness, particularly for adults with a serious mental illness and children with a serious emotional disturbance, and for individuals with a substance use disorder; and
(G)
specify a strategy to support the continued access to, or availability of, mental health and substance use disorder services, including to at-risk individuals (as defined in section 2802(b)(4)), during, or in response to, public health emergencies declared pursuant to section 319.
(m)

Biennial Report Concerning Activities and Progress.—
Not later than September 30, 2020, and every 2 years thereafter, the Assistant Secretary shall prepare and submit to the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives and the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate, and post on the Internet website of the Administration, a report containing at a minimum—
(1)
a review of activities conducted or supported by the Administration, including progress toward strategic priorities, goals, and objectives identified in the strategic plan developed under subsection (l);
(2)
an assessment of programs and activities carried out by the Assistant Secretary, including the extent to which programs and activities under this title and part B of title XIX meet identified goals and performance measures developed for the respective programs and activities;
(3)
a description of the progress made in addressing gaps in mental and substance use disorders prevention, treatment, and recovery services and improving outcomes by the Administration, including with respect to serious mental illnesses, serious emotional disturbances, and co-occurring disorders;
(4)
a description of the Administration’s activities to support the continued provision of mental health and substance use disorder services, as applicable, in response to public health emergencies declared pursuant to section 319;
(5)
a description of the manner in which the Administration coordinates and partners with other Federal agencies and departments related to mental and substance use disorders, including activities related to—
(A)
the implementation and dissemination of research findings into improved programs, including with respect to how advances in serious mental illness and serious emotional disturbance research have been incorporated into programs;
(B)
the recruitment, training, and retention of a mental and substance use disorders workforce;
(C)
the integration of mental disorder services, substance use disorder services, and physical health services;
(D)
relevant preparedness and response activities;
(E)
homelessness; and
(F)
veterans;
(6)
a description of the manner in which the Administration promotes coordination by grantees under this title, and part B of title XIX, with State or local agencies; and
(7)
a description of the activities carried out under section 501A(e), with respect to mental and substance use disorders, including—
(A)
the number and a description of grants awarded;
(B)
the total amount of funding for grants awarded;
(C)
a description of the activities supported through such grants, including outcomes of programs supported; and
(D)
information on how the National Mental Health and Substance Use Policy Laboratory is consulting with the Assistant Secretary for Planning and Evaluation and collaborating with the Center for Substance Abuse Treatment, the Center for Substance Abuse Prevention, the Center for Behavioral Health Statistics and Quality, and the Center for Mental Health Services to carry out such activities; and
(8)
recommendations made by the Assistant Secretary for Planning and Evaluation under section 6021 of the Helping Families in Mental Health Crisis Reform Act of 2016 to improve programs within the Administration, and actions taken in response to such recommendations to improve programs within the Administration.
The Assistant Secretary may meet reporting requirements established under this title by providing the contents of such reports as an addendum to the biennial report established under this subsection, notwithstanding the timeline of other reporting requirements in this title. Nothing in this subsection shall be construed to alter the content requirements of such reports or authorize the Assistant Secretary to alter the timeline of any such reports to be less frequent than biennially, unless as specified in this title.
(n)

Applications for Grants and Contracts.—
With respect to awards of grants, cooperative agreements, and contracts under this title, the Assistant Secretary, or the Director of the Center involved, as the case may be, may not make such an award unless—
(1)
an application for the award is submitted to the official involved;
(2)
with respect to carrying out the purpose for which the award is to be provided, the application provides assurances of compliance satisfactory to such official; and
(3)
the application is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the official determines to be necessary to carry out the purpose for which the award is to be provided.
(o)

Emergency Response.—
(1)

In general.—
Notwithstanding section 504 and except as 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.
(4)

Emergency response.—
Amounts made available for carrying out this subsection shall remain available through the end of the fiscal year following the fiscal year for which such amounts are appropriated.
(p)

Limitation on the Use of Certain Information.—
No 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.
(q)

Authorization of Appropriations.—
For the purpose of providing grants, cooperative agreements, and contracts under 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. 501A.
[290aa–0]

NATIONAL MENTAL HEALTH AND SUBSTANCE USE POLICY LABORATORY.
(a)

In General.—
There shall be established within the Administration a National Mental Health and Substance Use Policy Laboratory (referred to in this section as the “Laboratory”).
(b)

Responsibilities.—
The Laboratory shall—
(1)
continue to carry out the authorities and activities that were in effect for the Office of Policy, Planning, and Innovation as such Office existed prior to the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016;
(2)
identify, coordinate, and facilitate the implementation of policy changes likely to have a significant effect on mental health, mental illness, recovery supports, and the prevention and treatment of substance use disorder services;
(3)
work with the Center for Behavioral Health Statistics and Quality to collect, as appropriate, information from grantees under programs operated by the Administration in order to evaluate and disseminate information on evidence-based practices, including culturally and linguistically appropriate services, as appropriate, and service delivery models;
(4)
provide leadership in identifying and coordinating policies and programs, including evidence-based programs, related to mental and substance use disorders;
(5)
periodically review programs and activities operated by the Administration relating to the diagnosis or prevention of, treatment for, and recovery from, mental and substance use disorders to—
(A)
identify any such programs or activities that are duplicative;
(B)
identify any such programs or activities that are not evidence-based, effective, or efficient; and
(C)
formulate recommendations for coordinating, eliminating, or improving programs or activities identified under subparagraph (A) or (B) and merging such programs or activities into other successful programs or activities;
(6)
issue and periodically update information for entities applying for grants or cooperative agreements from the Substance Abuse and Mental Health Services Administration in order to—
(A)
encourage the implementation and replication of evidence-based practices; and
(B)
provide technical assistance to applicants for funding, including with respect to justifications for such programs and activities; and
(7)
carry out other activities as deemed necessary to continue to encourage innovation and disseminate evidence-based programs and practices.
(c)

Evidence-based Practices and Service Delivery Models.—
(1)

In general.—
In carrying out subsection (b)(3), the Laboratory—
(A)
may give preference to models that improve—
(i)
the coordination between mental health and physical health providers;
(ii)
the coordination among such providers and the justice and corrections system; and
(iii)
the cost effectiveness, quality, effectiveness, and efficiency of health care services furnished to adults with a serious mental illness, children with a serious emotional disturbance, or individuals in a mental health crisis; and
(B)
may include clinical protocols and practices that address the needs of individuals with early serious mental illness.
(2)

Consultation.—
In carrying out this section, the Laboratory shall consult with—
(A)
the Chief Medical Officer appointed under section 501(g);
(B)
representatives of the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, on an ongoing basis;
(C)
other appropriate Federal agencies;
(D)
clinical and analytical experts with expertise in psychiatric medical care and clinical psychological care, health care management, education, corrections health care, and mental health court systems, as appropriate; and
(E)
other individuals and agencies as determined appropriate by the Assistant Secretary.
(d)

Deadline for Beginning Implementation.—
The Laboratory shall begin implementation of this section not later than January 1, 2018.
(e)

Promoting Innovation.—
(1)

In general.—
The Assistant Secretary, in coordination with the Laboratory, may award grants to States, local governments, Indian Tribes or Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), educational institutions, and nonprofit organizations to develop evidence-based interventions, including culturally and linguistically appropriate services, as appropriate, for—
(A)
evaluating a model that has been scientifically demonstrated to show promise, but would benefit from further applied development, for—
(i)
enhancing the prevention, diagnosis, intervention, and treatment of, and recovery from, mental illness, serious emotional disturbances, substance use disorders, and co-occurring illness or disorders; or
(ii)
integrating or coordinating physical health services and mental and substance use disorders services; and
(B)
expanding, replicating, or scaling evidence-based programs across a wider area to enhance effective screening, early diagnosis, intervention, and treatment with respect to mental illness, serious mental illness, serious emotional disturbances, and substance use disorders, primarily by—
(i)
applying such evidence-based programs to the delivery of care, including by training staff in effective evidence-based treatments; or
(ii)
integrating such evidence-based programs into models of care across specialties and jurisdictions.
(2)

Consultation.—
In awarding grants under this subsection, the Assistant Secretary shall, as appropriate, consult with the Chief Medical Officer, appointed under section 501(g), the advisory councils described in section 502, the National Institute of Mental Health, the National Institute on Drug Abuse, and the National Institute on Alcohol Abuse and Alcoholism, as appropriate.
(f)

Authorization of Appropriations.—
To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2023 through 2027.
SEC. 501B.
[ 290aa-0a ]

BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.
(a)

In General.—
The Secretary shall establish, within the Substance Abuse and Mental Health Services Administration, an office to coordinate work relating to behavioral health crisis care across the operating divisions and agencies of the Department of Health and Human Services, including the Substance Abuse and Mental Health Services Administration, the Centers for Medicare & Medicaid Services, and the Health Resources and Services Administration, and external stakeholders.
(b)

Duty.—
The office established under subsection (a) shall—
(1)
convene Federal, State, Tribal, local, and private partners;
(2)
launch and manage Federal workgroups charged with making recommendations regarding issues related to mental health and substance use disorder crises, including with respect to health care best practices, workforce development, health disparities, data collection, technology, program oversight, public awareness, and engagement; and
(3)
support technical assistance, data analysis, and evaluation functions in order to assist States, localities, Territories, Indian Tribes, and Tribal organizations in developing crisis care systems and identifying best practices with the objective of expanding the capacity of, and access to, local crisis call centers, mobile crisis care, crisis stabilization, psychiatric emergency services, and rapid post-crisis follow-up care provided by—
(A)
the National Suicide Prevention and Mental Health Crisis Hotline and Response System;
(B)
the Veterans Crisis Line;
(C)
community mental health centers (as defined in section 1861(ff)(3)(B) of the Social Security Act);
(D)
certified community behavioral health clinics, as described in section 223 of the Protecting Access to Medicare Act of 2014; and
(E)
other community mental health and substance use disorder providers.
(c)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this section $5,000,000 for each of fiscal years 2023 through 2027.
SEC. 501C.
[ 290aa-0b ]

INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.
(a)

Establishment.—
(1)

In general.—
The Secretary, or the designee of the Secretary, shall establish a committee to be known as the Interdepartmental Serious Mental Illness Coordinating Committee (in this section referred to as the “Committee”).
(2)

Federal advisory committee act.—
Except as provided in this section, the provisions of the Federal Advisory Committee Act (5 U.S.C. App.) shall apply to the Committee.
(b)

Meetings.—
The Committee shall meet not fewer than 2 times each year.
(c)

Responsibilities.—
Not later than each of 1 year and 5 years after the date of enactment of this section, the Committee shall submit to Congress and any other relevant Federal department or agency a report including—
(1)
a summary of advances in serious mental illness and serious emotional disturbance research related to the prevention of, diagnosis of, intervention in, and treatment and recovery of serious mental illnesses, serious emotional disturbances, and advances in access to services and support for adults with a serious mental illness or children with a serious emotional disturbance;
(2)
an evaluation of the effect Federal programs related to serious mental illness have on public health, including outcomes such as—
(A)
rates of suicide, suicide attempts, incidence and prevalence of serious mental illnesses, serious emotional disturbances, and substance use disorders, overdose, overdose deaths, emergency hospitalizations, emergency department boarding, preventable emergency department visits, interaction with the criminal justice system, homelessness, and unemployment;
(B)
increased rates of employment and enrollment in educational and vocational programs;
(C)
quality of mental and substance use disorders treatment services; or
(D)
any other criteria as may be determined by the Secretary; and
(3)
specific recommendations for actions that agencies can take to better coordinate the administration of mental health services for adults with a serious mental illness or children with a serious emotional disturbance.
(d)

Membership.—
(1)

Federal members.—
The Committee shall be composed of the following Federal representatives, or the designees of such representatives—
(A)
the Secretary of Health and Human Services, who shall serve as the Chair of the Committee;
(B)
the Assistant Secretary for Mental Health and Substance Use;
(C)
the Attorney General;
(D)
the Secretary of Veterans Affairs;
(E)
the Secretary of Defense;
(F)
the Secretary of Housing and Urban Development;
(G)
the Secretary of Education;
(H)
the Secretary of Labor;
(I)
the Administrator of the Centers for Medicare & Medicaid Services;
(J)
the Administrator of the Administration for Community Living; and
(K)
the Commissioner of Social Security.
(2)

Non-federal members.—
The Committee shall also include not less than 14 non-Federal public members appointed by the Secretary of Health and Human Services, of which—
(A)
at least 2 members shall be an individual who has received treatment for a diagnosis of a serious mental illness;
(B)
at least 1 member shall be a parent or legal guardian of an adult with a history of a serious mental illness or a child with a history of a serious emotional disturbance;
(C)
at least 1 member shall be a representative of a leading research, advocacy, or service organization for adults with a serious mental illness;
(D)
at least 2 members shall be—
(i)
a licensed psychiatrist with experience in treating serious mental illnesses;
(ii)
a licensed psychologist with experience in treating serious mental illnesses or serious emotional disturbances;
(iii)
a licensed clinical social worker with experience treating serious mental illnesses or serious emotional disturbances; or
(iv)
a licensed psychiatric nurse, nurse practitioner, or physician assistant with experience in treating serious mental illnesses or serious emotional disturbances;
(E)
at least 1 member shall be a licensed mental health professional with a specialty in treating children and adolescents with a serious emotional disturbance;
(F)
at least 1 member shall be a mental health professional who has research or clinical mental health experience in working with minorities;
(G)
at least 1 member shall be a mental health professional who has research or clinical mental health experience in working with medically underserved populations;
(H)
at least 1 member shall be a State certified mental health peer support specialist;
(I)
at least 1 member shall be a judge with experience in adjudicating cases related to criminal justice or serious mental illness;
(J)
at least 1 member shall be a law enforcement officer or corrections officer with extensive experience in interfacing with adults with a serious mental illness, children with a serious emotional disturbance, or individuals in a mental health crisis; and
(K)
at least 1 member shall have experience providing services for homeless individuals and working with adults with a serious mental illness, children with a serious emotional disturbance, or individuals in a mental health crisis.
(3)

Terms.—
A member of the Committee appointed under paragraph (2) shall serve for a term of 3 years, and may be reappointed for 1 or more additional 3-year terms. Any member appointed to fill a vacancy for an unexpired term shall be appointed for the remainder of such term. A member may serve after the expiration of the member’s term until a successor has been appointed.
(e)

Working Groups.—
In carrying out its functions, the Committee may establish working groups. Such working groups shall be composed of Committee members, or their designees, and may hold such meetings as are necessary.
(f)

Sunset.—
The Committee shall terminate on September 30, 2027.

advisory councils
Sec. 502.
[290aa–1]
(a)

Appointment.—
(1)

In general.—
The Secretary shall appoint an advisory council for—
(A)
the Substance Abuse and Mental Health Services Administration;
(B)
the Center for Substance Abuse Treatment;
(C)
the Center for Substance Abuse Prevention; and
(D)
the Center for Mental Health Services.
Each such advisory council shall advise, consult with, and make recommendations to the Secretary and the Assistant Secretary or Director of the Administration or Center for which the advisory council is established concerning matters relating to the activities carried out by and through the Administration or Center and the policies respecting such activities.
(2)

Function and activities.—
An advisory council—
(A)
(i)
may on the basis of the materials provided by the organization respecting activities conducted at the organization, make recommendations to the Assistant Secretary or Director of the Administration or Center for which it was established respecting such activities;
(ii)
shall review applications submitted for grants and cooperative agreements for activities for which advisory council approval is required under section 504(d)(2) and recommend for approval applications for projects that show promise of making valuable contributions to the Administration's mission; and
(iii)
may review any grant, contract, or cooperative agreement proposed to be made or entered into by the organization;
(B)
may collect, by correspondence or by personal investigation, information as to studies and services that are being carried on in the United States or any other country as to the diseases, disorders, or other aspects of human health with respect to which the organization was established and with the approval of the Assistant Secretary or Director, whichever is appropriate, make such information available through appropriate publications for the benefit of public and private health entities and health professions personnel and for the information of the general public; and
(C)
may appoint subcommittees and convene workshops and conferences.
(b)

Membership.—
(1)

In general.—
Each advisory council shall consist of nonvoting ex officio members and not more than 12 members to be appointed by the Secretary under paragraph (3).
(2)

Ex officio members.—
The ex officio members of an advisory council shall consist of—
(A)
the Secretary;
(B)
the Assistant Secretary;
(C)
the Director of the Center for which the council is established;
(D)
the Under Secretary for Health of the Department of Veterans Affairs;
(E)
the Assistant Secretary for Defense for Health Affairs (or the designates of such officers);
(F)
the Chief Medical Officer, appointed under section 501(g);
(G)
the Director of the National Institute of Mental Health for the advisory councils appointed under subsections (a)(1)(A) and (a)(1)(D);
(H)
the Director of the National Institute on Drug Abuse for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C);
(I)
the Director of the National Institute on Alcohol Abuse and Alcoholism for the advisory councils appointed under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C); and
(J)
such additional officers or employees of the United States as the Secretary determines necessary for the advisory council to effectively carry out its functions.
(3)

Appointed members.—
Individuals shall be appointed to an advisory council under paragraph (1) as follows:
(A)
Nine of the members shall be appointed by the Secretary from among the leading representatives of the health disciplines (including public health and behavioral and social sciences) relevant to the activities of the Administration or Center for which the advisory council is established.
(B)
Three of the members shall be appointed by the Secretary from the general public and shall include leaders in fields of public policy, public relations, law, health policy economics, or management.
(C)
Not less than half of the members of the advisory council appointed under subsection (a)(1)(D)—
(i)
shall—
(I)
have a medical degree;
(II)
have a doctoral degree in psychology; or
(III)
have an advanced degree in nursing or social work from an accredited graduate school or be a certified physician assistant; and
(ii)
shall specialize in the mental health field.
(D)
Not less than half of the members of the advisory councils appointed under subsections (a)(1)(B) and (a)(1)(C)—
(i)
shall—
(I)
have a medical degree;
(II)
have a doctoral degree; or
(III)
have an advanced degree in nursing, public health, behavioral or social sciences, or social work from an accredited graduate school or be a certified physician assistant; and
(ii)
shall have experience in the provision of substance use disorder services or the development and implementation of programs to prevent substance misuse.
(4)

Compensation.—
Members of an advisory council who are officers or employees of the United States shall not receive any compensation for service on the advisory council. The remaining members of an advisory council shall receive, for each day (including travel time) they are engaged in the performance of the functions of the advisory council, compensation at rates not to exceed the daily equivalent to the annual rate in effect for grade GS–18 of the General Schedule.
(c)

Terms of Office.—
(1)

In general.—
The term of office of a member of an advisory council appointed under subsection (b) shall be 4 years, except that any member appointed to fill a vacancy for an unexpired term shall serve for the remainder of such term. The Secretary shall make appointments to an advisory council in such a manner as to ensure that the terms of the members not all expire in the same year. A member of an advisory council may serve after the expiration of such member's term until a successor has been appointed and taken office.
(2)

Reappointments.—
A member who has been appointed to an advisory council for a term of 4 years may not be reappointed to an advisory council during the 2-year period beginning on the date on which such 4-year term expired.
(3)

Time for appointment.—
If a vacancy occurs in an advisory council among the members under subsection (b), the Secretary shall make an appointment to fill such vacancy within 90 days from the date the vacancy occurs.
(d)

Chair.—
The Secretary shall select a member of an advisory council to serve as the chair of the council. The Secretary may so select an individual from among the appointed members, or may select the Assistant Secretary or the Director of the Center involved. The term of office of the chair shall be 2 years.
(e)

Meetings.—
An advisory council shall meet at the call of the chairperson or upon the request of the Assistant Secretary or Director of the Administration or Center for which the advisory council is established, but in no event less than 2 times during each fiscal year. The location of the meetings of each advisory council shall be subject to the approval of the Assistant Secretary or Director of Administration or Center for which the council was established.
(f)

Executive Secretary and Staff.—
The Assistant Secretary or Director of the Administration or Center for which the advisory council is established shall designate a member of the staff of the Administration or Center for which the advisory council is established to serve as the Executive Secretary of the advisory council. The Assistant Secretary or Director shall make available to the advisory council such staff, information, and other assistance as it may require to carry out its functions. The Assistant Secretary or Director shall provide orientation and training for new members of the advisory council to provide for their effective participation in the functions of the advisory council.

reports on alcoholism, alcohol abuse, and drug abuse
Sec. 503.
[290aa–2]
(a)
The Secretary shall submit to Congress on or before January 15, 1984, and every three years thereafter a report—
(1)
containing current information on the health consequences of using alcoholic beverages,
(2)
containing a description of current research findings made with respect to alcohol abuse and alcoholism, and
(3)
containing such recommendations for legislation and administrative action as the Secretary may deem appropriate.
(b)
The Secretary shall submit to Congress on or before January 15, 1984, and every three years thereafter a report—
(1)
describing the health consequences and extent of drug abuse in the United States;
(2)
describing current research findings made with respect to drug abuse, including current findings on the health effects of marihuana and the addictive property of tobacco; and
(3)
containing such recommendations for legislation and administrative action as the Secretary may deem appropriate.
SEC. 503A.
[290aa–2a]

REPORT ON INDIVIDUALS WITH CO-OCCURRING MENTAL ILLNESS AND SUBSTANCE ABUSE DISORDERS.
(a)

In General.—
Not later than 2 years after the date of the 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. 504.3
[290aa–3]

PEER REVIEW.
^3
Section 504 appears according to the probable intent of the Congress. Section 3401(b) of Public Law 106–310 (114 Stat. 1218) provides that the section “is amended as follows:”. No amendatory instructions were then given, but a substitute text was provided. The amendment probably should have instructed that section 504 “is amended to read as follows:”.
(a)

In General.—
The Secretary, after consultation with the Assistant Secretary, 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 one-fourth of the members of any such peer review group shall be officers or employees of the United States. In the case of any such peer review group that is reviewing a grant, cooperative agreement, or contract related to mental illness treatment, not less than half of the members of such peer review group shall be licensed and experienced professionals in the prevention, diagnosis, or treatment of, or recovery from, mental illness or co-occurring mental illness and substance use disorders and have a medical degree, a doctoral degree in psychology, or an advanced degree in nursing or social work from an accredited program, and the Secretary, in consultation with the Assistant Secretary, shall, to the extent possible, ensure such peer review groups include broad geographic representation, including both urban and rural representatives.
(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. 505.
[290aa–4]

CENTER FOR BEHAVIORAL HEALTH STATISTICS AND QUALITY.4
(a)

In General.—
The Assistant Secretary shall maintain within the Administration a Center for Behavioral Health Statistics and Quality (in this section referred to as the “Center”). The Center shall be headed by a Director (in this section referred to as the “Director”) appointed by the Secretary from among individuals with extensive experience and academic qualifications in research and analysis in behavioral health care or related fields.
^4
Section 502 of Public Law 104–237 (110 Stat. 3112) provides as follows:
``The Secretary of Health and Human Services shall develop a public health monitoring program to monitor methamphetamine abuse in the United States. The program shall include the collection and dissemination of data related to methamphetamine abuse which can be used by public health officials in policy development.''.
(b)
The Director shall—
(1)
coordinate the Administration’s integrated data strategy, including by collecting data each year on——
(A)
the national incidence and prevalence of the various forms of mental illness and substance abuse; and
(B)
the incidence and prevalence of such various forms in major metropolitan areas selected by the Director.5
^5
So in law. The period at the end of subparagraph (B) probably should be a semicolon.
(2)
provide statistical and analytical support for activities of the Administration;
(3)
recommend a core set of performance metrics to evaluate activities supported by the Administration; and
(4)
coordinate with the Assistant Secretary, the Assistant Secretary for Planning and Evaluation, and the Chief Medical Officer appointed under section 501(g), as appropriate, to improve the quality of services provided by programs of the Administration and the evaluation of activities carried out by the Administration.
(c)

Mental Health.—
With respect to the activities of the Director under subsection (b)(1) relating to mental health, the Director shall ensure that such activities include, at a minimum, the collection of data on—
(1)
the number and variety of public and nonprofit private treatment programs;
(2)
the number and demographic characteristics of individuals receiving treatment through such programs;
(3)
the type of care received by such individuals; and
(4)
such other data as may be appropriate.
(d)

Substance Abuse.—
(1)

In general.—
With respect to the activities of the Director under subsection (b)(1) relating to substance abuse, the Director shall ensure that such activities include, at a minimum, the collection of data on—
(A)
the number of individuals admitted to the emergency rooms of hospitals as a result of the abuse of alcohol or other drugs;
(B)
the number of deaths occurring as a result of substance abuse, as indicated in reports by coroners in coordination with the Centers for Disease Control and Prevention;
(C)
the number and variety of public and private nonprofit treatment programs, including the number and type of patient slots available;
(D)
the number of individuals seeking treatment through such programs, the number and demographic characteristics of individuals receiving such treatment, the percentage of individuals who complete such programs, and, with respect to individuals receiving such treatment, the length of time between an individual's request for treatment and the commencement of treatment;
(E)
the number of such individuals who return for treatment after the completion of a prior treatment in such programs and the method of treatment utilized during the prior treatment;
(F)
the number of individuals receiving public assistance for such treatment programs;
(G)
the costs of the different types of treatment modalities for drug and alcohol abuse and the aggregate relative costs of each such treatment modality provided within a State in each fiscal year;
(H)
to the extent of available information, the number of individuals receiving treatment for alcohol or drug abuse who have private insurance coverage for the costs of such treatment;
(I)
the extent of alcohol and drug abuse among high school students and among the general population; and
(J)
the number of alcohol and drug abuse counselors and other substance abuse treatment personnel employed in public and private treatment facilities.
(2)

Annual surveys; public availability of data.—
Annual survey6s shall be carried out in the collection of data under this subsection. Summaries and analyses of the data collected shall be made available to the public.
^6
The heading for paragraph (2) is the result of the amendment made by section 6004(6)(C) of Public Law 114–255. Such amendment probably should not have been made to strike “Annual surveys” (initial cap and small caps) and instead should have been “Annual Surveys”.
(e)

Consultation.—
After consultation with the States and with appropriate national organizations, the Assistant Secretary shall use existing standards and best practices to develop uniform criteria for the collection of data, using the best available technology, pursuant to this section.
SEC. 506.
[290aa–5]

GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
(a)

In General.—
The Secretary shall award grants, contracts and cooperative agreements to community-based public and private nonprofit entities for the purposes of providing mental health and substance use disorder services for homeless individuals. In 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 use disorder, 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 use disorder and mental health services to homeless individuals;
(4)
entities that demonstrate experience in providing housing for individuals in treatment for or in recovery from mental illness or a substance use disorder; 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 use disorder and are not suffering from a mental health disorder; and
(2)
make payments under subsection (a) to any entity that has a policy of—
(A)
excluding individuals from mental health services due to the existence or suspicion of a substance use disorder; or
(B)
has a policy of excluding individuals from substance use disorder services due to the existence or suspicion of mental illness.
(d)

Term of the Awards.—
No entity may receive a grant, 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$41,304,000 for each of fiscal years 2023 through 2027.
SEC. 506A.
[290aa–5a]

BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER RESOURCES FOR NATIVE AMERICANS.
(a)

Definitions.—
In this section:
(1)
The term “eligible entity” means any health program administered directly by the Indian Health Service, a Tribal health program, an Indian Tribe, a Tribal organization, an Urban Indian organization, and a Native Hawaiian health organization.
(2)
The terms “Indian Tribe”, “Tribal health program”, “Tribal organization”, and “Urban Indian organization” have the meanings given to the terms “Indian tribe”, “Tribal health program”, “tribal organization”, and “Urban Indian organization” in section 4 of the Indian Health Care Improvement Act.
(3)
The term “health program administered directly by the Indian Health Service” means a “health program administered by the Service” as such term is used in section 4(12)(A) of the Indian Health Care Improvement Act.
(4)
The term “Native Hawaiian health organization” means “Papa Ola Lokahi” as defined in section 12 of the Native Hawaiian Health Care Improvement Act.
(b)

Grant Program.—
(1)

In general.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, and in consultation with the Director of the Indian Health Service, as appropriate, shall award funds to eligible entities, in amounts developed in accordance with paragraph (2), to be used by the eligible entity to provide services for the prevention of, treatment of, and recovery from mental health and substance use disorders among American Indians, Alaska Natives, and Native Hawaiians.
(2)

Formula.—
The Secretary, in consultation with the Director of the Indian Health Service, using the process described in subsection (d), shall develop a formula to determine the amount of an award under paragraph (1).
(3)

Delivery of funds.—
On request from an Indian Tribe or Tribal organization, the Secretary, acting through the Assistant Secretary for Mental Health and Substance Use and in coordination with the Director of the Indian Health Service, may award funds under this section through a contract or compact under, as applicable, title I or V of the Indian Self-Determination and Education Assistance Act.
(c)

Technical Assistance and Program Evaluation.—
(1)

In general.—
The Secretary shall—
(A)
provide technical assistance to applicants and awardees under this section; and
(B)
in consultation with Indian Tribes and Tribal organizations, conference with Urban Indian organizations, and engagement with a Native Hawaiian health organization, identify and establish appropriate mechanisms for Indian Tribes and Tribal organizations, Urban Indian organizations, and a Native Hawaiian health organization to demonstrate outcomes and report data as required for participation in the program under this section.
(2)

Data submission and reporting.—
As a condition of receipt of funds under this section, an applicant shall agree to submit program evaluation data and reports consistent with the data submission and reporting requirements developed under this subsection.
(d)

