[House Report 116-552]
[From the U.S. Government Publishing Office]


116th Congress    }                                     {       Report
                        HOUSE OF REPRESENTATIVES
 2d Session       }                                     {       116-552

======================================================================



 
                  PURSUING EQUITY IN MENTAL HEALTH ACT

                                _______
                                

 September 29, 2020.--Committed to the Committee of the Whole House on 
            the State of the Union and ordered to be printed

                                _______
                                

 Mr. Pallone, from the Committee on Energy and Commerce, submitted the 
                               following

                              R E P O R T

                        [To accompany H.R. 5469]

    The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 5469) to address mental health issues for youth, 
particularly youth of color, and for other purposes, having 
considered the same, reports favorably thereon with an 
amendment and recommends that the bill as amended do pass.

                                CONTENTS

                                                                   Page
  I. Purpose and Summary.............................................. 4
 II. Background and Need for the Legislation.......................... 4
III. Committee Hearings............................................... 5
 IV. Committee Consideration.......................................... 6
  V. Committee Votes.................................................. 6
 VI. Oversight Findings............................................... 6
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures 6
VIII.Federal Mandates Statement....................................... 7

 IX. Statement of General Performance Goals and Objectives............ 7
  X. Duplication of Federal Programs.................................. 7
 XI. Committee Cost Estimate.......................................... 7
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits...... 7
XIII.Advisory Committee Statement..................................... 7

XIV. Applicability to Legislative Branch.............................. 7
 XV. Section-by-Section Analysis of the Legislation................... 8
XVI. Changes in Existing Law Made by the Bill, as Reported............ 9

    The amendment is as follows:
  Strike all after the enacting clause and insert the 
following:

SECTION 1. SHORT TITLE.

  This Act may be cited as the ``Pursuing Equity in Mental Health 
Act''.

SEC. 2. TABLE OF CONTENTS.

  The table of contents for this Act is as follows:

Sec. 1. Short title.
Sec. 2. Table of contents.

               TITLE I--HEALTH EQUITY AND ACCOUNTABILITY

Sec. 101. Integrated Health Care Demonstration Program.
Sec. 102. Addressing racial and ethnic minority mental health 
disparities research gaps.
Sec. 103. Health professions competencies to address racial and ethnic 
minority mental health disparities.
Sec. 104. Racial and ethnic minority behavioral and mental health 
outreach and education strategy.
Sec. 105. Additional funds for National Institutes of Health.
Sec. 106. Additional funds for National Institute on Minority Health 
and Health Disparities.

                       TITLE II--OTHER PROVISIONS

Sec. 201. Reauthorization of Minority Fellowship Program.
Sec. 202. Study on the Effects of Smartphone and Social Media Use on 
Adolescents.

               TITLE I--HEALTH EQUITY AND ACCOUNTABILITY

SEC. 101. INTEGRATED HEALTH CARE DEMONSTRATION PROGRAM.

  Part D of title V of the Public Health Service Act (42 U.S.C. 290dd 
et seq.) is amended by adding at the end the following:

``SEC. 554. INTERPROFESSIONAL HEALTH CARE TEAMS FOR PROVISION OF 
                    BEHAVIORAL HEALTH CARE IN PRIMARY CARE SETTINGS.

  ``(a) Grants.--The Secretary shall award grants to eligible entities 
for the purpose of establishing interprofessional health care teams 
that provide behavioral health care.
  ``(b) Eligible Entities.--To be eligible to receive a grant under 
this section, an entity shall be a Federally qualified health center 
(as defined in section 1861(aa) of the Social Security Act), rural 
health clinic, or behavioral health program, serving a high proportion 
of individuals from racial and ethnic minority groups (as defined in 
section 1707(g)).
  ``(c) Scientifically Based.--Integrated health care funded through 
this section shall be scientifically based, taking into consideration 
the results of the most recent peer-reviewed research available.
  ``(d) Authorization of Appropriations.--To carry out this section, 
there is authorized to be appropriated $20,000,000 for each of the 
first 5 fiscal years following the date of enactment of the Pursuing 
Equity in Mental Health Act.''.

