SAMHSA Modernization Act of 2010 - Amends the Public Health Service Act to reauthorize the Substance Abuse and Mental Health Services Administration (SAMHSA). Expands the activities of SAMHSA to include: (1) the provision of grants to integrate mental health and substance use disorder services into primary care settings; (2) the provision of grants for projects that address the mental health needs of older adults; and (3) programs to recruit and retain qualified mental health and substance use professionals.
Revises and reauthorizes appropriations for the Protection and Advocacy for Individuals with Mental Illness Act.
Requires the Secretary of Health and Human Services (HHS), acting through the Administrator of SAMHSA, to study whether the funds under the substance abuse prevention and treatment block grant and the community mental health services block grant are being distributed to states and territories according to need and to recommend changes in such distribution, if necessary.
Establishes the Task Force on Behavioral and Mental Health in Medical Education to develop a plan to strengthen the capacity of graduates of accredited schools of allopathic or osteopathic medicine to deliver integrated, comprehensive health care. Requires such plan to identify specific behavioral and mental health education that should be required for graduation from such schools.
Establishes the Council on Integration of Health Care Education to develop recommendations to strengthen the capacity of health care professionals and behavioral health providers to deliver integrated, comprehensive health care. Authorizes the Secretary to provide for the implementation of such recommendations.
[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5466 Introduced in House (IH)]
111th CONGRESS
2d Session
H. R. 5466
To amend titles V and XIX of the Public Health Service Act to revise
and extend substance use disorder and mental health programs, and for
other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
May 28, 2010
Mr. Kennedy (for himself and Mr. Gene Green of Texas) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend titles V and XIX of the Public Health Service Act to revise
and extend substance use disorder and mental health programs, and for
other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``SAMHSA
Modernization Act of 2010''.
(b) Table of Contents.--The table of contents of this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Amendments to title V of the Public Health Service Act.
Sec. 3. Amendments to title XIX of the Public Health Service Act.
Sec. 4. Repeal.
Sec. 5. Amendments to the Protection and Advocacy for Individuals with
Mental Illness Act.
Sec. 6. Study of the distribution of funds under the Substance Abuse
Prevention and treatment block grant and
the community Mental Health Services block
grant.
Sec. 7. Task force on behavioral and mental health in medical
education.
Sec. 8. Council on Integration of Health Care Education.
SEC. 2. AMENDMENTS TO TITLE V OF THE PUBLIC HEALTH SERVICE ACT.
(a) In General.--Title V of the Public Health Service Act (42
U.S.C. 290aa et seq.), except for the second part G (41 U.S.C. 290kk et
seq.), is amended to read as follows:
``TITLE V--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
``PART A--ORGANIZATION AND GENERAL AUTHORITIES
``SEC. 501. 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) Agencies.--The following entities 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) Administrator and Deputy Administrator.--
``(1) Administrator.--The Administration shall be headed by
an Administrator (hereinafter in this title referred to as the
`Administrator') who shall be appointed by the President, by
and with the advice and consent of the Senate.
``(2) Deputy administrator.--The Administrator, with the
approval of the Secretary, may appoint a Deputy Administrator
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
Administrator, 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
substance use disorder prevention services, promote mental
health and protect the legal rights of individuals with mental
illness or 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 prevention, treatment, and related
services that reflect the needs and preferences of individuals
with mental illness or substance use disorders and their
families;
``(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 C, sexually transmitted diseases,
tuberculosis, and other communicable diseases among individuals
with mental illness or substance use disorders and to develop
appropriate mental health and substance use disorder services
for individuals with such illnesses;
``(7) coordinate Federal policy with respect to the
provision of treatment services for substance use disorders
utilizing anti-addiction medications, including the
certification of opioid treatment programs and monitoring
compliance with requirements established in regulations,
including the authority to monitor and inspect programs to
ensure quality service and to suspend and revoke such
certifications;
``(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 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 treatment and
prevention services;
``(10) encourage public and private entities that provide
health insurance to provide benefits for substance use disorder
and mental health services;
``(11) promote the integration of substance use disorder
and mental health services into the mainstream of the health
care delivery system of the United States;
``(12) monitor compliance by hospitals and other facilities
with the requirements of sections 562 and 563;
``(13) with respect to grant programs authorized under this
title and part B of title XIX--
``(A) require that all grants that are awarded for
the provision of services are subject to performance
and outcome evaluations using the performance measures
developed in accordance with section 504(b);
``(B) 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
``(C) inform the State when funds are awarded to
entities within the State;
``(14) assure that services provided with amounts
appropriated under this title are culturally and linguistically
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
and mental health information 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 mental health and substance use disorder
services for older Americans in need of such services;
``(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 use
disorders, 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) collaborate with the Secretary of Defense and the
Secretary of Veterans Affairs to improve the provision of
mental health and substance use disorder services provided by
the Department of Defense and the Department of Veterans
Affairs to veterans and their families (including members of
the national guard and military reserve components who have
served in active duty and their families), including through
the provision of services using the telehealth capabilities of
the Department of Veterans Affairs;
``(20) in coordination with the Assistant Secretary for
Preparedness and Response of the Department of Health and Human
Services, the Administrator of the Federal Emergency Management
Agency, and the Director of the Centers for Disease Control and
Prevention, work with States to establish mental health and
substance use disorder emergency response plans and assist in
incorporating such plans into State emergency response plans in
preparation for possible emergencies or major disasters;
``(21) in coordination with the Secretary of Education and
the Secretary of Homeland Security, work with universities and
colleges to establish mental health and substance use disorder
emergency response plans and incorporate such plans into
overall institutional emergency response plans;
``(22) work with the Health Resources and Services
Administration and the Centers for Disease Control and
Prevention on integrating mental health and substance use
disorder promotion with general health promotion and disease
prevention;
``(23) collaborate with Federal departments and programs
that are part of the President's Interagency Council on
Homelessness, particularly the Department of Housing and Urban
Development, the Department of Labor, and the Department of
Veterans Affairs, and with other agencies within the Department
of Health and Human Services, particularly the Health Resources
and Services Administration, the Administration on Children and
Families, and the Centers for Medicare & Medicaid Services, to
design national strategies for providing services in supportive
housing that will assist in ending chronic homelessness and to
implement programs that address chronic homelessness;
``(24) work with States and other stakeholders to develop
and support activities to recruit and retain a mental health
and substance use disorders workforce that is qualified to
provide mental health or substance use disorder prevention and
treatment services in the public sector, which may include
fellowships, internships, and encouraging efforts to identify
essential skills and abilities for non-degreed and bachelor
degreed direct care staff, community leaders, and individuals
in recovery and their families; and
``(25) ensure that parents receiving services from a
program authorized under this title or under part B of title
XIX, receive referral for evaluation for early intervention
under part C of the Individuals with Disabilities Education
Improvement Act.
``(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 Administrator may delegate the function of
promoting and coordinating activities related to the prevention
and reduction of underage drinking, as well as 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 use disorder
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.--The Administrator, 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.
``(3) Report.--
``(A) In general.--Not less than once during each
2-year period, the Administrator, 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 particularly those focusing on underage
drinking, 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) Revisions.--Each report under subparagraph
(A) shall include a description of any revisions in the
plan under paragraph (2) made during the preceding 2
years.
``(f) Associate Administrator for Women's Services.--
``(1) Appointment.--The Administrator, with the approval of
the Secretary, shall appoint an Associate Administrator for
Women's Services.
``(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 use disorders 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;
``(iv) assure that the unique needs of
minority women, including Native American,
Alaskan Native, Hispanic, African-American and
Asian women, are recognized and addressed
within the activities of the Administration;
``(v) recognize the distinct condition of
maternal addiction and the specific needs that
pregnant and parenting women and their children
present to treatment approaches and
interventions; and
``(vi) explore the relationship between
sexual violence, trauma, and maternal addiction
in order to effectively respond to the distinct
pathways to addiction for pregnant and
parenting women;
``(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 Administrator from among physicians,
practitioners, treatment providers, prevention
specialists, and other health professionals, whose
clinical practice, specialization, or professional
expertise includes a significant focus on women's
substance use disorders 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 use disorder and mental
health services, including services which
require a multidisciplinary approach;
``(ii) collect and review data, including
information provided by the Secretary, and
report biannually to the Administrator
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 a description of activities
of the Committee, including findings made by
the Committee regarding--
``(I) the extent of expenditures
made for substance use disorder and
mental health services for women and
pregnant and parenting women by the
Administration; and
``(II) the estimated level of
funding needed for substance use
disorder and mental health services to
meet the needs of women and pregnant
and parenting 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 Administrator 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 use
disorder and mental health services.
``(3) Definition.--For purposes of this subsection, the
term `women's substance use disorder and mental health
conditions', with respect to women of all age, ethnic, and
racial groups, means all aspects of substance use disorders and
mental illness--
``(A) unique to or that directly affects women; or
``(B) with respect to which there have been
insufficient services involving women or insufficient
data.
``(g) Associate Administrator for Older Adult Services.--
``(1) Appointment.--The Administrator, with the consent of
the Secretary, shall appoint an individual to serve as the
Associate Administrator of Older Adult Services.
``(2) Duties.--The Associate Administrator appointed under
paragraph (1) shall act as the lead staff for the coordination,
promotion, and monitoring of--
``(A) services research on the prevention and
identification of mental health and substance use
disorders in the older adult population, including the
risk of suicide;
``(B) innovative projects for the delivery of
community-based mental health and substance use
disorder services for older adults, including senior
suicide prevention and the integration of mental health
services in primary care settings;
``(C) support for the development and dissemination
of evidence-based practice models, including models to
address mental health and substance-related disorders
in older adults, including the risk of suicide;
``(D) the development of model training programs
for mental health and substance use disorder
professionals and caregivers serving older adults; and
``(E) other activities, as designated by the
Administrator, to improve the mental health and
substance use disorders of older adults.
``(h) Services of Experts.--
``(1) In general.--The Administrator 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 centers.
``(2) Compensation and expenses.--
``(A) In general.--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) Limitations.--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 Administrator 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 Act shall not
apply to the duration of a peer review group appointed under this
subsection.
``(j) Voluntary Services.--The Administrator may accept voluntary
and uncompensated services.
``(k) Administration.--The Administrator 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) Report Concerning Activities and Progress.--Not later than 2
years after the date of enactment of the SAMHSA Modernization Act of
2010, and once every 2 years thereafter, the Administrator shall
prepare and submit to the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives, and to the
Committee on Health, Education, Labor, and Pensions and the Committee
on Appropriations of the Senate, the report containing, at a minimum--
``(1) the development and assessment of population-based
indicators of mental health and substance use disorders for the
United States and the progress made in addressing gaps in
services and improving outcomes by the Administration and by
other public health agencies;
``(2) a description of the activities carried out by the
Administration to improve the availability and quality of the
mental health and substance use disorder prevention and
treatment services;
``(3) an assessment of the success of programs funded under
this title and part B of title XIX in meeting the goals of the
program using the measures of performance developed in
accordance with section 504(b); and
``(4) a description of the manner in which the
Administration engages in partnerships with other Federal
agencies and promotes coordination by grantees under this title
and part B of title XIX with other State or local agencies.
``(m) Applications for Grants and Contracts.--
``(1) In general.--With respect to awards of grants,
cooperative agreements, and contracts under this title or other
statutory authority of the Administration, the Administrator,
or the Director of the Center involved, as the case may be, may
not make such an award unless--
``(A) an application for the award is submitted to
the official involved;
``(B) with respect to carrying out the purpose for
which the award is to be provided, the application
provides assurances of compliance with the requirements
of the grant, cooperative agreement, or contract
satisfactory to such official; and
``(C) 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.
``(2) Consideration of religion in employment decisions.--
With respect to any activity to be funded (in whole or in part)
through an award of a grant, cooperative agreement, or contract
under this title or any other statutory authority of the
Administration, the Administrator, or the Director of the
Center involved, as the case may be, may not make such an award
unless the applicant agrees to refrain from considering
religion or any profession of faith when making any employment
decision regarding an individual who is or will be assigned to
carry out any portion of the activity. This paragraph applies
notwithstanding any other provision of Federal law, including
any exemption otherwise applicable to a religious corporation,
association, educational institution, or society.
``(n) 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 use disorder 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 use disorder or mental health
emergency exists and publish such criteria in the Federal
Register prior to providing funds under this subsection.
``(o) 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 504 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.
``(p) Joint Funding of Projects.--
``(1) In general.--
``(A) Authority.--The Administrator is authorized
to enter into arrangements with other Federal agencies
to jointly carry out projects of common interest, to
transfer to such agencies funds appropriated under any
applicable program under this title, and to receive and
use funds from such, for projects of common interest.
``(B) Use.--Funds transferred or received pursuant
to subparagraph (A) shall be used only for purposes for
which such funds were appropriated and shall be made
available by contract or grant only to recipients
eligible to receive such funds under such laws.
``(C) Application of procedures.--If the
Administrator enters into an arrangement under this
subsection for the administration of a project, the
Federal agency administering the project shall use such
agency's procedures to award contracts or grants and to
administer such awards, unless the parties to the
arrangement specify the use of procedures of another
agency that is a party to the arrangement.
``(D) Criteria.--If the Administrator has entered
into an arrangement authorized under this paragraph and
the Secretary and the heads of the other Federal
agencies participating in the arrangement determine
that joint funding is necessary to address a special
need consistent with the purposes and authorized
activities of each program that provides funding under
the joint project, the Administrator and the heads of
the other participating agencies may develop a single
set of criteria for the jointly funded project and
require each applicant for such project to submit a
single application for review by the participating
agencies.
``(2) Joint applications.--The Administrator may develop
the criteria for, and require the submission of, joint
applications under 2 or more applicable programs under which
funds are awarded on a competitive basis, and may jointly
review and approve such applications separately from other
applications under such programs, where the Secretary
determines that such joint awards are necessary to address a
special need consistent with the purposes and authorized
activities of each such program. Any applicant for such a joint
award shall meet the eligibility requirements of each such
program.
``(3) Limitations on joint funding.--The Secretary may not
construe the provisions of this subsection to take precedence
over a limitation on joint funding contained in an applicable
law.
``(4) Congressional notice.--
``(A) In general.--The Administrator shall provide
notice to the Committee on Energy and Commerce of the
House of Representatives and Committee on Health,
Education, Labor, and Pensions of the Senate and the
Subcommittee on Labor, Health and Human Services and
Education of the Committee on Appropriations of the
House of Representatives and the Subcommittee on Labor,
Health and Human Services and Education of the
Committee on Appropriations of the Senate of each joint
funding agreement made with other Federal agencies
under this subsection not later than 60 days after the
making of such agreements.
``(B) Requirements.--A notice under subparagraph
(A) shall include--
``(i) a description of the purpose and
objectives of the joint funding arrangement;
``(ii) the amounts and sources, by program,
of the funds dedicated to such arrangement; and
``(iii) the criteria developed to govern
the award of contracts and grants.
``(q) Publications.--The Secretary, without regard to section 501
of title 44, United States Code, shall promptly publish, make available
in accessible formats, and disseminate widely, the results of research,
demonstration projects, and evaluations conducted or supported under
this title.
``(r) International.--For the purpose of advancing the status of
the health sciences in the United States (and thereby the health of the
American people), the Administrator may provide training and technical
assistance to foreign countries or international organizations, and
participate with foreign countries or international organizations in
cooperative endeavors in health care technology, health services
research, and statistical activities related to substance use disorders
and mental health, including participating and otherwise cooperating in
any international meetings, conferences, or other activities concerning
with substance use disorders or mental health.
``(s) Definition.--In this title, the terms `emergency' and `major
disaster' have the meanings given such terms in section 102 of the
Robert T. Stafford Disaster Relief and Emergency Assistance Act.
``(t) Authorization of Appropriations.--For the purpose of
providing grants, cooperative agreements, and contracts under this
section, there are authorized to be appropriated $50,000,000 for fiscal
year 2011, and such sums as may be necessary for each of the fiscal
years 2012 through 2015.
``SEC. 502. ADVISORY COUNCILS.
``(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 Administrator 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) may on the basis of the materials provided by
the organization respecting activities conducted at the
organization, make recommendations to the Administrator
or Director of the Administration or Center for which
it was established respecting such activities;
``(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 Administrator 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 Administrator;
``(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);
and
``(F) 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 and, as practicable,
age-appropriate health experts) 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 (including an
older adult or a member of their family), and shall
include consumers and leaders in fields of public
policy, public relations, law, health policy economics,
or management.
``(C) The Secretary shall appoint a member of the
Women's Advisory Council established under section
501(f)(2)(C) to each of the advisory councils as a
liaison between such councils and the Women's Advisory
Council.
``(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 Executive Level II.
``(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 Administrator or the Director of the Center involved. The term of
office of the chair shall be 2 years unless the Secretary appoints the
Administrator to serve as the chair.
``(e) Meetings.--An advisory council shall meet at the call of the
chairperson or upon the request of the Administrator 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 Administrator or Director of Administration or Center
for which the council was established.
``(f) Executive Secretary and Staff.--The Administrator 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 Administrator 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 Administrator 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.
``SEC. 503. PEER REVIEW.
``(a) In General.--The Secretary, after consultation with the
Administrator, 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.
``(c) Conditions.--The Secretary may establish limited exceptions
to the limitations contained in this section regarding participation of
Federal employees. The circumstances under which the Secretary may make
such an exception shall be made public.
``SEC. 504. DATA COLLECTION.
``(a) Data.--
``(1) In general.--The Secretary, acting through the
Administrator, shall, at a minimum, collect data each year--
``(A) with respect to mental health, concerning--
``(i) the national incidence and prevalence
of the various forms of mental illness and, in
particular, the national incidence and
prevalence of adults with serious mental
illness and children with serious emotional
disturbance (as such terms are defined for
purposes of section 1912);
``(ii) the number and variety of public and
nonprofit private treatment programs;
``(iii) the number and demographic
characteristics of individuals receiving
treatment through such programs;
``(iv) the type of care received by such
individuals;
``(v) the relationship between mental
illness and physical diseases; and
``(vi) such other issues as may be
appropriate; and
``(B) with respect to substance use, concerning--
``(i) the national incidence and prevalence
of the various forms of substance use;
``(ii) the incidence and prevalence of such
various forms of substance use in major
metropolitan areas selected by the Secretary;
``(iii) the number of individuals admitted
to the emergency rooms of hospitals as a result
of the abuse of alcohol or other drugs;
``(iv) the number of deaths occurring as a
result of substance use disorders, as indicated
in reports by coroners;
``(v) the number and variety of public and
private nonprofit treatment programs, including
their capacity and type of patient services
available;
``(vi) 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;
``(vii) 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;
``(viii) the number of individuals
receiving public assistance for such treatment
programs;
``(ix) the costs and effectiveness 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;
``(x) to the extent information is
available, the number of individuals receiving
treatment for alcohol or drug abuse who have
private insurance coverage for the costs of
such treatment;
``(xi) the extent of alcohol and drug abuse
among high school students and among the
general population; and
``(xii) the number of alcohol and drug
abuse counselors and other substance use
disorder treatment personnel employed in public
and private treatment facilities.