Consultation.—
The Secretary shall, using an accountable process, consult with Indian Tribes and Tribal organizations, confer with Urban Indian organizations, and engage with a Native Hawaiian health organization regarding the development of funding allocations pursuant to subsection (b)(2) and program evaluation and reporting requirements pursuant to subsection (c). In establishing such requirements, the Secretary shall seek to minimize administrative burden for eligible entities, as practicable.
(e)

Application.—
An entity desiring an award under subsection (b) shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may reasonably require.
(f)

Report.—
Not later than 3 years after the date of the enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022, the Secretary shall prepare and submit, to the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Energy and Commerce of the House of Representatives, 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, $80,000,000 for each of fiscal years 2023 through 2027.
Part B—

Centers and Programs
Subpart 1—

Center for Substance Abuse Treatment

center for substance abuse treatment7
Sec. 507.
[290bb]
(a)

Establishment.—
There is established in the Administration a Center for Substance Abuse Treatment (hereafter in this section referred to as the “Center”). The Center shall be headed by a Director (hereafter in this section referred to as the “Director”) appointed by the Secretary from among individuals with extensive experience or academic qualifications in the treatment of substance use disorders or in the evaluation of substance use disorder treatment systems.
^7
Section 4 of Public Law 108–358 (118 Stat. 1664) authorizes the Secretary of Health and Human Services to “award grants to public and nonprofit private entities to enable such entities to carry out science-based education programs in elementary and secondary schools to highlight the harmful effects of anabolic steroids”. Subsection (d) of such section provides that there is authorized to be appropriated to carry out the section $15,000,000 for each of the fiscal years 2005 through 2010.
(b)

Duties.—
The Director of the Center shall—
(1)
administer the substance use disorder treatment block grant program authorized in section 1921;
(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 use disorder treatment services to individuals who have had contact with the Justice system, especially adolescents;
(4)
collaborate with the Director of the Center for Substance Abuse Prevention in order to provide outreach services to identify individuals in need of treatment services, with emphasis on the provision of such services to pregnant and postpartum women and their infants and to individuals who illicitly use drugs intravenously;
(5)
collaborate with the Director of the National Institute on Drug Abuse, with the Director of the National Institute on Alcohol Abuse and Alcoholism, and with the States to promote the study, dissemination, and implementation of research findings that will improve the delivery and effectiveness of treatment services;
(6)
collaborate with the Administrator of the Health Resources and Services Administration and the Administrator of the Centers for Medicare & Medicaid Services to promote the increased integration into the mainstream of the health care system of the United States of programs for providing treatment services;
(7)
evaluate plans submitted by the States pursuant to section 1932(a)(6) in order to determine whether the plans adequately provide for the availability, allocation, and effectiveness of treatment services;
(8)
sponsor regional workshops on improving the quality and availability of treatment services;
(9)
provide technical assistance to public and nonprofit private entities that provide treatment services, including technical assistance with respect to the process of submitting to the Director applications for any program of grants or contracts ;
(10)
carry out activities to educate individuals on the need for establishing treatment facilities within their communities;
(11)
encourage public and private entities that provide health insurance to provide benefits for outpatient treatment services and other nonhospital-based treatment services;
(12)
evaluate treatment programs to determine the quality and appropriateness of various forms of treatment, which shall be carried out through grants, contracts, or cooperative agreements provided to public or nonprofit private entities;
(13)
ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded;
(14)
work with States, providers, and individuals in recovery, and their families, to promote the expansion of recovery support services and systems of care oriented toward recovery;
(15)
in cooperation with the Secretary, implement and disseminate, as appropriate, the recommendations in the report entitled “Protecting Our Infants Act: Final Strategy” issued by the Department of Health and Human Services in 2017; and
(16)
in cooperation with relevant stakeholders, and through public-private partnerships, encourage education about substance use disorders for pregnant women and health care providers who treat pregnant women and babies.
(c)

Grants and Contracts.—
In carrying out the duties established in subsection (b), the Director may make grants to and enter into contracts and cooperative agreements with public and nonprofit private entities.

residential treatment programs for pregnant and postpartum women
Sec. 508.
[290bb–1]
(a)

In General.—
The Director of the Center for Substance Abuse Treatment (referred to in this section as the “Director”) shall provide awards of grants, including the grants under subsection (r), cooperative agreements or contracts to public and nonprofit private entities for the purpose of providing to pregnant and postpartum women treatment for substance use disorders through programs in which, during the course of receiving treatment—
(1)
the women reside in or receive outpatient treatment services from facilities provided by the programs;
(2)
the minor children of the women reside with the women in such facilities, if the women so request; and
(3)
the services described in subsection (d) are available to or on behalf of the women.
(b)

Availability of Services for Each Participant.—
A funding agreement for an award under subsection (a) for an applicant is that, in the program operated pursuant to such subsection—
(1)
treatment services and each supplemental service will be available through the applicant, either directly or through agreements with other public or nonprofit private entities; and
(2)
the services will be made available to each woman admitted to the program and her children.
(c)

Individualized Plan of Services.—
A funding agreement for an award under subsection (a) for an applicant is that—
(1)
in providing authorized services for an eligible woman pursuant to such subsection, the applicant will, in consultation with the women, prepare an individualized plan for the provision of services for the woman and her children; and
(2)
treatment services under the plan will include—
(A)
individual, group, and family counseling, as appropriate, regarding substance use disorders; and
(B)
follow-up services to assist the woman in preventing a relapse into such a disorder.
(d)

Required Supplemental Services.—
In the case of an eligible woman, the services referred to in subsection (a)(3) are as follows:
(1)
Prenatal and postpartum health care.
(2)
Referrals for necessary hospital services.
(3)
For the infants and children of the woman—
(A)
pediatric health care, including treatment for any perinatal effects of a maternal substance use disorder and including screenings regarding the physical and mental development of the infants and children;
(B)
counseling and other mental health services, in the case of children; and
(C)
comprehensive social services.
(4)
Providing therapeutic, comprehensive child care for children during the periods in which the woman is engaged in therapy or in other necessary health and rehabilitative activities.
(5)
Training in parenting.
(6)
Counseling on the human immunodeficiency virus and on acquired immune deficiency syndrome.
(7)
Counseling on domestic violence and sexual abuse.
(8)
Counseling on obtaining employment, including the importance of graduating from a secondary school.
(9)
Reasonable efforts to preserve and support the family unit of the woman, including promoting the appropriate involvement of parents and others, and counseling the children of the woman.
(10)
Planning for and counseling to assist reentry into society, both before and after discharge, including referrals to any public or nonprofit private entities in the community involved that provide services appropriate for the woman and the children of the woman.
(11)
Case management services, including—
(A)
assessing the extent to which authorized services are appropriate for the woman and any child of such woman;
(B)
in the case of the services that are appropriate, ensuring that the services are provided in a coordinated manner;
(C)
assistance in establishing eligibility for assistance under Federal, State, and local programs providing health care services, mental health services, housing services, employment services, educational services, or social services; and
(D)
family reunification with children in kinship or foster care arrangements, where safe and appropriate.
(e)

Minimum Qualifications For Receipt of Award.—
(1)

Certification by relevant state agency.—
With respect to the principal agency of the State involved that administers programs relating to substance use disorders, the Director may make an award under subsection (a) to an applicant only if the agency has certified to the Director that—
(A)
the applicant has the capacity to carry out a program described in subsection (a);
(B)
the plans of the applicant for such a program are consistent with the policies of such agency regarding the treatment of substance use disorders; and
(C)
the applicant, or any entity through which the applicant will provide authorized services, meets all applicable State licensure or certification requirements regarding the provision of the services involved.
(2)

Status as medicaid provider.—
(A)

In general.—
Subject to subparagraphs (B) and (C), the Director may make an award under subsection (a) only if, in the case of any authorized service that is available pursuant to the State plan approved under title XIX of the Social Security Act for the State involved—
(i)
the applicant for the award will provide the service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(ii)
the applicant will enter into an agreement with a public or nonprofit private entity under which the entity will provide the service, and the entity has entered into such a participation agreement plan and is qualified to receive such payments.
(B)

Waiver of participation agreements.—
(i)

In general.—
In the case of an entity making an agreement pursuant to subparagraph (A)(ii) regarding the provision of services, the requirement established in such subparagraph regarding a participation agreement shall be waived by the Director if the entity does not, in providing health care services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits plan.
(ii)

Donations.—
A determination by the Director of whether an entity referred to in clause (i) meets the criteria for a waiver under such clause shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public.
(C)

Nonapplication of certain requirements.—
With respect to any authorized service that is available pursuant to the State plan described in subparagraph (A), the requirements established in such subparagraph shall not apply to the provision of any such service by an institution for mental diseases to an individual who has attained 21 years of age and who has not attained 65 years of age. For purposes of the preceding sentence, the term “institution for mental diseases” has the meaning given such term in section 1905(i) of the Social Security Act.
(f)

Requirement of Matching Funds.—
(1)

In general.—
With respect to the costs of the program to be carried out by an applicant pursuant to subsection (a), a funding agreement for an award under such subsection is that the applicant will make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that—
(A)
for the first fiscal year for which the applicant receives payments under an award under such subsection, is not less than $1 for each $9 of Federal funds provided in the award;
(B)
for any second such fiscal year, is not less than $1 for each $9 of Federal funds provided in the award; and
(C)
for any subsequent such fiscal year, is not less than $1 for each $3 of Federal funds provided in the award.
(2)

Determination of amount contributed.—
Non-Federal contributions required in 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 non-Federal contributions.
(g)

Outreach.—
A funding agreement for an award under subsection (a) for an applicant is that the applicant will provide a plan describing outreach services in the community involved to identify women who have a substance use disorder and to encourage the women to undergo treatment for such disorder. Such plan may include a description of how such applicant will target outreach to women disproportionately impacted by maternal substance use disorder.
(h)

Accessibility of Program; Cultural Context of Services.—
A funding agreement for an award under subsection (a) for an applicant is that—
(1)
the program operated pursuant to such subsection will be operated at a location that is accessible to low-income pregnant and postpartum women; and
(2)
authorized services will be provided in the language and the cultural context that is most appropriate.
(i)

Continuing Education.—
A funding agreement for an award under subsection (a) is that the applicant involved will provide for continuing education in treatment services for the individuals who will provide treatment in the program to be operated by the applicant pursuant to such subsection.
(j)

Imposition of Charges.—
A funding agreement for an award under subsection (a) for an applicant is that, if a charge is imposed for the provision of authorized services to or on behalf of an eligible woman, such charge—
(1)
will be made according to a schedule of charges that is made available to the public;
(2)
will be adjusted to reflect the income of the woman involved; and
(3)
will not be imposed on any such woman with an income of less than 185 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.
(k)

Reports to Director.—
A funding agreement for an award under subsection (a) is that the applicant involved will submit to the Director a report—
(1)
describing the utilization and costs of services provided under the award;
(2)
specifying the number of women served, the number of infants served, and the type and costs of services provided; and
(3)
providing such other information as the Director determines to be appropriate.
(l)

Requirement of Application.—
The Director may make an award under subsection (a) only if an application for the award is submitted to the Director containing such agreements, and the application is in such form, is made in such manner, and contains such other agreements and such assurances and information as the Director determines to be necessary to carry out this section.
(m)

Allocation of Awards.—
In making awards under subsection (a), the Director shall give priority to an applicant that agrees to use the award for a program serving an area that is a rural area, an area designated under section 332 by the Secretary as a health professional shortage area, or an area determined by the Director to have a shortage of family-based substance use disorder treatment options.
(n)

Duration of Award.—
The period during which payments are made to an entity from an award under subsection (a) may not exceed 5 years. The provision of such payments shall be subject to annual approval by the Director of the payments and subject to the availability of appropriations for the fiscal year involved to make the payments. This subsection may not be construed to establish a limitation on the number of awards under such subsection that may be made to an entity.
(o)

Evaluations; Dissemination of Findings.—
The Director shall, directly or through contract, provide for the conduct of evaluations of programs carried out pursuant to subsection (a). The Director shall disseminate to the States the findings made as a result of the evaluations.
(p)

Reports to Congress.—
Not later than October 1, 1994, the Director shall submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report describing programs carried out pursuant to this section (other than subsection (r)). Every 2 years thereafter, the Director shall prepare a report describing such programs carried out during the preceding 2 years, and shall submit the report to the Assistant Secretary for inclusion in the biennial report under section 501(m). Each report under this subsection shall include a summary of any evaluations conducted under subsection (m) during the period with respect to which the report is prepared.
(q)

Definitions.—
For purposes of this section:
(1)
The term “authorized services” means treatment services and supplemental services.
(2)
The term “eligible woman” means a woman who has been admitted to a program operated pursuant to subsection (a).
(3)
The term “funding agreement”, with respect to an award under subsection (a), means that the Director may make the award only if the applicant makes the agreement involved.
(4)
The term “treatment services” means treatment for a substance use disorder, including the counseling and services described in subsection (c)(2).
(5)
The term “supplemental services” means the services described in subsection (d).
(r)

Pilot Program for State Substance Abuse Agencies.—
(1)

In general.—
From amounts made available under subsection (s), the Director of the Center for Substance Abuse Treatment shall carry out a pilot program under which competitive grants are made by the Director to State substance abuse agencies—
(A)
to enhance flexibility in the use of funds designed to support family-based services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, including opioid use disorders;
(B)
to help State substance abuse agencies address identified gaps in services furnished to such women along the continuum of care, including services provided to women in nonresidential-based settings; and
(C)
to promote a coordinated, effective, and efficient State system managed by State substance abuse agencies by encouraging new approaches and models of service delivery.
(2)

Requirements.—
In carrying out the pilot program under this subsection, the Director shall—
(A)
require State substance abuse agencies to submit to the Director applications, in such form and manner and containing such information as specified by the Director, to be eligible to receive a grant under the program;
(B)
identify, based on such submitted applications, State substance abuse agencies that are eligible for such grants;
(C)
require services proposed to be furnished through such a grant to support family-based treatment and other services for pregnant and postpartum women with a primary diagnosis of a substance use disorder, including opioid use disorders;
(D)
not require that services furnished through such a grant be provided solely to women that reside in facilities;
(E)
not require that grant recipients under the program make available through use of the grant all the services described in subsection (d); and
(F)
consider not applying the requirements described in paragraphs (1) and (2) of subsection (f) to an applicant, depending on the circumstances of the applicant.
(3)

Required services.—
(A)

In general.—
The Director shall specify a minimum set of services required to be made available to eligible women through a grant awarded under the pilot program under this subsection. Such minimum set of services—
(i)
shall include the services requirements described in subsection (c) and be based on the recommendations submitted under subparagraph (B); and
(ii)
may be selected from among the services described in subsection (d) and include other services as appropriate.
(B)

Stakeholder input.—
The Director shall convene and solicit recommendations from stakeholders, including State substance abuse agencies, health care providers, persons in recovery from substance abuse, and other appropriate individuals, for the minimum set of services described in subparagraph (A).
(4)

Evaluation and report to congress.—
(A)

In general.—
The Director of the Center for Behavioral Health Statistics and Quality shall evaluate the pilot program at the conclusion of the first grant cycle funded by the pilot program.
(B)

Report.—
Not later than September 30, 2026, the Director of the Center for Behavioral Health Statistics and Quality, in coordination with the Director of the Center for Substance Abuse Treatment 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 on the evaluation under subparagraph (A). The report shall include, at a minimum—
(i)
outcomes information from the pilot program, including any resulting reductions in the use of alcohol and other drugs;
(ii)
engagement in treatment services;
(iii)
retention in the appropriate level and duration of services;
(iv)
increased access to the use of medications approved by the Food and Drug Administration for the treatment of substance use disorders in combination with counseling; and
(v)
other appropriate measures.
(C)

Recommendation.—
The report under subparagraph (B) shall include a recommendation by the Director of the Center for Substance Abuse Treatment as to whether the pilot program under this subsection should be extended.
(5)

State substance abuse agencies defined.—
For purposes of this subsection, the term “State substance abuse agency” means, with respect to a State, the agency in such State that manages the Substance Abuse Prevention and Treatment Block Grant under part B of title XIX.
(s)

Authorization of Appropriations.—
For the purpose of carrying out this section, there are authorized to be appropriated $38,931,000 for each of fiscal years 2026 through 2030. Of the amounts made available for a year pursuant to the previous sentence to carry out this section, not more than 25 percent of such amounts shall be made available for such year to carry out subsection (r), other than paragraph (5) of such subsection. Notwithstanding the preceding sentence, no funds shall be made available to carry out subsection (r) for a fiscal year unless the amount made available to carry out this section for such fiscal year is more than the amount made available to carry out this section for fiscal year 2016.
SEC. 509.
[290bb–2]

PRIORITY SUBSTANCE USE DISORDER TREATMENT NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE.
(a)

Projects.—
The Secretary shall address priority substance use disorder treatment needs of regional and national significance (as determined under subsection (b)) through the provision of or through assistance for—
(1)
knowledge development and application projects for treatment and rehabilitation and the conduct or support of evaluations of such projects;
(2)
training and technical assistance; and
(3)
targeted capacity response programs that permit States, local governments, communities, and Indian Tribes and Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act) to focus on emerging trends in substance use disorders and co-occurrence of substance use disorders with mental illness or other conditions.
The Secretary may carry out the activities described in this section directly or through grants , contracts, or cooperative agreements with States, political subdivisions of States, Indian tribes or tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service, or other public or nonprofit private entities.
(b)

Priority Substance Use Disorder Treatment Needs.—
(1)

In general.—
Priority substance use disorder treatment needs of regional and national significance shall be determined by the Secretary after consultation with States and other 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 use disorder 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 use disorder prevention and treatment programs.
(f)

Authorization of Appropriation.—
There are authorized to be appropriated to carry out this section, $521,517,000 for each of fiscal years 2023 through 2027.

action by national institute on drug abuse and states concerning military facilities
Sec. 513.8
[290bb–6]
(a)

Center for Substance Abuse Treatment.—
The Director of the Center for Substance Abuse Treatment shall—
^8
Sections 510 through 512 were repealed by section 3301(c) of Public Law 106–310 (114 Stat. 1209).
(1)
coordinate with the agencies represented on the Commission on Alternative Utilization of Military Facilities the utilization of military facilities or parts thereof, as identified by such Commission, established under the National Defense Authorization Act of 1989, that could be utilized or renovated to house nonviolent persons for drug treatment purposes;
(2)
notify State agencies responsible for the oversight of drug abuse treatment entities and programs of the availability of space at the installations identified in paragraph (1); and
(3)
assist State agencies responsible for the oversight of drug abuse treatment entities and programs in developing methods for adapting the installations described in paragraph (1) into residential treatment centers.
(b)

States.—
With regard to military facilities or parts thereof, as identified by the Commission on Alternative Utilization of Military Facilities established under section 3042 of the Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments Act of 1988, that could be utilized or renovated to house nonviolent persons for drug treatment purposes, State agencies responsible for the oversight of drug abuse treatment entities and programs shall—
(1)
establish eligibility criteria for the treatment of individuals at such facilities;
(2)
select treatment providers to provide drug abuse treatment at such facilities;
(3)
provide assistance to treatment providers selected under paragraph (2) to assist such providers in securing financing to fund the cost of the programs at such facilities; and
(4)
establish, regulate, and coordinate with the military official in charge of the facility, work programs for individuals receiving treatment at such facilities.
(c)

Reservation of Space.—
Prior to notifying States of the availability of space at military facilities under subsection (a)(2), the Director may reserve space at such facilities to conduct research or demonstration projects.
SEC. 514.
[290bb–7]

SUBSTANCE USE DISORDER TREATMENT AND EARLY INTERVENTION SERVICES FOR CHILDREN, ADOLESCENTS, AND YOUNG ADULTS.
(a)

In General.—
The Secretary shall award grants, contracts, or cooperative agreements to public and private nonprofit entities, including Indian Tribes or Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), or health facilities or programs operated by or in accordance with a contract or grant with the Indian Health Service, for the purpose of—
(1)
providing early identification and services to meet the needs of children, adolescents, and young adults who are at risk of substance use disorders;
(2)
providing substance use disorder treatment services for children, adolescents, and young adults, includingchildren, adolescents, and young adults with co-occurring mental illness and substance use disorders; and
(3)
providing assistance to pregnant women, and parenting women, with substance use disorders, in obtaining treatment services, linking mothers to community resources to support independent family lives, and staying in recovery so that children are in safe, stable home environments and receive appropriate health care services.
(b)

Priority.—
In awarding grants, contracts, or cooperative agreements under subsection (a), the Secretary shall give priority to applicants who propose to—
(1)
apply evidence-based and cost-effective methods;
(2)
coordinate the provision of services with other social service agencies in the community, including educational, juvenile justice, child welfare, substance abuse, and mental health agencies;
(3)
provide a continuum of integrated treatment services, including case management, for children, adolescents, and young adults with substance use disorders, including children, adolescents, and young adults with co-occurring mental illness and substance use disorders, and their families;
(4)
provide treatment that is gender-specific and culturally appropriate;
(5)
involve and work with families of children, adolescents, and young adults receiving services; and
(6)
provide aftercare services for children, adolescents, and young adults and their families after completion of treatment.
(c)

Duration of Grants.—
The Secretary shall award grants, contracts, or cooperative agreements under subsection (a) for 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, $29,605,000 for each of fiscal years 2023 through 2027.
[Section 514A was repealed by section 9017 of Public Law 114–255.]
SEC. 514B.
[290bb–10]

EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN TREATMENT AND INTERVENTIONS DEMONSTRATION.
(a)

Grants to Expand Access.—
(1)

Authority to award grants.—
The Secretary shall award grants, contracts, or cooperative agreements to State substance use disorder agencies, units of local government, nonprofit organizations, and Indian Tribes and Tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act) that have a high rate, or have had a rapid increase, in the use of heroin or other opioids, in order to permit such entities to expand activities, including an expansion in the availability of evidence-based medication-assisted treatment and other clinically appropriate services, with respect to the treatment of substance use disorders in the specific geographical areas of such entities where there is a high rate or rapid increase in the use of heroin or other opioids, such as in rural areas.
(2)

Nature of activities.—
Funds awarded under paragraph (1) shall be used for activities that are based on reliable scientific evidence of efficacy in the treatment of problems related to heroin or other opioids.
(b)

Application.—
To be eligible for a grant, contract, or cooperative agreement under subsection (a), an entity shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may reasonably require.
(c)

Evaluation.—
An entity that receives a grant, contract, or cooperative agreement under subsection (a) shall submit, in the application for such grant, contract, or 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 an evaluation at the completion of such project as the Secretary determines to be appropriate.
(d)

Geographic Distribution.—
In awarding grants, contracts, and cooperative agreements under this section, the Secretary shall ensure that not less than 15 percent of funds are awarded to eligible entities that are not located in metropolitan statistical areas (as defined by the Office of Management and Budget). The Secretary shall take into account the unique needs of rural communities, including communities with an incidence of individuals with opioid use disorder that is above the national average and communities with a shortage of prevention and treatment services.
(e)

Additional Activities.—
In administering grants, contracts, and cooperative agreements under subsection (a), the Secretary shall—
(1)
evaluate the activities supported under such subsection;
(2)
disseminate information, as appropriate, derived from evaluations as the Secretary considers appropriate;
(3)
provide States, Indian Tribes and Tribal organizations, and providers with technical assistance in connection with the provision of treatment of problems related to heroin and other opioids; and
(4)
fund only those applications that specifically support recovery services as a critical component of the program involved.
(f)

Authorization of Appropriations.—
To carry out this section, there are authorized to be appropriated $25,000,000 for each of fiscal years 2023 through 2027.
Subpart 2—

Center for Substance Abuse Prevention

center for substance abuse prevention
Sec. 515.
[290bb–21]
(a)
There is established in the Administration a Center for Substance Abuse Prevention (hereafter referred to in this part as the “Prevention Center”). The Prevention Center shall be headed by a Director appointed by the Secretary from individuals with extensive experience or academic qualifications in the prevention of drug or alcohol abuse.
(b)
The Director of the Prevention Center shall—
(1)
sponsor regional workshops on the prevention of drug and alcohol abuse through the reduction of risk and the promotion of resiliency;
(2)
coordinate the findings of research sponsored by agencies of the Service on the prevention of drug and alcohol abuse;
(3)
collaborate with the Director of the National Institute on Drug Abuse, the Director of the National Institute on Alcohol Abuse and Alcoholism, and States to promote the study of substance abuse prevention and the dissemination and implementation of research findings that will improve the delivery and effectiveness of substance abuse prevention activities;
(4)
develop effective drug and alcohol abuse prevention literature (including educational information on the effects of drugs abused by individuals, including drugs that are emerging as abused drugs);
(5)
in cooperation with the Secretary of Education, assure the widespread dissemination of prevention materials among States, political subdivisions, and school systems;
(6)
support clinical training programs for health professionals who provide substance use and misuse prevention and treatment services and other health professionals involved in illicit drug use education and prevention;
(7)
in cooperation with the Director of the Centers for Disease Control and Prevention, develop and disseminate educational materials to increase awareness for individuals at greatest risk for substance use disorders to prevent the transmission of communicable diseases, such as HIV, hepatitis, tuberculosis, and other communicable diseases;
(8)
conduct training, technical assistance, data collection, and evaluation activities of programs supported under the Drug Free Schools and Communities Act of 1986;
(9)
support the development of model, innovative, community-based programs that reduce the risk of alcohol and drug abuse among young people and promote resiliency;
(10)
collaborate with the Attorney General of the Department of Justice to develop programs to prevent drug abuse among high risk youth;
(11)
prepare for distribution documentary films and public service announcements for television and radio to educate the public, especially adolescent audiences, concerning the dangers to health resulting from the consumption of alcohol and drugs and, to the extent feasible, use appropriate private organizations and business concerns in the preparation of such announcements;
(12)
develop and support innovative demonstration programs designed to identify and deter the improper use or abuse of anabolic steroids by students, especially students in secondary schools;
(13)
ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded;
(14)
assist and support States in preventing illicit drug use, including emerging illicit drug use issues; and
(15)
in consultation with relevant stakeholders and in collaboration with the Director of the Centers for Disease Control and Prevention, develop educational materials for clinicians to use with pregnant women for shared decision making regarding pain management and the prevention of substance use disorders during pregnancy.
(c)
The Director may make grants and enter into contracts and cooperative agreements in carrying out subsection (b).
(d)
The Director of the Prevention Center shall establish a national data base providing information on programs for the prevention of substance abuse. The data base shall contain information appropriate for use by public entities and information appropriate for use by nonprofit private entities.
SEC. 516.
[290bb–22]

PRIORITY SUBSTANCE USE DISORDER PREVENTION NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE.
(a)

Projects.—
The Secretary shall address priority substance use disorder 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, including such programs that focus on emerging drug use issues.
The Secretary may carry out the activities described in this section directly or through grants, contracts, or cooperative agreements with States, political subdivisions of States, Indian Tribes or Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service, or other public or nonprofit private entities.
(b)

Priority Substance Use Disorder Prevention Needs.—
(1)

In general.—
Priority substance use disorder 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;
(B)
promoting the integration of substance use disorder prevention information and activities into primary health care systems; and
(C)
substance use disorder prevention among high-risk groups.
(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 use disorder prevention and treatment programs.
(f)

Authorization of Appropriation.—
There are authorized to be appropriated to carry out this section, $218,219,000 for each of fiscal years 2023 through 2027.
[Section 517 was repealed by section 9017 of Public Law 114–255. Section 518 was repealed by section 3202(b) of Public Law 106–310 (114 Stat. 1210). Section 519A was repealed by section 9017 of Public Law 114–255.]
SEC. 519B.
[290bb–25b]

PROGRAMS TO REDUCE UNDERAGE DRINKING.
(a)

Definitions.—
For purposes of this section:
(1)
The term “alcohol beverage industry” means the brewers, vintners, distillers, importers, distributors, and retail or online outlets that sell or serve beer, wine, and distilled spirits.
(2)
The term “school-based prevention” means programs, which are institutionalized, and run by staff members or school-designated persons or organizations in any grade of school, kindergarten through 12th grade.
(3)
The term “youth” means persons under the age of 21.
(b)

Sense of Congress.—
It is the sense of the Congress that:
(1)
A multi-faceted effort is needed to more successfully address the problem of underage drinking in the United States. A coordinated approach to prevention, intervention, treatment, enforcement, and research is key to making progress. This Act recognizes the need for a focused national effort, and addresses particulars of the Federal portion of that effort, as well as Federal support for State activities.
(2)
The Secretary of Health and Human Services shall continue to conduct research and collect data on the short and long-range impact of alcohol use and abuse upon adolescent brain development and other organ systems.
(3)
States and communities, including colleges and universities, are encouraged to adopt comprehensive prevention approaches, including—
(A)
evidence-based screening, programs and curricula;
(B)
brief intervention strategies;
(C)
consistent policy enforcement; and
(D)
environmental changes that limit underage access to alcohol.
(4)
Public health groups, consumer groups, and the alcohol beverage industry should continue and expand evidence-based efforts to prevent and reduce underage drinking.
(5)
The entertainment industries have a powerful impact on youth, and they should use rating systems and marketing codes to reduce the likelihood that underage audiences will be exposed to movies, recordings, or television programs with unsuitable alcohol content.
(6)
The National Collegiate Athletic Association, its member colleges and universities, and athletic conferences should affirm a commitment to a policy of discouraging alcohol use among underage students and other young fans.
(7)
Alcohol is a unique product and should be regulated differently than other products by the States and Federal Government. States have primary authority to regulate alcohol distribution and sale, and the Federal Government should support and supplement these State efforts. States also have a responsibility to fight youth access to alcohol and reduce underage drinking. Continued State regulation and licensing of the manufacture, importation, sale, distribution, transportation and storage of alcoholic beverages are clearly in the public interest and are critical to promoting responsible consumption, preventing illegal access to alcohol by persons under 21 years of age from commercial and non-commercial sources, maintaining industry integrity and an orderly marketplace, and furthering effective State tax collection.
(c)