SEC. 102. ADDRESSING RACIAL AND ETHNIC MINORITY MENTAL HEALTH 
                    DISPARITIES RESEARCH GAPS.

  Not later than 6 months after the date of the enactment of this Act, 
the Director of the National Institutes of Health shall enter into an 
arrangement with the National Academies of Sciences, Engineering, and 
Medicine (or, if the National Academies of Sciences, Engineering, and 
Medicine decline to enter into such an arrangement, the Patient-
Centered Outcomes Research Institute, the Agency for Healthcare 
Research and Quality, or another appropriate entity)--
          (1) to conduct a study with respect to mental health 
        disparities in racial and ethnic minority groups (as defined in 
        section 1707(g) of the Public Health Service Act (42 U.S.C. 
        300u-6(g))); and
          (2) to submit to the Congress a report on the results of such 
        study, including--
                  (A) a compilation of information on the dynamics of 
                mental disorders in such racial and ethnic minority 
                groups; and
                  (B) a compilation of information on the impact of 
                exposure to community violence, adverse childhood 
                experiences, structural racism, and other psychological 
                traumas on mental disorders in such racial and minority 
                groups.

SEC. 103. HEALTH PROFESSIONS COMPETENCIES TO ADDRESS RACIAL AND ETHNIC 
                    MINORITY MENTAL HEALTH DISPARITIES.

  (a) In General.--The Secretary of Health and Human Services shall 
award grants to qualified national organizations for the purposes of--
          (1) developing, and disseminating to health professional 
        educational programs best practices or core competencies 
        addressing mental health disparities among racial and ethnic 
        minority groups for use in the training of students in the 
        professions of social work, psychology, psychiatry, marriage 
        and family therapy, mental health counseling, and substance 
        misuse counseling; and
          (2) certifying community health workers and peer wellness 
        specialists with respect to such best practices and core 
        competencies and integrating and expanding the use of such 
        workers and specialists into health care to address mental 
        health disparities among racial and ethnic minority groups.
  (b) Best Practices; Core Competencies.--Organizations receiving funds 
under subsection (a) may use the funds to engage in the following 
activities related to the development and dissemination of best 
practices or core competencies described in subsection (a)(1):
          (1) Formation of committees or working groups comprised of 
        experts from accredited health professions schools to identify 
        best practices and core competencies relating to mental health 
        disparities among racial and ethnic minority groups.
          (2) Planning of workshops in national fora to allow for 
        public input into the educational needs associated with mental 
        health disparities among racial and ethnic minority groups.
          (3) Dissemination and promotion of the use of best practices 
        or core competencies in undergraduate and graduate health 
        professions training programs nationwide.
          (4) Establishing external stakeholder advisory boards to 
        provide meaningful input into policy and program development 
        and best practices to reduce mental health disparities among 
        racial and ethnic minority groups.
  (c) Definitions.--In this section:
          (1) Qualified national organization.--The term ``qualified 
        national organization'' means a national organization that 
        focuses on the education of students in one or more of the 
        professions of social work, psychology, psychiatry, marriage 
        and family therapy, mental health counseling, and substance 
        misuse counseling.
          (2) Racial and ethnic minority group.--The term ``racial and 
        ethnic minority group'' has the meaning given to such term in 
        section 1707(g) of the Public Health Service Act (42 U.S.C. 
        300u-6(g)).

SEC. 104. RACIAL AND ETHNIC MINORITY BEHAVIORAL AND MENTAL HEALTH 
                    OUTREACH AND EDUCATION STRATEGY.

  Part D of title V of the Public Health Service Act (42 U.S.C. 290dd 
et seq.), as amended by section 101, is further amended by adding at 
the end the following new section:

``SEC. 555. BEHAVIORAL AND MENTAL HEALTH OUTREACH AND EDUCATION 
                    STRATEGY.

