[Congressional Record Volume 151, Number 71 (Wednesday, May 25, 2005)]
[Senate]
[Pages S5923-S5926]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mrs. CLINTON (for herself and Ms. Collins):
  S. 1116. A bill to amend the Older Americans Act of 1965 to provide 
for mental health screening and treatment services, to amend the Public 
Health Service Act to provide for integration of mental health services 
and mental health treatment outreach teams, and for other purposes; to 
the Committee on Health, Education, Labor, and Pensions.
  Mrs. CLINTON. Mr. President, today, Senator Collins and I, and in the 
House of Representatives, Congressman Kennedy and Congressman Ros-
Lehtinen, are reintroducing the Positive Aging Act, in an effort to 
improve the accessibility and quality of mental health services for our 
rapidly growing population of older Americans.
  We are pleased to be reintroducing this important legislation during 
Mental Health and Aging Week.
  I want to acknowledge and thank our partners from the mental health 
and aging community who have collaborated with us and have been working 
diligently on these issues for many years, including the American 
Association for Geriatric Psychiatry, the American Psychological 
Association, the National Association of Social Workers, the American 
Nurses Association.
  Today, advances in medical science are helping us to live longer than 
ever before. In New York State alone, there are 2\1/2\ million citizens 
aged 65 or older. And this population will only continue to grow as the 
firs wave of Baby Boomers turns 65 in less than 10 years.
  As we look forward to this increased longevity, we must also 
acknowledge the challenges that we face related to the quality of life 
as we age. Chief among these are mental and behavioral health concerns.
  Although most older adults enjoy good mental health it is estimated 
that nearly 20 percent of Americans age 55 or older experience a mental 
disorder. It is anticipated that the number of seniors with mental and 
behavioral health problems will almost quadruple, from 4 million in 
1970 to 15 million in 2030.
  In New York State alone, there are an estimated 500,000 older adults 
with mental health disorders. As the baby boomers age we expect to see 
the number of seniors in need of mental health services in the State of 
New York grow to over 750,000.
  Among the most prevalent mental health concerns older adults 
encounter are anxiety, depression, cognitive impairment, and substance 
abuse. These disorders, if left untreated, can have severe physical and 
psychological implications. In fact, older adults have the highest 
rates of suicide in our country and depression is the foremost risk 
factor.
  The physical consequences of mental health disorders can be both 
expensive and debilitating. Depression has a powerful negative impact 
on ability to function, resulting in high rates of disability. The 
World Health Organization projects that by the year 2020, depression 
will remain a leading cause of disability, second only to 
cardiovascular disease. Even mild depression lowers immunity and may 
compromise a person's ability to fight infections and cancers. Research 
indicates that 50-70 percent of all primary care medical visits are 
related to psychological factors such as anxiety, depression, and 
stress.
  Mental disorders do not have to be a part of the aging process 
because we have effective treatments for these conditions. But in far 
too many instances our seniors go undiagnosed and untreated because of 
the current divide in our country between health care and mental health 
care.
  Too often physicians and other health professionals fail to recognize 
the signs and symptoms of mental health problems. Even more troubling, 
knowledge about treatment is simply not accessible to many primary care 
practitioners. As a whole, we have

[[Page S5924]]

failed to fully integrate mental health screening and treatment into 
our health service systems.
  These missed opportunities to diagnose and treat mental health 
disorders are taking a tremendous toll on seniors and increasing the 
burden on their families and our health care system.
  That is why I am reintroducing the Positive Aging Act with my co-
sponsors Senator Collins and Representatives Kennedy and Ros-Lehtinen.
  This legislation would amend the Older Americans Act and the Public 
Health Service Act to strengthen the delivery of mental health services 
to older Americans.
  Specifically, the Positive Aging Act would fund grants to states to 
provide screening and treatment for mental health disorders in seniors.
  It would also fund demonstration projects to provide these screening 
and treatment services to older adults residing in rural areas and in 
naturally occurring retirement communities, NORC's.
  This legislation would also authorize demonstration projects to reach 
out to seniors and make much needed collaborative mental health 
services available in community settings where older adults reside and 
already receive services such as primary care clinics, senior centers, 
adult day care programs, and assisted living facilities.
  Today, we are fortunate to have a variety of effective treatments to 
address the mental health needs of American seniors. I believe that we 
owe it to older adults in this country to do all that we can to ensure 
that high quality mental health care is both available and accessible.
  This legislation takes an important step in that direction and I look 
forward to working with you all to enact the Positive Aging Act during 
the upcoming Older Americans Act and SAMHSA reauthorizations.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 1116

       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 ``Positive Aging Act of 
     2005''.