Interagency Coordinating Committee; Annual Report on State Underage Drinking Prevention and Enforcement Activities.—
(1)

Interagency coordinating committee on the prevention of underage drinking.—
(A)

In general.—
The Secretary, in collaboration with the Federal officials specified in subparagraph (B), shall continue to support and enhance the efforts of the interagency coordinating committee, that began operating in 2004, focusing on underage drinking (referred to in this subsection as the “Committee”).
(B)

Other agencies.—
The officials referred to in subparagraph (A) are the Secretary of Education, the Attorney General, the Secretary of Transportation, the Secretary of the Treasury, the Secretary of Defense, the Surgeon General, the Director of the Centers for Disease Control and Prevention, the Director of the National Institute on Alcohol Abuse and Alcoholism, the Assistant Secretary for Mental Health and Substance Use, the Director of the National Institute on Drug Abuse, the Assistant Secretary for Children and Families, the Director of the Office of National Drug Control Policy, the Administrator of the National Highway Traffic Safety Administration, the Administrator of the Office of Juvenile Justice and Delinquency Prevention, the Chairman of the Federal Trade Commission, and such other Federal officials as the Secretary of Health and Human Services determines to be appropriate.
(C)

Chair.—
The Secretary of Health and Human Services shall serve as the chair of the Committee.
(D)

Duties.—
The Committee shall guide policy and program development across the Federal Government with respect to underage drinking, provided, however, that nothing in this section shall be construed as transferring regulatory or program authority from an agency to the Committee.
(E)

Consultations.—
The Committee shall actively seek the input of and shall consult with all appropriate and interested parties, including States, public health research and interest groups, foundations, and alcohol beverage industry trade associations and companies.
(F)

Annual report.—
(i)

In general.—
The Secretary, on behalf of the Committee, shall annually submit to the Congress a report that summarizes—
(I)
all programs and policies of Federal agencies designed to prevent and reduce underage drinking, including such programs and policies that support State efforts to prevent or reduce underage drinking;
(II)
the extent of progress in preventing and reducing underage drinking at State and national levels;
(III)
data that the Secretary shall collect with respect to the information specified in clause (ii); and
(IV)
such other information regarding underage drinking as the Secretary determines to be appropriate.
(ii)

Certain information.—
The report under clause (i) shall include information on the following:
(I)
Patterns and consequences of underage drinking as reported in research and surveys such as, but not limited to, Monitoring the Future, Youth Risk Behavior Surveillance System, the National Survey on Drug Use and Health, and the Fatality Analysis Reporting System.
(II)
Measures of the availability of alcohol from commercial and non-commercial sources to underage populations.
(III)
Measures of the exposure of underage populations to messages regarding alcohol in advertising, social media, and the entertainment media.
(IV)
Surveillance data, including, to the extent such information is available, information on the onset and prevalence of underage drinking, consumption patterns and beverage preferences, trends related to drinking among different age groups, including between youth and adults, the means of underage access, including trends over time, for these surveillance data, and other data, as appropriate. The Secretary shall develop a plan to improve the collection, measurement, and consistency of reporting Federal underage alcohol data.
(V)
Any additional findings resulting from research conducted or supported under subsection (g).
(VI)
Evidence-based best practices to prevent and reduce underage drinking and provide treatment services to those youth who need such services.
(2)

Annual report on state underage drinking prevention and enforcement activities.—
(A)

In general.—
The Secretary shall, with input and collaboration from other appropriate Federal agencies, States, Indian Tribes, territories, and public health, consumer, and alcohol beverage industry groups, annually issue a report on each State’s performance in enacting, enforcing, and creating laws, regulations, programs, and other actions to prevent or reduce underage drinking based on the best practices identified pursuant to paragraph (1)(F)(ii)(VI). For purposes of this paragraph, each such report, with respect to a year, shall be referred to as the “State Report”. Each State Report may be used as a resource to inform the identification and implementation of activities to prevent underage drinking, as determined to be appropriate by such State or other applicable entity.
(B)

Contents.—
(i)

Performance measures.—
The Secretary shall develop, in consultation with the Committee, a set of measures to be used in preparing the State Report on best practices, including as they relate to State laws, regulations, other actions, and enforcement practices.
(ii)

State report content.—
The State Report shall include updates on State laws, regulations, and other actions, including those described in previous reports to Congress, including with respect to the following:
(I)
Whether or not the State has comprehensive anti-underage drinking laws such as for the illegal sale, purchase, attempt to purchase, consumption, or possession of alcohol; illegal use of fraudulent ID; illegal furnishing or obtaining of alcohol for an individual under 21 years; the degree of strictness of the penalties for such offenses; and the prevalence of the enforcement of each of these infractions.
(II)
Whether or not the State has comprehensive liability statutes pertaining to underage access to alcohol such as dram shop, social host, and house party laws, and the prevalence of enforcement of each of these laws.
(III)
Whether or not the State encourages and conducts comprehensive enforcement efforts to prevent underage access to alcohol at retail outlets, such as random compliance checks and shoulder tap programs, and the number of compliance checks within alcohol retail outlets measured against the number of total alcohol retail outlets in each State, and the result of such checks.
(IV)
Whether or not the State encourages training on the proper selling and serving of alcohol for all sellers and servers of alcohol as a condition of employment.
(V)
Whether or not the State has policies and regulations with regard to direct sales to consumers and home delivery of alcoholic beverages.
(VI)
Whether or not the State has programs or laws to deter adults from purchasing alcohol for minors; and the number of adults targeted by these programs.
(VII)
Whether or not the State has enacted graduated drivers licenses and the extent of those provisions.
(VIII)
Whether or not the State has adopted any other policies consistent with evidence-based practices related to the prevention of underage alcohol use, which may include any such practices described in relevant reports issued by the Surgeon General and practices related to youth exposure to alcohol-related products and information.
(IX)
A description of the degree to which the practices of local jurisdictions within the State vary from one another.
(3)

Authorization of appropriations.—
There is authorized to be appropriated to carry out this subsection $1,000,000 for each of fiscal years 2023 through 2027.
(d)

National Media Campaign to Prevent Underage Drinking.—
(1)

In general.—
The Secretary, in consultation with the National Highway Traffic Safety Administration, shall develop or continue an intensive, multifaceted national media campaign aimed at adults to reduce underage drinking.
(2)

Purpose.—
The purpose of the national media campaign described in this section shall be to achieve the following objectives:
(A)
Promote community awareness of, and a commitment to, reducing underage drinking.
(B)
Encourage activities, including activities carried out by adults, that inhibit the illegal use of alcohol by youth.
(C)
Discourage activities, including activities carried out by adults, that promote the illegal use of alcohol by youth.
(3)

Components.—
When implementing the national media campaign described in this section, the Secretary shall—
(A)
educate the public about the public health and safety benefits of evidence-based strategies to reduce underage drinking, including existing laws related to the minimum legal drinking age, and engage the public and parents in the implementation of such strategies;
(B)
educate the public about the negative consequences of underage drinking;
(C)
identify specific actions by adults to discourage or inhibit underage drinking;
(D)
discourage adult conduct that tends to facilitate underage drinking;
(E)
establish collaborative relationships with local and national organizations and institutions to further the goals of the campaign and assure that the messages of the campaign are disseminated from a variety of sources;
(F)
conduct the campaign through multi-media sources; and
(G)
take into consideration demographics and other relevant factors to most effectively reach target audiences.
(4)

Consultation requirement.—
In developing and implementing the national media campaign described in this section, the Secretary shall review recommendations for reducing underage drinking, including those published by the National Academies of Sciences, Engineering, and Medicine and the Surgeon General. The Secretary shall also consult with interested parties including the alcohol beverage industry, medical, public health, and consumer and parent groups, law enforcement, institutions of higher education, community-based organizations and coalitions, and other relevant stakeholders.
(5)

Annual report.—
The Secretary shall produce an annual report on the progress of the development or implementation of the media campaign described in this subsection, including expenses and projected costs, and, as such information is available, report on the effectiveness of such campaign in affecting adult attitudes toward underage drinking and adult willingness to take actions to decrease underage drinking.
(6)

Research on youth-oriented campaign.—
The Secretary may, based on the availability of funds, conduct or support research on the potential success of a youth-oriented national media campaign to reduce underage drinking. The Secretary shall report to Congress any such results and any related recommendations.
(7)

Administration.—
The Secretary may enter into an agreement with another Federal agency to delegate the authority for execution and administration of the adult-oriented national media campaign.
(8)

Authorization of appropriations.—
There is authorized to be appropriated to carry out this section $2,500,000 for each of fiscal years 2023 through 2027.
(e)

Community-based Coalition Enhancement Grants to Prevent Underage Drinking.—
(1)

Authorization of program.—
The Assistant Secretary for Mental Health and Substance Use, in consultation with the Director of the Office of National Drug Control Policy, shall award enhancement grants to eligible entities to design, implement, evaluate, and disseminate comprehensive strategies to maximize the effectiveness of community-wide approaches to preventing and reducing underage drinking. This subsection is subject to the availability of appropriations.
(2)

Purposes.—
The purposes of this subsection are to—
(A)
prevent and reduce alcohol use among youth in communities throughout the United States;
(B)
strengthen collaboration among communities, the Federal Government, Tribal Governments, and State and local governments;
(C)
enhance intergovernmental cooperation and coordination on the issue of alcohol use among youth;
(D)
serve as a catalyst for increased citizen participation and greater collaboration among all sectors and organizations of a community that first demonstrates a long-term commitment to reducing alcohol use among youth;
(E)
implement evidence-based strategies to prevent and reduce underage drinking in communities; and
(F)
enhance, not supplant, effective local community initiatives for preventing and reducing alcohol use among youth.
(3)

Application.—
An eligible entity desiring an enhancement grant under this subsection shall submit an application to the Assistant Secretary at such time, and in such manner, and accompanied by such information and assurances, as the Assistant Secretary may require. Each application shall include—
(A)
a complete description of the entity’s current underage alcohol use prevention initiatives and how the grant will appropriately enhance the focus on underage drinking issues; or
(B)
a complete description of the entity’s current initiatives, and how it will use the grant to enhance those initiatives by adding a focus on underage drinking prevention.
(4)

Uses of funds.—
Each eligible entity that receives a grant under this subsection shall use the grant funds to carry out the activities described in such entity’s application submitted pursuant to paragraph (3) and obtain specialized training and technical assistance by the entity funded under section 4 of Public Law 107–82, as amended (21 U.S.C. 1521 note). Grants under this subsection shall not exceed $60,000 per year and may not exceed four years.
(5)

Supplement not supplant.—
Grant funds provided under this subsection shall be used to supplement, not supplant, Federal and non-Federal funds available for carrying out the activities described in this subsection.
(6)

Evaluation.—
Grants under this subsection shall be subject to the same evaluation requirements and procedures as the evaluation requirements and procedures imposed on recipients of drug-free community grants.
(7)

Definitions.—
For purposes of this subsection, the term “eligible entity” means an organization that is currently receiving or has received grant funds under the Drug-Free Communities Act of 1997.
(8)

Administrative expenses.—
Not more than 6 percent of a grant under this subsection may be expended for administrative expenses.
(9)

Authorization of appropriations.—
There is authorized to be appropriated to carry out this subsection $11,500,000 for each of fiscal years 2023 through 2027.
(f)

Grants to Organizations Representing Pediatric Providers and Other Related Health Professionals to Reduce Underage Drinking Through Screening and Brief Interventions.—
(1)

In general.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall make awards to one or more entities representing pediatric providers and other related health professionals with demonstrated ability to increase among the members of such entities effective practices to reduce the prevalence of alcohol use among individuals under the age of 21, including college students.
(2)

Purposes.—
Grants under this subsection shall be made to improve—
(A)
screening adolescents for alcohol use;
(B)
offering brief interventions to adolescents to discourage such use;
(C)
educating parents about the dangers of and methods of discouraging such use;
(D)
diagnosing and treating alcohol use disorders; and
(E)
referring patients, when necessary, to other appropriate care.
(3)

Use of funds.—
An entity receiving a grant under this section may use the grant funding to promote the practices specified in paragraph (2) among its members by—
(A)
providing training to health care providers;
(B)
disseminating best practices, including culturally and linguistically appropriate best practices, and developing and distributing materials; and
(C)
supporting other activities as determined appropriate by the Assistant Secretary.
(4)

Application.—
To be eligible to receive a grant under this subsection, an entity shall submit an application to the Assistant Secretary at such time, and in such manner, and accompanied by such information and assurances as the Secretary may require. Each application shall include—
(A)
a description of the entity;
(B)
a description of the activities to be completed that will promote the practices specified in paragraph (2);
(C)
a description of the entity’s qualifications for performing such activities; and
(D)
a timeline for the completion of such activities.
(5)

Definitions.—
For the purpose of this subsection:
(A)

Brief intervention.—
The term “brief intervention” means, after screening a patient, providing the patient with brief advice and other brief motivational enhancement techniques designed to increase the insight of the patient regarding the patient’s alcohol use, and any realized or potential consequences of such use to effect the desired related behavioral change.
(B)

Screening.—
The term “screening” means using validated patient interview techniques to identify and assess the existence and extent of alcohol use in a patient.
(6)

Authorization of appropriations.—
There is authorized to be appropriated to carry out this subsection $3,000,000 for each of fiscal years 2023 through 2027.
(g)

Data Collection and Research.—
(1)

Additional research on underage drinking.—
(A)

In general.—
The Secretary shall, subject to the availability of appropriations, support the collection of data, and conduct or support research that is not duplicative of research currently being conducted or supported by the Department of Health and Human Services, on underage drinking, with respect to the following:
(i)
The evaluation, which may include through the development of relevant capabilities of expertise within a State, of the effectiveness of comprehensive community-based programs or strategies and statewide systems to prevent and reduce underage drinking, across the underage years from early childhood to age 21, such as programs funded and implemented by governmental entities, public health interest groups and foundations, and alcohol beverage companies and trade associations.
(ii)
Obtaining and reporting more precise information than is currently collected on the scope of the underage drinking problem and patterns of underage alcohol consumption, including improved knowledge about the problem and progress in preventing, reducing, and treating underage drinking, as well as information on the rate of exposure of youth to advertising and other media messages encouraging and discouraging alcohol consumption.
(iii)
The development and identification of evidence-based or evidence-informed strategies to reduce underage drinking, which may include through translational research.
(iv)
Improving and conducting public health data collection on alcohol use and alcohol-related conditions in States, which may include by increasing the use of surveys, such as the Behavioral Risk Factor Surveillance System, to monitor binge and excessive drinking and related harms among individuals who are at least 18 years of age, but not more than 20 years of age, including harm caused to self or others as a result of alcohol use that is not duplicative of research currently being conducted or supported by the Department of Health and Human Services.
(B)

Authorization of appropriations.—
There is authorized to be appropriated to carry out this paragraph $5,000,000 for each of fiscal years 2023 through 2027.
(2)

National academies of sciences, engineering, and medicine study.—
(A)

In general.—
Not later than 12 months after the date of enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022, the Secretary shall—
(i)
contract with the National Academies of Sciences, Engineering, and Medicine to study developments in research on underage drinking and the implications of these developments; and
(ii)
report to the Congress on the results of such review.
(B)

Authorization of appropriations.—
There is authorized to be appropriated to carry out this paragraph $500,000 for fiscal year 2023.
SEC. 519D.
[290bb–25d]

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 four 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;9
^9
So in law. Probably should read “; and”. See section 3110 of Public Law 106–310 (114 Stat. 1185).
(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.
Subpart 3—

Center for Mental Health Services

center for mental health services
Sec. 520.
[290bb–31]
(a)

Establishment.—
There is established in the Administration a Center for Mental Health Services (hereafter in this section referred to as the “Center”). The Center shall be headed by a Director (hereafter in this section referred to as the “Director”) appointed by the Secretary from among individuals with extensive experience or academic qualifications in the provision of mental health services or in the evaluation of mental health service systems.
(b)

Duties.—
The Director of the Center shall—
(1)
design national goals and establish national priorities for—
(A)
the prevention of mental illness; and
(B)
the promotion of mental health;
(2)
encourage and assist local entities and State agencies to achieve the goals and priorities described in paragraph (1);
(3)
collaborate with the Director of the National Institute of Mental Health and the Chief Medical Officer, appointed under section 501(g), to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health and recovery support are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services, as appropriate;
(4)
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;
(5)
develop and coordinate Federal prevention policies and programs and to assure increased focus on the prevention of mental illness and the promotion of mental health, including through programs that reduce risk and promote resiliency;
(6)
in collaboration with the Director of the National Institute of Mental Health, develop improved methods of treating individuals with mental health problems and improved methods of assisting the families of such individuals;
(7)
administer the mental health services block grant program authorized in section 1911;
(8)
promote policies and programs at Federal, State, and local levels and in the private sector that foster independence, increase meaningful participation of individuals with mental illness in programs and activities of the Administration, and protect the legal rights of persons with mental illness, including carrying out the provisions of the Protection and Advocacy of Mentally Ill Individuals Act;
(9)
carry out the programs under part C;
(10)
carry out responsibilities for the Human Resource Development program, and programs of clinical training for health paraprofessional personnel and health professionals;
(11)
conduct services-related assessments, including evaluations of the organization and financing of care, self-help and consumer-run programs, mental health economics, mental health service systems, rural mental health and tele-mental health, and improve the capacity of State to conduct evaluations of publicly funded mental health programs;
(12)
disseminate mental health information, including evidence-based practices, to States, political subdivisions, educational agencies and institutions, treatment and prevention service providers, and the general public, including information concerning the practical application of research supported by the National Institute of Mental Health that is applicable to improving the delivery of services;
(13)
provide technical assistance to public and private entities that are providers of mental health services;
(14)
monitor and enforce obligations incurred by community mental health centers pursuant to the Community Mental Health Centers Act (as in effect prior to the repeal of such Act on August 13, 1981, by section 902(e)(2)(B) of Public Law 97–35 (95 Stat. 560));
(15)
conduct surveys with respect to mental health, such as the National Reporting Program;
(16)
assist States in improving their mental health data collection; and
(17)
ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded.
(c)

Grants and Contracts.—
In carrying out the duties established in subsection (b), the Director may make grants to and enter into contracts and cooperative agreements with public and nonprofit private entities.
SEC. 520A.
[290bb–32]

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, which may include technical assistance centers.
The Secretary may carry out the activities described in this subsection directly or through grants, contracts, or cooperative agreements with States, political subdivisions of States, Indian Tribes or Tribal organizations (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service, or, other public or 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.
(3)

Geriatric mental disorders.—
The Secretary shall, as appropriate, provide technical assistance to grantees regarding evidence-based practices for the prevention and treatment of geriatric mental 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.
(f)

Authorization of Appropriations.—
There are authorized to be appropriated to carry out this section $599,036,000 for each of fiscal years 2023 through 2027.
SEC. 520B.
[290bb–33]

STUDENT SUICIDE AWARENESS AND PREVENTION TRAINING.
(a)

In General.—
In awarding funds under section 520A, the Secretary shall give priority to applications under such section from a State educational agency, local educational agency, or Tribal educational agency, submitted directly or through a State or Indian Tribe, for funding for activities in secondary schools, where such agency has implemented, or includes in such application a plan to implement, a student suicide awareness and prevention training policy, which may include applicable youth suicide early intervention and prevention strategies implemented through section 520E—
(1)
establishing and implementing a school-based student suicide awareness and prevention training policy in accordance with subsection (c);
(2)
consulting with stakeholders (including principals, teachers, parents, local Tribal officials, and other relevant experts) and, as appropriate, utilizing information, models, and other resources made available by the Suicide Prevention Technical Assistance Center authorized under section 520C in the development of the policy under paragraph (1); and
(3)
collecting and reporting information in accordance with subsection (d).
(b)

Consideration.—
In giving priority to applicants as described in subsection (a), the Secretary shall, as appropriate, take into consideration the incidence and prevalence of suicide in the applicable jurisdiction and the costs of establishing and implementing, as applicable, a school-based student suicide awareness and prevention training policy.
(c)

School-Based Student Suicide Awareness and Prevention Training Policy.—
A school-based student suicide awareness and prevention training policy implemented pursuant to subsection (a)(1) shall—
(1)
be evidence-based;
(2)
be culturally- and linguistically-appropriate;
(3)
provide evidence-based training to students in grades 6 through 12, in coordination with school-based mental health resources, as applicable, regarding—
(A)
suicide prevention education and awareness, including associated risk factors;
(B)
methods that students can use to seek help; and
(C)
student resources for suicide awareness and prevention; and
(4)
provide for periodic retraining of such students.
(d)

Collection of Information and Reporting.—
Each State educational agency, local educational agency, and Tribal educational agency that receives priority to implement a new training policy pursuant to subsection (a)(1) shall report to the Secretary the following aggregated information, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws:
(1)
The number of trainings conducted, including the number of student trainings conducted, and the training delivery method used.
(2)
The number of students trained, disaggregated by age and grade level.
(3)
The number of help-seeking reports made by students after implementation of such policy.
(e)

Evidence-Based Program Availability.—
The Secretary shall coordinate with the Secretary of Education and the Secretary of the Interior to—
(1)
make publicly available the policies established by State educational agencies, local educational agencies, and Tribal educational agencies pursuant to this section and the training that is available to students and teams pursuant to such policies, in accordance with section 543A; and
(2)
provide technical assistance and disseminate best practices on student suicide awareness and prevention training policies, including through the Suicide Prevention Technical Assistance Center authorized under section 520C, as applicable, to State educational agencies, local educational agencies, and Tribal agencies.
(f)

Implementation.—
Not later than September 30, 2024, the Secretary shall 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 the number of recipients of funds under section 520A who have implemented training policies described in subsection (a)(1) and a summary of the information received under subsection (d).
(g)

Definitions.—
In this section:
(1)
The term “evidence-based” has the meaning given such term in section 8101 of the Elementary and Secondary Education Act of 1965.
(2)
The term “local educational agency” has the meaning given to such term in section 8101 of the Elementary and Secondary Education Act of 1965.
(3)
The term “State educational agency” has the meaning given to such term in section 8101 of the Elementary and Secondary Education Act of 1965.
(4)
The term “Tribal educational agency” has the meaning given to the term “tribal educational agency” in section 6132 of the Elementary and Secondary Education Act of 1965.
SEC. 520C.
[290bb–34]

SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.
(a)

Program Authorized.—
(1)

In general.—
The Secretary, acting through the Assistant Secretary, 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 a high risk for suicide.
(2)

Collaboration.—
In carrying out this subsection, as applicable with respect to assistance to entities serving members of the Armed Forces and veterans, the Secretary shall, as appropriate, collaborate with the Secretary of Defense and the Secretary of Veterans Affairs.
(b)

Responsibilities of the Center.—
The center established under subsection (a) shall conduct activities for the purpose of—
(1)
developing and continuing statewide or Tribal suicide early intervention and prevention strategies for all ages, particularly among groups that are at a high risk for suicide;
(2)
ensuring the surveillance of suicide early intervention and prevention strategies for all ages, particularly among groups that are at a high risk for suicide;
(3)
studying the costs and effectiveness of statewide and tribalsuicide early intervention and prevention strategies in order to provide information concerning relevant issues of importance to State, Tribal, and national policymakers;
(4)
further identifying and understanding causes and associated risk factors for suicide;
(5)
analyzing the efficacy of new and existing suicide early intervention and prevention techniques and technology;
(6)
ensuring the surveillance of suicidal behaviors and nonfatal suicidal attempts;
(7)
studying the effectiveness of State-sponsored statewide and Tribal suicide early intervention and prevention strategies on the overall wellness and health promotion strategies related to suicide attempts;
(8)
promoting the sharing of data regarding suicide with Federal agencies involved with suicide early intervention and prevention, and State-sponsored statewide or Tribal suicide early intervention and prevention strategies for the purpose of identifying previously unknown mental health causes and associated risk factors for suicide;
(9)
evaluating and disseminating outcomes and best practices of mental health and substance use disorder services at institutions of higher education; and
(10)
conducting other activities determined appropriate by the Secretary.
(c)

Authorization of Appropriations.—
For the purpose of carrying out this section, there are authorized to be appropriated $9,000,000 for each of fiscal years 2023 through 2027.
(d)

Annual Report.—
Not later than 2 years after the date of the enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022, 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 on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center.
[Section 520D was repealed by section 9017 of Public Law 114–255.]
SEC. 520E.
[290bb–36]

YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION STRATEGIES.
(a)

In General.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall award grants or cooperative agreements to eligible entities to—
(1)
develop and implement State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies in schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, pediatric health programs, and other child and youth support organizations;
(2)
support public organizations and private nonprofit organizations actively involved in State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies and in the development and continuation of State-sponsored statewide youth suicide early intervention and prevention strategies;
(3)
provide grants to institutions of higher education to coordinate the implementation of State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies;
(4)
collect and analyze data on State-sponsored statewide or Tribal youth suicide early intervention and prevention services that can be used to monitor the effectiveness of such services and for research, technical assistance, and policy development; and
(5)
assist eligible entities, through State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies, in achieving targets for youth suicide reductions under title V of the Social Security Act.
(b)

Eligible Entity.—
(1)

Definition.—
In this section, the term “eligible entity” means—
(A)
a State;
(B)
a public organization or private nonprofit organization designated by a State or Indian Tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act) to develop or direct the State-sponsored statewide or Tribal youth suicide early intervention and prevention strategy; or
(C)
a Federally recognized Indian Tribe or Tribal organization (as defined in the Indian Self-Determination and Education Assistance Act) or an urban Indian organization (as defined in the Indian Health Care Improvement Act) that is actively involved in the development and continuation of a Tribal youth suicide early intervention and prevention strategy.
(2)

Limitation.—
In carrying out this section, the Secretary shall ensure that a State does not receive more than 1 grant or cooperative agreement under this section at any 1 time. For purposes of the preceding sentence, a State shall be considered to have received a grant or cooperative agreement if the eligible entity involved is the State or an entity designated by the State under paragraph (1)(B). Nothing in this paragraph shall be construed to apply to entities described in paragraph (1)(C).
(3)

Consideration.—
In awarding grants under this section, the Secretary shall take into consideration the extent of the need of the applicant, including the incidence and prevalence of suicide in the State and among the populations of focus, including rates of suicide determined by the Centers for Disease Control and Prevention for the State or population of focus.
(4)

Consultation.—
An entity described in paragraph (1)(A) or (1)(B) that applies for a grant or cooperative agreement under this section shall agree to consult or confer with entities described in paragraph (1)(C) and Native Hawaiian Health Care Systems, as applicable, in the applicable State with respect to the development and implementation of a statewide early intervention strategy.
(c)

Preference.—
In providing assistance under a grant or cooperative agreement under this section, an eligible entity shall give preference to public organizations, private nonprofit organizations, political subdivisions, institutions of higher education, and Tribal organizations actively involved with the State-sponsored statewide or Tribal youth suicide early intervention and prevention strategy that—
(1)
provide early intervention and assessment services, including screening programs, to youth who are at risk for mental or emotional disorders that may lead to a suicide attempt, and that are integrated with school systems, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, pediatric health programs, and other child and youth support organizations;
(2)
demonstrate collaboration among early intervention and prevention services or certify that entities will engage in future collaboration;
(3)
employ or include in their applications a commitment to evaluate youth suicide early intervention and prevention practices and strategies adapted to the local community;
(4)
provide timely referrals for appropriate community-based mental health care and treatment of youth who are at risk for suicide in child-serving settings and agencies;
(5)
provide immediate support and information resources to families of youth who are at risk for suicide;
(6)
offer access to services and care to youth with diverse linguistic and cultural backgrounds;
(7)
offer appropriate postsuicide intervention services, care, and information to families, friends, schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, pediatric health programs, and other child and youth support organizations of youth who recently completed suicide;
(8)
offer continuous and up-to-date information and awareness campaigns that target parents, family members, child care professionals, community care providers, and the general public and highlight the risk factors associated with youth suicide and the life-saving help and care available from early intervention and prevention services;
(9)
ensure that information and awareness campaigns on youth suicide risk factors, and early intervention and prevention services, use effective communication mechanisms that are targeted to and reach youth, families, schools, educational institutions, pediatric health programs, and youth organizations;
(10)
provide a timely response system to ensure that child-serving professionals and providers are properly trained in youth suicide early intervention and prevention strategies and that child-serving professionals and providers involved in early intervention and prevention services are properly trained in effectively identifying youth who are at risk for suicide;
(11)
provide continuous training activities for child care professionals and community care providers on the latest youth suicide early intervention and prevention services practices and strategies;
(12)
conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations;
(13)
provide services in areas or regions with rates of youth suicide that exceed the national average as determined by the Centers for Disease Control and Prevention;
(14)
obtain informed written consent from a parent or legal guardian of an at-risk child before involving the child in a youth suicide early intervention and prevention program; and
(15)
provide to parents, legal guardians, and family members of youth, supplies to securely store means commonly used in suicide, if applicable, within the household.
(d)