  ``(a) In General.--The Secretary shall, in consultation with advocacy 
and behavioral and mental health organizations serving racial and 
ethnic minority groups, develop and implement an outreach and education 
strategy to promote behavioral and mental health and reduce stigma 
associated with mental health conditions and substance abuse among 
racial and ethnic minority groups. Such strategy shall--
          ``(1) be designed to--
                  ``(A) meet the diverse cultural and language needs of 
                the various racial and ethnic minority groups; and
                  ``(B) be developmentally and age-appropriate;
          ``(2) increase awareness of symptoms of mental illnesses 
        common among such groups, taking into account differences 
        within at-risk subgroups;
          ``(3) provide information on evidence-based, culturally and 
        linguistically appropriate and adapted interventions and 
        treatments;
          ``(4) ensure full participation of, and engage, both 
        consumers and community members in the development and 
        implementation of materials; and
          ``(5) seek to broaden the perspective among both individuals 
        in these groups and stakeholders serving these groups to use a 
        comprehensive public health approach to promoting behavioral 
        health that addresses a holistic view of health by focusing on 
        the intersection between behavioral and physical health.
  ``(b) Reports.--Beginning not later than 1 year after the date of the 
enactment of this section and annually thereafter, the Secretary shall 
submit to Congress, and make publicly available, a report on the extent 
to which the strategy developed and implemented under subsection (a) 
increased behavioral and mental health outcomes associated with mental 
health conditions and substance abuse among racial and ethnic minority 
groups.
  ``(c) Definition.--In this section, the term `racial and ethnic 
minority group' has the meaning given to that term in section 1707(g).
  ``(d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2021 through 2025.''.

SEC. 105. ADDITIONAL FUNDS FOR NATIONAL INSTITUTES OF HEALTH.

  (a) In General.--In addition to amounts otherwise authorized to be 
appropriated to the National Institutes of Health, there is authorized 
to be appropriated to such Institutes $100,000,000 for each of fiscal 
years 2021 through 2025 to build relations with communities and conduct 
or support clinical research, including clinical research on racial or 
ethnic disparities in physical and mental health.
  (b) Definition.--In this section, the term ``clinical research'' has 
the meaning given to such term in section 409 of the Public Health 
Service Act (42 U.S.C. 284d).

SEC. 106. ADDITIONAL FUNDS FOR NATIONAL INSTITUTE ON MINORITY HEALTH 
                    AND HEALTH DISPARITIES.

  In addition to amounts otherwise authorized to be appropriated to the 
National Institute on Minority Health and Health Disparities, there is 
authorized to be appropriated to such Institute $650,000,000 for each 
of fiscal years 2021 through 2025.

                       TITLE II--OTHER PROVISIONS

SEC. 201. REAUTHORIZATION OF MINORITY FELLOWSHIP PROGRAM.

  Section 597(c) of the Public Health Service Act (42 U.S.C. 297ll(c)) 
is amended by striking ``$12,669,000 for each of fiscal years 2018 
through 2022'' and inserting ``$25,000,000 for each of fiscal years 
2021 through 2025''.

SEC. 202. STUDY ON THE EFFECTS OF SMARTPHONE AND SOCIAL MEDIA USE ON 
                    ADOLESCENTS.

  (a) In General.--Not later than 1 year after the date of enactment of 
this Act, the Secretary of Health and Human Services shall conduct or 
support research on--
          (1) smartphone and social media use by adolescents; and
          (2) the effects of such use on--
                  (A) emotional, behavioral, and physical health and 
                development; and
                  (B) disparities in minority and underserved 
                populations.
  (b) Report.--Not later than 5 years after the date of the enactment 
of this Act, the Secretary shall submit to the Congress, and make 
publicly available, a report on the findings of research described in 
this section.

SEC. 203. TECHNICAL CORRECTION.

  Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is 
amended--
          (1) by redesignating the second section 550 (42 U.S.C. 290ee-
        10) (relating to Sobriety Treatment And Recovery Teams) as 
        section 553; and
          (2) by moving such section, as so redesignated, so as to 
        appear after section 552 (42 U.S.C. 290ee-7).

                         I. Purpose and Summary

    H.R. 5469, the ``Pursuing Equity in Mental Health Act'', 
introduced on December 17, 2019 by Representative Bonnie Watson 
Coleman (D-NJ), would authorize Federal funding to address 
mental health disparities among underserved populations, 
including communities of color. H.R. 5469 includes provisions 
that would: create a grant program targeted at high-poverty 
communities for culturally and linguistically appropriate 
mental health services; support research into disparities in 
mental health; reauthorize the Minority Fellowship Program to 
support more students of color entering the mental health 
workforce; and study the impact of smartphones and social media 
on adolescents.