``(2) Annual surveys.--The Secretary shall carry out annual
surveys with respect to the collection of data under this
subsection. Summaries and analyses of such data shall be made
available to the public.
``(b) National Outcome Measures.--
``(1) In general.--The Secretary, in consultation with
States and other stakeholders, shall establish national outcome
measures (including client and community measures) for
substance abuse and mental health programs to be used by
recipients of assistance through programs authorized under this
title and part B of title XIX, as appropriate.
``(2) Evaluation.--The Secretary shall be responsible for
evaluating the effect of the implementation of the outcome
measures developed under paragraph (1) and whether such outcome
measures continue to be important for measuring program success
and for recommending additional measures or modification to
current measures.
``(3) Modifications.--Any modifications made as a result of
an evaluation under paragraph (2) shall be made only after the
Secretary has consulted with States and other stakeholders and
after such modification are published in the Federal Register.
``(4) Deemed publication.--National outcome measures agreed
to by the States and other stakeholders prior to the date of
enactment of the SAMHSA Modernization Act of 2010 are deemed to
have been published in the Federal Register for the purposes of
paragraph (3).
``(c) State Infrastructure Grants.--
``(1) In general.--The Secretary may award grants to, and
enter into contracts or cooperative agreements with, States for
the purpose of developing and operating mental health or
substance use disorder data collection, analysis, and reporting
systems in accordance with the outcome measures developed under
subsection (b).
``(2) Matching requirement.--
``(A) In general.--With respect to the costs of the
program to be carried out under a grant under paragraph
(1) by a State, the Secretary may make an award under
such paragraph only if the applicant 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 50 percent of
such costs.
``(B) Determination of amount contributed.--Non-
Federal contributions under subparagraph (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, may not
be included in determining the amount of such
contributions.
``(3) Duration of support.--The period during which
payments may be made for a program under paragraph (1) may be
not less than 3 years nor more than 5 years.
``(d) Uniform Criteria.--After consultation with the States and
with appropriate national organizations, the Administrator shall
develop uniform criteria for the collection of data, using the best
available technology, pursuant to this section.
``(e) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated such sums as
may be necessary for each of fiscal years 2011 through 2015.
``SEC. 505. SUPPORTIVE SERVICES FOR HOMELESS INDIVIDUALS.
``(a) Grants for Treatment and Recovery for Homeless Individuals.--
``(1) 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).
``(2) Preferences.--In awarding grants, contracts, and
cooperative agreements under paragraph (1), the Secretary shall
give a preference to--
``(A) entities that provide integrated primary
health, substance use disorder, and mental health
services to homeless individuals;
``(B) entities that demonstrate effectiveness in
serving runaway, homeless, and street youth;
``(C) entities that have experience in providing
substance use disorder and mental health services to
homeless individuals;
``(D) entities that demonstrate experience in
providing housing for individuals in treatment for or
in recovery from mental illness or substance use
disorders; and
``(E) entities that demonstrate effectiveness in
serving homeless veterans.
``(3) Services for certain individuals.--In awarding
grants, contracts, and cooperative agreements under paragraph
(1), the Secretary shall not--
``(A) 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
``(B) make payments under such paragraph to any
entity that has a policy of--
``(i) excluding individuals from mental
health services due to the existence or
suspicion of substance use disorder; or
``(ii) has a policy of excluding
individuals from substance use disorder
services due to the existence or suspicion of
mental illness.
``(b) Grants for Services To End Long-Term Homelessness.--
``(1) In general.--
``(A) Grants.--The Secretary shall make grants to
entities described in subparagraph (B) for the purpose
of carrying out projects to provide the services
described in paragraph (4) to chronically homeless
individuals in permanent supportive housing.
``(B) Eligible entities.--For purposes of
subparagraph (A), an entity described in this
subparagraph is--
``(i) a State or political subdivision of a
State, an American Indian and Alaska Native
tribe, tribal organization, a health facility
or program operated by or pursuant to a
contract or grant with the Indian Health
Service, or a public or nonprofit private
entity, including a community-based provider of
homelessness services, health care, housing, or
other services important to individuals
experiencing chronic homelessness; or
``(ii) a consortium composed of entities
described in clause (i), which consortium
includes a public or nonprofit private entity
that serves as the lead applicant and has
responsibility for fiscal management, program
management, and coordinating the activities of
the consortium.
``(2) Priorities.--In making grants under paragraph (1),
the Secretary shall give priority to applicants demonstrating
that the applicants--
``(A) target the services described in paragraph
(4) to individuals or families who--
``(i) have been homeless for longer periods
of time or have experienced more episodes of
homelessness than are required to meet the
definition of chronic homelessness under this
section;
``(ii) have high rates of utilization of
emergency public systems of care; or
``(iii) have a history of interactions with
law enforcement and the criminal justice
system;
``(B) have greater funding commitments from State
or local government agencies responsible for overseeing
mental health treatment, substance use disorder
treatment, medical care, and employment (including
commitments to provide Federal funds in accordance with
paragraph (5)(B)(ii)(II));
``(C) will provide for an increase in the number of
units of permanent supportive housing that would serve
chronically homeless individuals in the community as a
result of an award of a grant under paragraph (1); and
``(D) have demonstrated experience providing
services to address the mental health and substance use
disorder problems of chronically homeless individuals
living in permanent supportive housing settings.
``(3) Geographic distribution.--The Secretary shall ensure
that consideration is given to geographic distribution (such as
urban and rural areas) in the awarding of grants under
paragraph (1).
``(4) Services.--The services referred to in paragraph (1)
are the following:
``(A) Services provided by the grantee or by
qualified subcontractors that promote recovery,
resiliency, and self-sufficiency and address barriers
to housing stability, including the following:
``(i) Mental health services, including
treatment services and recovery support
services and services that promote resiliency.
``(ii) Substance use disorder treatment and
recovery support services, including
counseling, treatment planning, recovery
coaching, and relapse prevention.
``(iii) Integrated, coordinated treatment
and recovery support services for co-occurring
disorders.
``(iv) Health education, including
referrals for medical and dental care.
``(v) Services designed to help individuals
make progress toward self-sufficiency and
recovery, including benefits advocacy, money
management, life-skills training, self-help
programs, and engagement and motivational
interventions.
``(vi) Parental skills and family support.
``(vii) Case management.
``(viii) Other supportive services that
promote an end to chronic homelessness.
``(ix) Coordination or partnership with
other agencies, programs, or mainstream
benefits to maximize the availability of
services and resources to meet the needs of
chronically homeless persons living in
supportive housing using cost-effective
approaches that avoid duplication.
``(x) Data collection and measuring
performance outcomes as specified in paragraph
(11).
``(B) Services, as described in subparagraph (A),
that are delivered to individuals and families who are
chronically homeless and who are scheduled to become
residents of permanent supportive housing within 90
days pending the location or development of an
appropriate unit of housing.
``(C) For individuals and families who are
otherwise eligible, and who have voluntarily chosen to
seek other housing opportunities after a period of
tenancy in supportive housing, services, as described
in subparagraph (A), that are delivered, for a period
of 90 days after exiting permanent supportive housing
or until the individuals have transitioned to
comprehensive services adequate to meet their current
needs, provided that the purpose of the services is to
support the individuals in their choice to transition
into housing that is responsive to their individual
needs and preferences.
``(5) Matching funds.--
``(A) In general.--A condition for the receipt of a
grant under paragraph (1) is that, with respect to the
cost of the project to be carried out by an applicant
pursuant to such subsection, the applicant agrees as
follows:
``(i) In the case of the initial grant
pursuant to paragraph (10)(A)(i), the applicant
will, in accordance with subparagraphs (B) and
(C), make available contributions toward such
costs in an amount that is not less than $1 for
each $3 of Federal funds provided in the grant.
``(ii) In the case of a renewal grant
pursuant to paragraph (10)(A)(ii), the
applicant will, in accordance with
subparagraphs (B) and (C), make available
contributions toward such costs in an amount
that is not less than $1 for each $1 of Federal
funds provided in the grant.
``(B) Source of contribution.--For purposes of
subparagraph (A), contributions made by an applicant
are in accordance with this paragraph if made as
follows:
``(i) The contribution is made from funds
of the applicant or from donations from public
or private entities.
``(ii) Of the contribution--
``(I) not less than 80 percent is
from non-Federal funds; and
``(II) not more than 20 percent is
from Federal funds provided under
programs that--
``(aa) are not expressly
directed at services for
homeless individuals, but whose
purposes are broad enough to
include the provision of a
service or services described
in paragraph (4) as authorized
expenditures under such
program; and
``(bb) do not prohibit
Federal funds under the program
from being used to provide a
contribution that is required
as a condition for obtaining
Federal funds.
``(C) Determination of amount contributed.--
Contributions required in subparagraph (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, may not
be included in determining the amount of non-Federal
contributions required in subparagraph (B)(ii)(I).
``(6) Administrative expenses.--A condition for the receipt
of a grant under paragraph (1) is that the applicant involved
agree that not more than 10 percent of the grant will be
expended for administrative expenses with respect to the grant.
Expenses for data collection and measuring performance outcomes
as specified in paragraph (11) shall not be considered as
administrative expenses subject to the limitation in this
paragraph.
``(7) Certain uses of funds.--Notwithstanding other
provisions of this section, not more than 20 percent of the
individuals served by a grantee under paragraph (1) may be
homeless individuals who are not chronically homeless.
``(8) Application for grant.--A grant may be made under
paragraph (1) only if an application for the grant is submitted
to the Secretary 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 subsection.
``(9) Certain requirements.--A condition for the receipt of
a grant under paragraph (1) is that the applicant involved
demonstrate the following:
``(A) The applicant and all direct providers of
services have the experience, infrastructure, and
expertise needed to ensure the quality and
effectiveness of services, which may be demonstrated by
any of the following:
``(i) Compliance with all local, city,
county, or State requirements for licensing,
accreditation, or certification (if any) which
are applicable to the proposed project.
``(ii) A minimum of 2 years experience
providing comparable services that do not
require licensing, accreditation, or
certification.
``(iii) Certification as a Medicaid service
provider, including health care for the
homeless programs and community health centers.
``(iv) An executed agreement with a
relevant State or local government agency that
will provide oversight over the mental health,
substance use disorder, or other services that
will be delivered by the project.
``(B) There is a mechanism for determining whether
residents are chronically homeless. Such a mechanism
may rely on local data systems or records of shelter
admission. If there are no sources of data regarding
the duration or number of homeless episodes, or if such
data are unreliable for the purposes of this paragraph,
an applicant must demonstrate that the project will
implement appropriate procedures, taking into
consideration the capacity of local homeless service
providers to document episodes of homelessness and the
challenges of engaging persons who have been
chronically homeless, to verify that an individual or
family meets the definition for being chronically
homeless under this subsection.
``(C) The applicant participates in a local,
regional, or statewide homeless management information
system.
``(10) Duration of initial and renewal grants; additional
provisions regarding renewal grants.--
``(A) In general.--Subject to subparagraphs (B) and
(C), the period during which payments are made to a
grantee under paragraph (1) shall be in accordance with
the following:
``(i) In the case of the initial grant, the
period of payments shall be not less than 3
years and not more than 5 years.
``(ii) In the case of a subsequent grant
(referred to in this subsection as a `renewal
grant'), the period of payments shall be not
more than 5 years.
``(B) Annual approval; availability of
appropriations; number of grants.--The provision of
payments under an initial or renewal grant is subject
to annual approval by the Secretary of the payments and
to the availability of appropriations for the fiscal
year involved to make the payments. This paragraph may
not be construed as establishing a limitation on the
number of grants under paragraph (1) that may be made
to an entity.
``(C) Additional provisions regarding renewal
grants.--
``(i) Compliance with minimum standards.--A
renewal grant may be made by the Secretary only
if the Secretary determines that the applicant
involved has, in the project carried out with
the grant, maintained compliance with minimum
standards for quality and successful outcomes
for housing retention, as determined by the
Secretary.
``(ii) Amount.--The maximum amount of a
renewal grant under this paragraph shall not
exceed an amount equal to 75 percent of the
amount of the grant awarded in the final year
of the initial grant period.
``(11) Strategic performance outcomes and reports.--
``(A) In general.--The Secretary shall, as a
condition of the receipt of grants under paragraph (1),
require grantees to provide data regarding the
performance outcomes of the projects carried out under
the grants. Consistent with the requirements and
procedures established by the Secretary, each grantee
shall measure and report specific performance outcomes
related to the long-term goals of increasing stability
within the community for people who have been
chronically homeless, and decreasing the recurrence of
periods of homelessness.
``(B) Performance outcomes.--The performance
outcomes described under subparagraph (A) shall
include, with respect to individuals who have been
chronically homeless--
``(i) improvements in housing stability;
``(ii) improvements in employment and
education;
``(iii) reductions in problems related to
substance use disorders;
``(iv) reductions in problems related to
mental health disorders; and
``(v) other areas as the Secretary
determines appropriate.
``(C) Coordination and consistency with other
homeless assistance programs.--
``(i) Procedures.--In establishing
strategic performance outcomes and reporting
requirements under subparagraph (A), the
Secretary shall develop and implement
procedures that minimize the costs and burdens
to grantees and program participants, and that
are practical, streamlined, and designed for
consistency with the requirements of the
homeless assistance programs administered by
the Secretary of Housing and Urban Development.
``(ii) Applicant coordination.--Applicants
under this subsection shall coordinate with
community stakeholders, including participants
in the local homeless management information
system, concerning the development of systems
to measure performance outcomes and with the
Secretary for assistance with data collection
and measurements activities.
``(D) Report.--A grantee shall submit an annual
report to the Secretary that--
``(i) identifies the grantee's progress
toward achieving its strategic performance
outcomes; and
``(ii) describes other activities conducted
by the grantee to increase the participation,
housing stability, and other improvements in
outcomes for individuals who have been
chronically homeless.
``(12) Training and technical assistance.--The Secretary,
directly or through awards of grants or contracts to public or
nonprofit private entities, shall provide training and
technical assistance regarding the planning, development, and
provision of services in projects under paragraph (1).
``(c) Definitions.--For purposes of this section:
``(1) Chronically homeless.--
``(A) In general.--The term `chronically homeless',
used with respect to an individual or family, means an
individual or family who--
``(i) is homeless and lives or resides in a
place not meant for human habitation, a safe
haven, or in an emergency shelter;
``(ii) has been homeless and living or
residing in a place not meant for human
habitation, a safe haven, or in an emergency
shelter continuously for at least 1 year or on
at least 4 separate occasions in the last 3
years; and
``(iii) has an adult head of household (or
a minor head of household if no adult is
present in the household) with a diagnosable
substance use disorder, serious mental illness,
developmental disability (as defined in section
102 of the Developmental Disabilities
Assistance and Bill of Rights Act of 2000 (42
U.S.C. 15002)), post traumatic stress disorder,
cognitive impairments resulting from a brain
injury, or chronic physical illness or
disability, including the co-occurrence of 2 or
more of those conditions.
``(B) Rule of construction.--A person who currently
lives or resides in an institutional care facility,
including a jail, substance use disorder or mental
health treatment facility, hospital or other similar
facility, and has resided there for fewer than 90 days
shall be considered chronically homeless if such person
met all of the requirements described in subparagraph
(A) prior to entering that facility.
``(2) Homeless.--The term `homeless' means sleeping in a
place not meant for human habitation or in an emergency
homeless shelter.
``(3) Homeless individual.--The term `homeless individual'
has the meaning given such term in section 330(h)(5)(A).
``(4) Permanent supportive housing.--
``(A) In general.--The term `permanent supportive
housing' means permanent, affordable housing with
flexible support services that are available and
designed to help the tenants stay housed and build the
necessary skills to live as independently as possible.
Such term does not include housing that is time-
limited. Supportive housing offers residents assistance
in reaching their full potential, which may include
opportunities to secure other housing that meets their
needs and preferences, based on individual choice
instead of the requirements of time-limited
transitional programs. Under this section, permanent
affordable housing includes permanent housing funded or
assisted through title IV of the McKinney-Vento
Homeless Assistance Act and section (8) of the United
States Housing Act of 1937.
``(B) Affordable.--For purposes of subparagraph
(A), the term `affordable' means within the financial
means of individuals who are extremely low income, as
defined by the Secretary of Housing and Urban
Development.
``(5) 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).
``(d) Term of the Awards.--No entity may receive a grant, contract,
or cooperative agreement under this section for more than 5 years.
``(e) Report.--Not later than 2 years after the date of enactment
of the SAMHSA Modernization Act of 2010, and once every 2 years
thereafter, the Secretary shall submit to the appropriate committees of
Congress a report concerning the programs and services provided under
this section. Such report shall include--
``(1) a summary of the information received by the
Secretary under paragraph (11) of subsection (b);
``(2) a description of how the services provided under each
such program are coordinated with State and local social
service programs and homelessness assistance programs and
Department of Veterans Affairs services programs; and
``(3) an evaluation of the manner in which funds are used
under such programs and the effectiveness of such programs in
ending chronic homelessness and improving outcomes for
individuals with mental illness and substance use disorder
problems.
``(f) Authorization of Appropriations.--
``(1) In general.--There is authorized to be appropriated
to carry out this section, $100,000,000 for fiscal year 2011,
and such sums as may be necessary for each of the fiscal years
2012 through 2015.
``(2) Continuing grants.--Of the total amount appropriated
to carry out this section, amounts shall first be allocated for
continuing grants awarded under section 505(a) (as such section
existed on the day before the date of enactment of the SAMHSA
Modernization Act of 2010.
``(3) Remaining funds.--Upon complying with paragraph (2),
any remaining funds shall be allocated equally between
subsections (a) and (b).
``SEC. 506. AMERICAN INDIANS AND ALASKA NATIVES.
``(a) Technical Assistance.--The Secretary shall provide technical
assistance to American Indian and Alaska Native tribes and tribal
organizations in submitting applications for any program of grants
under this title.
``(b) SAMHSA Tribal Technical Advisory Group.--
``(1) In general.--The Secretary shall establish and
maintain a Tribal Technical Advisory Group (referred to in this
section as the `Group') that shall be composed of--
``(A) Indian representation, as selected by the
tribes, from each of the 12 administrative units (Area
Offices) of the Indian Health Service;
``(B) a representative of the Indian Health
Service;
``(C) representatives of National Indian
Organizations with general interests in Indian health
care;
``(D) a representative of the Administration; and
``(E) a representative of a national organization
representing States' interests in mental health and
substance use disorders.
