[Congressional Record Volume 143, Number 69 (Thursday, May 22, 1997)]
[Senate]
[Pages S5011-S5013]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD:
  S. 793. A bill to amend the Public Health Service Act to require that 
the Center for Substance Abuse Treatment carry out treatment programs 
for adolescents; to the Committee on Labor and Human Resources.


           THE SERVICES FOR CHILDREN OF SUBSTANCE ABUSERS ACT

  S. 794. A bill to amend the Public Health Service Act to revise and 
extend the grant program for services for children of substance 
abusers; to the Committee on Labor and Human Resources.


           THE SUBSTANCE ABUSE TREATMENT FOR ADOLESCENTS ACT

  Mr. DODD. Mr. President, I rise today to introduce two bills which 
seek to address one of the most critical problems tearing at the fabric 
of American society: substance abuse. When we consider health care 
costs, lost time on the job, increased crime, and other related 
factors, it is estimated that drug and alcohol abuse cost this Nation 
more than $300 billion in 1993. While some efforts to address this 
problem have been successful, there is still a great deal of work to be 
done. The two bills that I am introducing, the Services for Children of 
Substance Abusers Act and the Substance Abuse Treatment for Adolescents 
Act, seek to provide additional tools for families to fight the battle 
of addiction and its debilitating social consequences.
  Addiction threatens the American family in several ways. The long 
term emotional health of an individual is shaped during childhood, and 
the children of substance abusers face numerous obstacles during their 
development. The children of substance abusers are typically deprived 
of the parent's attention and concern, and often the financial support 
to provide food, clothing, and shelter. In the most dramatic cases, 
children are exposed to substances prenatally and are deprived of a 
healthy future before they are even born.
  An estimated 7 million children are growing up with at least one 
substance abusing parent, and more than 200,000 women who gave birth in 
the United States in 1992 used illegal drugs at some time during their 
pregnancy. In addition, alcohol consumption by pregnant women has 
recently surged, despite public campaigns about the effects of alcohol 
on the developing fetus. Clearly these parents will need help if they 
hope to overcome their addictions and raise healthy children. 
Unfortunately, these parents often face several obstacles on the road 
to recovery.
  The basic problem with our current drug and alcohol treatment 
programs is that they fail to address the wide range of problems that 
addicted parents face. Many were physically or sexually abused as 
children. Many are victims of domestic violence. Many lack any formal 
job skills. Many will need child care assistance if they hope to enroll 
in a treatment program. Many fear that they will lose their children if 
they come forward for treatment. In short, these parents face several 
problems which extend far beyond their addictions.
  The Children of Substance Abusers Act is currently authorized in the 
Public Health Services Act, but it has never been funded. Today, I 
introduce a revised version of this legislation that seeks to give 
families affected by substance abuse somewhere to turn. The heart of 
the bill is the grant program which will provide $50 million for a 
comprehensive range of health, developmental, and social services to 
children, parents, and other family members. These services will 
enhance the

[[Page S5012]]

ability of parents to access drug and alcohol treatment and promote 
family preservation, where appropriate.
  The bill ensures that all children whose parents are substance 
abusers can enter the program and receive a range of services. The 
legislation addresses another critical need by providing grants to 
train professionals, child welfare workers, and other providers serving 
children to identify and address the effects of familial substance 
abuse.
  For years we have talked about the impact of substance abuse on 
families. We have all visited the neonatal intensive care units, and we 
have all seen reports on children who were abused and neglected because 
their parents were on drugs. The time has come for Congress to respond 
to what is going on in this country and take an aggressive step toward 
alleviating these problems.
  The Children of Substance Abusers Act is critical to our efforts to 
reach out to those families that are struggling with substance abuse, 
and I urge my colleagues to support the legislation I introduce today 
and fund this critical program.
  On another front, the increased prevalence of substance abuse among 
young Americans poses an additional public health crisis. Last year, 
the percentage of teens using drugs within the past month rose from 8.2 
to 10.9 percent, and the rate of drug use among 12 to 17 year-olds has 
doubled since 1992. I am particularly disappointed to learn that 
Connecticut's students report higher rates of drug use than their peers 
nationwide.
  Annually, more than 400,000 Americans under the age of 18 are in need 
of treatment, and in Connecticut approximately 6,700 students need 
substance abuse treatment. However, young people have few places to 
turn. Most treatment programs are designed for adults, and there are 
limited resources available for the treatment of adolescents with drug 
and alcohol problems.
  Federal and state initiatives have focused on preventing children 
from becoming substance abusers. While prevention efforts are effective 
and necessary, they do not provide for those adolescents with substance 
abuse problems. In addition, most substance abusing adolescents have 
co-occurring disorders, such as depression, learning disabilities, 
post-traumatic stress disorders, and other health problems which make 
treatment even more challenging.
  The Substance Abuse Treatment for Adolescents Act seeks to create a 
funding stream for adolescent treatment. This would be the first time 
that any money has ever been earmarked specifically for adolescent 
treatment, setting aside an estimated $70 million annually to address 
this problem. This bill would also eliminate the need within the public 
system for adolescent providers to compete with other groups for scarce 
treatment dollars, thereby allowing them to focus upon the real 
problem: successfully treating adolescent substance abusers.
  Mr. President, this legislation marks a significant step on the road 
toward improved treatment for adolescent substance abuse. It tells 
families that we care about their children's health and well-being, and 
it sends a signal to those individuals who struggle to help our kids 
overcome addiction that their hard work is not for naught, but will 
soon be rewarded.
  Mr. President, I ask unanimous consent that the text of the bills be 
printed in the Record.
  There being no objection, the bills were ordered to be printed in the 
Record, as follows:

                                 S. 793

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Substance Abuse Treatment 
     for Adolescents Act''.