              II. Background and Need for the Legislation

    According to the Substance Abuse and Mental Health Services 
Administration (SAMHSA), the prevalence of adults with any 
mental illness and serious mental illness is increasing.\1\ In 
2008, more than 39 million adults indicated they had a mental 
illness. By comparison, in 2019, more than 51 million adults 
indicated they had a mental illness. Additionally, suicide is 
still the tenth leading cause of death in the United States.\2\ 
Although suicide rates vary by age group, it is the second 
leading cause of death in people between the ages of 10 and 
34.\3\ When the data is disaggregated, research found a 
significant increase in the suicide rate among Black children 
and a significant decrease for White children.\4\
---------------------------------------------------------------------------
    \1\Substance Abuse and Mental Health Services Administration, Key 
substance use and mental health indicators in the United States: 
Results from the 2019 National Survey on Drug Use and Health (2020).
    \2\National Center for Health Statistics, Leading Causes of Death 
(www.cdc.gov/nchs/fastats/leading-causes-of-death.htm) (accessed 
September 18, 2020).
    \3\National Center for Health Statistics, Leading Causes of Death 
Reports, 1981-2018 (accessed September 18, 2020).
    \4\Jeffrey A. Bridge, PhD, et al., Suicide trends among elementary 
school-aged children in the United States from 1993 to 2012, Journal of 
the American Medical Association (Jul. 2015).
---------------------------------------------------------------------------
    As a rising junior at Newtown High School in Covington, 
Georgia, Arriana Gross said she saw firsthand the need to 
support youth mental health. In her testimony before the 
Committee, Arriana said, ``[i]n our school, a year doesn't go 
by without a student dying by suicide.''\5\ Further, she stated 
that, ``I am concerned that youth suicide has become so common 
that my school community and our Nation is stuck in a pattern 
of mourning and accepting these deaths as something that is 
normal, instead of seeing them as preventable and tragic.''\6\
---------------------------------------------------------------------------
    \5\House Committee on Energy and Commerce, Testimony of Arriana 
Gross, National Youth Advisory Board Member, Sandy Hook Promise 
Students Against Violence Everywhere (SAVE) Promise Club, Hearing on 
High Anxiety and Stress: Legislation to Improve Mental Health During 
Crisis, 116th Cong. (June 30, 2020).
    \6\Id.
---------------------------------------------------------------------------
    Mental health disparities exist for racial and ethnic 
minority populations. National Institute of Mental Health 
Director Joshua Gordon, M.D., Ph.D., wrote about those 
disparities, highlighting that inequalities ``lead to worse 
mental health outcomes in underserved and minority 
communities.''\7\ He also noted the increase in suicide rates 
amongst Black youth and the need to address the trend.\8\
---------------------------------------------------------------------------
    \7\National Institute of Mental Health, Racism and Mental Health 
Research: Steps Toward Equity (June 19, 2020) (www.nimh.nih.gov/about/
director/messages/2020/racism-and-mental-health-research-steps-toward-
equity.shtml).
    \8\National Institute of Mental Health, Responding to the Alarm: 
Addressing black Youth Suicide (June 3, 2020) (www.nimh.nih.gov/news/
media/2020/responding-to-the-alarm-addressing-black-youth-
suicide.shtml).
---------------------------------------------------------------------------
    In addition to addressing trends in suicide and mental 
health outcomes, Arthur C. Evans, Ph.D., Chief Executive 
Officer of the American Psychological Association, shared with 
the Committee the importance of addressing ``the disparities in 
the representations of scholars from diverse racial and ethnic 
backgrounds across psychology, as well as other fields of 
research, if we intend to make a dramatic impact in responding 
to the current and emerging mental health crisis before the 
country.''\9\
---------------------------------------------------------------------------
    \9\House Committee on Energy and Commerce, Testimony of Arthur C. 
Evans, Chief Executive Officer, American Psychological Association, 
Hearing on High Anxiety and Stress: Legislation to Improve Mental 
Health During Crisis, 116th Cong. (June 30, 2020).
---------------------------------------------------------------------------
    H.R. 5469 would help to address these issues by investing 
resources into better understanding racial and ethnic minority 
mental health disparities, improving outreach and support for 
racial and ethnic minorities, and supporting more students of 
color entering into mental health fields.