``(2) Purpose.--The purpose of the Group is to enhance the
tribal government to Federal Government relationship by
providing recommendations and advice to tribes, States, and the
Administration through--
``(A) identifying the barriers and issues in
providing mental health and substance use disorder
treatments and services between the Administration,
States and tribal health programs, including those
programs administered by the Indian Health Service;
``(B) providing expertise on policies, guidelines,
and programmatic issues affecting the delivery of
mental health and substance use disorder care for
American Indians and Alaska Natives;
``(C) facilitating any interaction relating to
intergovernmental and intragovernmental
responsibilities; and
``(D) providing any other advice or assistance to
the Administration to improve the mental health and
substance use disorder status levels of American
Indians and Alaska Natives.
``(3) Support no supplant.--The Group shall support and not
supplant the tribal consultation process between the
Administration and tribes.
``(4) Report.--Not later than 1 year after the date of the
enactment of the SAMHSA Modernization Act of 2010, and annually
thereafter, the Group shall prepare and submit, to the
Secretary, the Committee on Indian Affairs and the Committee on
Health, Education, Labor, and Pensions of the Senate, and the
Committee on Natural Resources and the Committee on Energy and
Commerce of the House of Representatives, a report describing
the activities, findings, and recommendations pursuant to this
section.
``(c) Duties.--The Secretary shall appoint an individual within the
Administration to--
``(1) act as a point of contact for tribes and tribal
organizations;
``(2) coordinate and provide technical assistance to tribes
and tribal organizations;
``(3) act as a knowledgeable source on American Indian and
Alaska Native mental health and substance use disorders issues;
``(4) advise grant review panels about the effectiveness of
traditional intervention and treatment methods used by American
Indians and Alaska Natives;
``(5) coordinates activities between the Administration and
the Group; and
``(6) coordinate activities between the Administration and
Indian Health Service.
``(d) Special Mental Health and Substance Use Disorders Programs
for American Indians and Alaska Natives.--
``(1) In general.--The Secretary shall award grants, in
addition to discretionary grants under this title, to provide
services for mental health and substance use disorders in
accordance with paragraph (2).
``(2) Service through indian health facilities.--For
purposes of paragraph (1), services under such subsection shall
be considered to be provided in accordance with this subsection
if such services are provided through an American Indian and
Alaska Native program operated by an Indian tribe, tribal
organization, Indian Health Service, or a health facility or
program operated by or pursuant to a contract or grant with the
Indian Health Service.
``(3) Data collection.--The Secretary shall periodically
collect and report on information concerning the numbers of
people served through grants pursuant to this subsection and
the effectiveness of such grants.
``(4) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
$40,000,000 for fiscal year 2011, and such sums as may be
necessary for fiscal years 2012 through and 2015.
``SEC. 507. EARLY DETECTION AND INTERVENTION FOR MENTAL ILLNESS AND
SUBSTANCE ABUSE DISORDERS.
``(a) In General.--The Administrator may award grants, contracts,
or cooperative agreements to eligible entities for mental illness and
substance abuse screening, brief intervention, referral, and recovery
services for individuals in primary health care settings.
``(b) Eligible Entity.--In this section, the term `eligible entity'
means a public or private nonprofit entity that--
``(1) provides primary health services;
``(2) seeks to integrate mental illness and substance abuse
services into its service system;
``(3) has developed a working relationship with providers
of mental health and substance abuse services; and
``(4) demonstrates a need for the inclusion of mental
illness and substance abuse services in its service system.
``(c) Priority.--In awarding grants, contracts, and cooperative
agreements under this section, the Secretary shall give priority to
eligible entities that--
``(1) provide services in rural or frontier areas of the
Nation;
``(2) provide services to American Indian or Alaska Native
populations; or
``(3) provide services on university and college campuses.
``(d) Use of Funds.--The Secretary may award a grant to an eligible
entity under this section only if the entity agrees to use the grant--
``(1) to provide screening, brief interventions, referral,
and recovery services for mental health and substance abuse;
``(2) to coordinate these services with primary health care
services in the same program;
``(3) to develop a network of facilities to which patients
can be referred if needed;
``(4) to purchase needed screening and other tools that
are--
``(A) necessary for providing the services; and
``(B) supported by research; and
``(5) to maintain communication with appropriate State
mental health and substance abuse agencies.
``(d) Duration.--The period of a grant, contract, or cooperative
agreement awarded under this section may not exceed 5 years.
``(e) Evaluation.--The Secretary may not award a grant, contract,
or cooperative agreement to an eligible entity under this section
unless the entity agrees--
``(1) to prepare and submit to the Secretary at the end of
the grant, contract, or cooperative agreement period an
evaluation of all activities funded through the grant,
contract, or cooperative agreement; and
``(2) to use such performance measures as may be stipulated
by the Secretary for purposes of such evaluation.
``(f) Study.--Not later than 4 years after the first appropriation
of funds to carry out this section, the Secretary--
``(1) shall conduct a study on the benefits of integrating
mental illness and substance abuse care within primary health
care, focusing on the performance measures stipulated by the
Secretary for purposes of evaluations under subsection (e); and
``(2) shall submit the results of such study to the
Committee on Health, Education, Labor, and Pensions of the
Senate and the Committee on Energy and Commerce of the House of
Representatives.
``(g) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there are
authorized to be appropriated $60,000,000 for fiscal year 2011
and such sums as may be necessary for fiscal years 2012 through
2015.
``(2) Program management.--Of the funds appropriated to
carry out this section for a fiscal year, the Secretary may use
not more than 5 percent to manage the program under this
section.
``SEC. 508. REPORT ON COORDINATION BETWEEN THE SUBSTANCE ABUSE AND
MENTAL HEALTH SERVICES ADMINISTRATION AND THE FEDERAL
EMERGENCY MANAGEMENT AGENCY.
``Not later than 1 year after the date of enactment of the SAMHSA
Modernization Act of 2010, the Administrator, in coordination with the
Administrator of the Federal Emergency Management Agency, shall submit
to the appropriate committees of Congress a report that contains the
following:
``(1) A description of the manner in which the Federal
Emergency Management Agency and the Administration have
coordinated to provide mental health and substance use disorder
outreach, counseling, and treatment following Presidentially
declared disasters.
``(2) An analysis of the manner in which the services
provided (as described in paragraph (1)) have been coordinated
with existing State and local mental health and substance use
disorder programs, including the manner in which such services
assisted the emergency response and post-disaster recovery and
how such services are delivered during the transition from an
emergency response situation to a post-disaster and recovery
situation.
``(3) An analysis of the methods by which the Federal
Emergency Management Agency and the Administration coordinated
with other appropriate Federal agencies to leverage use of
supplemental funds appropriated by Congress to meet the mental
health and substance use disorder needs of the affected
individuals following Presidentially declared disasters.
``(4) Recommendations of the actions that may be taken by
the Federal Emergency Management Agency and the Administration
to facilitate the improved provision of mental health and
substance use disorder outreach, counseling, and treatment
following Presidentially declared disasters, including an
analysis of ways in which the Crisis Counseling Program may be
used to meet community-identified mental health and substance
use disorder needs.
``PART B--CENTERS AND PROGRAMS
``Subpart 1--Center for Substance Abuse Treatment
``SEC. 510. CENTER FOR SUBSTANCE ABUSE TREATMENT.
``(a) In General.--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.
``(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 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 1931(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 carried out by the Director;
``(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) in carrying out paragraph (12), assess the quality,
appropriateness, and costs of various treatment forms from
specific patient groups and ensure that the national outcome
measures developed under section 504(b) are used with respect
to all appropriate grants administered by the Center; and
``(14) work with States, providers, and individuals in
recovery and their families to promote the expansion of
recovery support services and recovery oriented systems of
care.
``(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. 511. RESIDENTIAL TREATMENT PROGRAMS FOR PREGNANT AND PARENTING
WOMEN.
``(a) In General.--The Director of the Center for Substance Abuse
Treatment shall provide awards of grants, cooperative agreement, or
contracts to public and nonprofit private entities for the purpose of
providing to pregnant and parenting 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) services will be made available to each woman and
child admitted to the program.
``(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 child; 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 abuse.
``(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 maternal substance use
disorders 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 her
children;
``(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 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 outreach
services in the community involved to identify women who are engaging
in substance use disorders and to encourage the women to undergo
treatment for such abuse.
``(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 parenting 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 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 any entity 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 Administrator of the Health
Resources and Services Administration as a health professional shortage
area with a shortage of professionals, 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) 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
substance use disorders, including the counseling and services
described in subsection (c)(2).
``(5) The term `supplemental services' means the services
described in subsection (d).
``(q) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $50,000,000
for each of fiscal years 2011 through 2015.
``SEC. 512. 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 jurisdictions, communities, and American Indian
and Alaska Native tribes to focus on emerging trends in
substance use and co-occurrence of substance use disorders with
mental illness or other disorders.
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, territories, American Indian
and Alaska Native tribes, tribal organizations, or a health facility or
program operated by or pursuant to a contract or grant with the Indian
Health Service, and 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 and to provide treatment for older adults with
substance use disorders.
``(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, $500,000,000 for fiscal year
2011, and such sums as may be necessary for each of the fiscal years
2012 through 2015.
``SEC. 513. SERVICES TO ASSIST LOCAL COMMUNITIES IN ADDRESSING EMERGING
DRUGS.
``(a) Grants.--
``(1) In general.--The Secretary shall award grants to
eligible entities to assist local communities in addressing
emerging drug issues.
``(2) Definition.--In this section, the term `emerging drug
issue' means, with respect to an area--
``(A) a drug treatment problem that has occurred
because of--
``(i) a sudden increase in the demand for
drug treatment in the area; or
``(ii) the necessity of drug treatment
protocols that the area is not equipped to
provide; and
``(B) the lack of resources within the area to
address the problem.
``(b) Eligibility.--To be eligible to receive a grant under this
section, an entity shall--
``(1) be a public or nonprofit private entity, including
American Indian and Alaska Native tribes, tribal organizations,
or a health facility or program operated by or pursuant to a
contract or grant with the Indian Health Service;
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require, including--
``(A) information that demonstrates an emerging
drug issue in the area to be served under the grant and
the lack of available resources to address such issue;
``(B) a description of the area to be served under
the grant and the target population, if relevant, and
the need of such population for services;
``(C) data on the prevalence of the emerging drug
involved using whatever data may be available from the
appropriate State or local agencies, including
admissions data, waiting lists, data from law
enforcement, and other data to establish that there is
an emerging drug problem;
``(D) a summary of the need involved that is based
not only on prevalence but the fact that the emerging
drug requires skills that the area does not have;
``(E) a statement on the attempts by the local
areas to find funding from other sources including the
State;
``(F) information to demonstrate that the
identified need is consistent with the State priorities
(as evidenced by a letter from the governor of the
State);
``(G) a list of goals and objectives with respect
to activities under the grant;
``(H) an assurance that the entity will use
evidence-based practices, when available, in providing
services under the grant; and
``(I) an assurance that treatment activities will
be coordinated with prevention efforts.
``(c) Use of Funds.--An entity shall use amounts received under a
grant to--
``(1) carry out outreach and other strategies to increase
participation in, and access to, drug treatment services;
``(2) provide outpatient or residential drug treatment
services, including screening, assessment, and care management
services;
``(3) provide for the involvement of friends and families
in drug treatment; and
``(4) provide recovery support services that help prevent
relapse and promote sustained recovery, including assistance
with employment, housing, and establishing community
connections.
``(d) Coordination of Services.--An entity that receives a grant
under this section shall ensure that--
``(1) services provided under the grant are coordinated
with other community, social, and health agency service
provider programs, including programs conducted by mental
health departments, social services departments, health
departments, education agencies, juvenile and adult justice
systems, and child welfare agencies; and
``(2) drug treatment service systems are partnered with
prevention systems.
``(e) Priority.--In awarding grants under this section, the
Secretary shall give priority to entities that use a portion of grant
funds to serve rural areas.
``(f) Data Collection.--A grantee shall collect data on the
national outcome measures established under section 504(b) and any
other data needed to demonstrate the success of the grantee in
achieving the goals and objectives described in its application under
subsection (b)(2)(F).
``(g) Evaluation.--A grantee shall conduct and evaluation of the
activities carried out under the grant and provide the results of such
evaluation to the Secretary.
``(h) Grant Period.--The period of a grant under this section shall
be 3 years.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2011 through 2015.
``SEC. 514. ACTION BY THE CENTER FOR SUBSTANCE ABUSE TREATMENT AND
STATES CONCERNING MILITARY FACILITIES.
``(a) Center for Substance Abuse Treatment.--The Director of the
Center for Substance Abuse Treatment shall--
``(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. 515. SUBSTANCE USE DISORDER TREATMENT AND EARLY INTERVENTION
SERVICES FOR CHILDREN AND ADOLESCENTS.
``(a) In General.--The Secretary shall award grants, contracts, or
cooperative agreements to public and private nonprofit entities,
including American Indian and Alaska Native tribes, tribal
organizations, or a health facility or program operated by or pursuant
to 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 and adolescents who are at risk of
substance use disorders; and
``(2) providing substance use disorder treatment services
for children, including children and adolescents with co-
occurring mental illness and substance use disorders.
``(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 and adolescents with
substance use disorders, including children and adolescents
with co-occurring mental illness and substance use disorders
and their families;
``(4) provide services that are gender-specific and
culturally appropriate;
``(5) involve and work with families of children and
adolescents receiving services; and
``(6) provide aftercare services for children and
adolescents and their families after completion of treatment.
``(c) Duration of Grants.--The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for 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, $60,000,000 for fiscal year
2011, and such sums as may be necessary for fiscal years 2012 through
2015.
``Subpart 2--Center for Substance Abuse Prevention
``SEC. 520. CENTER FOR SUBSTANCE ABUSE PREVENTION.
``(a) In General.--There is established in the Administration a
Center for Substance Abuse Prevention (hereafter referred to in this
part as the `Prevention Center'). The 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) Duties.--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) develop effective drug and alcohol abuse prevention
literature (including literature on the adverse effects of
emerging drugs);
``(4) in cooperation with the Secretary of Education,
assure the widespread dissemination of prevention materials
among States, political subdivisions, and school systems;
``(5) support clinical training programs for substance use
disorder prevention practitioners and other health
professionals involved in drug abuse education, prevention;
``(6) in cooperation with the Director of the Centers for
Disease Control and Prevention, develop educational materials
designed to increase awareness of those at greatest risk for
substance use disorders thereby preventing new infections and
reducing the probability of the transmission of HIV, Hepatitis
C, sexually transmitted diseases, tuberculosis, and other
communicable diseases;
``(7) conduct training, technical assistance, data
collection, and evaluation activities of programs supported
under the Drug Free Schools and Communities Act of 1986;
``(8) support the development of model, innovative,
community-based programs that reduce the risk of substance use
and promote resiliency among young people;
``(9) collaborate with the Attorney General of the
Department of Justice to develop programs to prevent drug abuse
among high risk youth;
``(10) 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; and
``(11) 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.
``(c) Grants, Contracts, Cooperative Agreements.--The Director may
make grants and enter into contracts and cooperative agreements in
carrying out subsection (b).
``SEC. 521. 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 a
focus on emerging drugs.
The Secretary may carry out the activities described in this section
directly or through grants, contracts, or cooperative agreements with
States, territories, political subdivisions of States, American Indian
and Alaska Native tribes, tribal organizations and a health facility or
program operated by or pursuant to 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 priority and consideration.--
``(A) Priority.--In developing priority needs under
paragraph (1), the Secretary shall ensure that specific
priority is given to high risk youth, including youth
who--
``(i) are failing in, or who have dropped
out of, school;
``(ii) associate with peers who engage in
substance use;
``(iii) live in communities where drugs and
alcohol are readily available;
``(iv) are raised in a family with a
history of problem behaviors including drug and
alcohol abuse;
``(v) are identified as children of a
substance abuser;
``(vi) are victims of physical, sexual, or
psychological abuse;
``(vii) have committed a violent or
delinquent act;
``(viii) have experienced mental health
problems;
``(ix) have attempted suicide; or
``(x) have experienced long-term physical
pain due to injury.
``(B) Considerations.--In developing program
priorities under paragraph (1), the Secretary shall
give special consideration to--
``(i) applying the most promising
strategies and research-based primary
prevention approaches;
``(ii) promoting the integration of
substance use disorder prevention information
and activities into primary health care
systems; and
``(iii) supporting education projects that
focus on, or include, specific information
about the oral health risks and conditions
associated with drug use.
``(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, $300,000,000 for fiscal year
2011, and such sums as may be necessary for each of the fiscal years
2012 through 2015.
``SEC. 522. 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.
``(4) The term `IOM report' means the report released in
September 2003 by the National Research Council, Institute of
Medicine, and entitled `Reducing Underage Drinking: A
Collective Responsibility'.
``(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 formally establish 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
paragraph (1) 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
Administrator of the Substance Abuse and Mental Health
Services Administration, 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 Coordinating 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;
``(II) the extent of progress in
preventing and reducing underage
drinking nationally;
``(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 and
the entertainment media as reported by
the Federal Trade Commission.
``(IV) Surveillance data, including
information on the onset and prevalence
of underage drinking, consumption
patterns and the means of underage
access. 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 (f).
``(VI) Evidence-based best
practices to prevent and reduce
underage drinking and provide treatment
services to those youth who need them.
``(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, and programs to prevent or reduce underage
drinking.
``(B) State performance measures.--
``(i) In general.--The Secretary shall
develop, in consultation with the Committee, a
set of measures to be used in preparing the
report on best practices.
``(ii) Categories.--In developing these
measures, the Secretary shall consider
categories including, but not limited to:
``(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 programs targeted to youths,
parents, and caregivers to deter
underage drinking; and the number of
individuals served by these programs.
``(VIII) Whether or not the State
has enacted graduated drivers licenses
and the extent of those provisions.
``(IX) The amount that the State
invests, per youth capita, on the
prevention of underage drinking,
further broken down by the amount spent
on--
``(aa) compliance check
programs in retail outlets,
including providing technology
to prevent and detect the use
of false identification by
minors to make alcohol
purchases;
``(bb) checkpoints and
saturation patrols that include
the goal of reducing and
deterring underage drinking;
``(cc) community-based,
school-based, and higher-
education-based programs to
prevent underage drinking;
``(dd) underage drinking
prevention programs that target
youth within the juvenile
justice and child welfare
systems; and
``(ee) other State efforts
or programs as deemed
appropriate.
``(3) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection
$1,000,000 for fiscal year 2011, and $1,000,000 for each of the
fiscal years 2012 through 2015.