Requirement for Suicide Prevention Activities.—
Not less than 85 percent of grant funds received under this section shall be used to provide suicide prevention activities.
(e)

Coordination and Collaboration.—
(1)

In general.—
In carrying out this section, the Secretary shall collaborate with relevant Federal agencies and suicide working groups responsible for early intervention and prevention services relating to youth suicide.
(2)

Consultation.—
In carrying out this section, the Secretary shall consult with—
(A)
State and local agencies, including agencies responsible for early intervention and prevention services under title XIX of the Social Security Act, the State Children's Health Insurance Program under title XXI of the Social Security Act, and programs funded by grants under title V of the Social Security Act;
(B)
local and national organizations that serve youth at risk for suicide and their families;
(C)
relevant national medical and other health and education specialty organizations;
(D)
youth who are at risk for suicide, who have survived suicide attempts, or who are currently receiving care from early intervention services;
(E)
families and friends of youth who are at risk for suicide, who have survived suicide attempts, who are currently receiving care from early intervention and prevention services, or who have completed suicide;
(F)
qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve youth at risk for suicide and their families; and
(G)
third-party payers, managed care organizations, and related commercial industries.
(3)

Policy development.—
In carrying out this section, the Secretary shall—
(A)
coordinate and collaborate on policy development at the Federal level with the relevant Department of Health and Human Services agencies and suicide working groups and the Department of Education, as appropriate; and
(B)
consult on policy development at the Federal level with the private sector, including consumer, medical, suicide prevention advocacy groups, and other health and education professional-based organizations, with respect to State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies.
(f)

Rule of Construction; Religious and Moral Accommodation.—
Nothing in this section shall be construed to require suicide assessment, early intervention, or treatment services for youth whose parents or legal guardians object based on the parents' or legal guardians' religious beliefs or moral objections.
(g)

Evaluations and Report.—
(1)

Evaluations by eligible entities.—
Not later than 24 months after receiving a grant or cooperative agreement under this section, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement.
(2)

Report.—
Not later than December 31, 2025 , the Secretary shall submit to the appropriate committees of Congress a report concerning the results of—
(A)
the evaluations conducted under paragraph (1); and
(B)
an evaluation conducted by the Secretary to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this section.
(h)

Rule of Construction; Student Medication.—
Nothing in this section or section 520E–1 shall be construed to allow school personnel to require that a student obtain any medication as a condition of attending school or receiving services.
(i)

Prohibition.—
Funds appropriated to carry out this section, section 520C, section 520E–1, or section 520E–2 shall not be used to pay for or refer for abortion.
(j)

Parental consent.—
States and entities receiving funding under this section and section 520E–1 shall obtain prior written, informed consent from the child's parent or legal guardian for assessment services, school-sponsored programs, and treatment involving medication related to youth suicide conducted in elementary and secondary schools. The requirement of the preceding sentence does not apply in the following cases:
(1)
In an emergency, where it is necessary to protect the immediate health and safety of the student or other students.
(2)
Other instances, as defined by the State, where parental consent cannot reasonably be obtained.
(k)

Relation to Education Provisions.—
Nothing in this section or section 520E–1 shall be construed to supersede section 444 of the General Education Provisions Act, including the requirement of prior parental consent for the disclosure of any education records. Nothing in this section or section 520E–1 shall be construed to modify or affect parental notification requirements for programs authorized under the Elementary and Secondary Education Act of 1965 (as amended by the No Child Left Behind Act of 2001; Public Law 107–110).
(l)

Definitions.—
In this section:
(1)

Early intervention.—
The term “early intervention” means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition.
(2)

Educational institution; institution of higher education; school.—
The term—
(A)
“educational institution” means a school or institution of higher education;
(B)
“institution of higher education” has the meaning given such term in section 101 of the Higher Education Act of 1965; and
(C)
“school” means an elementary school or secondary school (as such terms are defined in section 8101 of the Elementary and Secondary Education Act of 1965).
(3)

Prevention.—
The term “prevention” means a strategy or approach that reduces the likelihood or risk of onset, or delays the onset, of adverse health problems that have been known to lead to suicide.
(4)

Youth.—
The term “youth” means individuals who are up to 24 years of age.
(m)

Authorization of Appropriations.—
For the purpose of carrying out this section, there are authorized to be appropriated $40,000,000 for each of fiscal years 2023 through 2027.
SEC. 520E–1.
[290bb–36a]

SUICIDE PREVENTION FOR CHILDREN AND ADOLESCENTS 10.
^{10}
The probable intent of the Congress is that the heading be “SUICIDE PREVENTION FOR YOUTH”. See the amendment described in section 3(b)(1)(A) of Public Law 108–355 (118 Stat. 1407). The amendment cannot be executed because the matter in the heading to be struck does not appear, as the amendatory instruction used the wrong font. The amendment referred to “CHILDREN AND ADOLESCENTS” rather than “CHILDREN AND ADOLESCENTS”. (The amendment is directed to section “520E”. Section 520E–1 above formerly was section 520E, and was redesignated by section 3(b)(2) of such Public Law.)
(a)

In General.—
The Secretary shall award grants or
cooperative agreements to public organizations, private nonprofit organizations, political subdivisions, consortia of political subdivisions, consortia of States, or Federally recognized Indian tribes or tribal organizations to design early intervention and prevention strategies that will complement the State-sponsored statewide or tribal youth suicide early intervention and prevention strategies developed pursuant to section 520E.
(b)

Collaboration.—
In carrying out subsection (a), the Secretary shall ensure that activities under this section are coordinated with the relevant Department of Health and Human Services agencies and suicide working groups.
(c)

Requirements.—
A public organization, private nonprofit organization, political subdivision, consortium of political subdivisions, consortium of States, or federally recognized Indian tribe or tribal organization desiring a grant, contract, or cooperative agreement under this section shall demonstrate that the suicide prevention program such entity proposes will—
(1)
(A)
comply with the State-sponsored statewide early intervention and prevention strategy as developed under section 520E; and
(B)
in the case of a consortium of States, receive the support of all States involved;
(2)
provide for the timely assessment, treatment, or referral for mental health or substance abuse services of youth at risk for suicide;
(3)
be based on suicide prevention practices and strategies that are adapted to the local community;
(4)
integrate its suicide prevention program into the existing health care system in the community including general, mental, and behavioral health services, and substance abuse services;
(5)
be integrated into other systems in the community that address the needs of youth including the school systems, educational institutions, juvenile justice system, substance abuse programs, mental health programs, foster care systems, and community child and youth support organizations;
(6)
use primary prevention methods to educate and raise awareness in the local community by disseminating evidence-based information about suicide prevention;
(7)
include suicide prevention, mental health, and related information and services for the families and friends of those who completed suicide, as needed;
(8)
offer access to services and care to youth with diverse linguistic and cultural backgrounds;
(9)
conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations;11
^{11}
So in law. Probably should include “and” after the semicolon at the end of paragraph (9). See section 3(b)(1)(D)(ix) of Public Law 108–355 (118 Stat. 1408).
(10)
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 a grant or cooperative agreement under this section shall be used to supplement, and not supplant, Federal and non-Federal funds available for carrying out the activities described in this section. Applicants shall provide financial information to demonstrate compliance with this section.
(e)

Condition.—
An applicant for a grant or cooperative agreement under subsection (a) shall demonstrate to the Secretary that the application complies with the State-sponsored statewide early intervention and prevention strategy as developed under section 520E and the applicant has the support of the local community and relevant public health officials.
(f)

Special Populations.—
In awarding grants 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 public organization, private nonprofit organization, political subdivision, consortium of political subdivisions, consortium of States, or Federally recognized Indian tribe or tribal organization receiving a grant 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 or cooperative agreement, including a process and outcome evaluation.
(h)

Distribution of Awards.—
In awarding grants 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 public organization, private nonprofit organization, political subdivision, consortium of political subdivisions, consortium of States, or Federally recognized Indian tribe or tribal organization receiving a grant 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 12 awarded under this section, the period during which payments under such award may be made to the recipient may not exceed 3 years.
^{12}
So in law. Probably should be “grant or cooperative agreement”. See the amendments made by section 3(b) of Public Law 108–355 (118 Stat. 1407).
(l)

Study.—
Within 1 year after the date of the 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 24 who attempt or complete suicide; and
(3)
a profile of services available to these groups and the use of these services by children and youths from paragraphs (1) and (2).
(m)

Definitions.—
In this section, the terms “early intervention”, “educational institution”, “institution of higher education”, “prevention”, “school”, and “youth” have the meanings given to those terms in section 520E.
(n)

Authorization of Appropriation.—
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.
SEC. 520E–2.
[290bb–36b]

MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES FOR STUDENTS IN HIGHER EDUCATION.
(a)

In General.—
The Secretary, acting through the Director of the Center for Mental Health Services and in consultation with the Secretary of Education, may award grants on a competitive basis to institutions of higher education to enhance services for students with mental health or substance use disorders that can lead to school failure, such as depression, substance use disorders, and suicide attempts, prevent mental and substance use disorders, reduce stigma, and improve the identification and treatment for students at risk, so that students will successfully complete their studies.
(b)

Use of Funds.—
The Secretary may not make a grant to an institution of higher education under this section unless the institution agrees to use the grant only for one or more of the following:
(1)
Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders and promote resiliency.
(2)
The operation of hotlines.
(3)
Preparing informational material.
(4)
Providing outreach services to notify students about available mental health and substance use disorder resources and services.
(5)
Administering voluntary mental health and substance use disorder screenings and assessments.
(6)
Supporting the training of students, faculty, and staff to recognize and respond effectively and appropriately to students experiencing mental health and substance use disorders.
(7)
Creating a network infrastructure to link institutions of higher education with health care providers who treat mental health and substance use disorders.
(8)
Providing mental health and substance use. disorders prevention and treatment services to students, which may include recovery support services and programming and early intervention, treatment, and management, including through the use of telehealth services.
(9)
Conducting research through a counseling or health center at the institution of higher education involved to improve the behavioral health of students through clinical services, outreach, prevention, promotion of mental health, or academic success, in a manner that is in compliance with all applicable personal privacy laws.
(10)
Supporting student groups on campus, including athletic teams, that engage in activities to educate students, including activities to reduce stigma surrounding mental and behavioral health disorders, and promote mental health.
(11)
Employing appropriately trained staff.
(12)
Developing and supporting evidence-based and emerging best practices, including a focus on culturally and linguistically appropriate best practices, and trauma-informed practices.
(c)

Eligible grant recipients.—
Any institution of higher education receiving a grant under this section may carry out activities under the grant through—
(1)
college counseling centers;
(2)
college and university psychological service centers;
(3)
mental health centers;
(4)
psychology training clinics; or
(5)
institution of higher education supported, evidence-based, mental health and substance use disorder programs.
(d)

Application.—
To be eligible to receive a grant under this section, an institution of higher education shall prepare and submit an application to the Secretary at such time and in such manner as the Secretary may require. At a minimum, the application shall include the following:
(1)
A description of the population to be targeted by the program carried out under the grant, including veterans whenever possible and appropriate, and of identified mental health and substance use disorder needs of students at the institution of higher education.
(2)
A description of Federal, State, local, private, and institutional resources currently available to address the needs described in paragraph (1) at the institution of higher education, 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.
(3)
A description of the outreach strategies of the institution of higher education for promoting mental health and access to services, including a proposed plan for reaching those students most in need of mental health services.
(4)
A plan to evaluate program outcomes, including a description of the proposed use of funds, the program objectives, and how the objectives will be met.
(5)
An assurance that the institution will submit a report to the Secretary each fiscal year on the activities carried out with the grant and the results achieved through those activities.
(6)
An outline of the objectives of the program carried out under the grant.
(7)
For an institution of higher education proposing to use the grant for an activity described in paragraph (8) or (9) of subsection (b), a description of the policies and procedures of the institution of higher education that are related to applicable laws regarding access to, and sharing of, treatment records of students at any campus-based mental health center or partner organization, including the policies and State laws governing when such records can be accessed and shared for non-treatment purposes and a description of the process used by the institution of higher education to notify students of these policies and procedures, including the extent to which written consent is required.
(8)
An assurance that grant funds will be used to supplement and not supplant any other Federal, State, or local funds available to carry out activities of the type carried out under the grant.
(e)

Requirement of Matching Funds.—
(1)

In general.—
The Secretary may make a grant under this section to an institution of higher education only if the institution agrees to make available (directly or through donations from public or private entities) non-Federal contributions in an amount that is not less than $1 for each $1 of Federal funds provided in the grant, toward the costs of activities carried out with the grant (as described in subsection (b)) and other activities by the institution to reduce student mental health and substance use disorders.
(2)

Determination of amount contributed.—
Non-Federal contributions required under paragraph (1) may be in cash or in kind. 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 non-Federal contributions.
(3)

Waiver.—
The Secretary may waive the requirement established in paragraph (1) with respect to an institution of higher education if the Secretary determines that extraordinary need at the institution justifies the waiver.
(f)

Reports.—
For each fiscal year that grants are awarded under this section, the Secretary shall conduct a study on the results of the grants and submit to the Committee on Energy and Commerce of the House of Representatives and the Committee on Health, Education, Labor, and Pensions of the Senate a report on such results that includes the following:
(1)
An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities.
(2)
Recommendations on how to improve access to mental health and substance use disorder services at institutions of higher education, including through prevention, early detection, early intervention, and efforts to reduce the incidence of suicide and substance use disorders.
(3)
An assessment of the mental health and substance use disorder needs of the populations served by recipients of grants under this section.
(g)

Definition.—
In this section, the term “institution of higher education” has the meaning given such term in section 101 of the Higher Education Act of 1965.
(h)

Technical Assistance.—
The Secretary may provide technical assistance to grantees in carrying out this section.
(i)

Authorization of Appropriations.—
For the purpose of carrying out this section, there are authorized to be appropriated $7,000,000 for each of fiscal years 2023 through 2027.
SEC. 520E–3.
[290bb–36c]

NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
(a)

In General.—
The Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline program (referred to in this section as the “program”), authorized under section 520A and in effect prior to the date of enactment of the Helping Families in Mental Health Crisis Reform Act of 2016.
(b)

Activities.—
In maintaining the program, the activities of the Secretary shall include—
(1)
supporting and coordinating a network of crisis centers across the United States for providing suicide prevention and mental health crisis intervention services, including appropriate follow-up services, to individuals seeking help at any time, day or night;
(2)
maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources;
(3)
consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline;
(4)
improving awareness of the program for suicide prevention and mental health crisis intervention services, including by conducting an awareness initiative and ongoing outreach to the public;
(5)
improving the collection and analysis of demographic information, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws, in order to understand disparities in access to the program among individuals who are seeking help; and
(6)
taking such steps as may be necessary to ensure the suicide prevention hotline is protected from cybersecurity incidents and eliminates known cybersecurity vulnerabilities.
(c)

Plan.—
(1)

In general.—
For purposes of supporting the crisis centers under subsection (b)(1) and maintaining the suicide prevention hotline under subsection (b)(2), the Secretary shall develop and implement a plan to ensure the provision of high-quality services.
(2)

Contents.—
The plan required by paragraph (1) shall include the following:
(A)
Program evaluation, including performance measures to assess progress toward the goals and objectives of the program and to improve the responsiveness and performance of the hotline, including at all backup call centers.
(B)
Requirements that crisis centers and backup centers must meet—
(i)
to participate in the network under subsection (b)(1); and
(ii)
to ensure that each telephone call and applicable other communication received by the hotline, including at backup call centers, is answered in a timely manner, consistent with evidence-based guidance or other guidance or best practices, as appropriate.
(C)
Specific recommendations and strategies for implementing evidence-based practices, including with respect to followup and communicating the availability of resources in the community for individuals in need.
(D)
Criteria for carrying out periodic testing of the hotline during each fiscal year, including at crisis centers and backup centers, to identify and address any problems in a timely manner.
(3)

Consultation.—
In developing requirements under paragraph (2)(B), the Secretary shall consult with State departments of health, local governments, Indian Tribes, and Tribal organizations.
(4)

Initial plan; updates.—
The Secretary shall—
(A)
not later than 1 year after the date of enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022, complete development of the initial plan under paragraph (1) and make such plan publicly available; and
(B)
periodically thereafter, update such plan and make the updated plan publicly available.
(d)

Improving Epidemiological Data.—
The Secretary shall, as appropriate, formalize and strengthen agreements between the Suicide Prevention Lifeline program and the Centers for Disease Control and Prevention with respect to the secure sharing of de-identified epidemiological data. Such agreements shall include appropriate privacy and security protections that meet the requirements of applicable Federal law, at a minimum.
(e)

Data to Assist State and Local Suicide Prevention Activities.—
The Secretary shall ensure that the aggregated information collected and any applicable analyses conducted under subsection (b)(5), including from local call centers, as applicable, are made available in a usable format to State and local agencies in order to inform suicide prevention activities.
(f)

Cybersecurity Reporting.—
(1)

Notification.—
(A)

In general.—
The program’s network administrator receiving Federal funding pursuant to subsection (a) shall report to the Assistant Secretary, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws—
(i)
any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such a vulnerability; and
(ii)
any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident.
(B)

Local and regional crisis centers.—
Local and regional crisis centers participating in the program shall report to the program’s network administrator identified under subparagraph (A), in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws—
(i)
any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such vulnerability; and
(ii)
any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident.
(2)

Notification.—
If the program’s network administrator receiving funding pursuant to subsection (a) discovers, or is informed by a local or regional crisis center pursuant to paragraph (1)(B) of, a cybersecurity vulnerability or incident, within a reasonable amount of time after such discovery or receipt of information, such entity shall report the vulnerability or incident to the Assistant Secretary.
(3)

Clarification.—
(A)

Oversight.—
(i)

Local and regional crisis centers.—
Except as provided in clause (ii), local and regional crisis centers participating in the program shall oversee all technology each center employs in the provision of services as a participant in the program.
(ii)

Network administrator.—
The program’s network administrator receiving Federal funding pursuant to subsection (a) shall oversee the technology each crisis center employs in the provision of services as a participant in the program if such oversight responsibilities are established in the applicable network participation agreement.
(B)

Supplement, not supplant.—
The cybersecurity incident reporting requirements under this subsection shall supplement, and not supplant, cybersecurity incident reporting requirements under other provisions of applicable Federal law that are in effect on the date of the enactment of the SUPPORT for Patients and Communities Reauthorization Act of 2025.
(g)

Authorization of Appropriations.—
To carry out this section, there are authorized to be appropriated $101,621,000 for each of fiscal years 2023 through 2027.
SEC. 520E–4.
[290bb-36d]

TREATMENT REFERRAL ROUTING SERVICE.
(a)

In General.—
The Secretary, acting through the Assistant Secretary, shall maintain the National Treatment Referral Routing Service (referred to in this section as the “Routing Service”) to assist individuals and families in locating mental and substance use disorders treatment providers.
(b)

Activities of the Secretary.—
To maintain the Routing Service, the activities of the Assistant Secretary shall include administering—
(1)
a nationwide, telephone number providing year-round access to information that is updated on a regular basis regarding local behavioral health providers and community-based organizations in a manner that is confidential, without requiring individuals to identify themselves, is in languages that include at least English and Spanish, and is at no cost to the individual using the Routing Service; and
(2)
an Internet website to provide a searchable, online treatment services locator of behavioral health treatment providers and community-based organizations, which shall include information on the name, location, contact information, and basic services provided by such providers and organizations.
(c)

Removing Practitioner Contact Information.—
In the event that the Internet website described in subsection (b)(2) contains information on any practitioner who prescribes narcotic drugs in schedule III, IV, or V of section 202 of the Controlled Substances Act for the purpose of maintenance or detoxification treatment, the Assistant Secretary—
(1)
shall provide an opportunity to such practitioner to have the contact information of the practitioner removed from the website at the request of the practitioner; and
(2)
may evaluate other methods to periodically update the information displayed on such website.
(d)

Rule of Construction.—
Nothing in this section shall be construed to prevent the Assistant Secretary from using any unobligated amounts otherwise made available to the Administration to maintain the Routing Service.
SEC. 520F.
[290bb–37]

MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT PROGRAM.
(a)

In General.—
The Secretary shall establish a pilot program under which the Secretary will award competitive grants to States, localities, territories, Indian Tribes, and Tribal organizations to establish new, or enhance existing, mobile crisis response teams that divert the response for mental health and substance use disorder crises from law enforcement to mobile crisis teams, as described in subsection (b).
(b)

Mobile Crisis Teams Described.—
A mobile crisis team, for purposes of this section, is a team of individuals—
(1)
that is available to respond to individuals in mental health and substance use disorder crises and provide immediate stabilization, referrals to community-based mental health and substance use disorder services and supports, and triage to a higher level of care if medically necessary;
(2)
which may include licensed counselors, clinical social workers, physicians, paramedics, crisis workers, peer support specialists, or other qualified individuals; and
(3)
which may provide support to divert mental health and substance use disorder crisis calls from the 9–1–1 system to the 9–8–8 system.
(c)

Priority.—
In awarding grants under this section, the Secretary shall prioritize applications which account for the specific needs of the communities to be served, including children and families, veterans, rural and underserved populations, and other groups at increased risk of death from suicide or overdose.
(d)

Report.—
(1)

Initial report.—
Not later than September 30, 2024, the Secretary shall submit to Congress a report on steps taken by States, localities, territories, Indian Tribes, and Tribal organizations prior to the date of enactment of this section to strengthen the partnerships among mental health providers, substance use disorder treatment providers, primary care physicians, mental health and substance use disorder crisis teams, paramedics, law enforcement officers, and other first responders.
(2)

Progress reports.—
Not later than one year after the date on which the first grant is awarded to carry out this section, and for each year thereafter, the Secretary shall submit to Congress a report on the grants made during the year covered by the report, which shall include—
(A)
impact data on the teams and people served by such programs, including demographic information of individuals served, volume, and types of service utilization;
(B)
outcomes of the number of linkages made to community-based resources or short-term crisis receiving and stabilization facilities, as applicable, and diversion from law enforcement or hospital emergency department settings;
(C)
data consistent with the State block grant requirements for continuous evaluation and quality improvement, and other relevant data as determined by the Secretary;
(D)
identification and, where appropriate, recommendations of best practices from States and localities providing mobile crisis response and stabilization services for youth and adults; and
(E)
identification of any opportunities for improvements to the program established under this section.
(e)

Authorization of Appropriations.—
There are authorized to be appropriated to carry out this section, $10,000,000 for each of fiscal years 2023 through 2027.
SEC. 520G.
[290bb–38]

GRANTS FOR JAIL DIVERSION PROGRAMS.
(a)

Program Authorized.—
The Secretary shall make grants to States, political subdivisions of States, and Indian Tribes and Tribal organizations (as the terms “Indian tribes” and “tribal organizations” are defined in section 4 of the Indian Self-Determination and Education Assistance Act), acting directly or through agreements with other public or nonprofit entities, or a health facility or program operated by or in accordance with a contract or grant with the Indian Health Service, 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, an Indian Tribe or Tribal organization, a health facility or program described in subsection (a), or a public or nonprofit entity referred to in subsection (a) 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 evidence-based practices, reflect current research findings, include case management, assertive community treatment, medication management and access, integrated mental health and co-occurring substance use disorder treatment, peer recovery support services, 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 use disorder 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)

Special Consideration Regarding Veterans.—
In awarding grants under subsection (a), the Secretary shall, as appropriate, give special consideration to entities proposing to use grant funding to support jail diversion services for veterans.
(e)

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 use disorder services to accommodate the diversion program;
(3)
train professionals and paraprofessionals involved in the system of care, and law enforcement officers, attorneys, and judges;
(4)
provide community outreach and crisis intervention; and
(5)
develop programs to divert individuals prior to booking , arrest, or release.
(f)

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.
(g)

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.
(h)

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.
(i)

Evaluations.—
The programs described in subsection (a) shall be evaluated not less than one time in every 12-month period using the methodology and outcome measures identified in the grant application.
(j)

Authorization of Appropriations.—
There are authorized to be appropriated to carry out this section $14,000,000 for each of fiscal years 2023 through 2027.
SEC. 520H.
[ 290bb-39 ]

PEER-SUPPORTED MENTAL HEALTH SERVICES.
(a)

Grants Authorized.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall award grants to eligible entities to enable such entities to develop, expand, and enhance access to mental health peer-delivered services.
(b)

Use of Funds.—
Grants awarded under subsection (a) shall be used to develop, expand, and enhance national, statewide, or community-focused programs, including virtual peer-support services and technology-related capabilities, including by—
(1)
carrying out workforce development, recruitment, and retention activities, to train, recruit, and retain peer-support providers;
(2)
building connections between mental health treatment programs, including between community organizations and peer-support networks, including virtual peer-support networks, and with other mental health support services;
(3)
reducing stigma associated with mental health disorders;
(4)
expanding and improving virtual peer mental health support services, including through the adoption of technologies and capabilities to expand access to virtual peer mental health support services, such as by acquiring equipment and software necessary to efficiently run virtual peer-support services; and
(5)
conducting research on issues relating to mental illness and the impact peer-support has on resiliency, including identifying—
(A)
the signs of mental illness;
(B)
the resources available to individuals with mental illness and to their families; and
(C)
the resources available to help support individuals living with mental illness.
(c)

Special Consideration.—
In carrying out this section, the Secretary shall give special consideration to the unique needs of rural areas.
(d)

Definition.—
In this section, the term “eligible entity” means—
(1)
a consumer-run nonprofit organization that—
(A)
is principally governed by people living with a mental health condition; and
(B)
mobilizes resources within and outside of the mental health community, which may include through peer-support networks, to increase the prevalence and quality of long-term wellness of individuals living with a mental health condition, including those with a co-occurring substance use disorder; or
(2)
an Indian Tribe, Tribal organization, Urban Indian organization, or consortium of Tribes or Tribal organizations.
(e)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this section $13,000,000 for each of fiscal years 2023 through 2027.
SEC. 520H–1.
[ 290bb-39a ]

BEST PRACTICES FOR BEHAVIORAL AND MENTAL HEALTH INTERVENTION TEAMS.
(a)

In General.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, and in consultation with the Secretary of Education, shall submit to the Health Education, Labor, and Pensions Committee of the Senate and the Energy and Commerce Committee of the House of Representatives a report that identifies best practices related to using behavioral and mental health intervention teams, which may be used to assist elementary schools, secondary schools, and institutions of higher education interested in voluntarily establishing and using such teams to support students exhibiting behaviors interfering with learning at school or who are at risk of harm to self or others.
(b)

Elements.—
The report under subsection (a) shall assess evidence supporting such best practices and, as appropriate, include consideration of the following:
(1)
How behavioral and mental health intervention teams might operate effectively from an evidence-based, objective perspective while protecting the constitutional and civil rights and privacy of individuals.
(2)
The use of behavioral and mental health intervention teams—
(A)
to identify and support students exhibiting behaviors interfering with learning or posing a risk of harm to self or others; and
(B)
to implement evidence-based interventions to meet the behavioral and mental health needs of such students.
(3)
How behavioral and mental health intervention teams can—
(A)
access evidence-based professional development to support students described in paragraph (2)(A); and
(B)
ensure that such teams—
(i)
are composed of trained, diverse stakeholders with expertise in child and youth development, behavioral and mental health, and disability; and
(ii)
use cross validation by a wide-range of individual perspectives on the team.
(4)
How behavioral and mental health intervention teams can help mitigate inappropriate referral to mental health services or law enforcement by implementing evidence-based interventions that meet student needs.
(c)

Consultation.—
In carrying out subsection (a), the Secretary shall consult with—
(1)
the Secretary of Education;
(2)
the Director of the National Threat Assessment Center of the United States Secret Service;
(3)
the Attorney General;
(4)
teachers (which shall include special education teachers), principals and other school leaders, school board members, behavioral and mental health professionals (including school-based mental health professionals), and parents of students;
(5)
local law enforcement agencies and campus law enforcement administrators;
(6)
privacy, disability, and civil rights experts; and
(7)
other education and mental health professionals as the Secretary deems appropriate.
(d)

Publication.—
The Secretary shall publish the report under subsection (a) in an accessible format on the internet website of the Department of Health and Human Services.
(e)

Definitions.—
In this section:
(1)
The term “behavioral and mental health intervention team” means a multidisciplinary team of trained individuals who—
(A)
are trained to identify and assess the behavioral health needs of children and youth and who are responsible for identifying, supporting, and connecting students exhibiting behaviors interfering with learning at school, or who are at risk of harm to self or others, with appropriate behavioral health services; and
(B)
develop and facilitate implementation of evidence-based interventions to—
(i)
mitigate the threat of harm to self or others posed by a student described in subparagraph (A);
(ii)
meet the mental and behavioral health needs of such students; and
(iii)
support positive, safe, and supportive learning environments.
(2)
The terms “elementary school”, “parent”, and “secondary school” have the meanings given to such terms in section 8101 of the Elementary and Secondary Education Act of 1965.
(3)
The term “institution of higher education” has the meaning given to such term in section 102 of the Higher Education Act of 1965.
SEC. 520I.
[290bb–40]

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. 520J.
[290bb–41]

MENTAL HEALTH AWARENESS TRAINING GRANTS.
(a)

In General.—
The Secretary shall award grants in accordance with the provisions of this section.
(b)

Mental Health 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 veterans, law enforcement, and other categories of individuals, as determined by the Secretary, 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 for evidence-based programs that provide training and education in accordance with paragraph (1) on matters including—
(A)
recognizing the signs and symptoms of mental illness;
(B)
(i)
resources available in the community for individuals with a mental illness and other relevant resources; or
(ii)
safely de-escalating crisis situations involving individuals with a mental illness; and
(C)
suicide intervention and prevention.
(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)