         TITLE I--AMENDMENTS TO THE OLDER AMERICANS ACT OF 1965

     SEC. 101. DEFINITIONS.

       Section 102 of the Older Americans Act of 1965 (42 U.S.C. 
     3002) is amended by adding at the end the following:
       ``(44) Mental health screening and treatment services.--The 
     term `mental health screening and treatment services' means 
     patient screening, diagnostic services, care planning and 
     oversight, therapeutic interventions, and referrals that 
     are--
       ``(A) provided pursuant to evidence-based intervention and 
     treatment protocols (to the extent such protocols are 
     available) for mental disorders prevalent in older 
     individuals (including, but not limited to, mood and anxiety 
     disorders, dementias of all kinds, psychotic disorders, and 
     substances and alcohol abuse), relying to the greatest extent 
     feasible on protocols that have been developed--
       ``(i) by or under the auspices of the Secretary; or
       ``(ii) by academicians with expertise in mental health and 
     aging; and
       ``(B) coordinated and integrated with the services of 
     social service, mental health, and health care providers in 
     an area in order to--
       ``(i) improve patient outcomes; and
       ``(ii) assure, to the maximum extent feasible, the 
     continuing independence of older individuals who are residing 
     in the area.''.

     SEC. 102. OFFICE OF OLDER ADULT MENTAL HEALTH SERVICES.

       Section 301(b) of the Older Americans Act of 1965 (42 
     U.S.C. 3021(b)) is amended by adding at the end the 
     following:
       ``(3) The Assistant Secretary shall establish within the 
     Administration an Office of Older Adult Mental Health 
     Services, which shall be responsible for the development and 
     implementation of initiatives to address the mental health 
     needs of older individuals.''.

     SEC. 103. GRANTS TO STATES FOR THE DEVELOPMENT AND OPERATION 
                   OF SYSTEMS FOR PROVIDING MENTAL HEALTH 
                   SCREENING AND TREATMENT SERVICES TO OLDER 
                   INDIVIDUALS LACKING ACCESS TO SUCH SERVICES.

       Title III of the Older Americans Act of 1965 (42 U.S.C. 
     3021 et seq.) is amended--
       (1) in section 303, by adding at the end the following:
       ``(f) There are authorized to be appropriated to carry out 
     part F (relating to grants for programs providing mental 
     health screening and treatment services) such sums as may be 
     necessary for fiscal year 2006 and each of the 5 succeeding 
     fiscal years.'';
       (2) in section 304(a)(1), by inserting ``and subsection 
     (f)'' after ``through (d)''; and
       (3) by adding at the end the following:

  ``PART F--MENTAL HEALTH SCREENING AND TREATMENT SERVICES FOR OLDER 
                              INDIVIDUALS

     ``SEC. 381. GRANTS TO STATES FOR PROGRAMS PROVIDING MENTAL 
                   HEALTH SCREENING AND TREATMENT SERVICES FOR 
                   OLDER INDIVIDUALS.

       ``(a) Program Authorized.--The Assistant Secretary shall 
     carry out a program for making grants to States under State 
     plans approved under section 307 for the development and 
     operation of--
       ``(1) systems for the delivery of mental health screening 
     and treatment services for older individuals who lack access 
     to such services; and
       ``(2) programs to--
       ``(A) increase public awareness regarding the benefits of 
     prevention and treatment of mental disorders in older 
     individuals;
       ``(B) reduce the stigma associated with mental disorders in 
     older individuals and other barriers to the diagnosis and 
     treatment of the disorders; and
       ``(C) reduce age-related prejudice and discrimination 
     regarding mental disorders in older individuals.
       ``(b) State Allocation and Priorities.--A State agency that 
     receives funds through a grant made under this section shall 
     allocate the funds to area agencies on aging to carry out 
     this part in planning and service areas in the State. In 
     allocating the funds, the State agency shall give priority to 
     planning and service areas in the State--
       ``(1) that are medically underserved; and
       ``(2) in which there are a large number of older 
     individuals.
       ``(c) Area Coordination of Services With Other Providers.--
     In carrying out this part, to more efficiently and 
     effectively deliver services to older individuals, each area 
     agency on aging shall--
       ``(1) coordinate services described in subsection (a) with 
     other community agencies, and voluntary organizations, 
     providing similar or related services; and
       ``(2) to the greatest extent practicable, integrate 
     outreach and educational activities with existing (as of the 
     date of the integration) health care and social service 
     providers serving older individuals in the planning and 
     service area involved.
       ``(d) Relationship to Other Funding Sources.--Funds made 
     available under this part shall supplement, and not supplant, 
     any Federal, State, and local funds expended by a State or 
     unit of general purpose local government (including an area 
     agency on aging) to provide the services described in 
     subsection (a).''.