``(d) National Media Campaign To Prevent Underage Drinking.--
``(1) Scope of the campaign.--The Secretary shall continue
to fund and oversee the production, broadcasting, and
evaluation of the national adult-oriented media public service
campaign if the Secretary determines that such campaign is
effective in achieving the media campaign's measurable
objectives.
``(2) Report.--The Secretary shall provide a report to the
Congress annually detailing the production, broadcasting, and
evaluation of the campaign referred to in paragraph (1), and to
detail in the report the effectiveness of the campaign in
reducing underage drinking, the need for and likely
effectiveness of an expanded adult-oriented media campaign, and
the feasibility and the likely effectiveness of a national
youth-focused media campaign to combat underage drinking.
``(3) Consultation requirement.--In carrying out the media
campaign, the Secretary shall direct the entity carrying out
the national adult-oriented media public service campaign to
consult with interested parties including both the alcohol
beverage industry and public health and consumer groups. The
progress of this consultative process is to be covered in the
report under paragraph (2).
``(4) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection,
$1,000,000 for fiscal year 2011 and $1,000,000 for each of the
fiscal years 2012 through 2015.
``(e) Interventions.--
``(1) Community-based coalition enhancement grants to
prevent underage drinking.--
``(A) Authorization of program.--The Administrator
of the Substance Abuse and Mental Health Services
Administration, in consultation with the Director of
the Office of National Drug Control Policy, shall
award, if the Administrator determines that the
Department of Health and Human Services is not
currently conducting activities that duplicate
activities of the type described in this subsection,
`enhancement grants' to eligible entities to design,
test, evaluate and disseminate effective strategies to
maximize the effectiveness of community-wide approaches
to preventing and reducing underage drinking. This
subsection is subject to the availability of
appropriations.
``(B) Purposes.--The purposes of this paragraph are
to--
``(i) prevent and reduce alcohol use among
youth in communities throughout the United
States;
``(ii) strengthen collaboration among
communities, the Federal Government, and State,
local, and tribal governments;
``(iii) enhance intergovernmental
cooperation and coordination on the issue of
alcohol use among youth;
``(iv) 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;
``(v) disseminate to communities timely
information regarding state-of-the-art
practices and initiatives that have proven to
be effective in preventing and reducing alcohol
use among youth; and
``(vi) enhance, not supplant, effective
local community initiatives for preventing and
reducing alcohol use among youth.
``(C) Application.--An eligible entity desiring an
enhancement grant under this paragraph shall submit an
application to the Administrator at such time, and in
such manner, and accompanied by such information as the
Administrator may require. Each application shall
include--
``(i) 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
``(ii) a complete description of the
entity's current initiatives, and how it will
use this grant to enhance those initiatives by
adding a focus on underage drinking prevention.
``(D) Uses of funds.--Each eligible entity that
receives a grant under this paragraph shall use the
grant funds to carry out the activities described in
such entity's application submitted pursuant to
subparagraph (C). Grants under this paragraph shall not
exceed $50,000 per year and may not exceed four years.
``(E) Supplement not supplant.--Grant funds
provided under this paragraph shall be used to
supplement, not supplant, Federal and non-Federal funds
available for carrying out the activities described in
this paragraph.
``(F) Evaluation.--Grants under this paragraph
shall be subject to the same evaluation requirements
and procedures as the evaluation requirements and
procedures imposed on recipients of drug free community
grants.
``(G) Definitions.--For purposes of this paragraph,
the term `eligible entity' means an organization that
is currently receiving or has received grant funds
under the Drug-Free Communities Act of 1997 (21 U.S.C.
1521 et seq.).
``(H) Administrative expenses.--Not more than 6
percent of a grant under this paragraph may be expended
for administrative expenses.
``(I) Authorization of appropriations.--There are
authorized to be appropriated to carry out this
paragraph $5,000,000 for fiscal year 2011, and
$5,000,000 for each of the fiscal years 2012 through
2015.
``(2) Grants directed at preventing and reducing alcohol
abuse at institutions of higher education.--
``(A) Authorization of program.--The Secretary
shall award grants to eligible entities to enable the
entities to prevent and reduce the rate of underage
alcohol consumption including binge drinking among
students at institutions of higher education.
``(B) Applications.--An eligible entity that
desires to receive a grant under this paragraph shall
submit an application to the Secretary at such time, in
such manner, and accompanied by such information as the
Secretary may require. Each application shall include--
``(i) a description of how the eligible
entity will work to enhance an existing, or
where none exists to build a, statewide
coalition;
``(ii) a description of how the eligible
entity will target underage students in the
State;
``(iii) a description of how the eligible
entity intends to ensure that the statewide
coalition is actually implementing the purpose
of this section and moving toward indicators
described in subparagraph (D);
``(iv) a list of the members of the
statewide coalition or interested parties
involved in the work of the eligible entity;
``(v) a description of how the eligible
entity intends to work with State agencies on
substance use disorder prevention and
education;
``(vi) the anticipated impact of funds
provided under this paragraph in preventing and
reducing the rates of underage alcohol use;
``(vii) outreach strategies, including ways
in which the eligible entity proposes to--
``(I) reach out to students and
community stakeholders;
``(II) promote the purpose of this
paragraph;
``(III) address the range of needs
of the students and the surrounding
communities; and
``(IV) address community norms for
underage students regarding alcohol
use; and
``(viii) such additional information as
required by the Secretary.
``(C) Uses of funds.--Each eligible entity that
receives a grant under this paragraph shall use the
grant funds to carry out the activities described in
such entity's application submitted pursuant to
subparagraph (B).
``(D) Accountability.--On the date on which the
Secretary first publishes a notice in the Federal
Register soliciting applications for grants under this
paragraph, the Secretary shall include in the notice
achievement indicators for the program authorized under
this paragraph. The achievement indicators shall be
designed--
``(i) to measure the impact that the
statewide coalitions assisted under this
paragraph are having on the institutions of
higher education and the surrounding
communities, including changes in the number of
incidents of any kind in which students have
abused alcohol or consumed alcohol while under
the age of 21 (including violations, physical
assaults, sexual assaults, reports of
intimidation, disruptions of school functions,
disruptions of student studies, mental health
referrals, illnesses, or deaths);
``(ii) to measure the quality and
accessibility of the programs or information
offered by the eligible entity; and
``(iii) to provide such other measures of
program impact as the Secretary determines
appropriate.
``(E) Supplement not supplant.--Grant funds
provided under this paragraph shall be used to
supplement, and not supplant, Federal and non-Federal
funds available for carrying out the activities
described in this paragraph.
``(F) Definitions.--For purposes of this paragraph:
``(i) Eligible entity.--The term `eligible
entity' means a State, institution of higher
education, or nonprofit entity.
``(ii) Institution of higher education.--
The term `institution of higher education' has
the meaning given the term in section 101(a) of
the Higher Education Act of 1965.
``(iii) Secretary.--The term `Secretary'
means the Secretary of Education.
``(iv) State.--The term `State' means each
of the 50 States, the District of Columbia, and
the Commonwealth of Puerto Rico.
``(v) Statewide coalition.--The term
`statewide coalition' means a coalition that--
``(I) includes, but is not limited
to--
``(aa) institutions of
higher education within a
State; and
``(bb) a nonprofit group, a
community underage drinking
prevention coalition, or
another substance use disorder
prevention group within a
State; and
``(II) works toward lowering the
alcohol abuse rate by targeting
underage students at institutions of
higher education throughout the State
and in the surrounding communities.
``(vi) Surrounding community.--The term
`surrounding community' means the community--
``(I) that surrounds an institution
of higher education participating in a
statewide coalition;
``(II) where the students from the
institution of higher education take
part in the community; and
``(III) where students from the
institution of higher education live in
off-campus housing.
``(G) Administrative expenses.--Not more than 5
percent of a grant under this paragraph may be expended
for administrative expenses.
``(H) Authorization of appropriations.--There are
authorized to be appropriated to carry out this
paragraph $6,000,000 for fiscal year 2011, and
$6,000,000 for each of the fiscal years 2012 through
2015.
``(f) Additional Research.--
``(1) Additional research on underage drinking.--
``(A) In general.--The Secretary shall, subject to
the availability of appropriations, collect 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) 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, including programs funded and implemented
by government entities, public health interest
groups and foundations, and alcohol beverage
companies and trade associations.
``(ii) Annually obtain and report 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) Compiling information on the
involvement of alcohol in unnatural deaths of
persons ages 12 to 20 in the United States,
including suicides, homicides, and
unintentional injuries such as falls,
drownings, burns, poisonings, and motor vehicle
crash deaths.
``(B) Certain matters.--The Secretary shall carry
out activities toward the following objectives with
respect to underage drinking:
``(i) Obtaining new epidemiological data
within the national or targeted surveys that
identify alcohol use and attitudes about
alcohol use during pre- and early adolescence,
including harm caused to self or others as a
result of adolescent alcohol use such as
violence, date rape, risky sexual behavior, and
prenatal alcohol exposure.
``(ii) Developing or identifying successful
clinical treatments for youth with alcohol
problems.
``(C) Peer review.--Research under subparagraph (A)
shall meet current Federal standards for scientific
peer review.
``(2) Authorization of appropriations.--There are
authorized to be appropriated to carry out this subsection
$6,000,000 for fiscal year 2011, and $6,000,000 for each of the
fiscal years 2012 through 2015.
``SEC. 523. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.
``(a) In General.--The Secretary shall make awards of grants,
cooperative agreements, or contracts to public and nonprofit private
entities, including American Indian and Alaska Native tribes, tribal
organizations, and a health facility or program operated by or pursuant
to a contract or grant with the Indian Health Service, to provide
services to individuals diagnosed with fetal alcohol syndrome or
alcohol-related birth defects.
``(b) Use of Funds.--An award under subsection (a) may, subject to
subsection (d), be used to--
``(1) screen and test individuals to determine the type and
level of services needed;
``(2) develop a comprehensive plan for providing services
to the individual;
``(3) provide mental health counseling;
``(4) provide substance use disorder prevention services
and treatment, if needed;
``(5) coordinate services with other social programs
including social services, justice system, educational
services, health services, mental health and substance use
disorder services, financial assistance programs, vocational
services and housing assistance programs;
``(6) provide vocational services;
``(7) provide health counseling;
``(8) provide housing assistance;
``(9) parenting skills training;
``(10) overall case management;
``(11) supportive services for families of individuals with
Fetal Alcohol Syndrome;
``(12) provide respite care for caretakers of individuals
with Fetal Alcohol Syndrome and other prenatal alcohol-related
disorders;
``(13) recruit and train mentors for individuals with Fetal
Alcohol Syndrome and other prenatal alcohol-related disorders;
``(14) provide educational and supportive services to
families of individuals with Fetal Alcohol Spectrum Disorders;
and
``(15) provide other services and programs, to the extent
authorized by the Secretary after consideration of
recommendations made by the National Task Force on Fetal
Alcohol Syndrome.
``(c) Requirements.--To be eligible to receive an award under
subsection (a), an applicant shall--
``(1) demonstrate that the program will be part of a
coordinated, comprehensive system of care for such individuals;
``(2) demonstrate an established communication with other
social programs in the community including social services,
justice system, financial assistance programs, health services,
educational services, mental health and substance use disorder
services, vocational services and housing assistance services;
``(3) show a history of working with individuals with fetal
alcohol syndrome or alcohol-related birth defects;
``(4) provide assurance that the services will be provided
in a culturally and linguistically appropriate manner; and
``(5) provide assurance that at the end of the 5-year award
period, other mechanisms will be identified to meet the needs
of the individuals and families served under such award.
``(d) Relationship to Payments Under Other Programs.--An award may
be made under subsection (a) only if the applicant involved agrees that
the award will not be expended to pay the expenses of providing any
service under this section to an individual to the extent that payment
has been made, or can reasonably be expected to be made, with respect
to such expenses--
``(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) 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.
``(f) 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.
``(g) Funding.--
``(1) Authorization of appropriations.--For the purpose of
carrying out this section, there are authorized to be
appropriated $25,000,000 for fiscal year 2011, and such sums as
may be necessary for each of the fiscal years 2012 through
2015.
``(2) Allocation.--Of the amounts appropriated under
paragraph (1) for a fiscal year, not less than $300,000 shall,
for purposes relating to fetal alcohol syndrome and alcohol-
related birth defects, be made available for collaborative,
coordinated interagency efforts with the National Institute on
Alcohol Abuse and Alcoholism, the National Institute on Child
Health and Human Development, the Health Resources and Services
Administration, the Agency for Healthcare Research and Quality,
the Centers for Disease Control and Prevention, the Department
of Education, and the Department of Justice.
``SEC. 524. 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
use disorder 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; or
``(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 abuse, alcohol use among
women of child bearing years, and alcohol use among pregnant
women and women considering pregnancy.
``(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 $9,200,000
for fiscal year 2011, and such sums as may be necessary for each of the
fiscal years 2012 through 2015.
``Subpart 3--Center for Mental Health Services
``SEC. 525. CENTER FOR MENTAL HEALTH SERVICES.
``(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 Department of Education and the
Department of Justice to develop programs to assist local
communities in addressing violence among children and
adolescents;
``(4) 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 through
programs that reduce risk and promote resiliency;
``(5) develop improved methods of treating individuals with
mental health problems and improved methods of assisting the
families of such individuals;
``(6) administer the mental health services block grant
program authorized in section 1911;
``(7) promote policies and programs at Federal, State, and
local levels and in the private sector that foster
independence, increase meaningful participation of, and protect
the legal rights of persons with mental illness, including
carrying out the provisions of the Protection and Advocacy of
Individuals with Mental Illness Act;
``(8) carry out the programs under part C;
``(9) carry out responsibilities for the Human Resource
Development program, and programs of clinical training for
paraprofessional personnel and health professionals;
``(10) 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, tele-mental
health, and improve the capacity of State to conduct
evaluations of publicly funded mental health programs;
``(11) provide technical assistance to public and private
entities that are providers of mental health services;
``(12) conduct surveys with respect to mental health, such
as the National Reporting Program; and
``(13) assist States in improving their mental health data
collection.
``(c) Grants and Contracts.--In carrying out the duties established
in subsection (b), the Director may makes grants to and enter into
contracts and cooperative agreements with public and nonprofit private
entities.
``SEC. 526. 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, territories, political subdivisions of States, Indian tribes
and tribal organizations, 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. The
requirements of this paragraph shall apply to Statewide
consumer family networks.
``(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.
``(f) Authorization of Appropriation.--
``(1) In general.--There are authorized to be appropriated
to carry out this section, $300,000,000 for fiscal year 2011,
and such sums as may be necessary for each of the fiscal years
2012 through 2015.
``(2) Data infrastructure.--If amounts are not appropriated
for a fiscal year to carry out section 1971 with respect to
mental health, then the Secretary shall make available, from
the amounts appropriated for such fiscal year under paragraph
(1), an amount equal to the sum of $6,000,000 and 10 percent of
all amounts appropriated for such fiscal year under such
paragraph in excess of $100,000,000, to carry out such section
1971.
``SEC. 527. SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.
``(a) Program Authorized.--The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration, 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 concerning the prevention of suicide among all
ages, particularly among groups that are at high risk for suicide.
``(b) Responsibilities of the Center.--The center established under
subsection (a) shall--
``(1) assist in the development or continuation of
statewide and tribal suicide early intervention and prevention
strategies for all ages, particularly among groups that are at
high risk for suicide;
``(2) ensure the surveillance of suicide early intervention
and prevention strategies for all ages, particularly among
groups that are at high risk for suicide;
``(3) study the costs and effectiveness of statewide and
tribal suicide early intervention and prevention strategies in
order to provide information concerning relevant issues of
importance to State, tribal, and national policymakers;
``(4) further identify and understand causes and associated
risk factors for suicide for all ages, particularly among
groups that are at high risk for suicide;
``(5) analyze the efficacy of new and existing suicide
early intervention and prevention techniques and technology for
all ages, particularly among groups that are at high risk for
suicide;
``(6) ensure the surveillance of suicidal behaviors and
nonfatal suicidal attempts;
``(7) study the effectiveness of State-sponsored statewide
and tribal suicide early intervention and prevention strategies
for all ages particularly among groups that are at high risk
for suicide on the overall wellness and health promotion
strategies related to suicide attempts;
``(8) promote the sharing of data regarding suicide with
Federal agencies involved with suicide early intervention and
prevention, and State-sponsored statewide and tribal suicide
early intervention and prevention strategies for the purpose of
identifying previously unknown mental health causes and
associated risk factors for suicide among all ages particularly
among groups that are at high risk for suicide;
``(9) evaluate and disseminate outcomes and best practices
of mental health and substance use disorder services at
institutions of higher education; and
``(10) conduct 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 $5,000,000
for fiscal year 2011, and such sums as may be necessary for each of
fiscal years 2012 through 2015.
``SEC. 528. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION STRATEGIES.
``(a) In General.--The Secretary, acting through the Administrator
of the Substance Abuse and Mental Health Services Administration, 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, 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 to develop or direct
the State-sponsored statewide 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
one grant or cooperative agreement under this section at any
one 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 constructed to apply to entities described
in paragraph (1)(C).
``(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, 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, 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, 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; and
``(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.
``(d) Requirement for Direct Services.--Not less than 85 percent of
grant funds received under this section shall be used to provide direct
services, of which not less than 5 percent shall be used for activities
authorized under subsection (a)(3).
``(e) Consultation and Policy Development.--
``(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
``(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 18
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 2 years after the date of
enactment of this section, 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 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 527, or section 529 shall not be used to pay for or refer for
abortion.
``(j) Parental Consent.--States and entities receiving funding
under this section 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
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 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 or secondary
school (as such terms are defined in section 9101 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
between 10 and 24 years of age.
``(m) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $34,000,000
for fiscal year 2011, $38,000,000 for fiscal year 2012, and $42,000,000
for fiscal year 2013, $46,000,000 for fiscal year 2014, and $50,000,000
for fiscal year 2015.
``SEC. 529. MENTAL HEALTH AND SUBSTANCE USE DISORDERS SERVICES ON
CAMPUS.
``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, 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, 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--
``(1) educational seminars;
``(2) the operation of hot lines;
``(3) preparation of informational material;
``(4) preparation of educational materials for families of
students to increase awareness of potential mental health and
substance use disorders issues of students enrolled at the
institution of higher education;
``(5) training programs for students and campus personnel
to respond effectively to students with mental health and
substance use disorders that can lead to school failure, such
as depression, substance use disorders, and suicide attempts,
and for staff on voluntary screening for such behavioral health
problems;
``(6) the creation of a networking infrastructure to link
colleges and universities that do not have mental health
services with health care providers who can treat mental health
and substance use disorders; or
``(7) the administration of voluntary mental health
screenings and assessments, not including the provision of
direct services.