Technical assistance.—
The Secretary may provide technical assistance to grantees in carrying out this section, which may include assistance with—
(A)
program evaluation and related activities, including related data collection and reporting;
(B)
implementing and disseminating evidence-based practices and programs; and
(C)
facilitating collaboration among grantees.
(8)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this subsection$24,963,000 for each of fiscal years 2023 through 2027.
SEC. 520K.
[290bb–42]

IMPROVING UPTAKE AND PATIENT ACCESS TO INTEGRATED CARE SERVICES.
(a)

Definitions.—
In this section:
(1)

Eligible entity.—
The term “eligible entity” means a State, or an appropriate State agency, in collaboration with—
(A)
1 or more qualified community programs as described in section 1913(b)(1); or
(B)
1 or more health centers (as defined in section 330(a)), rural health clinics (as defined in section 1861(aa) of the Social Security Act), or Federally qualified health centers (as defined in such section), or primary care practices serving adult or pediatric patients or both.
(2)

Integrated care; bidirectional integrated care.—
(A)
The term “integrated care” means collaborative models, including the psychiatric collaborative care model and other evidence-based or evidence-informed models, or practices for coordinating and jointly delivering behavioral and physical health services, which may include practices that share the same space in the same facility.
(B)
The term “bidirectional integrated care” means the integration of behavioral health care and specialty physical health care, and the integration of primary and physical health care within specialty behavioral health settings, including within primary health care settings.
(3)

Psychiatric collaborative care model.—
The term “psychiatric collaborative care model” means the evidence-based, integrated behavioral health service delivery method that includes—
(A)
care directed by the primary care team;
(B)
structured care management;
(C)
regular assessments of clinical status using developmentally appropriate, validated tools; and
(D)
modification of treatment as appropriate.
(4)

Special population.—
The term “special population” means—
(A)
adults with a serious mental illness or adults who have co-occurring mental illness and physical health conditions or chronic disease;
(B)
children and adolescents with a serious emotional disturbance who have a co-occurring physical health condition or chronic disease;
(C)
individuals with a substance use disorder; or
(D)
individuals with a mental illness who have a co-occurring substance use disorder.
(b)

Grants and Cooperative Agreements.—
(1)

In general.—
The Secretary may award grants and cooperative agreements to eligible entities to support the improvement of integrated care for physical and behavioral health care in accordance with paragraph (2).
(2)

Use of funds.—
A grant or cooperative agreement awarded under this section shall be used—
(A)
to promote full integration and collaboration in clinical practices between physical and behavioral health care, including for special populations;
(B)
to support the improvement of integrated care models for physical and behavioral health care to improve overall wellness and physical health status, including for special populations;
(C)
to promote the implementation and improvement of bidirectional integrated care services provided at entities described in subsection (a)(1), including evidence-based or evidence-informed screening, assessment, diagnosis, prevention, treatment, and recovery services for mental and substance use disorders, and co-occurring physical health conditions and chronic diseases; and
(D)
in the case of an eligible entity that is collaborating with a primary care practice, to support the implementation of evidence-based or evidence-informed integrated care models, including the psychiatric collaborative care model, including—
(i)
by hiring staff;
(ii)
by identifying and formalizing contractual relationships with other health care providers or other relevant entities offering care management and behavioral health consultation to facilitate the adoption of integrated care, including, as applicable, providers who will function as psychiatric consultants and behavioral health care managers in providing behavioral health integration services through the collaborative care model;
(iii)
by purchasing or upgrading software and other resources, as applicable, needed to appropriately provide behavioral health integration, including resources needed to establish a patient registry and implement measurement-based care; and
(iv)
for such other purposes as the Secretary determines to be applicable and appropriate.
(c)

Applications.—
(1)

In general.—
An eligible entity that is seeking a grant or cooperative agreement under this section shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require, including the contents described in paragraph (2).
(2)

Contents for awards.—
Any such application of an eligible entity seeking a grant or cooperative agreement under this section shall include, as applicable—
(A)
a description of a plan to achieve fully collaborative agreements to provide bidirectional integrated care to special populations;
(B)
a summary of the policies, if any, that are barriers to the provision of integrated care, and the specific steps, if applicable, that will be taken to address such barriers;
(C)
a description of partnerships or other arrangements with local health care providers to provide services to special populations and, as applicable, in areas with demonstrated need, such as Tribal, rural, or other medically underserved communities, such as those with a workforce shortage of mental health and substance use disorder, pediatric mental health, or other related professionals;
(D)
an agreement and plan to report to the Secretary performance measures necessary to evaluate patient outcomes and facilitate evaluations across participating projects; and
(E)
a description of the plan or progress in implementing the psychiatric collaborative care model, as applicable and appropriate;
(F)
a description of the plan or progress of evidence-based or evidence-informed integrated care models other than the psychiatric collaborative care model implemented by primary care practices, as applicable and appropriate; and
(G)
a plan for sustainability beyond the grant or cooperative agreement period under subsection (e).
(d)

Grant and Cooperative Agreement Amounts.—
(1)

Target amount.—
The target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section shall be no more than $2,000,000.
(2)

Adjustment permitted.—
The Secretary, taking into consideration the quality of an eligible entity’s application and the number of eligible entities that received grants under this section prior to the date of enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022, may adjust the target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section.
(3)

Limitation.—
An eligible entity that is receiving funding under subsection (b)—
(A)
may not allocate more than 10 percent of the funds awarded to such eligible entity under this section to administrative functions; and
(B)
shall allocate the remainder of such funding to health facilities that provide integrated care.
(e)

Duration.—
A grant or cooperative agreement under this section shall be for a period not to exceed 5 years.
(f)

Report on Program Outcomes.—
An eligible entity receiving a grant or cooperative agreement under this section shall submit an annual report to the Secretary. Such annual report shall include—
(1)
the progress made to reduce barriers to integrated care as described in the entity’s application under subsection (c);
(2)
a description of outcomes with respect to each special population listed in subsection (a)(4), including outcomes related to education, employment, and housing, or, as applicable and appropriate, outcomes for such populations receiving behavioral health care through the psychiatric collaborative care model in primary care practices; and
(3)
progress in meeting performance metrics and other relevant benchmarks; and
(4)
such other information that the Secretary may require.
(g)

Technical Assistance for Primary-behavioral Health Care Integration.—
(1)

Certain recipients.—
The Secretary may provide appropriate information, training, and technical assistance to eligible entities that receive a grant or cooperative agreement under subsection (b)(2), in order to help such entities meet the requirements of this section, including assistance with—
(A)
development and selection of integrated care models;
(B)
dissemination of evidence-based interventions in integrated care;
(C)
establishment of organizational practices to support operational and administrative success; and
(D)
as appropriate, appropriate information, training, and technical assistance in implementing the psychiatric collaborative care model when an eligible entity is collaborating with 1 or more primary care practices for the purposes of implementing the psychiatric collaborative care model.
(2)

Additional dissemination of technical information.—
In addition to providing the assistance described in paragraph (1) to recipients of a grant or cooperative agreement under this section, the Secretary may also provide such assistance to other States and political subdivisions of States, Indian Tribes and Tribal organizations, as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act, outpatient mental health and addiction treatment centers, community mental health centers that meet the criteria under section 1913(c), certified community behavioral health clinics described in section 223 of the Protecting Access to Medicare Act of 2014, primary care organizations such as Federally qualified health centers or rural health clinics as defined in section 1861(aa) of the Social Security Act, primary health care practices, the community-based organizations, and other entities engaging in integrated care activities, as the Secretary determines appropriate.
(h)

Report to Congress.—
Not later than 18 months after the date of enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022, and annually thereafter, the Secretary 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 summarizing the information submitted in reports to the Secretary under subsection (f), including progress made in meeting performance metrics and the uptake of integrated care models, any adjustments made to target amounts pursuant to subsection (d)(2), and any other relevant information.
(i)

Funding.—
(1)

Authorization of appropriations.—
To carry out this section, there is authorized to be appropriated $60,000,000 for each of fiscal years 2023 through 2027.
(2)

Increasing uptake of the psychiatric collaborative care model by primary care practices.—
Not less than 10 percent of funds appropriated to carry out this section shall be for the purposes of implementing the psychiatric collaborative care model implemented by primary care practices under subsection (b).
(3)

Funding contingency.—
Paragraph (2) shall not apply to a fiscal year unless the amount made available to carry out this section for such fiscal year exceeds the amount appropriated to carry out this section (as in effect before the date of enactment of the Restoring Hope for Mental Health and Well-Being Act of 2022) for fiscal year 2022.
SEC. 520L.
[290bb–43]

ADULT SUICIDE PREVENTION.
(a)

Grants.—
(1)

In general.—
The Assistant Secretary shall award grants to eligible entities described in paragraph (2) to implement suicide prevention and intervention programs, for adult individuals, that are designed to raise awareness of suicide prevention, establish referral processes, and improve care and outcomes for such individuals who are at risk of suicide.
(2)

Eligible entities.—
To be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency (or State health agency with mental or behavioral health functions), public health agency, a territory of the United States, or an Indian Tribe or Tribal organization (as the terms “Indian Tribe” and “Tribal organization” are defined in section 4 of the Indian Self-Determination and Education Assistance Act).
(3)

Use of funds.—
The grants awarded under paragraph (1) shall be used to implement programs, in accordance with such paragraph, that include one or more of the following components:
(A)
Screening for suicide risk, suicide intervention services, and services for referral for treatment for individuals at risk for suicide.
(B)
Implementing evidence-based practices to provide treatment for individuals at risk for suicide, including appropriate followup services.
(C)
Raising awareness of suicide prevention resources and promoting help seeking among those at risk for suicide.
(b)

Evaluations and Technical Assistance.—
The Assistant Secretary shall—
(1)
evaluate the activities supported by grants awarded under subsection (a), and disseminate, as appropriate, the findings from the evaluation;
(2)
provide appropriate information, training, and technical assistance, as appropriate, to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with selection and implementation of evidence-based interventions and frameworks to prevent suicide; and
(3)
identify best practices, as applicable, to improve the identification, assessment, treatment, and timely transition, as appropriate, to additional or follow-up care for individuals in emergency departments who are at risk for suicide and enhance the coordination of care for such individuals during and after discharge, in support of activities under subsection (a).
(c)

Duration.—
A grant under this section shall be for a period of not more than 5 years.
(d)

Authorization of Appropriations.—
There are authorized to be appropriated to carry out this section $30,000,000 for each of fiscal years 2023 through 2027.
SEC. 520M.
[290bb–44]

ASSERTIVE COMMUNITY TREATMENT GRANT PROGRAM.
(a)

In General.—
The Assistant Secretary shall award grants to eligible entities—
(1)
to establish assertive community treatment programs for adults with a serious mental illness; or
(2)
to maintain or expand such programs.
(b)

Eligible Entities.—
To be eligible to receive a grant under this section, an entity shall be a State, political subdivision of a State, Indian Tribe or Tribal organization (as such terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act), mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate.
(c)

Special Consideration.—
In selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient.
(d)

Additional Activities.—
The Assistant Secretary shall—
(1)
not later than the end of fiscal year 2026, 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 on the grant program under this section, including an evaluation of—
(A)
any cost savings and public health outcomes such as mortality, suicide, substance use disorders, hospitalization, and use of services;
(B)
rates of involvement with the criminal justice system of patients;
(C)
rates of homelessness among patients; and
(D)
patient and family satisfaction with program participation; and
(2)
provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs.
(e)

Authorization of Appropriations.—
(1)

In general.—
To carry out this section, there is authorized to be appropriated $9,000,000 for each of fiscal years 2023 through 2027.
(2)

Use of certain funds.—
Of the funds appropriated to carry out this section in any fiscal year, not more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d).
SEC. 520N.
[ 290bb-45 ]

CENTER OF EXCELLENCE FOR EATING DISORDERS FOR EDUCATION AND TRAINING ON EATING DISORDERS.
(a)

In General.—
The Secretary, acting through the Assistant Secretary, shall maintain, by competitive grant or contract, a Center of Excellence for Eating Disorders (referred to in this section as the “Center”) to improve the identification of, interventions for, and treatment of eating disorders in a manner that is developmentally, culturally, and linguistically appropriate.
(b)

Subgrants and Subcontracts.—
The Center shall coordinate and implement the activities under subsection (c), in whole or in part, which may include by awarding competitive subgrants or subcontracts—
(1)
across geographical regions; and
(2)
in a manner that is not duplicative.
(c)

Activities.—
The Center—
(1)
shall—
(A)
provide training and technical assistance, including for—
(i)
primary care and mental health providers to carry out screening, brief intervention, and referral to treatment for individuals experiencing, or at risk for, eating disorders; and
(ii)
other paraprofessionals and relevant individuals providing nonclinical community services to identify and support individuals with, or at disproportionate risk for, eating disorders;
(B)
facilitate the development of, and provide training materials to, health care providers (including primary care and mental health professionals) regarding the effective treatment and ongoing support of individuals with eating disorders, including children and marginalized populations at disproportionate risk for eating disorders;
(C)
collaborate and coordinate, as appropriate, with other centers of excellence, technical assistance centers, and psychiatric consultation lines of the Substance Abuse and Mental Health Services Administration and the Health Resources and Services Administration regarding eating disorders;
(D)
coordinate with the Director of the Centers for Disease Control and Prevention and the Administrator of the Health Resources and Services Administration, and other Federal agencies, as appropriate, to disseminate training to primary care and mental health care providers; and
(E)
support other activities, as determined appropriate by the Secretary; and
(2)
may—
(A)
support the integration of protocols pertaining to screening, brief intervention, and referral to treatment for individuals experiencing, or at risk for, eating disorders, with health information technology systems;
(B)
develop and provide training materials to health care providers, including primary care and mental health providers, to provide screening, brief intervention, and referral to treatment for members of the military and veterans experiencing, or at risk for, eating disorders; and
(C)
consult, as appropriate, with the Secretary of Defense and the Secretary of Veterans Affairs on prevention, identification, intervention for, and treatment of eating disorders.
(d)

Authorization of Appropriations.—
To carry out this section, there is authorized to be appropriated $1,000,000 for each of fiscal years 2023 through 2027.
Part C—

Projects for Assistance in Transition From Homelessness
SEC. 521.
[290cc–21]

FORMULA GRANTS TO STATES.
For the purpose of carrying out section 522, the Secretary, acting through the Director of the Center for Mental Health Services, shall for each of the fiscal years 2023 through 2027 make an allotment for each State in an amount determined in accordance with section 524. The Secretary shall make payments, as grants, each such fiscal year to each State from the allotment for the State if the Secretary approves for the fiscal year involved an application submitted by the State pursuant to section 529.
SEC. 522.
[290cc–22]

PURPOSE OF GRANTS.
(a)

In General.—
The Secretary may not make payments under section 521 unless the State involved agrees that the payments will be expended solely for making grants to political subdivisions of the State, and to nonprofit private entities (including community-based veterans organizations and other community organizations), for the purpose of providing the services specified in subsection (b) to individuals who—
(1)
(A)
are suffering from serious mental illness; or
(B)
are suffering from serious mental illness and from a substance use disorder; and
(2)
are homeless or at imminent risk of becoming homeless.
(b)

Specification of Services.—
The services referred to in subsection (a) are—
(1)
outreach services;
(2)
screening and diagnostic treatment services;
(3)
habilitation and rehabilitation services;
(4)
community mental health services;
(5)
alcohol or drug treatment services;
(6)
staff training, including the training of individuals who work in shelters, mental health clinics, substance use disorder programs, and other sites where homeless individuals require services;
(7)
case management services, including—
(A)
preparing a plan for the provision of community mental health services to the eligible homeless individual involved, and reviewing such plan not less than once every 3 months;
(B)
providing assistance in obtaining and coordinating social and maintenance services for the eligible homeless individuals, including services relating to daily living activities, personal financial planning, transportation services, and habilitation and rehabilitation services, prevocational and vocational services, and housing services;
(C)
providing assistance to the eligible homeless individual in obtaining income support services, including housing assistance, supplemental nutrition assistance program benefits, and supplemental security income benefits;
(D)
referring the eligible homeless individual for such other services as may be appropriate; and
(E)
providing representative payee services in accordance with section 1631(a)(2) of the Social Security Act if the eligible homeless individual is receiving aid under title XVI of such act and if the applicant is designated by the Secretary to provide such services;
(8)
supportive and supervisory services in residential settings;
(9)
referrals for primary health services, job training, educational services, and relevant housing services;
(10)
subject to subsection (h)(1)—
(A)
minor renovation, expansion, and repair of housing;
(B)
planning of housing;
(C)
technical assistance in applying for housing assistance;
(D)
improving the coordination of housing services;
(E)
security deposits;
(F)
the costs associated with matching eligible homeless individuals with appropriate housing situations; and
(G)
1-time rental payments to prevent eviction; and
(11)
other appropriate services, as determined by the Secretary.
(c)

Coordination.—
The Secretary may not make payments under section 521 unless the State involved agrees to make grants pursuant to subsection (a) only to entities that have the capacity to provide, directly or through arrangements, the services specified in section 522(b), including coordinating the provision of services in order to meet the needs of eligible homeless individuals who are both mentally ill and suffering from a substance use disorder.
(d)

Special Consideration Regarding Veterans.—
The Secretary may not make payments under section 521 unless the State involved agrees that, in making grants to entities pursuant to subsection (a), the State will give special consideration to entities with a demonstrated effectiveness in serving homeless veterans.
(e)

Special Rules.—
The Secretary may not make payments under section 521 unless the State involved agrees that grants pursuant to subsection (a) will not be made to any entity that—
(1)
has a policy of excluding individuals from mental health services due to the existence or suspicion of a substance use disorder; or
(2)
has a policy of excluding individuals from substance use disorder services due to the existence or suspicion of mental illness.
(f)

Administrative Expenses.—
The Secretary may not make payments under section 521 unless the State involved agrees that not more than 4 percent of the payments will be expended for administrative expenses regarding the payments.
(g)

Restrictions on Use of Funds.—
The Secretary may not make payments under section 521 unless the State involved agrees that—
(1)
not more than 20 percent of the payments will be expended for housing services under subsection (b)(10); and
(2)
the payments will not be expended—
(A)
to support emergency shelters or construction of housing facilities;
(B)
for inpatient psychiatric treatment costs or inpatient substance use disorder treatment costs; or
(C)
to make cash payments to intended recipients of mental health or substance use disorder services.
(h)

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.
SEC. 523.
[290cc–23]

REQUIREMENT OF MATCHING FUNDS.
(a)

In General.—
The Secretary may not make payments under section 521 unless, with respect to the costs of providing services pursuant to section 522, the State involved 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 $1 for each $3 of Federal funds provided in such payments.
(b)

Determination of Amount.—
Non-Federal contributions required in subsection (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, shall not be included in determining the amount of such non-Federal contributions.
(c)

Limitation Regarding Grants by States.—
The Secretary may not make payments under section 521 unless the State involved agrees that the State will not require the entities to which grants are provided pursuant to section 522(a) to provide non-Federal contributions in excess of the non-Federal contributions described in subsection (a).
SEC. 524.
[290cc–24]

DETERMINATION OF AMOUNT OF ALLOTMENT.
(a)

Minimum Allotment.—
The allotment for a State under section 521 for a fiscal year shall be the greater of—
(1)
$300,000 for each of the several States, the District of Columbia, and the Commonwealth of Puerto Rico, and $50,000 for each of Guam, the Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands; and
(2)
an amount determined in accordance with subsection (b).
(b)

Determination Under Formula.—
The amount referred to in subsection (a)(2) is the product of—
(1)
an amount equal to the amount appropriated under section 535(a) for the fiscal year; and
(2)
a percentage equal to the quotient of—
(A)
an amount equal to the population living in urbanized areas of the State involved, as indicated by the most recent data collected by the Bureau of the Census; and
(B)
an amount equal to the population living in urbanized areas of the United States, as indicated by the sum of the respective amounts determined for the States under subparagraph (A).
SEC. 525.
[290cc–25]

CONVERSION TO CATEGORICAL PROGRAM IN EVENT OF FAILURE OF STATE REGARDING EXPENDITURE OF GRANTS.
(a)

In General.—
Subject to subsection (c), the Secretary shall, from the amounts specified in subsection (b), make grants to public and nonprofit private entities for the purpose of providing to eligible homeless individuals the services specified in section 522(b).
(b)13

Specification of Funds.—
The amounts referred to in subsection (a) are any amounts made available in appropriations Acts for allotments under section 521 that are not paid to a State as a result of—
^{13}
So in law. Subparagraphs (A) through (C) probably should be redesignated as paragraphs (1) through (3), respectively. See section 511 of Public Law 104–645 (104 Stat. 4729).
(A)
the failure of the State to submit an application under section 529;
(B)
the failure of the State, in the determination of the Secretary, to prepare the application in accordance with such section or to submit the application within a reasonable period of time; or
(C)
the State informing the Secretary that the State does not intend to expend the full amount of the allotment made to the State.
(c)

Requirement of Provision of Services in State Involved.—
With respect to grants under subsection (a), amounts made available under subsection (b) as a result of the State involved shall be available only for grants to provide services in such State.
SEC. 526.
[290cc–26]

PROVISION OF CERTAIN INFORMATION FROM STATE.
The Secretary may not make payments under section 521 to a State unless, as part of the application required in section 529, the State submits to the Secretary a statement—
(1)
identifying existing programs providing services and housing to eligible homeless individuals and identify gaps in the delivery systems of such programs;
(2)
containing a plan for providing services and housing to eligible homeless individuals, which plan—
(A)
describes the coordinated and comprehensive means of providing services and housing to homeless individuals; and
(B)
includes documentation that suitable housing for eligible homeless individuals will accompany the provision of services to such individuals;
(3)
describes the source of the non-Federal contributions described in section 523;
(4)
contains assurances that the non-Federal contributions described in section 523 will be available at the beginning of the grant period;
(5)
describe any voucher system that may be used to carry out this part; and
(6)
contain such other information or assurances as the Secretary may reasonably require.
SEC. 527.
[290cc–27]

DESCRIPTION OF INTENDED EXPENDITURES OF GRANT.
(a)

In General.—
The Secretary may not make payments under section 521 unless—
(1)
as part of the application required in section 529, the State involved submits to the Secretary a description of the intended use for the fiscal year of the amounts for which the State is applying pursuant to such section;
(2)
such description identifies the geographic areas within the State in which the greatest numbers of homeless individuals with a need for mental health, substance use disorder, and housing services are located;
(3)
such description provides information relating to the programs and activities to be supported and services to be provided, including information relating to coordinating such programs and activities with any similar programs and activities of public and private entities; and
(4)
the State agrees that such description will be revised throughout the year as may be necessary to reflect substantial changes in the programs and activities assisted by the State pursuant to section 522.
(b)

Opportunity for Public Comment.—
The Secretary may not make payments under section 521 unless the State involved agrees that, in developing and carrying out the description required in subsection (a), the State will provide public notice with respect to the description (including any revisions) and such opportunities as may be necessary to provide interested persons, such as family members, consumers, and mental health, substance use disorder, and housing agencies, an opportunity to present comments and recommendations with respect to the description.
(c)

Relationship to State Comprehensive Mental Health Services Plan.—
(1)

In general.—
The Secretary may not make payments under section 521 unless the services to be provided pursuant to the description required in subsection (a) are consistent with the State comprehensive mental health services plan required in subpart 2 of part B of title XIX.
(2)

Special rule.—
The Secretary may not make payments under section 521 unless the services to be provided pursuant to the description required in subsection (a) have been considered in the preparation of, have been included in, and are consistent with, the State comprehensive mental health services plan referred to in paragraph (1).
SEC. 528.
[290cc–28]

REQUIREMENT OF REPORTS BY STATES.
(a)

In General.—
The Secretary may not make payments under section 521 unless the State involved agrees that, by not later than January 31 of each fiscal year, the State will prepare and submit to the Secretary a report in such form and containing such information as the Secretary determines (after consultation with the Assistant Secretary for Mental Health and Substance Use) to be necessary for—
(1)
securing a record and a description of the purposes for which amounts received under section 521 were expended during the preceding fiscal year and of the recipients of such amounts; and
(2)
determining whether such amounts were expended in accordance with the provisions of this part.
(b)

Availability to Public of Reports.—
The Secretary may not make payments under section 521 unless the State involved agrees to make copies of the reports described in subsection (a) available for public inspection.
(c)

Evaluations by Comptroller General.—
The Assistant Secretary for Mental Health and Substance Use shall evaluate at least once every 3 years the expenditures of grants under this part by eligible entities in order to ensure that expenditures are consistent with the provisions of this part, and shall include in such evaluation recommendations regarding changes needed in program design or operations.
SEC. 529.
[290cc–29]

REQUIREMENT OF APPLICATION.
The Secretary may not make payments under section 521 unless the State involved—
(1)
submits to the Secretary an application for the payments containing agreements and information in accordance with this part;
(2)
the agreements are made through certification from the chief executive officer of the State; and
(3)
the application otherwise 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 part.
SEC. 530.
[290cc–30]

TECHNICAL ASSISTANCE.
The Secretary, acting through the Assistant Secretary, shall provide technical assistance to eligible entities in developing planning and operating programs in accordance with the provisions of this part.
SEC. 531.
[290cc–31]

FAILURE TO COMPLY WITH AGREEMENTS.
(a)

Repayment of Payments.—
(1)
The Secretary may, subject to subsection (c), require a State to repay any payments received by the State under section 521 that the Secretary determines were not expended by the State in accordance with the agreements required to be contained in the application submitted by the State pursuant to section 529.
(2)
If a State fails to make a repayment required in paragraph (1), the Secretary may offset the amount of the repayment against the amount of any payment due to be paid to the State under section 521.
(b)

Withholding of Payments.—
(1)
The Secretary may, subject to subsection (c), withhold payments due under section 521 if the Secretary determines that the State involved is not expending amounts received under such section in accordance with the agreements required to be contained in the application submitted by the State pursuant to section 529.
(2)
The Secretary shall cease withholding payments from a State under paragraph (1) if the Secretary determines that there are reasonable assurances that the State will expend amounts received under section 521 in accordance with the agreements referred to in such paragraph.
(3)
The Secretary may not withhold funds under paragraph (1) from a State for a minor failure to comply with the agreements referred to in such paragraph.
(c)

Opportunity for Hearing.—
Before requiring repayment of payments under subsection (a)(1), or withholding payments under subsection (b)(1), the Secretary shall provide to the State an opportunity for a hearing.
(d)

Rule of Construction.—
Notwithstanding any other provision of this part, a State receiving payments under section 521 may not, with respect to any agreements required to be contained in the application submitted under section 529, be considered to be in violation of any such agreements by reason of the fact that the State, in the regular course of providing services under section 522(b) to eligible homeless individuals, incidentally provides services to homeless individuals who are not eligible homeless individuals.
SEC. 532.
[290cc–32]

PROHIBITION AGAINST CERTAIN FALSE STATEMENTS.
(a)

In General.—
(1)
A person may not knowingly make or cause to be made any false statement or representation of a material fact in connection with the furnishing of items or services for which amounts may be paid by a State from payments received by the State under section 521.
(2)
A person with knowledge of the occurrence of any event affecting the right of the person to receive any amounts from payments made to the State under section 521 may not conceal or fail to disclose any such event with the intent of securing such an amount that the person is not authorized to receive or securing such an amount in an amount greater than the amount the person is authorized to receive.
(b)

Criminal Penalty for Violation of Prohibition.—
Any person who violates a prohibition established in subsection (a) may for each violation be fined in accordance with title 18, United States Code, or imprisoned for not more than 5 years, or both.
SEC. 533.
[290cc–33]

NONDISCRIMINATION.
(a)

In General.—
(1)

Rule of construction regarding certain civil rights laws.—
For the purpose of applying the prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975, on the basis of handicap under section 504 of the Rehabilitation Act of 1973, on the basis of sex under title IX of the Education Amendments of 1972, or on the basis of race, color, or national origin under title VI of the Civil Rights Act of 1964, programs and activities funded in whole or in part with funds made available under section 521 shall be considered to be programs and activities receiving Federal financial assistance.
(2)

Prohibition.—
No person shall on the ground of sex or religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with funds made available under section 521.
(b)

Enforcement.—
(1)

Referrals to attorney general after notice.—
Whenever the Secretary finds that a State, or an entity that has received a payment pursuant to section 521, has failed to comply with a provision of law referred to in subsection (a)(1), with subsection (a)(2), or with an applicable regulation (including one prescribed to carry out subsection (a)(2)), the Secretary shall notify the chief executive officer of the State and shall request the chief executive officer to secure compliance. If within a reasonable period of time, not to exceed 60 days, the chief executive officer fails or refuses to secure compliance, the Secretary may—
(A)
refer the matter to the Attorney General with a recommendation that an appropriate civil action be instituted;
(B)
exercise the powers and functions provided by the Age Discrimination Act of 1975, section 504 of the Rehabilitation Act of 1973, title IX of the Education Amendments of 1972, or title VI of the Civil Rights Act of 1964, as may be applicable; or
(C)
take such other actions as may be authorized by law.
(2)

Authority of attorney general.—
When a matter is referred to the Attorney General pursuant to paragraph (1)(A), or whenever the Attorney General has reason to believe that a State or an entity is engaged in a pattern or practice in violation of a provision of law referred to in subsection (a)(1) or in violation of subsection (a)(2), the Attorney General may bring a civil action in any appropriate district court of the United States for such relief as may be appropriate, including injunctive relief.
SEC. 534.
[290cc–34]