     SEC. 104. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH 
                   SCREENING AND TREATMENT SERVICES TO OLDER 
                   INDIVIDUALS LIVING IN RURAL AREAS.

       The Older Americans Act of 1965 (42 U.S.C. 3001 et seq.) is 
     amended--
       (1) by inserting before section 401 the following:

      ``TITLE IV--GRANTS FOR EDUCATION, TRAINING, AND RESEARCH'';

       and
       (2) in part A of title IV, by adding at the end the 
     following:

     ``SEC. 422. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH 
                   SCREENING AND TREATMENT SERVICES TO OLDER 
                   INDIVIDUALS LIVING IN RURAL AREAS.

       ``(a) Definition.--In this section, the term `rural area' 
     means--
       ``(1) any area that is outside a metropolitan statistical 
     area (as defined by the Director of the Office of Management 
     and Budget); or
       ``(2) such similar area as the Secretary specifies in a 
     regulation issued under section 1886(d)(2)(D) of the Social 
     Security Act (42 U.S.C. 1395ww(d)(2)(D)).
       ``(b) Authority.--The Assistant Secretary shall make grants 
     to eligible public agencies and nonprofit private 
     organizations to pay part or all of the cost of developing or 
     operating model health care service projects involving the 
     provision of mental health screening and treatment services 
     to older individuals residing in rural areas.
       ``(c) Duration.--Grants made under this section shall be 
     made for 3-year periods.
       ``(d) Application.--To be eligible to receive a grant under 
     this section, a public agency or nonprofit private 
     organization shall submit to the Assistant Secretary an 
     application containing such information and assurances as the 
     Assistant Secretary may require, including--
       ``(1) information describing--
       ``(A) the geographic area and target population (including 
     the racial and ethnic composition of the target population) 
     to be served by the project; and
       ``(B) the nature and extent of the applicant's experience 
     in providing mental health screening and treatment services 
     of the type to be provided in the project;
       ``(2) assurances that the applicant will carry out the 
     project--
       ``(A) through a multidisciplinary team of licensed mental 
     health professionals;
       ``(B) using evidence-based intervention and treatment 
     protocols to the extent such protocols are available;
       ``(C) using telecommunications technologies as appropriate 
     and available; and
       ``(D) in coordination with other providers of health care 
     and social services (such as senior centers and adult day 
     care providers) serving the area; and
       ``(3) assurances that the applicant will conduct and submit 
     to the Assistant Secretary

[[Page S5925]]

     such evaluations and reports as the Assistant Secretary may 
     require.
       ``(e) Reports.--The Assistant Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     that includes summaries of the evaluations and reports 
     required under subsection (d)(3).
       ``(f) Coordination.--The Assistant Secretary shall provide 
     for appropriate coordination of programs and activities 
     receiving funds pursuant to a grant under this section with 
     programs and activities receiving funds pursuant to grants 
     under sections 381 and 423, and sections 520K and 520L of the 
     Public Health Service Act.''.

     SEC. 105. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH 
                   SCREENING AND TREATMENT SERVICES TO OLDER 
                   INDIVIDUALS LIVING IN NATURALLY OCCURRING 
                   RETIREMENT COMMUNITIES IN URBAN AREAS.

       Part A of title IV of the Older Americans Act of 1965 (42 
     U.S.C. 3032 et seq.), as amended by section 104, is further 
     amended by adding at the end the following:

     ``SEC. 423. DEMONSTRATION PROJECTS PROVIDING MENTAL HEALTH 
                   SCREENING AND TREATMENT SERVICES TO OLDER 
                   INDIVIDUALS LIVING IN NATURALLY OCCURRING 
                   RETIREMENT COMMUNITIES IN URBAN AREAS.