``(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.--An institution of higher education desiring a
grant under this section 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 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.
``(3) A description of the outreach strategies of the
institution of higher education for promoting 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.
``(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 Congress 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 efforts to reduce the incidence of
suicide and substance use disorders.
``(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) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $5,400,000
for fiscal year 2011, $5,800,000 for fiscal year 2012, $6,200,000 for
fiscal year 2013, $6,600,000 for fiscal year 2014, and $7,000,000 for
fiscal year 2015.
``SEC. 530. GRANTS FOR JAIL DIVERSION PROGRAMS.
``(a) Program Authorized.--The Secretary shall make up to 125
grants to States, political subdivisions of States, American Indian and
Alaska Native tribes and tribal organizations, acting directly or
through agreements with other public or nonprofit entities, or a health
facility or program operated by or pursuant to 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, Indian tribe or tribal organization
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, 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) 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 involved in the system of care,
and law enforcement officers, attorneys, and judges; and
``(4) provide community outreach and crisis intervention.
``(e) 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.
``(f) 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.
``(g) 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.
``(h) 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.
``(i) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $10,000,000 for fiscal year
2011, and such sums as may be necessary for fiscal years 2012 through
2015.
``SEC. 531. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS MENTAL
ILLNESS AND CO-OCCURRING SUBSTANCE USE DISORDERS.
``(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 use disorders.
``(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 use
disorders 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,
American Indian or Alaska Native tribe, tribal organization, or a
health facility operated by or pursuant to a contract or grant with the
Indian Health Service, 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 use disorders;
``(3) to provide integrated mental health and substance use
disorder 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 use disorders at
sites that previously provided only mental health services or
only substance use disorder 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 use
disorder 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 Appropriations.--There are authorized to be
appropriated to carry out this section, $14,000,000 for fiscal year
2011, and such sums as may be necessary for each of fiscal years 2012
through 2015.
``SEC. 532. GRANTS RELATING TO THE INTEGRATION AND CO-LOCATING OF
SERVICES.
``(a) Grants for Integration of Mental Health and Substance Use
Disorder Services in Primary Care and Mental Health Settings.--
``(1) In general.--The Secretary, acting through the
Director of the Center for Mental Health Services, shall award
grants to public and private nonprofit entities to integrate
mental health and substance use disorder early intervention,
prevention, treatment, referral, and recovery services into
primary care settings, for projects that address mental health
and substance use disorder needs, including programs that--
``(A) integrate mental health services for older
adults into primary care settings, in order to provide
screening, referrals, and evidence-based intervention
and treatment services by individuals with appropriate
training and experience in the treatment of older
adults, including licensed mental health professionals;
and
``(B) provide mental health and substance use
disorders early intervention, prevention, treatment,
referral, and recovery services, for children and
adults, that are in coordination with community mental
health service programs and other appropriately trained
providers of care.
``(2) Application.--To be eligible to receive a grant or
cooperative agreement under this subsection an entity shall
prepare and submit to the Secretary an application at such
time, in such manner, and containing such information the
Secretary may require, including--
``(A) an assessment of the mental health and
substance use disorders care needs of patients served
by the primary care provider and how such needs will be
addressed;
``(B) assurances that the primary care setting will
have appropriately qualified mental health and
substance use disorders professional staff, including
licensed mental health professionals, to ensure prompt
treatment or triage for referral services or providers;
``(C) assurances that the primary care setting will
encourage formal coordination with community mental
health service programs and other appropriate providers
to ensure continuity of care;
``(D) assurances that the primary care setting has
experience in providing services to a variety of
populations, including racial and ethnic minorities and
low-income populations;
``(E) assurances that the primary care settings
uses evidence-based intervention and treatment
protocols (to the extent such protocols are available)
for mental health and substance use disorders;
``(F) assurances to report to the Secretary
standardized clinical and behavioral data and other
performance data necessary to evaluate patient outcomes
and to facilitate evaluations across participating
projects; and
``(G) a plan for sustainability beyond the Federal
grant period.
``(3) Use of funds.--Amounts awarded under this subsection
may be used to--
``(A) provide mental health promotion and substance
use disorder prevention services;
``(B) screen individuals for mental illness or
substance use;
``(C) diagnose and determine an appropriate
intervention;
``(D) provide brief intervention for individuals at
risk of mental illness or substance use;
``(E) treat or refer for treatment of a mental
illness or substance use disorder;
``(F) provide recovery support services or
referring individuals for services;
``(G) provide caregiver support and educational and
transportation services to improve access and
retention; or
``(H) facilitate networking between primary care
professionals and mental health and substance use
disorders professionals for--
``(i) case management development; and
``(ii) professional mentoring.
``(4) Duration.--A project may receive funding pursuant to
a grant under this subsection for a period of up to 3 years,
with an extension period of 2 additional years at the
discretion of the Secretary.
``(5) Supplement, not supplant.--Funds made available under
this subsection shall supplement, and not supplant, other
Federal, State, or local funds available to an entity to carry
out activities described in this subsection.
``(6) Matching requirements.--With respect to the costs of
the activities to be carried out by an entity under a grant or
cooperative agreement under this subsection, beginning with the
third year of the grant program, an entity shall provide
assurances that the entity will make available (directly or
through donations from public or private entities, including
in-kind donations) non-Federal contributions towards such costs
in an amount that is not less than $1 for each $4 of Federal
funds provided under the grant or cooperative agreement.
``(7) Report.--Grantees under this subsection shall,
beginning with the end of the second year of the grant, submit
yearly reports to the Secretary on the activities of the
grantee in support of the grant and the latest performance
data. Such reports shall contain recommendations as how to
replicate the project.
``(b) Grants for Co-Locating Primary and Specialty Care in
Community-Based Mental Health Settings.--
``(1) Definitions.--In this subsection:
``(A) Eligible entity.--The term `eligible entity'
means a qualified community mental health program
defined under section 1913(b)(1).
``(B) Special populations.--The term `special
populations' refers to the following 3 groups:
``(i) Children and adolescents with mental
and emotional disturbances who have co-
occurring primary care conditions and chronic
diseases.
``(ii) Adults with mental illnesses who
have co-occurring primary care conditions and
chronic diseases.
``(iii) Older adults with mental illnesses
who have co-occurring primary care conditions
and chronic diseases.
``(2) Program authorized.--The Secretary, acting through
the Administrator of the Substance Abuse and Mental Health
Services Administration and in coordination with the Director
of the Health Resources and Services Administration, shall
award grants to eligible entities to establish demonstration
projects for the provision of coordinated and integrated
services to special populations through the co-location of
primary and specialty care services in community-based mental
health and substance use disorder settings.
``(3) Application.--To be eligible to receive a grant under
this subsection, an eligible entity shall submit an application
to the Administrator at such time, in such manner, and
accompanied by such information as the Administrator may
require. Each such application shall include--
``(A) an assessment of the primary care needs of
the patients served by the eligible entity and a
description of how the eligible entity will address
such needs; and
``(B) a description of partnerships, cooperative
agreements, or other arrangements with local primary
care providers, including community health centers, to
provide services to special populations.
``(4) Use of funds.--
``(A) In general.--For the benefit of special
populations, an eligible entity shall use funds awarded
under this subsection for--
``(i) the provision, by qualified primary
care professionals on a reasonable cost basis,
of--
``(I) primary care services on site
at the eligible entity;
``(II) diagnostic and laboratory
services; or
``(III) adult and pediatric eye,
ear, and dental screenings;
``(ii) reasonable costs associated with
medically necessary referrals to qualified
specialty care professionals;
``(iii) information technology required to
accommodate the clinical needs of primary and
specialty care professionals; or
``(iv) equipment needed to provide primary
care services on site at the eligible entity.
``(B) Limitation.--Not to exceed 15 percent of
grant funds may be used for activities described in
clauses (iii) and (iv) of subparagraph (A).
``(5) Geographic distribution.--The Secretary shall ensure
that grants awarded under this subsection are equitably
distributed among the geographical regions of the United States
and between urban and rural populations.
``(6) Evaluation.--Not later than 3 months after a grant or
cooperative agreement awarded under this subsection expires, 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.
``(c) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section, $70,000,0000 for fiscal year
2011 and such sums as may be necessary for each of fiscal years 2012
through 2015.
``SEC. 533. TRAINING GRANTS.
``(a) In General.--The Secretary shall award grants in accordance
with the provisions of this section.
``(b) Mental Illness Awareness Training Grants.--
``(1) In general.--The Secretary shall award grants to
States, political subdivisions of States, American Indian and
Alaska Native tribes, tribal organizations, a health facility
or program operated by or pursuant to a contract or grant with
the Indian Health Service, 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 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, law enforcement, 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 to--
``(A) train teachers and other relevant school
personnel to recognize symptoms of childhood and
adolescent mental disorders and appropriately respond;
``(B) train emergency services personnel to
identify and appropriately respond to persons with a
mental illness; and
``(C) provide education to such teachers and
personnel regarding resources that are available in the
community for individuals with a mental illness.
``(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) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection, $25,000,000
for fiscal year 2011 and such sums as may be necessary for each
of fiscal years 2012 through 2015.
``SEC. 534. OLDER ADULT MENTAL HEALTH GRANTS.
``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, shall award grants, contracts,
and cooperative agreements to public and private nonprofit entities for
projects that address the mental health needs of older adults,
including programs to--
``(1) support the establishment and maintenance of
interdisciplinary geriatric mental health specialist outreach
teams in community settings where older adults reside or
receive social services, in order to provide screening,
referrals, and evidence-based intervention and treatment
services, including services provided by licensed mental health
professionals;
``(2) develop and implement older adult suicide early
intervention and prevention strategies in 1 or more settings
that serve seniors, and collect and analyze data on older adult
suicide early intervention and prevention services for purposes
of monitoring, research, and policy development; and
``(3) other programs as designated by the Secretary, that
would improve the mental health of older Americans.
``(b) 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;
``(2) a variety of populations, including racial and ethnic
minorities and low-income populations, are served by projects
funded under this section; and
``(3) older adult suicide intervention and prevention
programs are targeted towards areas with high older adult
suicide rates.
``(c) 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);
``(2) agree to report to the Secretary standardized
clinical and behavioral data or other performance data
necessary to evaluate patient or program outcomes and to
facilitate evaluations across participating projects;
``(3) demonstrate how such applicant will collaborate with
other State and local public and private nonprofit
organizations; and
``(4) submit a plan for the sustainability of the program
beyond the Federal grant period.
``(d) Duration.--A project may receive funding under 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) Supplement, Not Supplant.--Funds made available under this
section shall be used to supplement, and not supplant, other Federal,
State, or local funds available to an entity to carry out activities
described in this section.
``(f) Matching Requirement.--With respect to the costs of the
activities to be carried out by an entity under a grant under this
section, beginning with the third year of the grant program, an entity
shall provide assurances that the entity will make available (directly
or through a donation from public or private entities, including in-
kind donations) non-Federal contributions towards such costs in an
amount that is not less than $1 for each $4 of Federal funds provided
under the grant.
``(g) Report.--Grantees under this section shall, beginning with
the end of the second year of the grant, submit yearly reports to the
Secretary on the activities of the grantee in support of the grant and
the latest performance data. Such reports shall contain recommendations
as how to replicate the project.
``(h) Definitions.--In this section, the term `older adult' has the
meaning given the term `older individual' in section 101 of the Older
Americans Act of 1965.
``(i) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, such sums as may be necessary
for each of fiscal years 2011 through 2015.
``SEC. 535. GRANTS FOR TELE-MENTAL HEALTH IN RURAL AND MEDICALLY
UNDERSERVED AREAS.
``(a) Program Authorized.--The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration and in coordination with the Administrator of the Health
Resources and Services Administration and the National Coordinator for
Health Information Technology, shall award grants to eligible entities
to provide tele-mental health in rural and medically underserved areas.
The Secretary shall ensure that such grant are coordinated with, and
are not duplicative of, activities funded by the Federal Communications
Commission.
``(b) Eligible Entity.--To be eligible for assistance under the
program under subsection (a), an entity shall be a qualified community
program as determined by the Secretary.
``(c) Application.--
``(1) In general.--Each eligible entity desiring a grant
under this section shall submit an application to the Secretary
at such time, in such manner, and containing such information
as the Secretary may reasonably require.
``(2) Assurances.--The application shall include assurances
that the applicant will meet the requirements of this
subsection and that the applicant possesses sufficient
infrastructure to manage the activities to be funded through
the grant and to evaluate and report on the outcomes resulting
from such activities.
``(d) Use of Funds.--An eligible entity shall use funds received
under a grant under this section for--
``(1) the provision of tele-mental health services,
including the provision of services to children and older
adults; or
``(2) technological improvements for the provision of tele-
mental health services in accordance with any guidelines, as
available, on health information technology that are developed
by the Secretary.
``(e) Geographic Distribution.--The Secretary shall ensure that
grants awarded under this section are equitably distributed among the
geographical regions of the United States and between urban and rural
populations.
``(f) Evaluation.--Not later than 3 months after the end of a
project that is funded by a grant awarded under this section, the
eligible entity involved 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.
``(g) Report.--Not later than 5 years after the date of enactment
of this section, the Secretary shall prepare and submit to the
appropriate committees of Congress a report that shall evaluate the
activities funded under this section.
``(h) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $20,000,000 for fiscal year
2011, and such sums as may be necessary for each of fiscal years 2012
through 2015.
``SEC. 536. IMPROVING HEALTH INFORMATION TECHNOLOGY FOR MENTAL HEALTH
PROVIDERS.
``The Secretary, in consultation with the Secretary of Veterans
Affairs, shall collaborate with the Administrator and the National
Coordinator for Health Information Technology to develop and implement
a plan for ensuring that the National Health Information Infrastructure
addresses the needs of mental health and substance abuse treatment
providers.
``PART C--PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS
``SEC. 541. FORMULA GRANTS TO STATES.
``For the purpose of carrying out section 542, the Secretary,
acting through the Director of the Center for Mental Health Services,
shall for each fiscal year make an allotment for each State in an
amount determined in accordance with section 544. 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 549.
``SEC. 542. PURPOSE OF GRANTS.
``(a) In General.--The Secretary may not make payments under
section 541 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
substance use disorders; 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, food stamps, 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 541 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
542(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 substance use disorder.
``(d) Special Consideration Regarding Veterans.--The Secretary may
not make payments under section 541 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 541 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 substance
use disorders; 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 541 unless the State involved agrees that not more than 4
percent of the payments will be expended for administrative expenses
regarding the payments.
``(g) Maintenance of Effort.--The Secretary may not make payments
under section 541 unless the State involved agrees that the State will
maintain State expenditures for services specified in subsection (b) at
a level that is not less than the average level of such expenditures
maintained by the State for the 2-year period preceding the fiscal year
for which the State is applying to receive such payments.
``(h) Restrictions on Use of Funds.--The Secretary may not make
payments under section 541 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.
``(i) 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. 543. REQUIREMENT OF MATCHING FUNDS.
``(a) In General.--The Secretary may not make payments under
section 541 unless, with respect to the costs of providing services
pursuant to section 542, 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 541 unless the State involved agrees that
the State will not require the entities to which grants are provided
pursuant to section 542(a) to provide non-Federal contributions in
excess of the non-Federal contributions described in subsection (a).
``SEC. 544. DETERMINATION OF AMOUNT OF ALLOTMENT.
``(a) Determination Under Formula.--Subject to subsection (b), the
allotment required in section 541 for a State for a fiscal year is the
product of--
``(1) an amount equal to the amount appropriated for
allotments under section 555 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).
``(b) Minimum Allotment.--
``(1) In general.--Subject to paragraph (2), the allotment
for a State under section 541 for a fiscal year shall, at a
minimum, be the greater of--
``(A) the amount the State received under section
541 in fiscal year 2007; and
``(B) $600,000 for each of the several States, the
District of Columbia, and the Commonwealth of Puerto
Rico, and $100,000 for each of Guam, the Virgin
Islands, American Samoa, and the Commonwealth of the
Northern Mariana Islands.
``(2) Condition.--If the funds appropriated in any fiscal
year under section 555 are insufficient to ensure that States
receive a minimum allotment in accordance with paragraph (1),
then--
``(A) no State shall receive less than the amount
they received in fiscal year 2007; and
``(B) any funds remaining after amounts are
provided under subparagraph (A) shall be used to meet
the requirement of paragraph (1)(B), to the maximum
extent possible.
``(c) Study Concerning Formula.--Not later than 1 year after the
date of enactment of the SAMHSA Modernization Act of 2010, the
Administrator shall conduct a study concerning the formula used for
allotments under subsection (a). Such study shall include an evaluation
of quality indicators of need for purposes of revising such formula for
determinations of the amount of subsequent allotments. The
Administrator shall submit to the appropriate committees of Congress, a
report concerning the results of such study.
``SEC. 545. 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 542(b).
``(b) Specification of Funds.--The amounts referred to in
subsection (a) are any amounts made available in appropriations Acts
for allotments under section 541 that are not paid to a State as a
result of--
``(1) the failure of the State to submit an application
under section 549;
``(2) 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
``(3) 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. 546. PROVISION OF CERTAIN INFORMATION FROM STATE.
``The Secretary may not make payments under section 541 to a State
unless, as part of the application required in section 549, 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 543;
``(4) contains assurances that the non-Federal
contributions described in section 543 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. 547. DESCRIPTION OF INTENDED EXPENDITURES OF GRANT.
``(a) In General.--The Secretary may not make payments under
section 541 unless--
``(1) as part of the application required in section 549,
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 542.
``(b) Opportunity for Public Comment.--The Secretary may not make
payments under section 541 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 541 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 I of part B of title XIX.
``(2) Special rule.--The Secretary may not make payments
under section 541 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. 548. REQUIREMENT OF REPORTS BY STATES.
``(a) In General.--The Secretary may not make payments under
section 541 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 Administrator of
the Substance Abuse and Mental Health Services Administration) to be
necessary for--
``(1) securing a record and a description of the purposes
for which amounts received under section 541 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 541 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 Administrator of the
Substance Abuse and Mental Health Services Administration 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. 549. REQUIREMENT OF APPLICATION.
``The Secretary may not make payments under section 541 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. 550. TECHNICAL ASSISTANCE.
``The Secretary, through the Administrator, shall provide technical
assistance to eligible entities in developing planning and operating
programs in accordance with the provisions of this part.
``SEC. 551. 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 541 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 549.
``(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 541.
``(b) Withholding of Payments.--
``(1) The Secretary may, subject to subsection (c),
withhold payments due under section 541 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 549.
``(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 541 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 541 may not, with
respect to any agreements required to be contained in the application
submitted under section 549, 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 542(b) to eligible homeless
individuals, incidentally provides services to homeless individuals who
are not eligible homeless individuals.