DEFINITIONS.
For purposes of this part:
(1)

Eligible homeless individual.—
The term “eligible homeless individual” means an individual described in section 522(a).
(2)

Homeless individual.—
The term “homeless individual” has the meaning given such term in section 330(h)(5).
(3)

State.—
The term “State” means each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.
(4)

Substance use disorder services.—
The term “substance use disorder services” has the meaning given the term “substance abuse services” in section 330(h)(5)(C).
SEC. 535.
[290cc–35]

FUNDING.
(a)

Authorization of Appropriations.—
For the purpose of carrying out this part, there is authorized to be appropriated $64,635,000 for each of fiscal years 2023 through 2027.
(b)

Effect of Insufficient Appropriations for Minimum Allotments.—
(1)

In general.—
If the amounts made available under subsection (a) for a fiscal year are insufficient for providing each State with an allotment under section 521 of not less than the applicable amount under section 524(a)(1), the Secretary shall, from such amounts as are made available under such subsection, make grants to the States for providing to eligible homeless individuals the services specified in section 522(b).
(2)

Rule of construction.—
Paragraph (1) may not be construed to require the Secretary to make a grant under such paragraph to each State.
Part D—

Miscellaneous Provisions Relating to Substance Abuse and Mental Health
SEC. 541.
[290dd]

SUBSTANCE ABUSE AMONG GOVERNMENT AND OTHER EMPLOYEES.
(a)

Programs and Services.—
(1)

Development.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall be responsible for fostering substance abuse prevention and treatment programs and services in State and local governments and in private industry.
(2)

Model programs.—
(A)

In general.—
Consistent with the responsibilities described in paragraph (1), the Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall develop a variety of model programs suitable for replication on a cost-effective basis in different types of business concerns and State and local governmental entities.
(B)

Dissemination of information.—
The Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall disseminate information and materials relative to such model programs to the State agencies responsible for the administration of substance abuse prevention, treatment, and rehabilitation activities and shall, to the extent feasible provide technical assistance to such agencies as requested.
(b)

Deprivation of Employment.—
(1)

Prohibition.—
No person may be denied or deprived of Federal civilian employment or a Federal professional or other license or right solely on the grounds of prior substance abuse.
(2)

Application.—
This subsection shall not apply to employment in—
(A)
the Central Intelligence Agency;
(B)
the Federal Bureau of Investigation;
(C)
the National Security Agency;
(D)
any other department or agency of the Federal Government designated for purposes of national security by the President; or
(E)
in any position in any department or agency of the Federal Government, not referred to in subparagraphs (A) through (D), which position is determined pursuant to regulations prescribed by the head of such agency or department to be a sensitive position.
(3)

Rehabilitation Act.—
The inapplicability of the prohibition described in paragraph (1) to the employment described in paragraph (2) shall not be construed to reflect on the applicability of the Rehabilitation Act of 1973 or other anti-discrimination laws to such employment.
(c)

Construction.—
This section shall not be construed to prohibit the dismissal from employment of a Federal civilian employee who cannot properly function in his employment.
SEC. 542.
[290dd–1]

ADMISSION OF SUBSTANCE ABUSERS TO PRIVATE AND PUBLIC HOSPITALS AND OUTPATIENT FACILITIES.
(a)

Nondiscrimination.—
Substance abusers who are suffering from medical conditions shall not be discriminated against in admission or treatment, solely because of their substance abuse, by any private or public general hospital, or outpatient facility (as defined in section 1624(4)) which receives support in any form from any program supported in whole or in part by funds appropriated to any Federal department or agency.
(b)

Regulations.—
(1)

In general.—
The Secretary shall issue regulations for the enforcement of the policy of subsection (a) with respect to the admission and treatment of substance abusers in hospitals and outpatient facilities which receive support of any kind from any program administered by the Secretary. Such regulations shall include procedures for determining (after opportunity for a hearing if requested) if a violation of subsection (a) has occurred, notification of failure to comply with such subsection, and opportunity for a violator to comply with such subsection. If the Secretary determines that a hospital or outpatient facility subject to such regulations has violated subsection (a) and such violation continues after an opportunity has been afforded for compliance, the Secretary may suspend or revoke, after opportunity for a hearing, all or part of any support of any kind received by such hospital from any program administered by the Secretary. The Secretary may consult with the officials responsible for the administration of any other Federal program from which such hospital or outpatient facility receives support of any kind, with respect to the suspension or revocation of such other Federal support for such hospital or outpatient facility.
(2)

Department of veterans affairs.—
The Secretary of Veterans Affairs, acting through the Under Secretary for Health, shall, to the maximum feasible extent consistent with their responsibilities under title 38, United States Code, prescribe regulations making applicable the regulations prescribed by the Secretary under paragraph (1) to the provision of hospital care, nursing home care, domiciliary care, and medical services under such title 38 to veterans suffering from substance abuse. In prescribing and implementing regulations pursuant to this paragraph, the Secretary shall, from time to time, consult with the Secretary of Health and Human Services in order to achieve the maximum possible coordination of the regulations, and the implementation thereof, which they each prescribe.
SEC. 543.
[290dd–2]

CONFIDENTIALITY OF RECORDS.
(a)

Requirement.—
Records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance use disorder education, prevention, training, treatment, rehabilitation, or research, which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States shall, except as provided in subsection (e), be confidential and be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b).
(b)

Permitted Disclosure.—
(1)

Consent.—
The following shall apply with respect to the contents of any record referred to in subsection (a):
(A)
Such contents may be used or disclosed in accordance with the prior written consent of the patient with respect to whom such record is maintained.
(B)
Once prior written consent of the patient has been obtained, such contents may be used or disclosed by a covered entity, business associate, or a program subject to this section for purposes of treatment, payment, and health care operations as permitted by the HIPAA regulations. Any information so disclosed may then be redisclosed in accordance with the HIPAA regulations. Section 13405(c) of the Health Information Technology and Clinical Health Act (42 U.S.C. 17935(c)) shall apply to all disclosures pursuant to subsection (b)(1) of this section.
(C)
It shall be permissible for a patient’s prior written consent to be given once for all such future uses or disclosures for purposes of treatment, payment, and health care operations, until such time as the patient revokes such consent in writing.
(D)
Section 13405(a) of the Health Information Technology and Clinical Health Act (42 U.S.C. 17935(a)) shall apply to all disclosures pursuant to subsection (b)(1) of this section.
(2)

Method for disclosure.—
Whether or not the patient, with respect to whom any given record referred to in subsection (a) is maintained, gives written consent, the content of such record may be disclosed as follows:
(A)
To medical personnel to the extent necessary to meet a bona fide medical emergency.
(B)
To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient in any report of such research, audit, or evaluation, or otherwise disclose patient identities in any manner.
(C)
If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefor, including the need to avert a substantial risk of death or serious bodily harm. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose appropriate safeguards against unauthorized disclosure.
(D)
To a public health authority, so long as such content meets the standards established in section 164.514(b) of title 45, Code of Federal Regulations (or successor regulations) for creating de-identified information.
(c)

Use of Records in Criminal, Civil, or Administrative Contexts.—
Except as otherwise authorized by a court order under subsection (b)(2)(C) or by the consent of the patient, a record referred to in subsection (a), or testimony relaying the information contained therein, may not be disclosed or used in any civil, criminal, administrative, or legislative proceedings conducted by any Federal, State, or local authority, against a patient, including with respect to the following activities:
(1)
Such record or testimony shall not be entered into evidence in any criminal prosecution or civil action before a Federal or State court.
(2)
Such record or testimony shall not form part of the record for decision or otherwise be taken into account in any proceeding before a Federal, State, or local agency.
(3)
Such record or testimony shall not be used by any Federal, State, or local agency for a law enforcement purpose or to conduct any law enforcement investigation.
(4)
Such record or testimony shall not be used in any application for a warrant.
(d)

Application.—
The prohibitions of this section continue to apply to records concerning any individual who has been a patient, irrespective of whether or when such individual ceases to be a patient.
(e)

Nonapplicability.—
The prohibitions of this section do not apply to any interchange of records—
(1)
within the Uniformed Services or within those components of the Department of Veterans Affairs furnishing health care to veterans; or
(2)
between such components and the Uniformed Services.
The prohibitions of this section do not apply to the reporting under State law of incidents of suspected child abuse and neglect to the appropriate State or local authorities.
(f)

Penalties.—
The provisions of sections 1176 and 1177 of the Social Security Act shall apply to a violation of this section to the extent and in the same manner as such provisions apply to a violation of part C of title XI of such Act. In applying the previous sentence—
(1)
the reference to “this subsection” in subsection (a)(2) of such section 1176 shall be treated as a reference to “this subsection (including as applied pursuant to section 543(f) of the Public Health Service Act)”; and
(2)
in subsection (b) of such section 1176—
(A)
each reference to “a penalty imposed under subsection (a)” shall be treated as a reference to “a penalty imposed under subsection (a) (including as applied pursuant to section 543(f) of the Public Health Service Act)”; and
(B)
each reference to “no damages obtained under subsection (d)” shall be treated as a reference to “no damages obtained under subsection (d) (including as applied pursuant to section 543(f) of the Public Health Service Act)”.
(g)

Regulations.—
Except as provided in subsection (h), the Secretary shall prescribe regulations to carry out the purposes of this section. Such regulations may contain such definitions, and may provide for such safeguards and procedures, including procedures and criteria for the issuance and scope of orders under subsection (b)(2)(C), as in the judgment of the Secretary are necessary or proper to effectuate the purposes of this section, to prevent circumvention or evasion thereof, or to facilitate compliance therewith.
(h)

Application to Department of Veterans Affairs.—
The Secretary of Veterans Affairs, acting through the Chief Medical Director, shall, to the maximum feasible extent consistent with their responsibilities under title 38, United States Code, prescribe regulations making applicable the regulations prescribed by the Secretary of Health and Human Services under subsection (g) of this section to records maintained in connection with the provision of hospital care, nursing home care, domiciliary care, and medical services under such title 38 to veterans suffering from substance use disorder. In prescribing and implementing regulations pursuant to this subsection, the Secretary of Veterans Affairs shall, from time to time, consult with the Secretary of Health and Human Services in order to achieve the maximum possible coordination of the regulations, and the implementation thereof, which they each prescribe.
(i)

Antidiscrimination.—
(1)

In general.—
No entity shall discriminate against an individual on the basis of information received by such entity pursuant to an inadvertent or intentional disclosure of records, or information contained in records, described in subsection (a) in—
(A)
admission, access to, or treatment for health care;
(B)
hiring, firing, or terms of employment, or receipt of worker’s compensation;
(C)
the sale, rental, or continued rental of housing;
(D)
access to Federal, State, or local courts; or
(E)
access to, approval of, or maintenance of social services and benefits provided or funded by Federal, State, or local governments.
(2)

Recipients of federal funds.—
No recipient of Federal funds shall discriminate against an individual on the basis of information received by such recipient pursuant to an intentional or inadvertent disclosure of such records or information contained in records described in subsection (a) in affording access to the services provided with such funds.
(j)

Notification in Case of Breach.—
The provisions of section 13402 of the HITECH Act (42 U.S.C. 17932) shall apply to a program or activity described in subsection (a), in case of a breach of records described in subsection (a), to the same extent and in the same manner as such provisions apply to a covered entity in the case of a breach of unsecured protected health information.
(k)

Definitions.—
For purposes of this section:
(1)

Breach.—
The term “breach” has the meaning given such term for purposes of the HIPAA regulations.
(2)

Business associate.—
The term “business associate” has the meaning given such term for purposes of the HIPAA regulations.
(3)

Covered entity.—
The term “covered entity” has the meaning given such term for purposes of the HIPAA regulations.
(4)

Health care operations.—
The term “health care operations” has the meaning given such term for purposes of the HIPAA regulations.
(5)

HIPAA regulations.—
The term “HIPAA regulations” has the meaning given such term for purposes of parts 160 and 164 of title 45, Code of Federal Regulations.
(6)

Payment.—
The term “payment” has the meaning given such term for purposes of the HIPAA regulations.
(7)

Public health authority.—
The term “public health authority” has the meaning given such term for purposes of the HIPAA regulations.
(8)

Treatment.—
The term “treatment” has the meaning given such term for purposes of the HIPAA regulations.
(9)14

Unsecured protected health information.—
The term “unprotected health information” has the meaning given such term for purposes of the HIPAA regulations.
^{14}
The discrepancy in the paragraph heading and definition in paragraph (9) is so in law. See amendment made by section 3121(d) of division A of Public Law 116–136.
SEC. 543A.
[290dd–2a]

PROMOTING ACCESS TO INFORMATION ON EVIDENCE-BASED PROGRAMS AND PRACTICES.
(a)

In General.—
The Assistant Secretary shall, as appropriate, improve access to reliable and valid information on evidence-based programs and practices, including information on the strength of evidence associated with such programs and practices, related to mental and substance use disorders for States, local communities, nonprofit entities, and other stakeholders, by posting on the Internet website of the Administration information on evidence-based programs and practices that have been reviewed by the Assistant Secretary in accordance with the requirements of this section.
(b)

Applications.—
(1)

Application period.—
In carrying out subsection (a), the Assistant Secretary may establish a period for the submission of applications for evidence-based programs and practices to be posted publicly in accordance with subsection (a).
(2)

Notice.—
In establishing the application period under paragraph (1), the Assistant Secretary shall provide for the public notice of such application period in the Federal Register. Such notice may solicit applications for evidence-based programs and practices to address gaps in information identified by the Assistant Secretary, the National Mental Health and Substance Use Policy Laboratory established under section 501A, or the Assistant Secretary for Planning and Evaluation, including pursuant to the evaluation and recommendations under section 6021 of the Helping Families in Mental Health Crisis Reform Act of 2016 or priorities identified in the strategic plan under section 501(l).
(c)

Requirements.—
The Assistant Secretary may establish minimum requirements for the applications submitted under subsection (b), including applications related to the submission of research and evaluation.
(d)

Review and Rating.—
(1)

In general.—
The Assistant Secretary shall review applications prior to public posting in accordance with subsection (a), and may prioritize the review of applications for evidence-based programs and practices that are related to topics included in the notice provided under subsection (b)(2).
(2)

System.—
In carrying out paragraph (1), the Assistant Secretary may utilize a rating and review system, which may include information on the strength of evidence associated with the evidence-based programs and practices and a rating of the methodological rigor of the research supporting the applications.
(3)

Public access to metrics and rating.—
The Assistant Secretary shall make the metrics used to evaluate applications under this section, and any resulting ratings of such applications, publicly available.
SEC. 544.
[290dd–3]

GRANTS FOR REDUCING OVERDOSE DEATHS.
(a)

Establishment.—
(1)

In general.—
The Secretary shall award grants to eligible entities to expand access to drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(2)

Eligible entity.—
For purposes of this section, the term “eligible entity” means a State, Territory, locality, or Indian Tribe or Tribal organization (as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act).
(3)

Subgrants.—
For the purposes for which a grant is awarded under this section, the eligible entity receiving the grant may award subgrants to a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act), an opioid treatment program (as defined in section 8.2 of title 42, Code of Federal Regulations (or any successor regulations)), any practitioner dispensing narcotic drugs for the purpose of maintenance or detoxification treatment, or any nonprofit organization that the Secretary deems appropriate, which may include Urban Indian organizations (as defined in section 4 of the Indian Health Care Improvement Act).
(4)

Prescribing.—
For purposes of this section, the term “prescribing” means, with respect to a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, the practice of prescribing such drug or device—
(A)
in conjunction with an opioid prescription for patients at an elevated risk of overdose, including patients prescribed both an opioid and a benzodiazepine;
(B)
in conjunction with an opioid agonist approved under section 505 of the Federal Food, Drug, and Cosmetic Act for the treatment of opioid use disorder;
(C)
to the caregiver or a close relative of patients at an elevated risk of overdose from opioids; or
(D)
in other circumstances in which a provider identifies a patient is at an elevated risk for an intentional or unintentional overdose from heroin or prescription opioid therapies.
(b)

Application.—
To be eligible to receive a grant under this section, an eligible entity shall submit to the Secretary, in such form and manner as specified by the Secretary, an application that describes—
(1)
the extent to which the area to which the entity will furnish services through use of the grant is experiencing significant morbidity and mortality caused by opioid abuse;
(2)
the criteria that will be used to identify eligible patients to participate in such program; and
(3)
a plan for sustaining the program after Federal support for the program has ended.
(c)

Use of Funds.—
An eligible entity receiving a grant under this section may use amounts under the grant for any of the following activities, but may use not more than 20 percent of the grant funds for activities described in paragraphs (3) and (4):
(1)
To establish a program for prescribing a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(2)
To train and provide resources for health care providers and pharmacists on the prescribing of drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(3)
To purchase drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, for distribution under the program described in paragraph (1).
(4)
To offset the co-payments and other cost sharing associated with drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(5)
To establish protocols to connect patients who have experienced an overdose with appropriate treatment, including overdose reversal medications, medication assisted treatment, and appropriate counseling and behavioral therapies.
(d)

Improving Access to Overdose Treatment.—
(1)

Information on best practices.—
(A)

Health and human services.—
The Secretary of Health and Human Services may provide information to States, localities, Indian Tribes, Tribal organizations, and Urban Indian organizations on best practices for prescribing or co-prescribing a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, including for patients receiving chronic opioid therapy and patients being treated for opioid use disorders.
(B)

Defense.—
The Secretary of Health and Human Services may, as appropriate, consult with the Secretary of Defense regarding the provision of information to prescribers within Department of Defense medical facilities on best practices for prescribing or co-prescribing a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, including for patients receiving chronic opioid therapy and patients being treated for opioid use disorders.
(C)

Veterans affairs.—
The Secretary of Health and Human Services may, as appropriate, consult with the Secretary of Veterans Affairs regarding the provision of information to prescribers within Department of Veterans Affairs medical facilities on best practices for prescribing or co-prescribing a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, including for patients receiving chronic opioid therapy and patients being treated for opioid use disorders.
(2)

Rule of construction.—
Nothing in this subsection shall be construed as establishing or contributing to a medical standard of care.
(e)

Evaluations by Recipients.—
As a condition of receipt of a grant under this section, an eligible entity shall, for each year for which the grant is received, submit to the Secretary an evaluation of activities funded by the grant which contains such information as the Secretary may reasonably require.
(f)

Reports by the Secretary.—
Not later than 5 years after the date on which the first grant under this section is awarded, the Secretary shall submit to the appropriate committees of the House of Representatives and of the Senate a report aggregating the information received from the grant recipients for such year under subsection (e) and evaluating the outcomes achieved by the programs funded by grants awarded under this section.
(g)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this section, $5,000,000 for the period of fiscal years 2023 through 2027.
SEC. 545.
[290ee]

OPIOID OVERDOSE REVERSAL MEDICATION ACCESS, EDUCATION, AND CO-PRESCRIBING GRANT PROGRAMS.
(a)

Grants.—
The Secretary shall make grants to States, localities, Indian Tribes, and Tribal organizations (as those terms are defined in section 4 of the Indian Self-Determination and Education Assistance Act) to—
(1)
implement strategies that increase access to drugs or devicesapproved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose, as appropriate, pursuant to a standing order;
(2)
encourage pharmacies to dispense opioid overdose reversal medication pursuant to a standing order;
(3)
encourage health care providers to co-prescribe, as appropriate, drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose;
(4)
develop or provide training materials that persons authorized to prescribe or dispense a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose may use to educate the public concerning—
(A)
when and how to safely administer such drug or device; and
(B)
steps to be taken after administering such drug or device; and
(5)
educate the public concerning the availability of drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose without a person-specific prescription.
(b)

Certain Requirement.—
A grant may be made under this section only if the State involved has authorized standing orders to be issued for drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(c)

Preference in Making Grants.—
In making grants under this section, the Secretary may give preference to States that have a significantly higher rate of opioid overdoses than the national average, and that—
(1)
have not implemented standing orders regarding drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose;
(2)
authorize standing orders to be issued that permit community-based organizations, substance abuse programs, or other nonprofit entities to acquire, dispense, or administer drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose; or
(3)
authorize standing orders to be issued that permit police, fire, or emergency medical services agencies to acquire and administer drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(d)

Grant Terms.—
(1)

Number.—
A State may not receive more than one grant under this section at a time.
(2)

Period.—
A grant under this section shall be for a period of 5 years.
(3)

Limitations.—
A State may—
(A)
use not more than 10 percent of a grant under this section for educating the public pursuant to subsection (a)(5); and
(B)
use not less than 20 percent of a grant under this section to offset cost-sharing for distribution and dispensing of drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose.
(e)

Applications.—
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 reasonably require, including detailed proposed expenditures of grant funds.
(f)

Reporting.—
A State that receives a grant under this section shall, at least annually for the duration of the grant, submit a report to the Secretary evaluating the progress of the activities supported through the grant. Such reports shall include information on the number of pharmacies in the State that dispense a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose under a standing order, and other information as the Secretary determines appropriate to evaluate the use of grant funds.
(g)

Definitions.—
In this section the term “standing order” means a document prepared by a person authorized to prescribe medication that permits another person to acquire, dispense, or administer medication without a person-specific prescription.
(h)

Authorization of Appropriations.—
(1)

In general.—
To carry out this section, there are authorized to be appropriated $5,000,000 for the period of fiscal years 2023 through 2027.
(2)

Administrative costs.—
Not more than 3 percent of the amounts made available to carry out this section may be used by the Secretary for administrative expenses of carrying out this section.
SEC. 546.
[290ee–1]

FIRST RESPONDER TRAINING.
(a)

Program Authorized.—
The Secretary shall make grants to States, local governmental entities, and Indian Tribes and Tribal organizations (as defined in section 4 of the Indian Self-Determination and Education Assistance Act) to allow first responders and members of other key community sectors to administer a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose.
(b)

Application.—
(1)

In general.—
An entity seeking a grant under this section shall submit an application to the Secretary—
(A)
that meets the criteria under paragraph (2); and
(B)
at such time, in such manner, and accompanied by such information as the Secretary may require.
(2)

Criteria.—
An entity, in submitting an application under paragraph (1), shall—
(A)
describe the evidence-based methodology and outcome measurements that will be used to evaluate the program funded with a grant under this section, and specifically explain how such measurements will provide valid measures of the impact of the program;
(B)
describe how the program could be broadly replicated if demonstrated to be effective;
(C)
identify the governmental and community agencies with which the entity will coordinate to implement the program; and
(D)
describe how the entity will ensure that law enforcement agencies will coordinate with their corresponding State substance abuse and mental health agencies to identify protocols and resources that are available to overdose victims and families, including information on treatment and recovery resources.
(c)

Use of Funds.—
An entity shall use a grant received under this section to—
(1)
make a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose available to be carried and administered by first responders and members of other key community sectors;
(2)
train and provide resources for first responders and members of other key community sectors on carrying and administering a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose;
(3)
establish processes, protocols, and mechanisms for referral to appropriate treatment, which may include an outreach coordinator or team to connect individuals receiving overdose reversal drugs to followup services; and
(4)
train and provide resources for first responders and members of other key community sectors on safety around fentanyl, carfentanil, and other dangerous licit and illicit drugs to protect themselves from exposure to such drugs and respond appropriately when exposure occurs.
(d)

Technical Assistance Grants.—
The Secretary shall make a grant for the purpose of providing technical assistance and training on the use of a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose, mechanisms for referral to appropriate treatment, and safety around fentanyl, carfentanil, and other dangerous licit and illicit drugs.
(e)

Geographic Distribution.—
In making grants under this section, the Secretary shall ensure that not less than 20 percent of grant funds are awarded to eligible entities that are not located in metropolitan statistical areas (as defined by the Office of Management and Budget). The Secretary shall take into account the unique needs of rural communities, including communities with an incidence of individuals with opioid use disorder that is above the national average and communities with a shortage of prevention and treatment services.
(f)

Evaluation.—
The Secretary shall conduct an evaluation of grants made under this section to determine—
(1)
the number of first responders and members of other key community sectors equipped with a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose;
(2)
the number of opioid, heroin, and other drug overdoses reversed by first responders and members of other key community sectors receiving training and supplies of a drug or device approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose, through a grant received under this section;
(3)
the number of responses to requests for services by the entity or subgrantee, to overdose;
(4)
the extent to which overdose victims and families receive information about treatment services and available data describing treatment admissions; and
(5)
the number of first responders and members of other key community sectors trained on safety around fentanyl, carfentanil, and other dangerous licit and illicit drugs.
(g)

Other Key Community Sectors.—
In this section, the term “other key community sectors” includes substance use disorder treatment providers, emergency medical services agencies, agencies and organizations working with prison and jail populations and offender reentry programs, health care providers, harm reduction groups, pharmacies, community health centers, tribal health facilities, and mental health providers.
(h)

Authorization of Appropriations.—
To carry out this section, there are authorized to be appropriated $57,000,000 for each of fiscal years 2026 through 2030.
SEC. 547.
[290ee–2]

BUILDING COMMUNITIES OF RECOVERY.
(a)

Definition.—
In this section, the term “recovery community organization” means an independent nonprofit organization that—
(1)
mobilizes resources within and outside of the recovery community, which may include through a peer support network, to increase the prevalence and quality of long-term recovery from substance use disorders; and
(2)
is wholly or principally governed by people in recovery for substance use disorders who reflect the community served.
(b)

Grants Authorized.—
The Secretary shall award grants to recovery community organizations to enable such organizations to develop, expand, and enhance recovery services.
(c)

Federal Share.—
The Federal share of the costs of a program funded by a grant under this section may not exceed 85 percent.
(d)

Use of Funds.—
Grants awarded under subsection (b)—
(1)
shall be used to develop, expand, and enhance community and statewide recovery support services; and
(2)
may be used to—
(A)
build connections between recovery networks, including between recovery community organizations and peer support networks, and with other recovery support services, including—
(i)
behavioral health providers;
(ii)
primary care providers and physicians;
(iii)
educational and vocational schools;
(iv)
employers;
(v)
housing services;
(vi)
child welfare agencies; and
(vii)
other recovery support services that facilitate recovery from substance use disorders, including non-clinical community services;
(B)
reduce stigma associated with substance use disorders; and
(C)
conduct outreach on issues relating to substance use disorders and recovery, including—
(i)
identifying the signs of substance use disorder;
(ii)
the resources available to individuals with substance use disorder and to families of an individual with a substance use disorder, including programs that mentor and provide support services to children;
(iii)
the resources available to help support individuals in recovery; and
(iv)
related medical outcomes of substance use disorders, the potential of acquiring an infection commonly associated with illicit drug use, and neonatal abstinence syndrome among infants exposed to opioids during pregnancy.
(e)

Special Consideration.—
In carrying out this section, the Secretary shall give special consideration to the unique needs of rural areas, including areas with an age-adjusted rate of drug overdose deaths that is above the national average and areas with a shortage of prevention and treatment services.
(f)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this section $17,000,000 for each of fiscal years 2026 through 2030.
SEC. 547A.
[290ee–2a]

PEER SUPPORT TECHNICAL ASSISTANCE CENTER.
(a)

Establishment.—
The Secretary, acting through the Assistant Secretary, shall establish or operate a National Peer-Run Training and Technical Assistance Center for Addiction Recovery Support (referred to in this section as the “Center”).
(b)

Functions.—
The Center established under subsection (a) shall provide technical assistance and support to recovery community organizations and peer support networks, including such assistance and support related to—
(1)
training on identifying—
(A)
signs of substance use disorder;
(B)
resources to assist individuals with a substance use disorder, or resources for families of an individual with a substance use disorder; and
(C)
best practices for the delivery of recovery support services;
(2)
the provision of translation services, interpretation, or other such services for clients with limited English speaking proficiency;
(3)
data collection to support research, including for translational research;
(4)
capacity building, such as—
(A)
professional development of peer support specialists; and
(B)
making recovery support services available in nonclinical settings; and
(5)
evaluation and improvement, as necessary, of the effectiveness of such services provided by recovery community organizations.
(c)

Best Practices.—
The Center established under subsection (a) shall periodically issue best practices for use by recovery community organizations and peer support networks.
(d)

Regional Centers.—
(1)

In general.—
The Secretary may establish one regional technical assistance center (referred to in this subsection as the “Regional Center”), with existing resources, to assist the Center in carrying out activities described in subsection (b) within the geographic region of such Regional Center in a manner that is tailored to the needs of such region.
(2)

Evaluation.—
Not later than 4 years after the date of enactment of the SUPPORT for Patients and Communities Reauthorization Act of 2025, the Secretary shall evaluate the activities of the Regional Center 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 on the findings of such evaluation, including—
(A)
a description of the distinct roles and responsibilities of the Regional Center and the Center;
(B)
available information relating to the outcomes of the Regional Center under this subsection, such as any impact on the operations and efficiency of the Center relating to requests for technical assistance and support within the region of such Regional Center;
(C)
a description of any gaps or areas of duplication relating to the activities of the Regional Center and the Center within such region; and
(D)
recommendations relating to the modification, expansion, or termination of the Regional Center under this subsection.
(3)

Termination.—
This subsection shall terminate on September 30, 2030.
(e)

Recovery Community Organization.—
In this section, the term “recovery community organization” has the meaning given such term in section 547.
(f)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2026 through 2030.
SEC. 548.
[290ee–3]

STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID ABUSE RESPONSE.
(a)

Definitions.—
In this section:
(1)

Dispenser.—
The term “dispenser” has the meaning given the term in section 102 of the Controlled Substances Act (21 U.S.C. 802).
(2)

Prescriber.—
The term “prescriber” means a dispenser who prescribes a controlled substance, or the agent of such a dispenser.
(3)

Prescriber of a schedule ii, iii, or iv controlled substance.—
The term “prescriber of a schedule II, III, or IV controlled substance” does not include a prescriber of a schedule II, III, or IV controlled substance that dispenses the substance—
(A)
for use on the premises on which the substance is dispensed;
(B)
in a hospital emergency room, when the substance is in short supply;
(C)
for a certified opioid treatment program; or
(D)
in other situations as the Secretary may reasonably determine.
(4)

Schedule ii, iii, or iv controlled substance.—
The term “schedule II, III, or IV controlled substance” means a controlled substance that is listed on schedule II, schedule III, or schedule IV of section 202(c) of the Controlled Substances Act.
(b)

Grants for Comprehensive Opioid Abuse Response.—
(1)

In general.—
The Secretary shall award grants to States, and combinations of States, to implement an integrated opioid abuse response initiative.
(2)

Purposes.—
A State receiving a grant under this section shall establish a comprehensive response plan to opioid abuse, which may include—
(A)
education efforts around opioid use, treatment, and addiction recovery, including education of residents, medical students, and physicians and other prescribers of schedule II, III, or IV controlled substances on relevant prescribing guidelines, the prescription drug monitoring program of the State described in subparagraph (B), and overdose prevention methods;
(B)
establishing, maintaining, or improving a comprehensive prescription drug monitoring program to track dispensing of schedule II, III, or IV controlled substances, which may—
(i)
provide for data sharing with other States; and
(ii)
allow all individuals authorized by the State to write prescriptions for schedule II, III, or IV controlled substances to access the prescription drug monitoring program of the State;
(C)
developing, implementing, or expanding prescription drug and opioid addiction treatment programs by—
(i)
expanding the availability of treatment for prescription drug and opioid addiction, including medication-assisted treatment and behavioral health therapy, as appropriate;
(ii)
developing, implementing, or expanding screening for individuals in treatment for prescription drug and opioid addiction for hepatitis C and HIV, and treating or referring those individuals if clinically appropriate; or
(iii)
developing, implementing, or expanding recovery support services and programs at high schools or institutions of higher education;
(D)
developing, implementing, and expanding efforts to prevent overdose death from opioid abuse or addiction to prescription medications and opioids; and
(E)
advancing the education and awareness of the public, providers, patients, consumers, and other appropriate entities regarding the dangers of opioid abuse, safe disposal of prescription medications, and detection of early warning signs of opioid use disorders.
(3)

Application.—
A State seeking a grant under this section shall submit to the Secretary an application in such form, and containing such information, as the Secretary may reasonably require.
(4)

Use of funds.—
A State that receives a grant under this section shall use the grant for the cost, including the cost for technical assistance, training, and administration expenses, of carrying out an integrated opioid abuse response initiative as outlined by the State’s comprehensive response plan to opioid abuse established under paragraph (2).
(5)

Priority considerations.—
In awarding grants under this section, the Secretary shall, as appropriate, give priority to a State that—
(A)
(i)
provides civil liability protection for first responders, health professionals, and family members who have received appropriate training in administering a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose; and
(ii)
submits to the Secretary a certification by the attorney general of the State that the attorney general has—
(I)
reviewed any applicable civil liability protection law to determine the applicability of the law with respect to first responders, health care professionals, family members, and other individuals who—
- (aa)
have received appropriate training in administering a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose; and
- (bb)
may administer a drug or device approved or cleared under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected opioid overdose; and
(II)
concluded that the law described in subclause (I) provides adequate civil liability protection applicable to such persons;
(B)
has a process for enrollment in services and benefits necessary by criminal justice agencies to initiate or continue treatment in the community, under which an individual who is incarcerated may, while incarcerated, enroll in services and benefits that are necessary for the individual to continue treatment upon release from incarceration;
(C)
ensures the capability of data sharing with other States, where applicable, such as by making data available to a prescription monitoring hub;
(D)
ensures that data recorded in the prescription drug monitoring program database of the State are regularly updated, to the extent possible;
(E)
ensures that the prescription drug monitoring program of the State notifies prescribers and dispensers of schedule II, III, or IV controlled substances when overuse or misuse of such controlled substances by patients is suspected; and
(F)
has in effect one or more statutes or implements policies that maximize use of prescription drug monitoring programs by individuals authorized by the State to prescribe schedule II, III, or IV controlled substances.
(6)

Evaluation.—
In conducting an evaluation of the program under this section pursuant to section 701 of the Comprehensive Addiction and Recovery Act of 2016, with respect to a State, the Secretary shall report on State legislation or policies related to maximizing the use of prescription drug monitoring programs and the incidence of opioid use disorders and overdose deaths in such State.
(7)

States with local prescription drug monitoring programs.—
(A)

In general.—
In the case of a State that does not have a prescription drug monitoring program, a county or other unit of local government within the State that has a prescription drug monitoring program shall be treated as a State for purposes of this section, including for purposes of eligibility for grants under paragraph (1).
(B)

Plan for interoperability.—
In submitting an application to the Secretary under paragraph (3), a county or other unit of local government shall submit a plan outlining the methods such county or unit of local government shall use to ensure the capability of data sharing with other counties and units of local government within the state and with other States, as applicable.
(c)

Authorization of Funding.—
For the purpose of carrying out this section, there are authorized to be appropriated $5,000,000 for each of fiscal years 2017 through 2021.
SEC. 549.
[290ee–4]

MENTAL AND BEHAVIORAL HEALTH OUTREACH AND EDUCATION AT INSTITUTIONS OF HIGHER EDUCATION.
(a)

Purpose.—
It is the purpose of this section to increase access to, and reduce the stigma associated with, mental health services to ensure that students at institutions of higher education have the support necessary to successfully complete their studies.
(b)

National Public Education Campaign.—
The Secretary, acting through the Assistant Secretary and in collaboration with the Director of the Centers for Disease Control and Prevention, shall convene an interagency, public-private sector working group to plan, establish, and begin coordinating and evaluating a targeted public education campaign that is designed to focus on mental and behavioral health on the campuses of institutions of higher education. Such campaign shall be designed to—
(1)
improve the general understanding of mental health and mental disorders;
(2)
encourage help-seeking behaviors relating to the promotion of mental health, prevention of mental disorders, and treatment of such disorders;
(3)
make the connection between mental and behavioral health and academic success; and
(4)
assist the general public in identifying the early warning signs and reducing the stigma of mental illness.
(c)

Composition.—
The working group convened under subsection (b) shall include—
(1)
mental health consumers, including students and family members;
(2)
representatives of institutions of higher education, including minority-serving institutions as described in section 371(a) of the Higher Education Act of 1965 (20 U.S.C. 1067q) and community colleges;
(3)
representatives of national mental and behavioral health associations and associations of institutions of higher education;
(4)
representatives of health promotion and prevention organizations at institutions of higher education;
(5)
representatives of mental health providers, including community mental health centers; and
(6)
representatives of private-sector and public-sector groups with experience in the development of effective public health education campaigns.
(d)

Plan.—
The working group under subsection (b) shall develop a plan that—
(1)
targets promotional and educational efforts to the age population of students at institutions of higher education and individuals who are employed in settings of institutions of higher education, including through the use of roundtables;
(2)
develops and proposes the implementation of research-based public health messages and activities;
(3)
provides support for local efforts to reduce stigma by using the National Health Information Center as a primary point of contact for information, publications, and service program referrals; and
(4)
develops and proposes the implementation of a social marketing campaign that is targeted at the population of students attending institutions of higher education and individuals who are employed in settings of institutions of higher education.
(e)

Definition.—
In this section, the term “institution of higher education” has the meaning given such term in section 101 of the Higher Education Act of 1965 (20 U.S.C. 1001).
(f)

Authorization of Appropriations.—
To carry out this section, there are authorized to be appropriated $1,000,000 for the period of fiscal years 2023 through 2027.
SEC.
550.
[290ee–5]

NATIONAL RECOVERY HOUSING BEST PRACTICES.
(a)

Best Practices for Operating Recovery Housing.—
(1)

In general.—
The Secretary, in consultation with the individuals and entities specified in paragraph (2), shall continue activities to identify, facilitate the development of, and periodically update consensus-based best practices, which may include model laws for implementing suggested minimum standards for operating, and promoting the availability of, high-quality recovery housing.
(2)

Consultation.—
In carrying out the activities described in paragraph (1), the Secretary shall consult with, as appropriate—
(A)
officials representing the agencies described in subsection (e)(2);
(B)
directors or commissioners, as applicable, of State health departments, Tribal health departments, State Medicaid programs, and State insurance agencies;
(C)
representatives of health insurance issuers;
(D)
national accrediting entities and reputable providers of, and analysts of, recovery housing services, including Indian Tribes, Tribal organizations, and Tribally designated housing entities that provide recovery housing services, as applicable;
(E)
individuals with a history of substance use disorder; and
(F)
other stakeholders identified by the Secretary.
(3)

Availability.—
The best practices referred to in paragraph (1) shall be—
(A)
made publicly available; and
(B)
published on the public website of the Substance Abuse and Mental Health Services Administration.
(4)

Exclusion of guideline on treatment services.—
In facilitating the development of best practices under paragraph (1), the Secretary may not include any best practices with respect to substance use disorder treatment services.
(b)

Identification of Fraudulent Recovery Housing Operators.—
(1)

In general.—
The Secretary, in consultation with the individuals and entities described in paragraph (2), shall identify or facilitate the development of common indicators that could be used to identify potentially fraudulent recovery housing operators.
(2)

Consultation.—
In carrying out the activities described in paragraph (1), the Secretary shall consult with, as appropriate, the individuals and entities specified in subsection (a)(2) and the Attorney General of the United States.
(3)

Requirements.—
(A)

Practices for identification and reporting.—
In carrying out the activities described in paragraph (1), the Secretary shall consider how law enforcement, public and private payers, and the public can best identify and report fraudulent recovery housing operators.
(B)

Factors to be considered.—
In carrying out the activities described in paragraph (1), the Secretary shall identify or develop indicators, which may include indicators related to—
(i)
unusual billing practices;
(ii)
average lengths of stays;
(iii)
excessive levels of drug testing (in terms of cost or frequency); and
(iv)
unusually high levels of recidivism.
(c)

Dissemination.—
The Secretary shall, as appropriate, disseminate the best practices identified or developed under subsection (a) and the common indicators identified or developed under subsection (b) to—
(1)
State agencies, which may include the provision of technical assistance to State agencies seeking to adopt or implement such best practices;
(2)
Indian Tribes, Tribal organizations, and tribally designated housing entities;
(3)
the Attorney General of the United States;
(4)
the Secretary of Labor;
(5)
the Secretary of Housing and Urban Development;
(6)
State and local law enforcement agencies;
(7)
health insurance issuers;
(8)
recovery housing entities; and
(9)
the public.
(d)

Requirements.—
In carrying out the activities described in subsections (a) and (b), the Secretary, in consultation with appropriate individuals and entities described in subsections (a)(2) and (b)(2), shall consider how recovery housing is able to support recovery and prevent relapse, recidivism, or overdose (including overdose death), including by improving access and adherence to treatment, including medication-assisted treatment.
(e)

Coordination of Federal Activities to Promote the Availability of Housing for Individuals Experiencing Homelessness, Individuals With a Mental Illness, and Individuals With a Substance Use Disorder.—
(1)

In general.—
The Secretary, acting through the Assistant Secretary, and the Secretary of Housing and Urban Development shall convene an interagency working group for the following purposes:
(A)
To increase collaboration, cooperation, and consultation among the Department of Health and Human Services, the Department of Housing and Urban Development, and the Federal agencies listed in paragraph (2)(B), with respect to promoting the availability of housing, including high-quality recovery housing, for individuals experiencing homelessness, individuals with mental illnesses, and individuals with substance use disorder.
(B)
To align the efforts of such agencies and avoid duplication of such efforts by such agencies.
(C)
To develop objectives, priorities, and a long-term plan for supporting State, Tribal, and local efforts with respect to the operation of high-quality recovery housing that is consistent with the best practices developed under this section.
(D)
To improve information on the quality of recovery housing.
(2)

Composition.—
The interagency working group under paragraph (1) shall be composed of—
(A)
the Secretary, acting through the Assistant Secretary, and the Secretary of Housing and Urban Development, who shall serve as the co-chairs; and
(B)
representatives of each of the following Federal agencies:
(i)
The Centers for Medicare & Medicaid Services.
(ii)
The Substance Abuse and Mental Health Services Administration.
(iii)
The Health Resources and Services Administration.
(iv)
The Office of the Inspector General of the Department of Health and Human Services.
(v)
The Indian Health Service.
(vi)
The Department of Agriculture.
(vii)
The Department of Justice.
(viii)
The Office of National Drug Control Policy.
(ix)
The Bureau of Indian Affairs.
(x)
The Department of Labor.
(xi)
The Department of Veterans Affairs.
(xii)
Any other Federal agency as the co-chairs determine appropriate.
(3)

Meetings.—
The working group shall meet on a quarterly basis.
(4)

Reports to congress.—
Not later than 4 years after the date of the enactment of this section, the working group shall submit to the Committee on Health, Education, Labor, and Pensions, the Committee on Agriculture, Nutrition, and Forestry, and the Committee on Finance of the Senate and the Committee on Energy and Commerce, the Committee on Ways and Means, the Committee on Agriculture, and the Committee on Financial Services of the House of Representatives a report describing the work of the working group and any recommendations of the working group to improve Federal, State, and local coordination with respect to recovery housing and other housing resources and operations for individuals experiencing homelessness, individuals with a mental illness, and individuals with a substance use disorder.
(f)

Grants for Implementing National Recovery Housing Best Practices.—
(1)

In general.—
The Secretary shall award grants to States (and political subdivisions thereof), Indian Tribes, and territories—
(A)
for the provision of technical assistance to implement the guidelines and recommendations developed under subsection (a); and
(B)
to promote—
(i)
the availability of recovery housing for individuals with a substance use disorder; and
(ii)
the maintenance of recovery housing in accordance with best practices developed under this section.
(2)

State promotion plans.—
Not later than 90 days after receipt of a grant under paragraph (1), and every 2 years thereafter, each State (or political subdivisions thereof,) Indian Tribe, or territory receiving a grant under paragraph (1) shall submit to the Secretary, and publish on a publicly accessible internet website of the State (or political subdivisions thereof), Indian Tribe, or territory—
(A)
the plan of the State (or political subdivisions thereof), Indian Tribe, or territory, with respect to the promotion of recovery housing for individuals with a substance use disorder located within the jurisdiction of such State (or political subdivisions thereof), Indian Tribe, or territory; and
(B)
a description of how such plan is consistent with the best practices developed under this section.
(g)

Rule of Construction.—
Nothing in this section shall be construed to provide the Secretary with the authority to require States to adhere to minimum standards in the State oversight of recovery housing.
(h)

Definitions.—
In this section:
(1)
The term “recovery housing” means a shared living environment free from alcohol and illicit drug use and centered on peer support and connection to services that promote sustained recovery from substance use disorders.
(2)
The terms “Indian Tribe” and “Tribal organization” have the meanings given those terms in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 5304).
(3)
The term “tribally designated housing entity” has the meaning given that term in section 4 of the Native American Housing Assistance and Self-Determination Act of 1996 (25 U.S.C. 4103).
(i)

Authorization of Appropriations.—
To carry out this section, there is authorized to be appropriated $5,000,000 for the period of fiscal years 2023 through 2027.
SEC. 550A.
[290ee-10]

SOBRIETY TREATMENT AND RECOVERY TEAMS.
(a)

In General.—
The Secretary may make grants to States, units of local government, or tribal governments to establish or expand Sobriety Treatment And Recovery Team (referred to in this section as “START”) or other similar programs to determine the effectiveness of pairing social workers or mentors with families that are struggling with a substance use disorder and child abuse or neglect in order to help provide peer support, intensive treatment, and child welfare services to such families.
(b)

Allowable Uses.—
A grant awarded under this section may be used for one or more of the following activities:
(1)
Training eligible staff, including social workers, social services coordinators, child welfare specialists, substance use disorder treatment professionals, and mentors.
(2)
Expanding access to substance use disorder treatment services and drug testing.
(3)
Enhancing data sharing with law enforcement agencies, child welfare agencies, substance use disorder treatment providers, judges, and court personnel.
(4)
Program evaluation and technical assistance.
(c)

Program Requirements.—
A State, unit of local government, or tribal government receiving a grant under this section shall—
(1)
serve only families for which—
(A)
there is an open record with the child welfare agency; and
(B)
substance use disorder was a reason for the record or finding described in paragraph (1); and
(2)
coordinate any grants awarded under this section with any grant awarded under section 437(f) of the Social Security Act focused on improving outcomes for children affected by substance abuse.
(d)

Technical Assistance.—
The Secretary may reserve not more than 5 percent of funds provided under this section to provide technical assistance on the establishment or expansion of programs funded under this section from the National Center on Substance Abuse and Child Welfare.
SEC. 551.
[290ee–6]

REGIONAL CENTERS OF EXCELLENCE IN SUBSTANCE USE DISORDER EDUCATION.
(a)

In General.—
The Secretary, in consultation with appropriate agencies, shall award cooperative agreements to eligible entities for the designation of such entities as Regional Centers of Excellence in Substance Use Disorder Education for purposes of improving health professional training resources with respect to substance use disorder prevention, treatment, and recovery.
(b)

Eligibility.—
To be eligible to receive a cooperative agreement under subsection (a), an entity shall—
(1)
be an accredited entity that offers education to students in various health professions, which may include—
(A)
a teaching hospital;
(B)
a medical school;
(C)
a certified behavioral health clinic; or
(D)
any other health professions school, school of public health, or Cooperative Extension Program at institutions of higher education, as defined in section 101 of the Higher Education Act of 1965, engaged in the prevention, treatment, or recovery of substance use disorders;
(2)
demonstrate community engagement and partnerships with community stakeholders, including entities that train health professionals, mental health counselors, social workers, peer recovery specialists, substance use treatment programs, community health centers, physician offices, certified behavioral health clinics, research institutions, and law enforcement; and
(3)
submit to the Secretary an application containing such information, at such time, and in such manner, as the Secretary may require.
(c)

Activities.—
An entity receiving an award under this section shall develop, evaluate, and distribute evidence-based resources regarding the prevention and treatment of, and recovery from, substance use disorders. Such resources may include information on—
(1)
the neurology and pathology of substance use disorders;
(2)
advancements in the treatment of substance use disorders;
(3)
techniques and best practices to support recovery from substance use disorders;
(4)
strategies for the prevention and treatment of, and recovery from substance use disorders across patient populations; and
(5)
other topic areas that are relevant to the objectives described in subsection (a).
(d)

Geographic Distribution.—
In awarding cooperative agreements under subsection (a), the Secretary shall take into account regional differences among eligible entities and shall make an effort to ensure geographic distribution.
(e)

Evaluation.—
The Secretary shall evaluate each project carried out by an entity receiving an award under this section and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities.
(f)

Funding.—
There is authorized to be appropriated to carry out this section, $4,000,000 for each of fiscal years 2019 through 2023.
SEC. 552.
[290ee–7]

COMPREHENSIVE OPIOID RECOVERY CENTERS.
(a)

In General.—
The Secretary shall award grants on a competitive basis to eligible entities to establish or operate a comprehensive opioid recovery center (referred to in this section as a “Center”). A Center may be a single entity or an integrated delivery network.
(b)

Grant Period.—
(1)

In general.—
A grant awarded under subsection (a) shall be for a period of not less than 3 years and not more than 5 years.
(2)

Renewal.—
A grant awarded under subsection (a) may be renewed, on a competitive basis, for additional periods of time, as determined by the Secretary. In determining whether to renew a grant under this paragraph, the Secretary shall consider the data submitted under subsection (h).
(c)

Minimum Number of Centers.—
The Secretary shall allocate the amounts made available under subsection (j) such that not fewer than 10 grants may be awarded. Not more than one grant shall be made to entities in a single State for any one period.
(d)

Application.—
(1)

Eligible entity.—
An entity is eligible for a grant under this section if the entity offers treatment and other services for individuals with a substance use disorder.
(2)

Submission of application.—
In order to be eligible for a grant under subsection (a), an entity shall submit an application to the Secretary at such time, in such manner, and containing such information and assurances, including relevant documentation, as the Secretary may require. Such application shall include—
(A)
evidence that such entity carries out, or has the demonstrated capability to carry out, through referral or contractual arrangements, the activities described in subsection (g); and
(B)
such other information as the Secretary may require.
(e)

Priority.—
In awarding grants under subsection (a), the Secretary shall give priority to eligible entities—
(1)
located in a State with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate, as determined by the Director of the Centers for Disease Control and Prevention; or
(2)
serving an Indian Tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act) with an age-adjusted rate of drug overdose deaths that is above the national overdose mortality rate, as determined through appropriate mechanisms determined by the Secretary in consultation with Indian Tribes.
(f)

Preference.—
In awarding grants under subsection (a), the Secretary may give preference to eligible entities utilizing technology-enabled collaborative learning and capacity building models, including such models as defined in section 2 of the Expanding Capacity for Health Outcomes Act (Public Law 114–270; 130 Stat. 1395), to conduct the activities described in this section.
(g)

Center Activities.—
Each Center shall, at a minimum, carry out the following activities directly, through referral, or through contractual arrangements, which may include carrying out such activities through technology-enabled collaborative learning and capacity building models described in subsection (f):
(1)

Treatment and recovery services.—
Each Center shall—
(A)
Ensure that intake, evaluations, and periodic patient assessments meet the individualized clinical needs of patients, including by reviewing patient placement in treatment settings to support meaningful recovery.
(B)
Provide the full continuum of treatment services, including—
(i)
all drugs and devices approved or cleared under the Federal Food, Drug, and Cosmetic Act and all biological products licensed under section 351 of this Act to treat substance use disorders or reverse overdoses, pursuant to Federal and State law;
(ii)
medically supervised withdrawal management, that includes patient evaluation, stabilization, and readiness for and entry into treatment;
(iii)
counseling provided by a program counselor or other certified professional who is licensed and qualified by education, training, or experience to assess the psychological and sociological background of patients, to contribute to the appropriate treatment plan for the patient, and to monitor patient progress;
(iv)
treatment, as appropriate, for patients with co-occurring substance use and mental disorders;
(v)
testing, as appropriate, for infections commonly associated with illicit drug use;
(vi)
residential rehabilitation, and outpatient and intensive outpatient programs;
(vii)
recovery housing;
(viii)
community-based and peer recovery support services;
(ix)
job training, job placement assistance, and continuing education assistance to support reintegration into the workforce; and
(x)
other best practices to provide the full continuum of treatment and services, as determined by the Secretary.
(C)
Ensure that all programs covered by the Center include medication-assisted treatment, as appropriate, and do not exclude individuals receiving medication-assisted treatment from any service.
(D)
Periodically conduct patient assessments to support sustained and clinically significant recovery, as defined by the Assistant Secretary for Mental Health and Substance Use.
(E)
Provide onsite access to medication, as appropriate, and toxicology services; for purposes of carrying out this section.
(F)
Operate a secure, confidential, and interoperable electronic health information system.
(G)
Offer family support services such as child care, family counseling, and parenting interventions to help stabilize families impacted by substance use disorder, as appropriate.
(2)

Outreach.—
Each Center shall carry out outreach activities regarding the services offered through the Centers, which may include—
(A)
training and supervising outreach staff, as appropriate, to work with State and local health departments, health care providers, the Indian Health Service, State and local educational agencies, schools funded by the Indian Bureau of Education, institutions of higher education, State and local workforce development boards, State and local community action agencies, public safety officials, first responders, Indian Tribes, child welfare agencies, as appropriate, and other community partners and the public, including patients, to identify and respond to community needs;
(B)
ensuring that the entities described in subparagraph (A) are aware of the services of the Center; and
(C)
disseminating and making publicly available, including through the internet, evidence-based resources that educate professionals and the public on opioid use disorder and other substance use disorders, including co-occurring substance use and mental disorders.
(h)

Data Reporting and Program Oversight.—
(1)

In general.—
With respect to a grant awarded under subsection (a), not later than 90 days after the end of the first year of the grant period, and annually thereafter for the duration of the grant period (including the duration of any renewal period for such grant), the entity shall submit data, as appropriate, to the Secretary regarding—
(A)
the programs and activities funded by the grant;
(B)
health outcomes of the population of individuals with a substance use disorder who received services from the Center, evaluated by an independent program evaluator through the use of outcomes measures, as determined by the Secretary;
(C)
the retention rate of program participants; and
(D)
any other information that the Secretary may require for the purpose of—ensuring that the Center is complying with all the requirements of the grant, including providing the full continuum of services described in subsection (g)(1)(B).
(2)

Additional reporting for certain eligible entities.—
An entity carrying out activities described in subsection (g) through referral or contractual arrangements shall include in the submissions required under paragraph (1) information related to the status of such referrals or contractual arrangements, including an assessment of whether such referrals or contractual arrangements are supporting the ability of such entity to carry out such activities.
(i)

Privacy.—
The provisions of this section, including with respect to data reporting and program oversight, shall be subject to all applicable Federal and State privacy laws.
(j)

Authorization of Appropriations.—
There is authorized to be appropriated $10,000,000 for each of fiscal years 2026 through 2030 for purposes of carrying out this section.
SEC. 553.
[290ee–10]

RURAL EMERGENCY MEDICAL SERVICE TRAINING AND EQUIPMENT ASSISTANCE PROGRAM.
(a)

Grants.—
The Secretary, acting through the Assistant Secretary, shall award grants to eligible entities to enable such entities to provide for improved emergency medical services in rural areas or to residents of rural areas.
(b)

Eligibility; Application.—
To be eligible to receive grant under this section, an entity shall—
(1)
be—
(A)
an emergency medical services agency operated by a local or tribal government (including fire-based and non-fire based); or
(B)
an emergency medical services agency that is described in section 501(c) of the Internal Revenue Code of 1986 and exempt from tax under section 501(a) of such Code; and
(2)
submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.
(c)

Use of Funds.—
An entity—
(1)
shall use amounts received through a grant under subsection (a) to—
(A)
train emergency medical services personnel as appropriate to obtain and maintain licenses and certifications relevant to service in an emergency medical services agency described in subsection (b)(1);
(B)
conduct courses that qualify graduates to serve in an emergency medical services agency described in subsection (b)(1) in accordance with State and local requirements;
(C)
fund specific training to meet Federal or State licensing or certification requirements;
(D)
acquire emergency medical services equipment; and
(E)
ensure emergency medical services personnel are trained on mental health and substance use disorders and care for individuals with such disorders in emergency situations; and
(2)
may use amounts received through a grant under subsection (a) to—
(A)
recruit and retain emergency medical services personnel, which may include volunteer personnel;
(B)
develop new ways to educate emergency health care providers through the use of technology-enhanced educational methods;
(C)
acquire personal protective equipment for emergency medical services personnel as required by the Occupational Safety and Health Administration; or
(D)
acquire drugs or devices approved, cleared, or otherwise legally marketed under the Federal Food, Drug, and Cosmetic Act for emergency treatment of known or suspected overdose.
(d)

Grant Amounts.—
Each grant awarded under this section shall be in an amount not to exceed $200,000.
(e)

Definitions.—
In this section:
(1)
The term “emergency medical services”—
(A)
means resources used by a public or private nonprofit licensed entity to deliver medical care outside of a medical facility under emergency conditions that occur as a result of the condition of the patient; and
(B)
includes services delivered (either on a compensated or volunteer basis) by an emergency medical services provider or other provider that is licensed or certified by the State involved as an emergency medical technician, a paramedic, or an equivalent professional (as determined by the State).
(2)
The term “rural area” means—
(A)
a nonmetropolitan statistical area;
(B)
an area designated as a rural area by any law or regulation of a State; or
(C)
a rural census tract of a metropolitan statistical area (as determined under the most recent rural urban commuting area code as set forth by the Office of Management and Budget).
(f)

Authorization of Appropriations.—
(1)

In general.—
There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2024 through 2028.
(2)

Administrative costs.—
The Secretary may use not more than 10 percent of the amount appropriated under paragraph (1) for a fiscal year for the administrative expenses of carrying out this section.
Part E—

Children With Serious Emotional Disturbances
SEC. 561.
[290ff]

COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.
(a)

Grants to Certain Public Entities.—
(1)

In general.—
The Secretary, acting through the Director of the Center for Mental Health Services, shall make grants to public entities for the purpose of providing comprehensive community mental health services to children with a serious emotional disturbance, which may include efforts to identify and serve children at risk.
(2)

Definition of public entity.—
For purposes of this part, the term “public entity” means any State, any political subdivision of a State, and any Indian tribe or tribal organization (as defined in section 4(b) and section 4(c) of the Indian Self-Determination and Education Assistance Act).
(b)

Considerations in Making Grants.—
(1)

Requirement of status as grantee under part b of title xix.—
The Secretary may make a grant under subsection (a) to a public entity only if—
(A)
in the case of a public entity that is a State, the State is such a grantee under section 1911;
(B)
in the case of a public entity that is a political subdivision of a State, the State in which the political subdivision is located is such a grantee; and
(C)
in the case of a public entity that is an Indian tribe or tribal organization, the State in which the tribe or tribal organization is located is such a grantee.
(2)