       ``(a) Definitions.--In this section:
       ``(1) Naturally occurring retirement community.--The term 
     `naturally occurring retirement community' means a 
     residential area (such as an apartment building, housing 
     complex or development, or neighborhood) not originally built 
     for older individuals but in which a substantial number of 
     individuals have aged in place (and become older individuals) 
     while residing in such area.
       ``(2) Urban area.--The term `urban area' means--
       ``(A) a metropolitan statistical area (as defined by the 
     Director of the Office of Management and Budget); or
       ``(B) such similar area as the Secretary specifies in a 
     regulation issued under section 1886(d)(2)(D) of the Social 
     Security Act (42 U.S.C. 1395ww(d)(2)(D)).
       ``(b) Authority.--The Assistant Secretary shall make grants 
     to eligible public agencies and nonprofit private 
     organizations to pay part or all of the cost of developing or 
     operating model health care service projects involving the 
     provision of mental health screening and treatment services 
     to older individuals residing in naturally occurring 
     retirement communities located in urban areas.
       ``(c) Duration.--Grants made under this section shall be 
     made for 3-year periods.
       ``(d) Application.--To be eligible to receive a grant under 
     this section, a public agency or nonprofit private 
     organization shall submit to the Assistant Secretary an 
     application containing such information and assurances as the 
     Assistant Secretary may require, including--
       ``(1) information describing--
       ``(A) the naturally occurring retirement community and 
     target population (including the racial and ethnic 
     composition of the target population) to be served by the 
     project; and
       ``(B) the nature and extent of the applicant's experience 
     in providing mental health screening and treatment services 
     of the type to be provided in the project;
       ``(2) assurances that the applicant will carry out the 
     project--
       ``(A) through a multidisciplinary team of licensed mental 
     health professionals;
       ``(B) using evidence-based intervention and treatment 
     protocols to the extent such protocols are available; and
       ``(C) in coordination with other providers of health care 
     and social services serving the retirement community; and
       ``(3) assurances that the applicant will conduct and submit 
     to the Assistant Secretary such evaluations and reports as 
     the Assistant Secretary may require.
       ``(e) Reports.--The Assistant Secretary shall prepare and 
     submit to the appropriate committees of Congress a report 
     that includes summaries of the evaluations and reports 
     required under subsection (d)(3).
       ``(f) Coordination.--The Assistant Secretary shall provide 
     for appropriate coordination of programs and activities 
     receiving funds pursuant to grants made under this section 
     with programs and activities receiving funds pursuant to 
     grants made under sections 381 and 422, and sections 520K and 
     520L of the Public Health Service Act.''.

             TITLE II--PUBLIC HEALTH SERVICE ACT AMENDMENTS

     SEC. 201. DEMONSTRATION PROJECTS TO SUPPORT INTEGRATION OF 
                   MENTAL HEALTH SERVICES IN PRIMARY CARE 
                   SETTINGS.

       Subpart 3 of part B of title V of the Public Health Service 
     Act (42 U.S.C. 290bb-31 et seq.) is amended--
       (1) in section 520(b)--
       (A) in paragraph (14), by striking ``and'' after the 
     semicolon;
       (B) in paragraph (15), by striking the period at the end 
     and inserting ``; and''; and
       (C) by adding at the end the following:
       ``(16) conduct the demonstration projects specified in 
     section 520K.''; and
       (2) by adding at the end the following:

     ``SEC. 520K. PROJECTS TO DEMONSTRATE INTEGRATION OF MENTAL 
                   HEALTH SERVICES IN PRIMARY CARE SETTINGS.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Center for Mental Health Services, shall 
     award grants to public and private nonprofit entities for 
     projects to demonstrate ways of integrating mental health 
     services for older patients into primary care settings, such 
     as health centers receiving a grant under section 330 (or 
     determined by the Secretary to meet the requirements for 
     receiving such a grant), other Federally qualified health 
     centers, primary care clinics, and private practice sites.
       ``(b) Requirements.--In order to be eligible for a grant 
     under this section, the project to be carried out by the 
     entity shall provide for collaborative care within a primary 
     care setting, involving psychiatrists, psychologists, and 
     other licensed mental health professionals (such as social 
     workers and advanced practice nurses) with appropriate 
     training and experience in the treatment of older adults, in 
     which screening, assessment, and intervention services are 
     combined into an integrated service delivery model, 
     including--
       ``(1) screening services by a mental health professional 
     with at least a masters degree in an appropriate field of 
     training;
       ``(2) referrals for necessary prevention, intervention, 
     follow-up care, consultations, and care planning oversight 
     for mental health and other service needs, as indicated; and
       ``(3) adoption and implementation of evidence-based 
     protocols, to the extent available, for prevalent mental 
     health disorders, including depression, anxiety, behavioral 
     and psychological symptoms of dementia, psychosis, and misuse 
     of, or dependence on, alcohol or medication.
       ``(c) Considerations in Awarding Grants.--In awarding 
     grants under this section, the Secretary, to the extent 
     feasible, shall ensure that--
       ``(1) projects are funded in a variety of geographic areas, 
     including urban and rural areas; and
       ``(2) a variety of populations, including racial and ethnic 
     minorities and low-income populations, are served by projects 
     funded under this section.
       ``(d) Duration.--A project may receive funding pursuant to 
     a grant under this section for a period of up to 3 years, 
     with an extension period of 2 additional years at the 
     discretion of the Secretary.
       ``(e) Application.--To be eligible to receive a grant under 
     this section, a public or private nonprofit entity shall--
       ``(1) submit an application to the Secretary (in such form, 
     containing such information, and at such time as the 
     Secretary may specify); and
       ``(2) agree to report to the Secretary standardized 
     clinical and behavioral data necessary to evaluate patient 
     outcomes and to facilitate evaluations across participating 
     projects.
       ``(f) Evaluation.--Not later than July 31 of each calendar 
     year, the Secretary shall submit to Congress a report 
     evaluating the projects receiving awards under this section 
     for such year.
       ``(g) Supplement, Not Supplant.--Funds made available under 
     this section shall supplement, and not supplant, other 
     Federal, State, or local funds available to an entity to 
     carry out activities described in this section.
       ``(h) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     to carry out this section for fiscal year 2006 and each 
     fiscal year thereafter.''.

     SEC. 202. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH TREATMENT 
                   OUTREACH TEAMS.

       Subpart 3 of part B of title V of the Public Health Service 
     Act (42 U.S.C. 290bb-31 et seq.), as amended by section 201, 
     is further amended by adding at the end the following:

     ``SEC. 520L. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH 
                   TREATMENT OUTREACH TEAMS.

       ``(a) In General.--The Secretary, acting through the 
     Director of the Center for Mental Health Services, shall 
     award grants to public or private nonprofit entities that are 
     community-based providers of geriatric mental health 
     services, to support the establishment and maintenance by 
     such entities of multi-disciplinary geriatric mental health 
     outreach teams in community settings where older adults 
     reside or receive social services. Entities eligible for such 
     grants include--
       ``(1) mental health service providers of a State or local 
     government;
       ``(2) outpatient programs of private, nonprofit hospitals;
       ``(3) community mental health centers meeting the criteria 
     specified in section 1913(c); and
       ``(4) other community-based providers of mental health 
     services.
       ``(b) Requirements.--To be eligible to receive a grant 
     under this section, an entity shall--
       ``(1) adopt and implement, for use by its mental health 
     outreach team, evidence-based intervention and treatment 
     protocols (to the extent such protocols are available) for 
     mental disorders prevalent in older individuals (including, 
     but not limited to, mood and anxiety disorders, dementias of 
     all kinds, psychotic disorders, and substance and alcohol 
     abuse), relying to the greatest extent feasible on protocols 
     that have been developed--
       ``(A) by or under the auspices of the Secretary; or
       ``(B) by academicians with expertise in mental health and 
     aging;
       ``(2) provide screening for mental disorders, diagnostic 
     services, referrals for treatment, and case management and 
     coordination through such teams; and

[[Page S5926]]