``SEC. 552. 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 541.
``(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 541 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. 553. 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 541 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 541.
``(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 541, 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. 554. DEFINITIONS.
``For purposes of this part:
``(1) Eligible homeless individual.--The term `eligible
homeless individual' means an individual described in section
542(a).
``(2) Homeless individual.--The term `homeless individual'
has the meaning given such term in section 330(h)(5)(A).
``(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. 555. FUNDING.
``(a) Authorization of Appropriations.--For the purpose of carrying
out this part, there is authorized to be appropriated $75,000,000 for
each of the fiscal years 2011 through 2015.
``(b) Allocation for Technical Assistance.--For purposes of
carrying out section 550, the Administrator shall obligate 2 percent of
the amounts appropriated under subsection (a) for a fiscal year.
``PART D--MISCELLANEOUS PROVISIONS RELATING TO SUBSTANCE USE DISORDERS
AND MENTAL ILLNESS
``SEC. 561. SUBSTANCE USE DISORDERS AMONG GOVERNMENT AND OTHER
EMPLOYEES.
``(a) Programs and Services.--
``(1) Development.--The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration, shall be responsible for fostering substance
use disorder 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 Administrator of the
Substance Abuse and Mental Health Services
Administration, 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 Administrator of the Substance Abuse
and Mental Health Services Administration, shall
disseminate information and materials relative to such
model programs to the State agencies responsible for
the administration of substance use disorder
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 use
disorders.
``(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. 562. 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 use disorder, 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 use disorders. 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. 563. 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 content of any record referred to in
subsection (a) may be disclosed in accordance with the prior
written consent of the patient with respect to whom such record
is maintained, but only to such extent, under such
circumstances, and for such purposes as may be allowed under
regulations prescribed pursuant to subsection (g).
``(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 therefore, 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.
``(c) Use of Records in Criminal Proceedings.--Except as authorized
by a court order granted under subsection (b)(2)(C), no record referred
to in subsection (a) may be used to initiate or substantiate any
criminal charges against a patient or to conduct any investigation of a
patient.
``(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.--Any person who violates any provision of this
section or any regulation issued pursuant to this section shall be
fined in accordance with title 18, United States Code.
``(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 disorders. 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.
``PART E--CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES
``SEC. 571. 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.
``(3) Waiver regarding native american and alaskan native
tribes and tribal organizations.--In the case of a grantee that
is a Native Americans or Alaskan Native tribe or tribal
organization, the Secretary may waive, in whole or in part, the
requirements of this subsection.
``SEC. 572. 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 571(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 571(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 571(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 571(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 571(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 571(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 571(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 571(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 571(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
573; 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 571(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 571(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 571(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 574(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. 573. INDIVIDUALIZED PLAN FOR SERVICES.
``(a) In General.--A funding agreement for a grant under section
571(a) is that a system of care under section 572(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 571(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;
``(c) Coordination With Services Under Individuals With
Disabilities Education Act.--A funding agreement for a grant under
section 571(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 572(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 571(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 572 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 572(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. 574. ADDITIONAL PROVISIONS.
``(a) Optional Services.--In addition to services described in
subsection (c) of section 572, a system of care under subsection (a) of
such section may, in expending a grant under section 571(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 572(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 573;
``(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 571(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 571(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 571(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 571(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 571(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 571(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 571(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 571(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. 575. GENERAL PROVISIONS.
``(a) Duration of Support.--The period during which payments are
made to a public entity from a grant under section 571(a) may not
exceed 6 fiscal years.
``(b) Technical Assistance.--
``(1) In general.--The Secretary shall, upon the request of
a public entity--
``(A) provide technical assistance to the entity
regarding the process of submitting to the Secretary
applications for grants under section 571(a) and 576;
and
``(B) provide to the entity training and technical
assistance with respect to the planning, development,
and operation of systems of care pursuant to section
572.
``(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 571(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 572(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) and any
foster parents of the child.
``(3) The term `funding agreement', with respect to a grant
under section 571(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.
``SEC. 576. STATE INTEGRATED SYSTEMS OF CARE GRANTS FOR KEEPING
FAMILIES TOGETHER.
``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services, shall award grants or
cooperative agreements to States for the purpose of facilitating and
promoting the implementation in local communities of an integrated
system of care for children with mental illness, especially for those
with serious emotional disturbance.
``(b) Applications.--To be eligible for a grant under subsection
(a), a State shall submit to the Secretary an applications that shall
include, at a minimum, the following:
``(1) An assurance that the State will establish a board to
be made up of, at least, the directors of the State departments
or agencies responsible for mental health, substance use
disorder, child welfare, education, medicaid, juvenile justice,
and consumers and families of consumers to carry out the
purpose of the grant.
``(2) A description of the specific population that the
State wishes to focus on under the grant.
``(3) An assurance that the plan required under subsection
(e) will be submitted within 18 months of the receipt of the
grant.
``(4) Otherwise be in such form, made in such manner, and
contain such agreements, assurances, and information as the
Secretary determines to be necessary.
``(c) Duration of Grants.--The period during which payments are
made under a grant under this section may not exceed 5 years.
``(d) Priority.--In awarding grants under this section, the
Secretary shall give priority to States that elect to use grant funds
to focus on children who are, or are at risk of being placed, in the
child welfare or juvenile justice systems as a direct result of parents
relinquishing their rights in order to get the mental health services
their child needs.
``(e) Plan.--To be eligible to receive a grant under this section,
a State shall agree to submit to the Secretary for approval, a plan,
within 18 months of the receipt of the grant, that at a minimum
includes the following:
``(1) A description of the population that the State will
focus on, including indications on the number of individuals in
the population and the severity of their mental illness.
``(2) A description of how these individuals are being
served or not served by the State system.
``(3) A description of the finances that are currently
being used throughout the State to serve this population,
including funds from the mental health agency.
``(4) A description of the types of services such
population is receiving, including if applicable, services
provided under section 571.
``(5) A description of the coordination that exists among
the various agencies serving children, including child welfare,
education, health, and juvenile justice agencies.
``(6) A description of the barriers that exist in the
provision of services, including State policies and procedures.
``(7) A description of how the State intends to overcome
these barriers, including changing the barriers within State
policies and procedures.
``(8) A description of how the State will finance the
implementation of systems of care for children.
``(9) A description of how the State intends to promote a
comprehensive system of care that includes a shift in reliance
on residential and institutional services to increased home and
community-based services.
``(10) A description of the number of children in the child
welfare or juvenile justice system as a direct result of
parents relinquishing their rights in order to get the mental
health services that their child needed.
``(11) A description of how the State intends to track
outcomes through data collection for individuals that receive
services in the system of care, including improved school
attendance and achievement, reduced substance use, reduced
contact with law enforcement, detention and arrest rates,
reductions in out-of-home placement, and mental health
improvements sustained.
``(f) Use of Funds.--Amounts received under a grant under this
section may be used for any activity necessary for the development of
the plan submitted under subsection (e) and any costs associated with
the implementation of the approved plan.
``(g) Training and Technical Assistance.--The Secretary shall, upon
the request of the State, provide training and technical assistance to
the State in the development and implementation of the plan submitted
under subsection (e).
``(h) Reports.--Beginning with the second year in which a State
receives a grant under this section, and each grant year thereafter,
the State shall submit a report to the Secretary detailing the State's
progress in implementing the plan submitted under subsection (e).
``SEC. 577. AUTHORIZATION OF APPROPRIATIONS.
``(a) Authorization of Appropriations.--For the purpose of carrying
out this part, there are authorized to be appropriated $150,000,000 for
fiscal year 2011, and such sums as may be necessary for each of the
fiscal years 2012 through 2015.
``(b) Grants Under Section 576.--Not to exceed $10,000,000 of the
amount appropriated under subsection (a) for each fiscal year may be
used for grants under section 576.
``PART F--WORKFORCE DEVELOPMENT
``SEC. 581. WORKFORCE DEVELOPMENT GRANTS, CONTRACTS, AND COOPERATIVE
AGREEMENTS FOR MENTAL HEALTH AND SUBSTANCE USE DISORDERS.
``(a) Purpose.--It is the purpose of this section to promote
workforce development by identifying and implementing innovative and
effective strategies to recruit and retain qualified mental health
promotion and treatment and substance use disorder prevention and
treatment staff and by disseminating those strategies to States and
public and non-profit private providers of mental health and substance
use disorder services.
``(b) Grants and Contracts.--The Secretary shall award grants,
contracts, or cooperative agreements to eligible entities to identify
and implement effective, innovative strategies to recruit and retain a
workforce qualified to provide mental health and substance use disorder
prevention and treatment services in the public sector.
``(c) Eligibility.--To be eligible to receive a grant, contract, or
cooperative agreement under this section, an entity shall--
``(1) be a State, American Indian or Alaska Native tribe,
tribal organization, a health facility or program operated by
or pursuant to a contract or grant with the Indian Health
Service, or non-profit entity;
``(2) submit to the Secretary an application at such time,
in such manner, and containing such information as the
Secretary may require;
``(3) agree to collect and provide to the Secretary such
data as required by the Secretary to objectively demonstrate
the effect of the strategy implemented through such grant,
contract, or cooperative agreement; and
``(4) agree to participate in conferences conducted by the
Secretary expressly for the purposes of developing
recommendations on best practices for recruiting and retaining
a qualified workforce.
``(d) Use of Funds.--
``(1) In general.--An entity shall use amounts received
under this section to identify and implement innovative
strategies to--
``(A) identify and recruit individuals into the
mental health and substance use disorder public service
workforce, including paraprofessionals and individuals
in recovery and their families;
``(B) assist individuals in obtaining basic or
specialized competencies for providing mental health
promotion and treatment services and substance use
disorder prevention, treatment, and recovery services;
and
``(C) retain qualified mental health and substance
use disorder treatment staff, including staff who
provide services that promote mental health, prevent
substance use, or treat mental illness and substance
use disorders.
``(2) Limitation.--Eligible entities that receive funds
under this section may not use such funds to pay for loan
repayment or forgiveness programs, or for a degree at an
institution of higher education or at any other institution.
``(e) Priorities.--In awarding grants, contracts, or cooperative
agreements under this section the Secretary shall ensure that priority
is given to--
``(1) entities in rural areas and mental health and
substance use disorder manpower shortage areas; and
``(2) entities that agree to focus on the inclusion of
racial and ethnic minorities in the workforce.
``(f) Geographic Distribution.--The Secretary shall ensure that to
the extent practicable, an equitable distribution of grants, contracts,
and cooperative agreements among the geographical regions of the United
States and between urban and rural populations.
``(g) Technical Assistance.--The Secretary shall provide technical
assistance to eligible entities and conduct conferences to promote the
sharing of ideas for the development of best practices in the
recruitment and retention of a qualified mental health and substance
use disorder prevention and treatment workforce.
``(h) Evaluation.--Not later than 3 years after the receipt of a
grant, contract, or cooperative agreement under this section, an entity
shall--
``(1) conduct an evaluation of the activities carried out
with funds received under the grant, contract, or cooperative
agreement;
``(2) submit to the Secretary a report concerning the
results of the evaluation under paragraph (1); and
``(3) participate in any further evaluation of the program
by the Secretary.
``(i) Dissemination.--The Secretary shall disseminate to States and
public and non-profit private providers of mental health and substance
use disorder services the proven effective strategies developed under
this section.
``(j) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $25,000,000 for fiscal year
2011, and such sums as may be necessary for each of fiscal years 2012
through 2015.
``SEC. 582. DATA COLLECTION AND REPORT ON WORKFORCE ISSUES.
``Not later than 5 years after the date of enactment of the SAMHSA
Modernization Act of 2010, the Administrator shall submit to the
appropriate committees of Congress a report based on the data collected
pursuant to sections 1912(b) and 1931(b). Such report shall contain--
``(1) an assessment of the mental health and substance use
disorder workforce capacity, strengths, and weaknesses as of
the date of the report;
``(2) recommendations for legislation to assist Congress in
reauthorizing this title in fiscal year 2014;
``(3) specific recommendations for States, communities, and
public and non-profit private providers of mental health and
substance use disorder services;
``(4) data and best practices identified under section 581;
and
``(5) recommendations for national outcomes measures of
workforce.
``PART G--SCHOOL-BASED MENTAL HEALTH
``SEC. 585. SCHOOL-BASED MENTAL HEALTH AND CHILDREN AND VIOLENCE.
``(a) In General.--The Secretary, in collaboration with the
Secretary of Education and in consultation with the Attorney General,
shall, directly or through grants, contracts or cooperative agreements
awarded to public entities and local education agencies, assist local
communities and schools in applying a public health approach to mental
health services both in schools and in the community. Such approach
should provide comprehensive age appropriate services and supports and
incorporate age appropriate strategies of positive behavioral
interventions and supports. A comprehensive school mental health
program funded under this section shall assist children in dealing with
violence.
``(b) Activities.--Under the program under subsection (a), the
Secretary may--
``(1) provide financial support to enable local communities
to implement a comprehensive school mental health program that
incorporates positive behavioral interventions and supports to
foster the health and development of children;
``(2) provide technical assistance to local communities
with respect to the development of programs described in
paragraph (1);
``(3) provide assistance to local communities in the
development of policies to address child and adolescent mental
health issues and violence when and if it occurs;
``(4) facilitate community partnerships among families,
students, law enforcement agencies, education systems, mental
health and substance use disorder service systems, family-based
mental health service systems, welfare agencies, healthcare
service systems, and other community-based 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.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a) an entity shall--
``(A) be a partnership between a local education
agency and at least one community program or agency
that is involved in mental health; and
``(B) submit an application, that is endorsed by
all members of the partnership, that makes the
assurances described in paragraph (2).
``(2) Required assurances.--An application under paragraph
(1) shall assure the following:
``(A) That the applicant will ensure that, in
carrying out activities under this section, the local
educational agency involved will enter into a
memorandum of understanding--
``(i) with, at a minimum, public or private
mental health entities, healthcare entities,
law enforcement or juvenile justice entities,
child welfare agencies, family-based mental
health entities, families and family
organizations, and other community-based
entities; and
``(ii) that clearly states--
``(I) the responsibilities of each
partner with respect to the activities
to be carried out;
``(II) how each partner will be
accountable for carrying out such
responsibilities; and
``(III) the amount of non-Federal
funding or in-kind contributions that
each such partner will contribute in
order to sustain the program.
``(B) That the comprehensive school-based mental
health program carried out under this section support
the flexible use of funds to address--
``(i) the promotion of the social,
emotional, and mental health of all students in
an environment that is conducive to learning;
``(ii) the reduction in the likelihood of
at risk students developing social or emotional
problems or mental health and substance use
disorders;
``(iii) the early identification of social
or emotional problems or mental health and
substance use disorders and the provision of
early intervention services;
``(iv) the treatment or referral for
treatment of students with existing social or
emotional problems or mental health and
substance use disorders; and
``(v) the development and implementation of
programs to assist children in dealing with
violence.
``(C) That the comprehensive mental health program
carried out under this section will provide for in-
service training of all school personnel, including
ancillary staff and volunteers, in--
``(i) the techniques and support needed to
identify early children with, or at risk of,
mental illness;
``(ii) the use of referral mechanisms that
effectively link such children to treatment
intervention services;
``(iii) strategies that promote a
schoolwide positive environment, and includes
an on-going training and coaching component;
``(iv) strategies for promoting the social,
emotional, and mental health of all students;
and
``(v) strategies to increase the knowledge
and skills of school and community leaders on
the application of a public health approach to
comprehensive school-based mental health
programs.
``(D) That the comprehensive school-based mental
health programs carried out under this section will
demonstrate the measures to be taken to sustain the
program after funding under this section terminates.
``(E) That the local education agency partnership
involved is supported by the State educational and
mental health system to ensure that the sustainability
of the programs is established after funding under this
section terminates.
``(F) That the comprehensive school-based mental
health program carried out under this section is based
on scientifically valid research, when available, or
evidence-based practices.
``(G) That the comprehensive school-based mental
health program carried out under this section is
coordinated with early intervening activities carried
out under the Individuals with Disabilities Education
Act.
``(d) Geographical Distribution.--The Secretary shall ensure that
grants, contracts or cooperative agreements under subsection (a) will
be distributed equitably among the regions of the country and among
urban and rural areas.
``(e) Duration of Awards.--With respect to a grant, contract or
cooperative agreement under subsection (a), the period during which
payments under such an award will be made to the recipient shall be 5
years. An entity may only receive one award under this section, except
that an entity that is providing services and supports on a regional
basis may receive additional funding after the expiration of the
preceding grant period.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Administrator shall
develop a process for evaluating activities carried out under
this section. Such process shall include--
``(A) the development of guidelines for the
submission of program data by such recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under
this section; and
``(C) the submission of annual reports by such
recipients concerning the effectiveness of programs
carried out under this section.
``(2) Measures of outcomes.--
``(A) In general.--The Administrator shall develop
measures of outcomes to be applied by recipients of
assistance under this section, and the Administrator,
in evaluating the effectiveness of programs carried out
under this section. Such measures shall include student
and family measures as provided for in subparagraph (B)
and local educational measures as provided for under
subparagraph (C).
``(B) Student and family measures of outcomes.--The
measures of outcomes developed under paragraph (1)(B)
relating to students and families shall, with respect
to activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) whether the program resulted in an
increase in social and emotional competency;
``(ii) whether the program resulted in an
increase in student academic achievement;
``(iii) whether the program resulted in a
reduction in disruptive and aggressive
behaviors;
``(iv) whether the program resulted in
improved family functioning;
``(v) whether the program resulted in a
reduction in substance use disorders;
``(vi) whether the program resulted in a
reduction in suspensions, truancy, expulsions
and violence; and
``(vii) whether the program resulted in
improved access to care for mental health
disorders.
``(C) Local educational outcomes.--The outcome
measures developed under paragraph (1)(B) relating to
local educational systems shall, with respect to
activities carried out under a program under this
section, at a minimum include provisions to evaluate--
``(i) the effectiveness of comprehensive
school mental health programs established under
this section;
``(ii) the effectiveness of formal
partnership linkages among child and family
serving institutions, community support
systems, and the educational system;
``(iii) the progress made in sustaining the
program once funding under the grant has
expired; and
``(iv) the effectiveness of training and
professional development programs for all
school personnel.
``(3) Submission of annual data.--An entity that receives a
grant, contract, or cooperative agreement under this section
shall annually submit to the Administrator a report that
include data to evaluate the success of the program carried out
by the entity based on whether such program is achieving the
purposes of the program. Such reports shall utilize the
measures of outcomes under paragraph (2) in a reasonable manner
to demonstrate the progress of the program in achieving such
purposes.