                        III. Committee Hearings

    For the purposes of section 103(i) of H. Res. 6 of the 
116th Congress, the following hearing was used to develop or 
consider H.R. 5469:
    The Subcommittee on Health held a virtual legislative 
hearing on June 30, 2020, entitled, ``High Anxiety and Stress: 
Legislation to Improve Mental Health During Crisis.'' The 
hearing focused on H.R. 5469, the ``Pursuing Equity in Mental 
Health Act'', and 21 other bills. The Subcommittee received 
testimony from the following witnesses:
           The Honorable Patrick J. Kennedy, Founder of 
        the Kennedy Forum and former Member of Congress;
           Arthur C. Evans, Jr. Ph.D., Chief Executive 
        Officer, American Psychological Association;
           Jeffrey L. Geller, M.D., M.P.H., President, 
        American Psychiatric Association, Professor of 
        Psychiatry and Director of Public Sector Psychiatry at 
        the University of Massachusetts Medical School 
        Worcester Recovery Center and Hospital; and
           Ms. Arriana Gross, National Youth Advisory 
        Board Member, Sandy Hook Promise Students Against 
        Violence Everywhere (SAVE) Promise Club.

                      IV. Committee Consideration

    Representative Watson Coleman (D-NJ) introduced H.R. 5469, 
the ``Pursuing Equity in Mental Health Act'', on December 17, 
2019 and the bill was referred to the Committee on Energy and 
Commerce. The bill was then referred to the Subcommittee on 
Health on December 18, 2019. A legislative hearing was held on 
the bill on June 30, 2020.
    On September 9, 2020, H.R. 5469 was discharged from further 
consideration by the Subcommittee on Health as the bill was 
called up for markup by the full Committee on Energy and 
Commerce. The full Committee met in virtual open markup session 
on September 9, 2020, pursuant to notice, to consider H.R. 
5469. During consideration of the bill, an amendment in the 
nature of a substitute offered by Mr. Cardenas of California 
was agreed to by a voice vote. Upon conclusion of consideration 
of the bill, the full Committee agreed to a motion on final 
passage by Mr. Pallone, Chairman of the committee, to order 
H.R. 5469 reported favorably to the House, amended, by a voice 
vote, a quorum being present.

                           V. Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list each record vote 
on the motion to report legislation and amendments thereto. The 
Committee advises that there were no record votes taken on H.R. 
5469, including the motion for final passage of the bill.

                         VI. Oversight Findings

    Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1) 
of rule X of the Rules of the House of Representatives, the 
oversight findings and recommendations of the Committee are 
reflected in the descriptive portion of the report.

 VII. New Budget Authority, Entitlement Authority, and Tax Expenditures

    Pursuant to 3(c)(2) of rule XIII of the Rules of the House 
of Representatives, the Committee adopts as its own the 
estimate of new budget authority, entitlement authority, or tax 
expenditures or revenues contained in the cost estimate 
prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.
    The Committee has requested but not received from the 
Director of the Congressional Budget Office a statement as to 
whether this bill contains any new budget authority, spending 
authority, credit authority, or an increase or decrease in 
revenues or tax expenditures.

                    VIII. Federal Mandates Statement

    The Committee adopts as its own the estimate of Federal 
mandates prepared by the Director of the Congressional Budget 
Office pursuant to section 423 of the Unfunded Mandates Reform 
Act.

       IX. Statement of General Performance Goals and Objectives

    Pursuant to clause 3(c)(4) of rule XIII, the general 
performance goal or objective of this legislation is to address 
mental health issues for youth, particularly youth of color, 
through increased research and support services, and for other 
purposes.

                   X. Duplication of Federal Programs

    Pursuant to clause 3(c)(5) of rule XIII, no provision of 
H.R. 5469 is known to be duplicative of another Federal 
program, including any program that was included in a report to 
Congress pursuant to section 21 of Public Law 111-139 or the 
most recent Catalog of Federal Domestic Assistance.