       ``(3) coordinate and integrate the services provided by 
     such team with the services of social service, mental health, 
     and medical providers at the site or sites where the team is 
     based in order to--
       ``(A) improve patient outcomes; and
       ``(B) to assure, to the maximum extent feasible, the 
     continuing independence of older adults who are residing in 
     the community.
       ``(c) Cooperative Arrangements With Sites Serving as Bases 
     for Outreach.--An entity receiving a grant under this section 
     may enter into an agreement with a person operating a site at 
     which a geriatric mental health outreach team of the entity 
     is based, including--
       ``(1) senior centers;
       ``(2) adult day care programs;
       ``(3) assisted living facilities; and
       ``(4) recipients of grants to provide services to senior 
     citizens under the Older Americans Act of 1965, under which 
     such person provides (and is reimbursed by the entity, out of 
     funds received under the grant, for) any supportive services, 
     such as transportation and administrative support, that such 
     person provides to an outreach team of such entity.
       ``(d) Considerations in Awarding Grants.--In awarding 
     grants under this section, the Secretary, to the extent 
     feasible, shall ensure that--
       ``(1) projects are funded in a variety of geographic areas, 
     including urban and rural areas; and
       ``(2) a variety of populations, including racial and ethnic 
     minorities and low-income populations, are served by projects 
     funded under this section.
       ``(e) Application.--To be eligible to receive a grant under 
     this section, an entity shall--
       ``(1) submit an application to the Secretary (in such form, 
     containing such information, at such time as the Secretary 
     may specify); and
       ``(2) agree to report to the Secretary standardized 
     clinical and behavioral data necessary to evaluate patient 
     outcomes and to facilitate evaluations across participating 
     projects.
       ``(f) Coordination.--The Secretary shall provide for 
     appropriate coordination of programs and activities receiving 
     funds pursuant to a grant under this section with programs 
     and activities receiving funds pursuant to grants under 
     section 520K and sections 381, 422, and 423 of the Older 
     Americans Act of 1965.
       ``(g) Evaluation.--Not later than July 31 of each calendar 
     year, the Secretary shall submit to Congress a report 
     evaluating the projects receiving awards under this section 
     for such year.
       ``(h) Supplement, Not Supplant.--Funds made available under 
     this section shall supplement, and not supplant, other 
     Federal, State, or local funds available to an entity to 
     carry out activities described in this section.
       ``(i) Authorization of Appropriations.--There are 
     authorized to be appropriated such sums as may be necessary 
     to carry out this section for fiscal year 2006 and each 
     fiscal year thereafter.''.

     SEC. 203. DESIGNATION OF DEPUTY DIRECTOR FOR OLDER ADULT 
                   MENTAL HEALTH SERVICES IN CENTER FOR MENTAL 
                   HEALTH SERVICES.

       Section 520 of the Public Health Service Act (42 U.S.C. 
     290bb-31) is amended--
       (1) by redesignating subsection (c) as subsection (d); and
       (2) by inserting after subsection (b) the following:
       ``(c) Deputy Director for Older Adult Mental Health 
     Services in Center for Mental Health Services.--The Director, 
     after consultation with the Administrator, shall designate a 
     Deputy Director for Older Adult Mental Health Services, who 
     shall be responsible for the development and implementation 
     of initiatives of the Center to address the mental health 
     needs of older adults. Such initiatives shall include--
       ``(1) research on prevention and identification of mental 
     disorders in the geriatric population;
       ``(2) innovative demonstration projects for the delivery of 
     community-based mental health services for older Americans;
       ``(3) support for the development and dissemination of 
     evidence-based practice models, including models to address 
     dependence on, and misuse of, alcohol and medication in older 
     adults; and
       ``(4) development of model training programs for mental 
     health professionals and care givers serving older adults.''.

     SEC. 204. MEMBERSHIP OF ADVISORY COUNCIL FOR THE CENTER FOR 
                   MENTAL HEALTH SERVICES.

       Section 502(b)(3) of the Public Health Service Act (42 
     U.S.C. 290aa-1(b)(3)) is amended by adding at the end the 
     following:
       ``(C) In the case of the advisory council for the Center 
     for Mental Health Services, the members appointed pursuant to 
     subparagraphs (A) and (B) shall include representatives of 
     older Americans, their families, and geriatric mental health 
     specialists.''.

     SEC. 205. PROJECTS OF NATIONAL SIGNIFICANCE TARGETING 
                   SUBSTANCE ABUSE IN OLDER ADULTS.

       Section 509(b)(2) of the Public Health Service Act (42 
     U.S.C. 290bb-2(b)(2)) is amended by inserting before the 
     period the following: ``, and to providing treatment for 
     older adults with alcohol or substance abuse or addiction, 
     including medication misuse or dependence''.

     SEC. 206. CRITERIA FOR STATE PLANS UNDER COMMUNITY MENTAL 
                   HEALTH SERVICES BLOCK GRANTS.

       (a) In General.--Section 1912(b)(4)of the Public Health 
     Service Act (42 U.S.C. 300x-2(b)(4)) is amended to read as 
     follows:
       ``(4) Targeted services to older individuals, individuals 
     who are homeless, and individuals living in rural areas.--The 
     plan describes the State's outreach to and services for older 
     individuals, individuals who are homeless, and individuals 
     living in rural areas, and how community-based services will 
     be provided to these individuals.''.
       (b) Effective Date.--The amendment made by subsection (a) 
     shall apply to State plans submitted on or after the date 
     that is 180 days after the date of enactment of this Act.
                                 ______