``(4) Evaluation by administrator.--Based on the data
submitted under paragraph (3), the Administrator shall annually
submit to Congress a report concerning the results and
effectiveness of the programs carried out with assistance
received under this section.
``(g) Information and Education.--The Secretary shall establish
comprehensive information and education programs to disseminate the
findings of the knowledge development and application under this
section to the general public and to health care professionals.
``(h) Amount of Grants and Authorization of Appropriations.--
``(1) Amount of grants.--A grant under this section shall
be in an amount that is not more than $1,000,000 for each of
grant years 2011 through 2015. The Secretary shall determine
the amount of each such grant based on criteria determined by
the Secretary.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $200,000,000 for
each of fiscal years 2011 through 2015.
``SEC. 586. GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO EXPERIENCE
VIOLENCE RELATED STRESS.
``(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 the continued
operation of the National Child Traumatic Stress Initiative, that focus
on the behavioral and biological aspects of psychological trauma
response and for developing knowledge with regard to evidence-based
practices for treating trauma-related 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) related to the development of knowledge
and provision of services based on evidence-based practices for
treating disorders associated with psychological trauma, the Secretary
shall give priority to mental health agencies and programs that have
established clinical and basic research experience in the field of
trauma-related mental disorders, and that contribute to the
establishment of a national trauma infrastructure.
``(c) Geographical Distribution.--The Secretary shall ensure that
grants, contracts or cooperative agreements under subsection (a) with
respect to centers of excellence are distributed equitably among the
regions of the country and among urban and rural areas.
``(d) Evaluation.--The Secretary, as part of the application
process, shall require that each applicant for a grant, contract or
cooperative agreement under subsection (a) submit a plan for the
rigorous 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.
``(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 for 5 years.
Such grants, contracts or agreements may be renewed, except that
expertise and experience in the field of trauma-related disorders shall
be the priority criterion for new and continuing grant, contract, or
cooperative agreement awards.
``(f) Authorization of Appropriations.--There is authorized to be
appropriated to carry out this section, $50,000,000 for fiscal year
2011, and such sums as may be necessary for each of fiscal years 2012
through 2015.
``PART H--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES
``Subpart I--Medical Facilities
``SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
MEDICAL 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. REPORTING REQUIREMENT.
``(a) In General.--Each facility to which the Protection and
Advocacy for Mentally Ill Individuals Act of 1986 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.
``(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 1986 (42 U.S.C.
10802(3)).
``SEC. 593. REGULATIONS AND ENFORCEMENT.
``(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 1986
(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.
``Subpart II--Non-Medical and Community-Based Facilities
``SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF INDIVIDUALS OF
CERTAIN NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR
CHILDREN AND YOUTH.
``(a) Protection of Rights.--
``(1) In general.--
``(A) Community-based facilities.--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.
``(B) Schools.--A public, private, residential or
non-residential school (as defined in regulations to be
promulgated by the Secretary in consultation with the
Secretary of Education) 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
individual of the facility, including the right to be
free from physical or mental abuse, corporal punishment
(as defined by State law), 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 an individual by a facility described in
subsection (a)(1) if--
``(A) the restraints or seclusion are imposed only
in emergency circumstances and only to ensure the
immediate physical safety of the individual, a staff
member, students, 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 in the case of facilities
described in subsection (a)(1)(B) promulgated by the
Secretary in consultation with the Secretary of
Education) and pursuant to a process determined
appropriate by the State and approved by the Secretary,
and in the case of facilities described in subsection
(a)(1)(B) approved by the Secretary in consultation
with the Secretary of Education, 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 to 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, and in the case
of facilities described in subsection (a)(1)(B)
promulgated by the Secretary in consultation
with the Secretary of Education), 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 individual's freedom of movement that is
not a standard treatment for the individual's medical
or psychiatric condition in a facility described in
subsection (a)(1) is prohibited.
``(B) Prohibition.--The use of mechanical
restraints in a facility described in subsection (a)(1)
is prohibited.
``(C) Limitation.--A 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 individual 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
an individual'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 an individual 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 or individual service plan and may involve the
separation of the individual from the group, in a non-locked
setting, for the purpose of calming. Time out is not seclusion.
``SEC. 596. REPORTING REQUIREMENT.
``Each facility (described in section 595(a)(1)) shall notify the
appropriate State licensing or regulatory agency, as determined by the
Secretary, and in the case of facilities described in section
595(a)(1)(B) determined by the Secretary in consultation with the
Secretary of Education--
``(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 Secretary of Education in the case of facilities
described in section 595(a)(1)(B), and the States.
``SEC. 597. REGULATIONS AND ENFORCEMENT.
``(a) Training.--Not later than 6 months after the date of the
enactment of the SAMHSA Modernization Act of 2010, the Secretary, after
consultation with the Secretary of Education in the case of facilities
described in section 595(a)(1)(B), appropriate State, local, public and
private protection and advocacy organizations, health care
professionals, social workers, facilities described in section
595(a)(1), and individuals receiving services from such facilities,
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 that monitor compliance of facilities
described in section 595(a)(1)(B) with Federal and State laws
and standards to develop rules and monitoring requirements
concerning behavior management practice that will ensure
compliance with Federal regulations and meet the requirements
of subsection (b);
``(3) 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
``(4) 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 individuals, 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 596.
``(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 to any Federal department or agency.''.
(b) Technical Amendments.--Part G of title V of the Public Health
Service Act (42 U.S.C. 290kk et seq.), as added by section 144 of the
Community Renewal Tax Relief Act of 2000 (as enacted into law by
section 1(a)(7) of Public Law 106-554; 114 Stat. 2763A-619), is
amended--
(1) by redesignating such part as part I;
(2) by transferring such part so as to appear after part H
(as so designated by the amendment made by subsection (a)); and
(3) by redesignating sections 581 through 584 as sections
599 through 599C, respectively.
SEC. 3. AMENDMENTS TO TITLE XIX OF THE PUBLIC HEALTH SERVICE ACT.
(a) In General.--Part B of title XIX of the Public Health Service
Act (42 U.S.C. 300x-1 et seq.), except for section 1955 (42 U.S.C.
300x-65), is amended to read as follows:
``PART B--BLOCK GRANTS REGARDING MENTAL HEALTH AND SUBSTANCE USE
DISORDERS
``Subpart I--Block Grants for Community Mental Health Services
``SEC. 1911. FORMULA GRANTS TO STATES.
``(a) In General.--For the purpose described in subsection (b), the
Secretary, acting through the Director of the Center for Mental Health
Services, shall make an allotment each fiscal year for each State in an
amount determined in accordance with section 1918. The Secretary shall
make a grant to the State of the allotment made for the State for the
fiscal year if the State submits to the Secretary an application in
accordance with section 1917.
``(b) Purpose of Grants.--A funding agreement for a grant under
subsection (a) is that, subject to section 1916, the State involved
will expend the grant only for the purpose of--
``(1) providing community mental health services for adults
with serious mental illness and children with serious emotional
disturbances as defined in accordance with section 1912(c);
``(2) carrying out the plan submitted under section 1912(a)
by the State for the fiscal year involved;
``(3) evaluating programs and services carried out under
this subpart; and
``(4) planning, administration, and educational activities
related to providing services under the plan.
``SEC. 1912. STATE PLAN FOR COMPREHENSIVE COMMUNITY MENTAL HEALTH
SERVICES FOR CERTAIN INDIVIDUALS.
``(a) In General.--The Secretary may make a grant under section
1911 only if--
``(1) the State involved submits to the Secretary a plan
for providing comprehensive community mental health services to
adults with a serious mental illness and to children with a
serious emotional disturbance;
``(2) the plan meets the criteria specified in subsection
(b); and
``(3) the plan is approved by the Secretary.
``(b) Criteria for Plan.--
``(1) In general.--In accordance with subsection (a), a
State shall, at least once every 3 years, submit to the
Secretary a plan that, at a minimum, includes the following:
``(A) System of care.--A description of the State's
system of care that contains the following:
``(i) Comprehensive community-based mental
health systems.--The plan shall--
``(I) identify the single State
agency to be responsible for the
administration of the program under the
grant, including any third party who
administers mental health services and
is responsible for complying with the
requirements of this part with respect
to the grant;
``(II) provide for an organized
community-based system of care for
individuals with mental illness and
describe available services and
resources in a comprehensive system of
care, including services for
individuals with co-occurring
disorders;
``(III) include a description of
the manner in which the State and local
entities will coordinate services
(including health services,
rehabilitation services, employment
services, housing services, educational
services, substance use disorder
services, juvenile justice services,
law enforcement services, social
services, child welfare services,
medical and dental care services, and
other support services to be provided
with Federal, State, and local public
and private resources) with other
agencies to enable individuals
receiving services to function outside
of inpatient or residential
institutions, to the maximum extent of
their capabilities, including services
to be provided by local school systems
under the Individuals with Disabilities
Education Act;
``(IV) include a description of how
the State promotes evidence-based
practices;
``(V) include a description of case
management services;
``(VI) provide for activities
leading to a reduction of
hospitalization;
``(VII) include a description of
how the State integrates mental health
and substance use disorder services and
primary health care, which may include
providing mental health and substance
use disorder services in primary care
settings or providing primary and
specialty care services in community-
based mental health and substance use
disorder service settings; and
``(VIII) include a description of
how the State assures a smooth
transition of children with serious
emotional disturbances from the
children's service system to the adult
service system.
``(ii) Mental health system data and
epidemiology.--Utilizing the definitions for
adults with a serious mental illness and
children with a serious emotional disturbance
established in accordance with subsection (c),
the plan shall--
``(I) provide estimates on the
incidence and prevalence of individuals
who are adults with a serious mental
illness and children with a serious
emotional disturbance in the State, by
age, sex, race, and ethnicity;
``(II) provide information on the
number of adults with a serious mental
illness and children with a serious
emotional disturbance in community-
based treatment within the State by
age, sex, race, and ethnicity;
``(III) provide estimates on the
number of adults with a serious mental
illness and children with a serious
emotional disturbance who are homeless
or have a co-occurring mental health
and substance use disorder; and
``(IV) provide the latest national
outcome measurement data in accordance
with section 504(b).
``(iii) Children's services.--In the case
of children with a serious emotional
disturbance (as defined pursuant to subsection
(c)), the plan shall provide for a system of
integrated social services, educational
services, child welfare services, juvenile
justice services, law enforcement services, and
substance use disorder services that, together
with health and mental health services, will be
provided in order for such children to receive
care that is appropriate for their multiple
needs (such system to include services provided
under the Individuals with Disabilities
Education Act).
``(iv) Targeted services to rural,
homeless, and older adult populations.--The
plan shall describe the State's outreach to and
services for individuals who are homeless and
older adults with mental illness, and the
manner in which community-based services will
be provided to individuals residing in rural
areas.
``(v) Management services.--The plan shall
describe--
``(I) the resources available in
the State to pay for the services
including funding under Medicaid, other
Federal programs such as grants to the
State, local jurisdictions of the
State, or non-profit private entities
awarded grants under title V and how
the State is maximizing these
resources, and the manner in which the
State intends to expend the grant under
section 1911 for the fiscal year
involved;
``(II) the manner in which the
State intends to comply with each of
the funding agreements in this subpart
and subpart III; and
``(III) the existing mental health
and substance use disorders workforce,
including data on the number of
individuals who serve in the system of
care designated by profession, the need
for additional professionals and
paraprofessionals, the efforts of the
State to recruit and retain a qualified
mental health and substance use
disorders workforce, and a copy of the
standards the State uses in certifying
or licensing community-based mental
health services facilities and mental
health providers.
``(B) System analysis.--An analysis of the mental
health system of care within the State that identifies
the strengths and weaknesses of that system of care,
and an assessment of the adequacy of that system of
care to respond to the need for services.
``(C) Goal and objectives.--A set of quantifiable
goals and objectives for the period of the plan,
including goals and objectives related to the national
outcomes measures established in accordance with
section 504, including targets and milestones that are
intended to be met and the activities that will be
undertaken to achieve those targets.
``(D) Other information.--Any other information
determined appropriate by the Secretary.
``(2) Authority regarding modifications.--As a condition of
awarding a grant to a State under section 1911 for a fiscal
year, the Secretary may require that the State modify any
provision of the plan submitted by the State under this section
(including provisions on priorities in carrying out authorized
activities). If the Secretary approves such plan and awards a
grant to the State for the fiscal year, the Secretary may not
during such year require the State to modify the plan.
``(3) State request for modifications.--If the State
determines that modifications to the State plan under this
section are necessary, the State may request the approval of
the Secretary for such modifications through the annual report
of the State under section 1942.
``(4) Mental health emergency response.--
``(A) Requirements.--The State plan under this
section shall include the State's plan for addressing
the mental health and substance use disorder needs of
individuals in the State in the event of an emergency
or major disaster.
``(B) Demonstration.--The State shall demonstrate
how the mental health and substance use disorder plan
under subparagraph (A) for providing for the mental
health needs of individuals in the event of an
emergency or major disaster is incorporated into the
State's All-Hazards Public Health Emergency
Preparedness and Response Plan required under section
319C-1. If the mental health emergency response plan
under subparagraph (A) is not so incorporated, the
State shall describe how such plan will be incorporated
into the State Emergency Response Plan during the
period that the State plan under this section is in
effect.
``(C) Definitions.--In this paragraph, the terms
`emergency' and `major disaster' have the meanings
given such terms in section 102 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act.
``(c) Definitions Regarding Mental Illness and Emotional
Disturbance; Methods for Estimate of Incidence and Prevalence.--
``(1) Establishment by secretary of definitions;
dissemination.--For purposes of this subpart, the Secretary
shall establish definitions for the terms `adults with a
serious mental illness' and `children with a serious emotional
disturbance'. The Secretary shall disseminate the definitions
to the States.
``(2) Standardized methods.--The Secretary shall establish
standardized methods for making the estimates required in
subsection (b)(1) with respect to a State. A funding agreement
for a grant under section 1911 for the State is that the State
will utilize such methods in making the estimates.
``SEC. 1913. CERTAIN AGREEMENTS.
``(a) Allocation for Systems of Integrated Services for Children.--
``(1) In general.--With respect to children with a serious
emotional disturbance, a funding agreement for a grant under
section 1911 is that the State involved will expend not less
than an amount equal to the amount expended by the State for
fiscal year 2006.
``(2) Waiver.--
``(A) Upon the request of a State, the Secretary
may provide to the State a waiver of all or part of the
requirement established in paragraph (1) if the
Secretary determines that the State is providing an
adequate level of comprehensive community mental health
services for children with a serious emotional
disturbance, as indicated by a comparison of the number
of such children for which such services are sought
with the availability in the State of the services.
``(B) The Secretary shall approve or deny a request
for a waiver under subparagraph (A) not later than 120
days after the date on which the request is made.
``(C) Any waiver provided by the Secretary under
subparagraph (A) shall be applicable only to the fiscal
year involved.
``(b) Providers of Services.--A funding agreement for a grant under
section 1911 for a State is that, with respect to the plan submitted
under section 1912(a) for the fiscal year involved--
``(1) services under the plan will be provided only through
appropriate, qualified community programs (which may include
community mental health centers, child mental-health programs,
psychosocial rehabilitation programs, mental health peer-
support programs, and mental-health primary consumer-directed
programs); and
``(2) services under the plan will be provided through
community mental health centers only if the centers meet the
criteria specified in subsection (c).
``(c) Criteria for Mental Health Centers.--The criteria referred to
in subsection (b)(2) regarding community mental health centers are as
follows:
``(1) With respect to mental health services, the centers
provide services as follows:
``(A) Services principally to individuals residing
in a defined geographic area (hereafter in this
subsection referred to as a `service area').
``(B) Outpatient services, including specialized
outpatient services for children, older Americans,
individuals with a serious mental illness, and
residents of the service areas of the centers who have
been discharged from inpatient treatment at a mental
health facility.
``(C) 24-hour-a-day emergency care services.
``(D) Day treatment or other partial
hospitalization services, or psychosocial
rehabilitation services.
``(E) Screening for patients being considered for
admission to State mental health facilities to
determine the appropriateness of such admission.
``(2) The mental health services of the centers are
provided, within the limits of the capacities of the centers,
to any individual residing or employed in the service area of
the center regardless of ability to pay for such services.
``(3) The mental health services of the centers are
available and accessible promptly, as appropriate and in a
manner which preserves human dignity and assures continuity and
high quality care.
``SEC. 1914. STATE MENTAL HEALTH PLANNING COUNCIL.
``(a) In General.--A funding agreement for a grant under section
1911 is that the State involved will establish and maintain a State
mental health planning council in accordance with the conditions
described in this section.
``(b) Duties.--A condition under subsection (a) for a Council is
that the duties of the Council are--
``(1) to review plans provided to the Council pursuant to
section 1915(a) by the State involved and to submit to the
State any recommendations of the Council for modifications to
the plans;
``(2) to serve as an advocate for adults with a serious
mental illness, children with a severe emotional disturbance,
and other individuals with mental illnesses or emotional
problems; and
``(3) to monitor, review, and evaluate, not less than once
each year, the allocation and adequacy of mental health
services within the State.
``(c) Membership.--
``(1) In general.--A condition under subsection (a) for a
Council is that the Council be composed of residents of the
State, including representatives of--
``(A) the principal State agencies with respect
to--
``(i) mental health, education, vocational
rehabilitation, criminal justice, housing, and
social services; and
``(ii) the development of the plan
submitted pursuant to title XIX of the Social
Security Act;
``(B) public and private entities concerned with
the need, planning, operation, funding, and use of
mental health services and related support services;
``(C) adults with serious mental illnesses who are
receiving (or have received) mental health services;
and
``(D) the families of such adults or families of
children with emotional disturbance.
``(2) Certain requirements.--A condition under subsection
(a) for a Council is that--
``(A) with respect to the membership of the
Council, the ratio of parents of children with a
serious emotional disturbance to other members of the
Council is sufficient to provide adequate
representation of such children in the deliberations of
the Council; and
``(B) not less than 50 percent of the members of
the Council are individuals who are not State employees
or providers of mental health services.
``(d) Definition.--For purposes of this section, the term `Council'
means a State mental health planning council.
``SEC. 1915. ADDITIONAL PROVISIONS.
``(a) Review of State Plan by Mental Health Planning Council.--The
Secretary may make a grant under section 1911 to a State only if--
``(1) the plan submitted under section 1912(a) with respect
to the grant and the report of the State under section 1942(a)
concerning the preceding fiscal year has been reviewed by the
State mental health planning council under section 1914; and
``(2) the State submits to the Secretary any
recommendations received by the State from such council for
modifications to the plan (without regard to whether the State
has made the recommended modifications) and any comments
concerning the annual report.