                      XI. Committee Cost Estimate

    Pursuant to clause 3(d)(1) of rule XIII, the Committee 
adopts as its own the cost estimate prepared by the Director of 
the Congressional Budget Office pursuant to section 402 of the 
Congressional Budget Act of 1974.

    XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits

    Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the 
Committee finds that H.R. 5469 contains no earmarks, limited 
tax benefits, or limited tariff benefits.

                   XIII. Advisory Committee Statement

    No advisory committee within the meaning of section 5(b) of 
the Federal Advisory Committee Act was created by this 
legislation.

                XIV. Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act.

           XV. Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 designates that the short title may be cited as 
the ``Pursuing Equity in Mental Health Act''.

Sec. 2. Table of contents

    Section 2 is the table of contents for the bill.

               TITLE I--HEALTH EQUITY AND ACCOUNTABILTIY


Sec. 101. Integrated Health Care Demonstration Program

    Section 101 amends the Public Health Service Act to direct 
the Secretary of the U.S. Department of Health and Human 
Services (the Secretary) to award grants to support 
interprofessional behavioral health care teams. Entities that 
are eligible to receive such grants include Federally qualified 
health centers, rural health clinics, or behavioral health 
programs serving a high proportion of individuals from racial 
and ethnic minority groups. Integrated health care funded 
through the program shall be scientifically based. The program 
is authorized at $20 million for each fiscal year for the first 
five years following enactment of the Act.

Sec. 102. Addressing racial and ethnic minority mental health 
        disparities research gaps

    Section 102 directs the Director of the National Institutes 
of Health to enter into an arrangement with the National 
Academies of Sciences, Engineering, and Medicine (or another 
appropriate entity) to study racial and ethnic minority mental 
health disparities not later than six months following 
enactment. The Director shall submit a report to Congress about 
mental health disorders within racial and ethnic minority 
groups, in addition to the effects of community violence, 
adverse childhood experience, structural racism, and other 
traumas affecting mental illness in those groups.

Sec. 103. Health professions competencies to address racial and ethnic 
        minority mental health disparities

    Section 103 directs the Secretary of Health and Human 
Services to award grants to qualified national organizations to 
develop and disseminate training materials on best practices or 
core competencies for addressing mental health disparities 
among racial and ethnic minority groups. These grants can be 
used for certifying community health workers and peer wellness 
specialists in best practices and core competencies and 
integrating such workers into racial and ethnic minority 
communities to address mental health disparities. Organizations 
receiving funding under this program may use such grant funds 
for identifying best practices and core competencies on racial 
and ethnic mental health disparities, workshop planning, 
dissemination and promotion of best practices or core 
competencies in undergraduate and graduate health professions 
training programs, and stakeholder advisory boards. Qualified 
national organizations eligible for this program are national 
organizations that focus on the education of students in 
certain health professions.

Sec. 104. Racial and ethnic minority behavioral and mental health 
        outreach and education strategy

    Section 104 amends the Public Health Service Act to direct 
the Secretary to develop and implement an outreach and 
education strategy to promote behavioral health and mental 
health among racial and ethnic minority groups. The strategy 
must reduce stigma associated with mental health conditions and 
substance use disorders, be designed to meet diverse cultural 
and language needs, be developmentally and age-appropriate, 
increase awareness of mental illnesses among groups, engage 
consumers and community members, and promote a holistic view of 
health. The Secretary is required to submit a report to 
Congress on the strategy and make the strategy publicly 
available not later than one year after enactment. The program 
is authorized at $10 million for each of fiscal years 2021 
through 2025 to carry out activities in this section.

Sec. 105. Additional funds for the National Institutes of Health

    Section 105 authorizes $100 million for each of the fiscal 
years 2021 through 2025 to build relationships with communities 
and conduct or support clinical research on racial or ethnic 
disparities.

Sec. 106. Additional funds for the National Institute on Minority 
        Health and Health Disparities

    Section 106 authorizes $650 million for each of the fiscal 
years 2021 through 2025 for the National Institute on Minority 
Health and Health Disparities.