Requirement of status as medicaid provider.—
(A)
Subject to subparagraph (B), the Secretary may make a grant under subsection (a) only if, in the case of any service under such subsection that is covered in the State plan approved under title XIX of the Social Security Act for the State involved—
(i)
the public entity involved will provide the service directly, and the entity has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or
(ii)
the public entity will enter into an agreement with an organization under which the organization will provide the service, and the organization has entered into such a participation agreement and is qualified to receive such payments.
(B)
(i)
In the case of an organization making an agreement under subparagraph (A)(ii) regarding the provision of services under subsection (a), the requirement established in such subparagraph regarding a participation agreement shall be waived by the Secretary if the organization does not, in providing health or mental health services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.
(ii)
A determination by the Secretary of whether an organization referred to in clause (i) meets the criteria for a waiver under such clause shall be made without regard to whether the organization accepts voluntary donations regarding the provision of services to the public.
(3)

Certain considerations.—
In making grants under subsection (a), the Secretary shall—
(A)
equitably allocate such assistance among the principal geographic regions of the United States;
(B)
consider the extent to which the public entity involved has a need for the grant; and
(C)
in the case of any public entity that is a political subdivision of a State or that is an Indian tribe or tribal organization—
(i)
shall consider any comments regarding the application of the entity for such a grant that are received by the Secretary from the State in which the entity is located; and
(ii)
shall give special consideration to the entity if the State agrees to provide a portion of the non-Federal contributions required in subsection (c) regarding such a grant.
(c)

Matching Funds.—
(1)

In general.—
A funding agreement for a grant under subsection (a) is that the public entity involved will, with respect to the costs to be incurred by the entity in carrying out the purpose described in such subsection, make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that—
(A)
for the first fiscal year for which the entity receives payments from a grant under such subsection, is not less than $1 for each $3 of Federal funds provided in the grant;
(B)
for any second or third such fiscal year, is not less than $1 for each $3 of Federal funds provided in the grant;
(C)
for any fourth such fiscal year, is not less than $1 for each $1 of Federal funds provided in the grant; and
(D)
for any fifth and sixth such fiscal year, is not less than $2 for each $1 of Federal funds provided in the grant.
(2)

Determination of amount contributed.—
(A)
Non-Federal contributions required in 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 non-Federal contributions.
(B)
In making a determination of the amount of non-Federal contributions for purposes of subparagraph (A), the Secretary may include only non-Federal contributions in excess of the average amount of non-Federal contributions made by the public entity involved toward the purpose described in subsection (a) for the 2-year period preceding the first fiscal year for which the entity receives a grant under such section.
SEC. 562.
[290ff–1]

REQUIREMENTS WITH RESPECT TO CARRYING OUT PURPOSE OF GRANTS.
(a)

Systems of Comprehensive Care.—
(1)

In general.—
A funding agreement for a grant under section 561(a) is that, with respect to children with a serious emotional disturbance, the public entity involved will carry out the purpose described in such section only through establishing and operating 1 or more systems of care for making each of the mental health services specified in subsection (c) available to each child provided access to the system. In providing for such a system, the public entity may make grants to, and enter into contracts with, public and nonprofit private entities.
(2)

Structure of system.—
A funding agreement for a grant under section 561(a) is that a system of care under paragraph (1) will—
(A)
be established in a community selected by the public entity involved;
(B)
consist of such public agencies and nonprofit private entities in the community as are necessary to ensure that each of the services specified in subsection (c) is available to each child provided access to the system;
(C)
be established pursuant to agreements that the public entity enters into with the agencies and entities described in subparagraph (B);
(D)
coordinate the provision of the services of the system; and
(E)
establish an office whose functions are to serve as the location through which children are provided access to the system, to coordinate the provision of services of the system, and to provide information to the public regarding the system.
(3)

Collaboration of local public entities.—
A funding agreement for a grant under section 561(a) is that, for purposes of the establishment and operation of a system of care under paragraph (1), the public entity involved will seek collaboration among all public agencies that provide human services in the community in which the system is established, including but not limited to those providing mental health services, educational services, child welfare services, or juvenile justice services.
(b)

Limitation on Age of Children Provided Access to System.—
A funding agreement for a grant under section 561(a) is that a system of care under subsection (a) will provide an individual with access to the system through the age of 21 years.
(c)

Required Mental Health Services of System.—
A funding agreement for a grant under section 561(a) is that mental health services provided by a system of care under subsection (a) will include, with respect to a serious emotional disturbance in a child—
(1)
diagnostic and evaluation services;
(2)
outpatient services provided in a clinic, office, school or other appropriate location, including individual, group and family counseling services, professional consultation, and review and management of medications;
(3)
emergency services, available 24-hours a day, 7 days a week;
(4)
intensive home-based services for children and their families when the child is at imminent risk of out-of-home placement;
(5)
intensive day-treatment services;
(6)
respite care;
(7)
therapeutic foster care services, and services in therapeutic foster family homes or individual therapeutic residential homes, and groups homes caring for not more than 10 children; and
(8)
assisting the child in making the transition from the services received as a child to the services to be received as an adult.
(d)

Required Arrangements Regarding Other Appropriate Services.—
(1)

In general.—
A funding agreement for a grant under section 561(a) is that—
(A)
a system of care under subsection (a) will enter into a memorandum of understanding with each of the providers specified in paragraph (2) in order to facilitate the availability of the services of the provider involved to each child provided access to the system; and
(B)
the grant under such section 561(a), and the non-Federal contributions made with respect to the grant, will not be expended to pay the costs of providing such non-mental health services to any individual.
(2)

Specification of non-mental health services.—
The providers referred to in paragraph (1) are providers of medical services other than mental health services, providers of educational services, providers of vocational counseling and vocational rehabilitation services, and providers of protection and advocacy services with respect to mental health.
(3)

Facilitation of services of certain programs.—
A funding agreement for a grant under section 561(a) is that a system of care under subsection (a) will, for purposes of paragraph (1), enter into a memorandum of understanding regarding facilitation of—
(A)
services available pursuant to title XIX of the Social Security Act, including services regarding early periodic screening, diagnosis, and treatment;
(B)
services available under parts B and C of the Individuals with Disabilities Education Act; and
(C)
services available under other appropriate programs, as identified by the Secretary.
(e)

General Provisions Regarding Services of System.—
(1)

Case management services.—
A funding agreement for a grant under section 561(a) is that a system of care under subsection (a) will provide for the case management of each child provided access to the system in order to ensure that—
(A)
the services provided through the system to the child are coordinated and that the need of each such child for the services is periodically reassessed;
(B)
information is provided to the family of the child on the extent of progress being made toward the objectives established for the child under the plan of services implemented for the child pursuant to section 563; and
(C)
the system provides assistance with respect to—
(i)
establishing the eligibility of the child, and the family of the child, for financial assistance and services under Federal, State, or local programs providing for health services, mental health services, educational services, social services, or other services; and
(ii)
seeking to ensure that the child receives appropriate services available under such programs.
(2)

Other provisions.—
A funding agreement for a grant under section 561(a) is that a system of care under subsection (a), in providing the services of the system, will—
(A)
provide the services of the system in the cultural context that is most appropriate for the child and family involved;
(B)
ensure that individuals providing such services to the child can effectively communicate with the child and family in the most direct manner;
(C)
provide the services without discriminating against the child or the family of the child on the basis of race, religion, national origin, sex, disability, or age;
(D)
seek to ensure that each child provided access to the system of care remains in the least restrictive, most normative environment that is clinically appropriate; and
(E)
provide outreach services to inform individuals, as appropriate, of the services available from the system, including identifying children with a serious emotional disturbance who are in the early stages of such disturbance.
(3)

Rule of construction.—
An agreement made under paragraph (2) may not be construed—
(A)
with respect to subparagraph (C) of such paragraph—
(i)
to prohibit a system of care under subsection (a) from requiring that, in housing provided by the grantee for purposes of residential treatment services authorized under subsection (c), males and females be segregated to the extent appropriate in the treatment of the children involved; or
(ii)
to prohibit the system of care from complying with the agreement made under subsection (b); or
(B)
with respect to subparagraph (D) of such paragraph, to authorize the system of care to expend the grant under section 561(a) (or the non-Federal contributions made with respect to the grant) to provide legal services or any service with respect to which expenditures regarding the grant are prohibited under subsection (d)(1)(B).
(f)

Restrictions on Use of Grant.—
A funding agreement for a grant under section 561(a) is that the grant, and the non-Federal contributions made with respect to the grant, will not be expended—
(1)
to purchase or improve real property (including the construction or renovation of facilities);
(2)
to provide for room and board in residential programs serving 10 or fewer children;
(3)
to provide for room and board or other services or expenditures associated with care of children in residential treatment centers serving more than 10 children or in inpatient hospital settings, except intensive home-based services and other services provided on an ambulatory or outpatient basis; or
(4)
to provide for the training of any individual, except training authorized in section 564(a)(2) and training provided through any appropriate course in continuing education whose duration does not exceed 2 days.
(g)

Waivers.—
The Secretary may waive one 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.
SEC. 563.
[290ff–2]

INDIVIDUALIZED PLAN FOR SERVICES.
(a)

In General.—
A funding agreement for a grant under section 561(a) is that a system of care under section 562(a) will develop and carry out an individualized plan of services for each child provided access to the system, and that the plan will be developed and carried out with the participation of the family of the child and, unless clinically inappropriate, with the participation of the child.
(b)

Multidisciplinary Team.—
A funding agreement for a grant under section 561(a) is that the plan required in subsection (a) will be developed, and reviewed and as appropriate revised not less than once each year, by a multidisciplinary team of appropriately qualified individuals who provide services through the system, including as appropriate mental health services, other health services, educational services, social services, and vocational counseling and rehabilitation;15
^{15}
So in law. See section 119 of Public Law 102–321 (106 Stat. 349). Probably should be a period.
(c)

Coordination With Services Under Individuals with Disabilities Education Act.—
A funding agreement for a grant under section 561(a) is that, with respect to a plan under subsection (a) for a child, the multidisciplinary team required in subsection (b) will—
(1)
in developing, carrying out, reviewing, and revising the plan consider any individualized education program in effect for the child pursuant to part B of the Individuals with Disabilities Education Act;
(2)
ensure that the plan is consistent with such individualized education program and provides for coordinating services under the plan with services under such program; and
(3)
ensure that the memorandum of understanding entered into under section 562(d)(3)(B) regarding such Act includes provisions regarding compliance with this subsection.
(d)

Contents of Plan.—
A funding agreement for a grant under section 561(a) is that the plan required in subsection (a) for a child will—
(1)
identify and state the needs of the child for the services available pursuant to section 562 through the system;
(2)
provide for each of such services that is appropriate to the circumstances of the child, including, except in the case of children who are less than 14 years of age, the provision of appropriate vocational counseling and rehabilitation, and transition services (as defined in section 602 of the Individuals with Disabilities Education Act);
(3)
establish objectives to be achieved regarding the needs of the child and the methodology for achieving the objectives; and
(4)
designate an individual to be responsible for providing the case management required in section 562(e)(1) or certify that case management services will be provided to the child as part of the individualized education program of the child under the Individuals with Disabilities Education Act.
SEC. 564.
[290ff–3]

ADDITIONAL PROVISIONS.
(a)

Optional Services.—
In addition to services described in subsection (c) of section 562, a system of care under subsection (a) of such section may, in expending a grant under section 561(a), provide for—
(1)
preliminary assessments to determine whether a child should be provided access to the system;
(2)
training in—
(A)
the administration of the system;
(B)
the provision of intensive home-based services under paragraph (4) of section 562(c), intensive day treatment under paragraph (5) of such section, and foster care or group homes under paragraph (7) of such section; and
(C)
the development of individualized plans for purposes of section 563;
(3)
recreational activities for children provided access to the system; and
(4)
such other services as may be appropriate in providing for the comprehensive needs with respect to mental health of children with a serious emotional disturbance.
(b)

Comprehensive Plan.—
The Secretary may make a grant under section 561(a) only if, with respect to the jurisdiction of the public entity involved, the entity has submitted to the Secretary, and has had approved by the Secretary, a plan for the development of a jurisdiction-wide system of care for community-based services for children with a serious emotional disturbance that specifies the progress the public entity has made in developing the jurisdiction-wide system, the extent of cooperation across agencies serving children in the establishment of the system, the Federal and non-Federal resources currently committed to the establishment of the system, and the current gaps in community services and the manner in which the grant under section 561(a) will be expended to address such gaps and establish local systems of care.
(c)

Limitation on Imposition of Fees for Services.—
A funding agreement for a grant under section 561(a) is that, if a charge is imposed for the provision of services under the grant, such charge—
(1)
will be made according to a schedule of charges that is made available to the public;
(2)
will be adjusted to reflect the income of the family of the child involved; and
(3)
will not be imposed on any child whose family has income and resources of equal to or less than 100 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.
(d)

Relationship to Items and Services Under Other Programs.—
A funding agreement for a grant under section 561(a) is that the grant, and the non-Federal contributions made with respect to the grant, will not be expended to make payment for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service—
(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)

Limitation on Administrative Expenses.—
A funding agreement for a grant under section 561(a) is that not more than 2 percent of the grant will be expended for administrative expenses incurred with respect to the grant by the public entity involved.
(f)

Reports to Secretary.—
A funding agreement for a grant under section 561(a) is that the public entity involved will annually submit to the Secretary (and provide a copy to the State involved) a report on the activities of the entity under the grant that includes a description of the number of children provided access to systems of care operated pursuant to the grant, the demographic characteristics of the children, the types and costs of services provided pursuant to the grant, the availability and use of third-party reimbursements, estimates of the unmet need for such services in the jurisdiction of the entity, and the manner in which the grant has been expended toward the establishment of a jurisdiction-wide system of care for children with a serious emotional disturbance, and such other information as the Secretary may require with respect to the grant.
(g)

Description of Intended Uses of Grant.—
The Secretary may make a grant under section 561(a) only if—
(1)
the public entity involved submits to the Secretary a description of the purposes for which the entity intends to expend the grant;
(2)
the description identifies the populations, areas, and localities in the jurisdiction of the entity with a need for services under this section; and
(3)
the description provides information relating to the services and activities to be provided, including a description of the manner in which the services and activities will be coordinated with any similar services or activities of public or nonprofit entities.
(h)

Requirement of Application.—
The Secretary may make a grant under section 561(a) only if an application for the grant is submitted to the Secretary, the application contains the description of intended uses required in subsection (g), 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.
SEC. 565.
[290ff–4]

GENERAL PROVISIONS.
(a)

Duration of Support.—
The period during which payments are made to a public entity from a grant under section 561(a) may not exceed 6 fiscal years.
(b)

Technical Assistance.—
(1)

In general.—
The Secretary shall, upon the request of a public entity , regardless of whether such public entity is receiving a grant under section 561(a)—
(A)
provide technical assistance to the entity regarding the process of submitting to the Secretary applications for grants under section 561(a); and
(B)
provide to the entity training and technical assistance with respect to the planning, development, and operation of systems of care described in section 562.
(2)

Authority for grants and contracts.—
The Secretary may provide technical assistance under subsection (a) directly or through grants to, or contracts with, public and nonprofit private entities.
(c)

Evaluations and Reports by Secretary.—
(1)

In general.—
The Secretary shall, directly or through contracts with public or private entities, provide for annual evaluations of programs carried out pursuant to section 561(a). The evaluations shall assess the effectiveness of the systems of care operated pursuant to such section, including longitudinal studies of outcomes of services provided by such systems, other studies regarding such outcomes, the effect of activities under this part on the utilization of hospital and other institutional settings, the barriers to and achievements resulting from interagency collaboration in providing community-based services to children with a serious emotional disturbance, and assessments by parents of the effectiveness of the systems of care.
(2)

Report to congress.—
The Secretary shall, not later than 1 year after the date on which amounts are first appropriated under subsection (c), and annually thereafter, submit to the Congress a report summarizing evaluations carried out pursuant to paragraph (1) during the preceding fiscal year and making such recommendations for administrative and legislative initiatives with respect to this section as the Secretary determines to be appropriate.
(d)

Definitions.—
For purposes of this part:
(1)
The term “child” means an individual through the age of 21 years.
(2)
The term “family”, with respect to a child provided access to a system of care under section 562(a), means—
(A)
the legal guardian of the child; and
(B)
as appropriate regarding mental health services for the child, the parents of the child (biological or adoptive, as the case may be), kinship caregivers of the child, and any foster parents of the child.
(3)
The term “funding agreement”, with respect to a grant under section 561(a) to a public entity, means that the Secretary may make such a grant only if the public entity makes the agreement involved.
(4)
The term “serious emotional disturbance” includes, with respect to a child, any child who has a serious emotional disorder, a serious behavioral disorder, or a serious mental disorder.
(e)

Rule of Construction.—
Nothing in this part shall be construed as limiting the rights of a child with a serious emotional disturbance under the Individuals with Disabilities Education Act.
(f)

Funding.—
(1)16

Authorization of appropriations.—
For the purpose of carrying out this part, there are authorized to be appropriated $125,000,000 for each of fiscal years 2023 through 2027.
^{16}
Indentation is so in law. See section 1411(b)(1) of division FF of Public Law 117-328. Such amendment should have been made to paragraph (2), not paragraph (1).
(2)17

Limitation regarding technical assistance.—
Not more than 10 percent of the amounts appropriated under paragraph (1) for a fiscal year may be expended for carrying out subsection (b).
^{17}
Indentation is so in law. See section 2017(2)(C)(ii) of Public Law 103–43 (107 Stat. 218).
Part F—

Model Comprehensive Program for Treatment of Substance Abuse 18
^{18}
The part designation and heading for part F are so in law. Part F formerly consisted of section 571. That section was repealed by section 3301(c)(4) of Public Law 106–310 (114 Stat. 1209), but there was no conforming amendment to strike the designation and heading for part F.
Part G 19—

Projects for Children and Violence
SEC. 581.19
[290hh]

CHILDREN AND VIOLENCE.
^{19}
There is another part G in this title, which also begins with a section 581. See page 677. That part G relates to services provided through religious organizations.
(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.
[290hh–1]

GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO EXPERIENCE TRAUMATIC EVENTS.
(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 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 and dissemination 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.
(b)

Priorities.—
In awarding grants, contracts or cooperative agreements under subsection (a)(2) (related to the development and dissemination of knowledge on evidence-based practices for treating mental, behavioral, and biological disorders associated with psychological trauma), the Secretary shall give priority to universities, hospitals, mental health agencies, and other programs that have established clinical expertise and research experience in the field of trauma-related mental disorders.
(c)

Child Outcome Data.—
The NCTSI coordinating center described in subsection (a)(1) shall collect, analyze, report, and make publicly available, as appropriate, 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.—
(1)

Coordinating center.—
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.
(2)

NCTSI grantees.—
In carrying out subsection (a)(2), NCTSI grantees shall develop trainings and other resources, as applicable and appropriate, to support implementation of the evidence-based practices developed and disseminated under such subsection.
(e)

Dissemination and Collaboration.—
(1)

Coordinating center.—
The NCTSI coordinating center shall, as appropriate, collaborate with—
(A)
the Secretary, in the dissemination and implementation of evidence-based and trauma-informed interventions, treatments, products, and other resources to appropriate stakeholders; and
(B)
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.
(2)

NCTSI grantees.—
NCTSI grantees shall, as appropriate, collaborate with other such grantees, the NCTSI coordinating center, and the Secretary in carrying out subsections (a)(2) and (d)(2).
(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.
(g)

Geographical Distribution.—
The Secretary shall ensure that grants, contracts or cooperative agreements under subsection (a) are distributed equitably among the regions of the United States and among urban and rural areas.
(h)

Application and Evaluation.—
To be eligible to receive a grant, contract, or cooperative agreement under subsection (a), a public or nonprofit private entity or an Indian Tribe or Tribal organization shall submit to the Secretary an application at such time, in such manner, and containing such information and assurances as the Secretary may require, including—
(1)
a plan for the 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; and
(2)
a description of how such entity, Indian Tribe, or Tribal organization will support efforts led by the Secretary or the NCTSI coordinating center, as applicable, to evaluate activities carried out under this section.
(i)

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 not be less than 4 years, but shall not exceed 5 years. Such grants, contracts or agreements may be renewed.
(j)

Authorization of Appropriations.—
There is authorized to be appropriated to carry out this section—
(1)
$98,887,000 for fiscal year 2026;
(2)
$98,887,000 for fiscal year 2027;
(3)
$98,887,000 for fiscal year 2028;
(4)
$100,000,000 for fiscal year 2029; and
(5)
$100,000,000 for fiscal year 2030.
(k)

Short Title.—
This section may be cited as the “Donald J. Cohen National Child Traumatic Stress Initiative”.
PART H—

REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN FACILITIES
SEC. 591.
[290ii]

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.
[290ii–1]

REPORTING REQUIREMENT.
(a)

In General.—
Each facility to which the Protection and Advocacy for Mentally Ill Individuals Act of 198620 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.
^{20}
Probably should be Protection and Advocacy for Individuals with Mental Illness Act. See section 3206(a) of Public Law 106–310 (114 Stat. 1193).
(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 198620 (42 U.S.C. 10802(3)).
SEC. 593.21
[290ii–3]

REGULATIONS AND ENFORCEMENT.
^{21}
Section 593 appears according to the probable intent of the Congress. Section 3207 of Public Law 106–310 (114 Stat. 1196) added sections 591 and 592, and closing quotations were provided at the end of section 592. Immediately following that section, however, section 593 appeared in quotations, and closing quotations were provided at the end of the section. The probable intent of the Congress is that closing quotations should not have been provided at the end of section 592.
(a)

Training.—
Not later than 1 year after the date of the 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 198620 (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.
PART I—

REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH
SEC. 595.
[290jj]

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.
[290jj–1]

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.
[290jj–2]

REGULATIONS AND ENFORCEMENT.
(a)

Training.—
Not later than 6 months after the date of the 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.
Part J—

Services Provided Through Religious Organizations 22
^{22}
Section 1955 of this Act also relates to religious organizations as providers of substance abuse services. That section was added by section 3305 of Public Law 106–310 (114 Stat. 1212).
SEC. 596.
[290kk]

APPLICABILITY TO DESIGNATED PROGRAMS.
(a)

Designated Programs.—
Subject to subsection (b), this part applies to discretionary and formula grant programs administered by the Substance Abuse and Mental Health Services Administration that make awards of financial assistance to public or private entities for the purpose of carrying out activities to prevent or treat substance abuse (in this part referred to as a “designated program”). Designated programs include the program under subpart II of part B of title XIX (relating to formula grants to the States).
(b)

Limitation.—
This part does not apply to any award of financial assistance under a designated program for a purpose other than the purpose specified in subsection (a).
(c)

Definitions.—
For purposes of this part (and subject to subsection (b)):
(1)
The term “designated program” has the meaning given such term in subsection (a).
(2)
The term “financial assistance” means a grant, cooperative agreement, or contract.
(3)
The term “program beneficiary” means an individual who receives program services.
(4)
The term “program participant” means a public or private entity that has received financial assistance under a designated program.
(5)
The term “program services” means treatment for substance abuse, or preventive services regarding such abuse, provided pursuant to an award of financial assistance under a designated program.
(6)
The term “religious organization” means a nonprofit religious organization.
SEC. 596A.
[290kk–1]

RELIGIOUS ORGANIZATIONS AS PROGRAM PARTICIPANTS.
(a)

In General.—
Notwithstanding any other provision of law, a religious organization, on the same basis as any other nonprofit private provider—
(1)
may receive financial assistance under a designated program; and
(2)
may be a provider of services under a designated program.
(b)

Religious Organizations.—
The purpose of this section is to allow religious organizations to be program participants on the same basis as any other nonprofit private provider without impairing the religious character of such organizations, and without diminishing the religious freedom of program beneficiaries.
(c)

Nondiscrimination Against Religious Organizations.—
(1)

Eligibility as program participants.—
Religious organizations are eligible to be program participants on the same basis as any other nonprofit private organization as long as the programs are implemented consistent with the Establishment Clause and Free Exercise Clause of the First Amendment to the United States Constitution. Nothing in this Act shall be construed to restrict the ability of the Federal Government, or a State or local government receiving funds under such programs, to apply to religious organizations the same eligibility conditions in designated programs as are applied to any other nonprofit private organization.
(2)

Nondiscrimination.—
Neither the Federal Government nor a State or local government receiving funds under designated programs shall discriminate against an organization that is or applies to be a program participant on the basis that the organization has a religious character.
(d)

Religious Character and Freedom.—
(1)

Religious organizations.—
Except as provided in this section, any religious organization that is a program participant shall retain its independence from Federal, State, and local government, 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 shall require a religious organization to—
(A)
alter its form of internal governance; or
(B)
remove religious art, icons, scripture, or other symbols,
in order to be a program participant.
(e)

Employment Practices.—
Nothing in this section shall be construed to modify or affect the provisions of any other Federal or State law or regulation that relates to discrimination in employment. A religious organization's exemption provided under section 702 of the Civil Rights Act of 1964 regarding employment practices shall not be affected by its participation in, or receipt of funds from, a designated program.
(f)

Rights of Program Beneficiaries.—
(1)

In general.—
If an individual who is a program beneficiary or a prospective program beneficiary objects to the religious character of a program participant, within a reasonable period of time after the date of such objection such program participant shall refer such individual to, and the appropriate Federal, State, or local government that administers a designated program or is a program participant shall provide to such individual (if otherwise eligible for such services), program services that—
(A)
are from an alternative provider that is accessible to, and has the capacity to provide such services to, such individual; and
(B)
have a value that is not less than the value of the services that the individual would have received from the program participant to which the individual had such objection.
Upon referring a program beneficiary to an alternative provider, the program participant shall notify the appropriate Federal, State, or local government agency that administers the program of such referral.
(2)

Notices.—
Program participants, public agencies that refer individuals to designated programs, and the appropriate Federal, State, or local governments that administer designated programs or are program participants shall ensure that notice is provided to program beneficiaries or prospective program beneficiaries of their rights under this section.
(3)

Additional requirements.—
A program participant making a referral pursuant to paragraph (1) shall—
(A)
prior to making such referral, consider any list that the State or local government makes available of entities in the geographic area that provide program services; and
(B)
ensure that the individual makes contact with the alternative provider to which the individual is referred.
(4)

Nondiscrimination.—
A religious organization that is a program participant shall not in providing program services or engaging in outreach activities under designated programs discriminate against a program beneficiary or prospective program beneficiary on the basis of religion or religious belief.
(g)

Fiscal Accountability.—
(1)

In general.—
Except as provided in paragraph (2), any religious organization that is a program participant shall be subject to the same regulations as other recipients of awards of Federal financial assistance to account, in accordance with generally accepted auditing principles, for the use of the funds provided under such awards.
(2)

Limited audit.—
With respect to the award involved, a religious organization that is a program participant shall segregate Federal amounts provided under award into a separate account from non-Federal funds. Only the award funds shall be subject to audit by the government.
(h)

Compliance.—
With respect to compliance with this section by an agency, a religious organization may obtain judicial review of agency action in accordance with chapter 7 of title 5, United States Code.
SEC.
596B.
[290kk–2]

LIMITATIONS ON USE OF FUNDS FOR CERTAIN PURPOSES.
No funds provided under a designated program shall be expended for sectarian worship, instruction, or proselytization.
SEC. 596C.
[290kk–3]

EDUCATIONAL REQUIREMENTS FOR PERSONNEL IN DRUG TREATMENT PROGRAMS.
(a)

Findings.—
The Congress finds that—
(1)
establishing unduly rigid or uniform educational qualification for counselors and other personnel in drug treatment programs may undermine the effectiveness of such programs; and
(2)
such educational requirements for counselors and other personnel may hinder or prevent the provision of needed drug treatment services.
(b)

Nondiscrimination.—
In determining whether personnel of a program participant that has a record of successful drug treatment for the preceding three years have satisfied State or local requirements for education and training, a State or local government shall not discriminate against education and training provided to such personnel by a religious organization, so long as such education and training includes basic content substantially equivalent to the content provided by nonreligious organizations that the State or local government would credit for purposes of determining whether the relevant requirements have been satisfied.
PART K—

MINORITY FELLOWSHIP PROGRAM
SEC. 597.
[290ll]

FELLOWSHIPS.
(a)

In General.—
The Secretary shall maintain a program, to be known as the Minority Fellowship Program, under which the Secretary shall award fellowships, which may include stipends, for the purposes of—
(1)
increasing the knowledge of mental and substance use disorders practitioners on issues related to diagnosis, prevention, treatment, and recovery support for individuals who are from racial and ethnic minority populations and who have a mental or substance use disorder;
(2)
improving the quality of mental and substance use disorder prevention and treatment services delivered to racial and ethnic minority populations; and
(3)
increasing the number of culturally competent mental and substance use disorders professionals who teach, administer services, conduct research, and provide direct mental or substance use disorder services to racial and ethnic minority populations.
(b)

Training Covered.—
The fellowships awarded under subsection (a) shall be for postbaccalaureate training (including for master’s and doctoral degrees) for mental and substance use disorder treatment professionals, including in the fields of psychiatry, addiction medicine, nursing, social work, psychology, marriage and family therapy, mental health counseling, and substance use disorder and addiction counseling.
(c)

Authorization of Appropriations.—
To carry out this section, there are authorized to be appropriated $25,000,000 for each of fiscal years 2023 through 2027.