     SEC. 2. AMENDMENT TO PUBLIC HEALTH SERVICE ACT.

       Section 507 of the Public Health Service Act (42 U.S.C. 
     290bb) is amended by adding at the end the following:
       ``(d) Provision of Services.--Notwithstanding any other 
     provision of law, the Secretary, acting through the Center 
     for Substance Abuse Treatment, shall ensure that not less 
     than 20 percent of the amounts appropriated under this 
     subpart for the programs and activities of the Center for 
     Substance Abuse Treatment for each fiscal year, but in no 
     case less than $20,000,000, is used to carry out adolescent 
     specific substance abuse treatment programs. Such programs 
     shall include the provision of services to such adolescents 
     as well as the conduct of evaluations and research concerning 
     the effects of such services.''.
                                                                    ____


                                 S. 794

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Services for Children of 
     Substance Abusers Reauthorization Act''.

     SEC. 2. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT.

       (a) Administration and Activities.--
       (1) Administration.--Section 399D(a) of the Public Health 
     Service Act (42 U.S.C. 280d(a)(1)) is amended--
       (A) in paragraph (1), by striking ``Administrator'' and all 
     that follows through ``Administration'' and insert ``Director 
     of the Substance Abuse and Mental Health Services 
     Administration''; and
       (B) in paragraph (2), by striking ``Administrator of the 
     Substance Abuse and Mental Health Services Administration'' 
     and inserting ``Administrator of the Health Resources and 
     Services Administration''.
       (2) Activities.--Section 399D(a)(1) of the Public Health 
     Service Act (42 U.S.C. 280d(a)(1)) is amended--
       (A) in subparagraph (B), by striking ``and'' at the end;
       (B) in subparagraph (C), by striking the period and 
     inserting the following: ``through family social services; 
     child protective services; child care providers (including 
     Head Start, schools, and early childhood development 
     programs); community-based family resource and support 
     centers; the criminal justice system; health and mental 
     health providers through screenings conducted during regular 
     childhood examinations and other examinations; self and 
     family member referrals; treatment services; and other 
     service providers and agencies serving children and families; 
     and''; and
       (C) by adding at the end the following:
       ``(D) to provide education and training to health care 
     professionals, child welfare providers, and the personnel or 
     such providers who provide services to children and 
     families.''.
       (3) Identification of certain children.--Section 
     399D(a)(3)(A) of the Public Health Service Act (42 U.S.C. 
     280d(a)(3)(A)) is amended--
       (A) in clause (i), by striking ``(i) the entity'' and 
     inserting ``(i)(I) the entity'';
       (B) in clause (ii)--
       (i) by striking ``(ii) the entity'' and inserting ``(II) 
     the entity''; and
       (ii) by striking the period and inserting ``; and''; and
       (C) by adding at the end the following:
       ``(iii) the entity will identify children who may be 
     eligible for medical assistance under a State program under 
     title XIX of the Social Security Act.''.
       (b) Services for Children.--Section 399D(b) of the Public 
     Health Service Act (42 U.S.C. 280d(b)) is amended--
       (1) in paragraph (1), by inserting ``alcohol and drug,'' 
     after ``psychological,''; and
       (2) by striking paragraph (5) and inserting the following:
       ``(5) Drug and alcohol treatment and prevention 
     services.''.
       (c) Services for Affected Families.--Section 399D(c) of the 
     Public Health Service Act (42 U.S.C. 280d(c)) is amended--
       (1) in paragraph (1)--
       (A) in the matter preceding subparagraph (A), by inserting 
     before the semicolon the following: ``, or through an entity 
     the meets applicable State licensure or certification 
     requirements regarding the services involved''; and
       (B) by adding at the end the following:
       ``(D) Aggressive outreach to family members with substance 
     abuse problems.
       ``(E) Inclusion of consumer in the development, 
     implementation, and monitoring of Family Services Plan.''; 
     and
       (2) in paragraph (2)--
       (A) by striking subparagraph (A) and inserting the 
     following:
       ``(A) Alcohol and drug treatment services, including 
     screening and assessment, diagnosis, detoxification, 
     individual, group and family counseling, relapse prevention, 
     and case management.'';
       (B) by striking subparagraph (C) and inserting the 
     following:
       ``(C) Pre- and post-pregnancy family planning services and 
     counseling on the human immunodeficiency virus and acquired 
     immune deficiency syndrome.'';
       (C) in subparagraph (D), by striking ``conflict and''; and
       (D) in subparagraph (E), by striking ``Remedial'' and 
     inserting ``Career planning and''.
       (d) Eligible Entities.--Section 399D(d) of the Public 
     Health Service Act (42 U.S.C. 280d(d)) is amended--
       (1) by striking the matter preceding paragraph (1) and 
     inserting:
       ``(d) Eligible entities.--The Secretary shall distribute 
     the grants through the following types of entities:'';
       (2) in paragraph (1), by inserting ``or prevention'' after 
     ``drug treatment''; and
       (3) in paragraph (2)--
       (A) in subparagraph (A), by striking ``; and'' and 
     inserting ``; or''; and
       (B) in subparagraph (B), by inserting ``or pediatric health 
     or mental health providers and family mental health 
     providers'' before the period.