                       TITLE II--OTHER PROVISIONS


Sec. 201. Reauthorization of Minority Fellowship Program

    Section 201 revises the authorization for the Minority 
Fellowship Program at the Substance Abuse and Mental Health 
Administration to provide the program $25 million for each of 
the fiscal years 2021 through 2025.

Sec. 202. Study on the effects of smartphone and social media use on 
        adolescents

    Section 202 directs the Secretary to conduct or support 
research on smartphones and social media use on adolescents. 
The research shall cover the effects of such use on emotional, 
behavioral, and physical health and development and disparities 
among minority and underserved populations. The Secretary is 
directed to submit a report to Congress not later than five 
years on the findings of such research.

Sec. 203. Technical correction

    Section 203 makes technical corrections to the Public 
Health Service Act.

       XVI. Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (existing law 
proposed to be omitted is enclosed in black brackets, new 
matter is printed in italics, and existing law in which no 
change is proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

           *       *       *       *       *       *       *



Part D--Miscellaneous Provisions Relating to Substance Abuse and Mental 
Health

           *       *       *       *       *       *       *



SEC. [550.]  553. 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. 554. INTERPROFESSIONAL HEALTH CARE TEAMS FOR PROVISION OF 
                    BEHAVIORAL HEALTH CARE IN PRIMARY CARE SETTINGS.

  (a) Grants.--The Secretary shall award grants to eligible 
entities for the purpose of establishing interprofessional 
health care teams that provide behavioral health care.
  (b) Eligible Entities.--To be eligible to receive a grant 
under this section, an entity shall be a Federally qualified 
health center (as defined in section 1861(aa) of the Social 
Security Act), rural health clinic, or behavioral health 
program, serving a high proportion of individuals from racial 
and ethnic minority groups (as defined in section 1707(g)).
  (c) Scientifically Based.--Integrated health care funded 
through this section shall be scientifically based, taking into 
consideration the results of the most recent peer-reviewed 
research available.
  (d) Authorization of Appropriations.--To carry out this 
section, there is authorized to be appropriated $20,000,000 for 
each of the first 5 fiscal years following the date of 
enactment of the Pursuing Equity in Mental Health Act.

SEC. 555. BEHAVIORAL AND MENTAL HEALTH OUTREACH AND EDUCATION STRATEGY.

  (a) In General.--The Secretary shall, in consultation with 
advocacy and behavioral and mental health organizations serving 
racial and ethnic minority groups, develop and implement an 
outreach and education strategy to promote behavioral and 
mental health and reduce stigma associated with mental health 
conditions and substance abuse among racial and ethnic minority 
groups. Such strategy shall--
          (1) be designed to--
                  (A) meet the diverse cultural and language 
                needs of the various racial and ethnic minority 
                groups; and
                  (B) be developmentally and age-appropriate;
          (2) increase awareness of symptoms of mental 
        illnesses common among such groups, taking into account 
        differences within at-risk subgroups;
          (3) provide information on evidence-based, culturally 
        and linguistically appropriate and adapted 
        interventions and treatments;
          (4) ensure full participation of, and engage, both 
        consumers and community members in the development and 
        implementation of materials; and
          (5) seek to broaden the perspective among both 
        individuals in these groups and stakeholders serving 
        these groups to use a comprehensive public health 
        approach to promoting behavioral health that addresses 
        a holistic view of health by focusing on the 
        intersection between behavioral and physical health.
  (b) Reports.--Beginning not later than 1 year after the date 
of the enactment of this section and annually thereafter, the 
Secretary shall submit to Congress, and make publicly 
available, a report on the extent to which the strategy 
developed and implemented under subsection (a) increased 
behavioral and mental health outcomes associated with mental 
health conditions and substance abuse among racial and ethnic 
minority groups.
  (c) Definition.--In this section, the term ``racial and 
ethnic minority group'' has the meaning given to that term in 
section 1707(g).
  (d) Authorization of Appropriations.--There is authorized to 
be appropriated to carry out this section $10,000,000 for each 
of fiscal years 2021 through 2025.

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                  PART K--MINORITY FELLOWSHIP PROGRAM

SEC. 597. 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 
        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, 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 [$12,669,000 
for each of fiscal years 2018 through 2022] $25,000,000 for 
each of fiscal years 2021 through 2025.

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