[[Page S5013]]

       (e) Submission of Information.--Section 399D(h) of the 
     Public Health Service Act (42 U.S.C. 280d(h)) is amended--
       (1) in paragraph (2)--
       (A) by inserting ``including maternal and child health'' 
     before ``mental'';
       (B) by striking ``treatment programs''; and
       (C) by striking ``and the State agency responsible for 
     administering public maternal and child health services'' and 
     inserting ``, the State agency responsible for administering 
     alcohol and drug programs, the State lead agency, and the 
     State Interagency Coordinating Council under part H of the 
     Individuals with Disabilities Education Act''; and
       (2) in paragraph (3)(B), by inserting before the semicolon 
     the following: ``when the child can be cared for at home 
     without endangering the child's safety''.
       (f) Reports.--Section 399D(i)(6) of the Public Health 
     Service Act (42 U.S.C. 280d(k)(6)) is amended--
       (1) in subparagraph (D), by striking ``and'' at the end;
       (2) in subparagraph (E), by adding ``and'' after the 
     semicolon; and
       (3) by adding at the end the following:
       ``(F) the number of children described in subparagraph (C) 
     for whom the permanent plan is other than family 
     reunification;''.
       (g) Evaluations.--Section 399D(l) of the Public Health 
     Service Act (42 U.S.C. 280d(l)) is amended--
       (1) in paragraph (4), by inserting before the semicolon the 
     following: ``, including increased participation in work or 
     employment-related activities and decreased participation in 
     welfare programs'';
       (2) in paragraph (5), by striking ``children whose'' and 
     inserting ``children who can be cared for at home without 
     endangering their safety and whose''; and
       (3) in paragraph (6), by inserting before the semicolon the 
     following: ``if the reunification would not endanger the 
     child''.
       (h) Report to Congress.--Section 399D(m) of the Public 
     Health Service Act (42 U.S.C. 280d(m)) is amended--
       (1) in paragraph (2), by adding ``and'' at the end;
       (2) in paragraph (3), by striking the semicolon at the end 
     and inserting a period; and
       (3) by striking paragraphs (4) and (5).
       (i) Data Collection.--Section 399D(n) of the Public Health 
     Service Act (42 U.S.C. 280d(n)) is amended by adding at the 
     end the following: ``The periodic report shall include a 
     quantitative estimate of the prevalence of alcohol and drug 
     problems in families involved in the child welfare system, 
     the barriers to treatment and prevention services facing 
     these families, and policy recommendations for removing the 
     identified barriers, including training for child welfare 
     workers.''.
       (j) Definition.--Section 399D(o)(2)(B) of the Public Health 
     Service Act (42 U.S.C. 280d(o)(2)(B)) is amended by striking 
     ``dangerous''.
       (k) Authorization of Appropriations.--Section 399D(p) of 
     the Public Health Service Act (42 U.S.C. 280d(p)) is amended 
     to read as follows:
       ``(p) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated $50,000,000 for fiscal year 1998, and such sums 
     as may be necessary for fiscal year 1999.''.
       (l) Grants for Training and Conforming Amendments.--Section 
     399D of the Public Health Service Act (42 U.S.C. 280d) is 
     amended--
       (1) by striking subsection (f);
       (2) by striking subsection (k);
       (3) by redesignating subsections (d), (e), (g), (h), (i), 
     (j), (l), (m), (n), (o), and (p) as subsections (e) through 
     (o), respectively;
       (4) by inserting after subsection (c), the following:
       ``(d) Training for Health Care Professionals, Child Welfare 
     Providers, and Other Personnel.--The Secretary may make a 
     grant under subsection (a) for the training of health care 
     professionals, child welfare providers, and other personnel 
     who provide services to vulnerable children and families. 
     Such training shall be to assist professionals in recognizing 
     the drug and alcohol problems of their clients and to enhance 
     their skills in identifying and obtaining substance abuse 
     prevention and treatment resources.'';
       (5) in subsection (k)(2) (as so redesignated), by striking 
     ``(h)'' and inserting ``(i)''; and
       (6) in paragraphs (3)(E) and (5) of subsection (m) (as so 
     redesignated), by striking ``(d)'' and inserting ``(e)''.
                                 ______