``(b) Maintenance of Effort Regarding State Expenditures for Mental
Health.--
``(1) Requirement.--
``(A) In general.--A funding agreement for a grant
under section 1911 is that the State involved will
maintain State expenditures for community mental health
services at a level that is not less than the average
level of such expenditures maintained by the State for
the 2-year period preceding the fiscal year for which
the State is applying for the grant.
``(B) Condition.--A State shall be deemed to be in
compliance with subparagraph (A) for a fiscal year if
State expenditures of the type described in
subparagraph (A) for such fiscal year are at least 97
percent of the average of such State expenditures for
the preceding 2-year period.
``(2) Future fiscal years.--Determinations of whether a
State has complied with paragraph (1) for each fiscal year
shall be based on the State funding level for the preceding 2-
year period as required under paragraph (1)(A) without regard
to reduction in the actual amount of State expenditures as
permitted under paragraph (1)(B) or under a waiver under
paragraph (4).
``(3) Exclusion of certain funds.--The Secretary may
exclude from the aggregate State expenditures under paragraph
(1), funds appropriated for authorized activities which are of
a non-recurring nature and for a specific purpose.
``(4) Waiver.--
``(A) In general.--The Secretary may, upon the
request of a State, waive the requirements established
in paragraph (1), in whole or in part, if--
``(i) the Secretary determines that
extraordinary economic conditions in the State
in the year involved or in the previous year
justify the waiver; or
``(ii) the State or any part of the State
has experienced a natural disaster that has
received a Presidential Disaster Declaration
under section 102 of the Robert T. Stafford
Disaster Relief and Emergency Assistance Act.
``(B) Date certain for acting upon request.--The
Secretary shall approve or deny a request for a waiver
under subparagraph (A) not later than 120 days after
the date on which the request is made.
``(C) Applicability of waiver.--A waiver provided
by the Secretary under subparagraph (A) shall be
applicable only to the fiscal year involved.
``(5) Noncompliance by state.--
``(A) In general.--In making a grant under section
1911 to a State for a fiscal year, the Secretary shall
make a determination of whether, for the previous
fiscal year, the State complied with the agreement made
under paragraph (1). If the Secretary determines that a
State has failed to maintain such compliance, the
Secretary shall reduce the amount of the allotment
under section 1911 for the State in the year in which
the determination is made by an amount equal to the
amount constituting such failure for the previous
fiscal year.
``(B) Alternative penalty.--A State that has failed
to comply with this section and that would otherwise be
subject to a reduction in the State's allotment under
section 1911, may, with the approval of the Secretary,
in lieu of having the State's allotment under section
1911 reduced, agree to comply with the results of a
negotiated agreement that is approved by the Secretary
and carried out in accordance with guidelines issued by
the Secretary.
``(C) Submission of information to the secretary.--
The Secretary may make a grant under section 1911 for a
fiscal year only if the State involved submits to the
Secretary information sufficient to enable the
Secretary to make the determination required in
subparagraph (A).
``SEC. 1916. RESTRICTIONS ON USE OF PAYMENTS.
``(a) In General.--A funding agreement for a grant under section
1911 is that the State involved will not expend the grant--
``(1) to provide inpatient services;
``(2) to make cash payments to intended recipients of
health services;
``(3) to purchase or improve land, purchase, construct, or
permanently improve (other than minor remodeling) any building
or other facility, or purchase major medical equipment;
``(4) to satisfy any requirement for the expenditure of
non-Federal funds as a condition for the receipt of Federal
funds; or
``(5) to provide financial assistance to any entity other
than a public or nonprofit private entity.
``(b) Limitation on Administrative Expenses.--A funding agreement
for a grant under section 1911 is that the State involved will not
expend more than 5 percent of the grant for administrative expenses
with respect to the grant.
``SEC. 1917. APPLICATION FOR GRANT.
``(a) In General.--For purposes of section 1911, an application for
a grant under such section for a fiscal year is in accordance with this
section if, subject to subsection (b)--
``(1) the plan is received by the Secretary not later than
September 1 of the fiscal year prior to the fiscal year for
which a State is seeking funds, and the report from the
previous fiscal year as required under section 1942(a) is
received by December 1 of the fiscal year of the grant;
``(2) the application contains each funding agreement that
is described in this subpart or subpart III for such a grant
(other than any such agreement that is not applicable to the
State);
``(3) the agreements are made through certification from
the chief executive officer of the State;
``(4) with respect to such agreements, the application
provides assurances of compliance satisfactory to the
Secretary;
``(5) the application contains the plan required in section
1912(a), the information required in section 1915(b), and the
report required in section 1942(a);
``(6) the application contains recommendations in
compliance with section 1915(a), or if no such recommendations
are received by the State, the application otherwise
demonstrates compliance with such section; and
``(7) the application (including the plan under section
1912(a)) is otherwise 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 subpart.
``(b) Waivers Regarding Certain Territories.--In the case of any
territory of the United States except Puerto Rico, the Secretary may
waive such provisions of this subpart and subpart III as the Secretary
determines to be appropriate, other than the provisions of section
1916.
``SEC. 1918. DETERMINATION OF AMOUNT OF ALLOTMENT.
``(a) States.--
``(1) Determination under formula.--Subject to subsection
(b), the Secretary shall determine the amount of the allotment
required in section 1911 for a State for a fiscal year in
accordance with the following formula:
``x
A (----)
u
``(2) Determination of term `a'.--For purposes of paragraph
(1), the term `A' means the difference between--
``(A) the amount appropriated under section 1920(a)
for allotments under section 1911 for the fiscal year
involved; and
``(B) an amount equal to 1.5 percent of the amount
referred to in subparagraph (A).
``(3) Determination of term `u'.--For purposes of paragraph
(1), the term `U' means the sum of the respective terms `X'
determined for the States under paragraph (4).
``(4) Determination of term `x'.--For purposes of paragraph
(1), the term `X' means the product of--
``(A) an amount equal to the product of--
``(i) the term `P', as determined for the
State involved under paragraph (5); and
``(ii) the factor determined under
paragraph (8) for the State; and
``(B) the greater of--
``(i) 0.4; and
``(ii) an amount equal to an amount
determined for the State in accordance with the
following formula:
``R%
1 = .35 (----)
P%
``(5) Determination of term `p'.--
``(A) For purposes of paragraph (4), the term `P'
means the sum of--
``(i) an amount equal to the product of
0.107 and the number of individuals in the
State who are between 18 and 24 years of age
(inclusive);
``(ii) an amount equal to the product of
0.166 and the number of individuals in the
State who are between 25 and 44 years of age
(inclusive);
``(iii) an amount equal to the product of
0.099 and the number of individuals in the
State who are between 45 and 64 years of age
(inclusive); and
``(iv) an amount equal to the product of
0.082 and the number of individuals in the
State who are 65 years of age or older.
``(B) With respect to data on population that is
necessary for purposes of making a determination under
subparagraph (A), the Secretary shall use the most
recent data that is available from the Secretary of
Commerce pursuant to the decennial census and pursuant
to reasonable estimates by such Secretary of changes
occurring in the data in the ensuing period.
``(6) Determination of term `r%'.--
``(A) For purposes of paragraph (4), the term `R%',
except as provided in subparagraph (D), means the
percentage constituted by the ratio of the amount
determined under subparagraph (B) for the State
involved to the amount determined under subparagraph
(C).
``(B) The amount determined under this subparagraph
for the State involved is the quotient of--
``(i) the most recent 3-year arithmetic
mean of the total taxable resources of the
State, as determined by the Secretary of the
Treasury; divided by
``(ii) the factor determined under
paragraph (8) for the State.
``(C) The amount determined under this subparagraph
is the sum of the respective amounts determined for the
States under subparagraph (B) (including the District
of Columbia).
``(D)(i) In the case of the District of Columbia,
for purposes of paragraph (4), the term `R%' means the
percentage constituted by the ratio of the amount
determined under clause (ii) for such District to the
amount determined under clause (iii).
``(ii) The amount determined under this clause for
the District of Columbia is the quotient of--
``(I) the most recent 3-year arithmetic
mean of total personal income in such District,
as determined by the Secretary of Commerce;
divided by
``(II) the factor determined under
paragraph (8) for the District.
``(iii) The amount determined under this clause is
the sum of the respective amounts determined for the
States (including the District of Columbia) by making,
for each State, the same determination as is described
in clause (ii) for the District of Columbia.
``(7) Determination of term `p%'.--For purposes of
paragraph (4), the term `P%' means the percentage constituted
by the ratio of the term `P' determined under paragraph (5) for
the State involved to the sum of the respective terms `P'
determined for the States.
``(8) Determination of certain factor.--
``(A) The factor determined under this paragraph
for the State involved is a factor whose purpose is to
adjust the amount determined under clause (i) of
paragraph (4)(A), and the amounts determined under each
of subparagraphs (B)(i) and (D)(ii)(I) of paragraph
(6), to reflect the differences that exist between the
State and other States in the costs of providing
comprehensive community mental health services to
adults with a serious mental illness and to children
with a serious emotional disturbance.
``(B) Subject to subparagraph (C), the factor
determined under this paragraph and in effect for the
fiscal year involved shall be determined according to
the methodology described in the report entitled
`Adjusting the Alcohol, Drug Abuse and Mental Health
Services Block Grant Allocations for Poverty
Populations and Cost of Service', dated March 30, 1990,
and prepared by Health Economics Research, a
corporation, pursuant to a contract with the National
Institute on Drug Abuse.
``(C) The factor determined under this paragraph
for the State involved may not for any fiscal year be
greater than 1.1 or less than 0.9.
``(D)(i) Not later than October 1, 1992, the
Secretary, after consultation with the Comptroller
General, shall in accordance with this section make a
determination for each State of the factor that is to
be in effect for the State under this paragraph. The
factor so determined shall remain in effect through
fiscal year 1994, and shall be recalculated every third
fiscal year thereafter.
``(ii) After consultation with the Comptroller
General, the Secretary shall, through publication in
the Federal Register, periodically make such
refinements in the methodology referred to in
subparagraph (B) as are consistent with the purpose
described in subparagraph (A).
``(b) Minimum Allotments for States.--With respect to fiscal year
2000, and subsequent fiscal years, the amount of the allotment of a
State under section 1911 shall not be less than the amount the State
received under such section for fiscal year 1998.
``(c) Territories.--
``(1) Determination under formula.--Subject to paragraphs
(2) and (4), the amount of an allotment under section 1911 for
a territory of the United States for a fiscal year shall be the
product of--
``(A) an amount equal to the amounts reserved under
paragraph (3) for the fiscal year; and
``(B) a percentage equal to the quotient of--
``(i) the civilian population of the
territory, as indicated by the most recently
available data; divided by
``(ii) the aggregate civilian population of
the territories of the United States, as
indicated by such data.
``(2) Minimum allotment for territories.--The amount of an
allotment under section 1911 for a territory of the United
States for a fiscal year shall be the greater of--
``(A) the amount determined under paragraph (1) for
the territory for the fiscal year;
``(B) $50,000; and
``(C) with respect to fiscal years 1993 and 1994,
an amount equal to 20.6 percent of the amount received
by the territory from allotments made pursuant to this
part for fiscal year 1992.
``(3) Reservation of amounts.--The Secretary shall each
fiscal year reserve for the territories of the United States
1.5 percent of the amounts appropriated under section 1920(a)
for allotments under section 1911 for the fiscal year.
``(4) Availability of data on population.--With respect to
data on the civilian population of the territories of the
United States, if the Secretary determines for a fiscal year
that recent such data for purposes of paragraph (1)(B) do not
exist regarding a territory, the Secretary shall for such
purposes estimate the civilian population of the territory by
modifying the data on the territory to reflect the average
extent of change occurring during the ensuing period in the
population of all territories with respect to which recent such
data do exist.
``(5) Applicability of certain provisions.--For purposes of
subsection (a), the term `State' does not include the
territories of the United States.
``SEC. 1919. DEFINITIONS.
``For purposes of this subpart:
``(1) The terms `adults with a serious mental illness' and
`children with a serious emotional disturbance' have the
meanings given such terms under section 1912(c)(1).
``(2) The term `funding agreement', with respect to a grant
under section 1911 to a State, means that the Secretary may
make such a grant only if the State makes the agreement
involved.
``SEC. 1920. FUNDING.
``(a) Authorization of Appropriations.--For the purpose of carrying
out this subpart, and subpart III and section 504 with respect to
mental health, there are authorized to be appropriated $450,000,000 for
fiscal year 2011, and such sums as may be necessary for each of the
fiscal years 2012 through 2015.
``(b) Allocations for Technical Assistance, Data Collection, and
Program Evaluation.--
``(1) In general.--For the purpose of carrying out section
1948(a) and 1945(g) with respect to mental health and the
purposes specified in paragraphs (2) and (3), the Secretary
shall obligate 5 percent of the amounts appropriated under
subsection (a) for a fiscal year.
``(2) Data collection.--The purpose specified in this
paragraph is carrying out section 504 with respect to mental
health.
``(3) Program evaluation.--The purpose specified in this
paragraph is the conduct of evaluations of prevention and
treatment programs and services with respect to mental health
to determine methods for improving the availability and quality
of such programs and services.
``Subpart II--Block Grants for Prevention and Treatment of Substance
Use Disorders
``SEC. 1921. FORMULA GRANTS TO STATES.
``(a) In General.--For the purpose described in subsection (b), the
Secretary, acting through the Center for Substance Abuse Treatment,
shall make an allotment each fiscal year for each State in an amount
determined in accordance with section 1932. The Secretary shall make a
grant to the State of the allotment made for the State for the fiscal
year if the State submits to the Secretary an application in accordance
with section 1931.
``(b) Authorized Activities.--A funding agreement for a grant under
subsection (a) is that, subject to section 1930, the State involved
will expend the grant only for the purpose of carrying out the plan
developed in accordance with section 1931(b) and for planning, carrying
out, and evaluating activities to prevent and treat substance use
disorders and for related activities authorized in section 1924.
``SEC. 1922. CERTAIN ALLOCATIONS.
``(a) Allocation Regarding Primary Prevention Programs.--A funding
agreement for a grant under section 1921 is that, in expending the
grant, the State involved will expend not less than 20 percent for
programs to prevent the abuse of alcohol and drugs that are--
``(1) designed to reach an entire population or large
audience, including activities intended to address
environmental issues related to the use of alcohol and drugs;
``(2) designed to target subgroups that may be at risk of
using substances; and
``(3) designed to identify and intervene with individuals
who are experiencing early signs of substance use or abuse.
``(b) Allocations Regarding Women.--
``(1) In general.--Subject to paragraph (2), a funding
agreement for a grant under section 1921 for a fiscal year is
that the State will expend not less than it expended in fiscal
year 2006 on treatment services for pregnant women and women
with dependent children.
``(2) Waiver.--
``(A) Upon the request of a State, the Secretary
may provide to the State a waiver of all or part of the
requirement established in paragraph (1) if the
Secretary determines that the State is providing an
adequate level of treatments services for women
described in such paragraph, as indicated by a
comparison of the number of such women seeking the
services with the availability in the State of the
services.
``(B) The Secretary shall approve or deny a request
for a waiver under subparagraph (A) not later than 120
days after the date on which the request is made.
``(C) Any waiver provided by the Secretary under
subparagraph (A) shall be applicable only to the fiscal
year involved.
``(3) Childcare and prenatal care.--A funding agreement for
a grant under section 1921 for a State is that each entity
providing treatment services with amounts reserved under
paragraph (1) by the State will, directly or through
arrangements with other public or nonprofit private entities,
make available prenatal care to women receiving such services
and, while the women are receiving the services, childcare.
``SEC. 1923. INTRAVENOUS SUBSTANCE ABUSE.
``A funding agreement for a grant under section 1921 is that the
State involved, in providing amounts from the grant to any entity for
treatment services, will require the entity to carry out activities to
encourage individuals in need of such treatment who are intravenous
drug users to undergo treatment.
``SEC. 1924. REQUIREMENTS REGARDING TUBERCULOSIS AND OTHER COMMUNICABLE
DISEASES, AND THE HUMAN IMMUNODEFICIENCY VIRUS.
``(a) Tuberculosis and Other Communicable Diseases.--
``(1) In general.--A funding agreement for a grant under
section 1921 is that the State involved will require that any
entity receiving amounts from the grant for operating a program
of treatment for substance use disorders--
``(A) will, directly or through arrangements with
other public or nonprofit private entities, routinely
make available services for tuberculosis and other
communicable diseases to each individual receiving
treatment for such abuse; and
``(B) in the case of an individual in need of such
treatment who is denied admission to the program on the
basis of the lack of the capacity of the program to
admit the individual, will refer the individual to
another provider of tuberculosis and other communicable
diseases services.
``(2) Services.--For purposes of paragraph (1), the term
`tuberculosis and other communicable diseases services', with
respect to an individual, means--
``(A) counseling the individual with respect to
tuberculosis and other communicable diseases;
``(B) testing to determine whether the individual
has contracted and of such diseases and testing to
determine the form of treatment for the disease that is
appropriate for the individual; and
``(C) providing such treatment to the individual.
``(b) Human Immunodeficiency Virus.--
``(1) Requirement for certain states.--
``(A) In general.--In the case of a State described
in paragraph (2), a funding agreement for a grant under
section 1921 is that--
``(i) with respect to individuals
undergoing treatment for substance use
disorders, the State will, subject to
subsection (c), carry out 1 or more projects to
make available to the individuals early
intervention services for HIV disease at the
sites at which the individuals are undergoing
such treatment;
``(ii) for the purpose of providing such
early intervention services through such
projects, the State will make available 5
percent of the amount of the grant; and
``(iii) the State will, subject to
subsection (d), carry out such projects only in
geographic areas of the State that have the
greatest need for the projects.
``(B) Other states.--In the case of a State that is
not a designated State as described in paragraph (2),
the State may expend not to exceed 5 percent of the
amount of the grant for the provision of HIV early
intervention services on the condition that the State
provides such services in accordance with this
subsection.
``(2) Designated states.--For purposes of this subsection,
a State described in this paragraph is any State whose rate of
cases of acquired immune deficiency syndrome is 10 or more such
cases per 100,000 individuals (as indicated by the number of
such cases reported to and confirmed by the Director of the
Centers for Disease Control and Prevention for the most recent
calendar year for which such data are available).
``(3) Use of existing programs regarding substance use
disorders.--With respect to programs that provide treatment
services for substance use disorders, a funding agreement for a
grant under section 1921 for a designated State is that each
such program participating in a project under paragraph (1)
will be a program that began operation prior to the fiscal year
for which the State is applying to receive the grant. A program
that so began operation may participate in a project under
paragraph (1) without regard to whether the program has been
providing early intervention services for HIV disease.
``(4) Requirement regarding rural areas.--
``(1) In general.--A funding agreement for a grant
under section 1921 for a designated State is that, if
the State will carry out 2 or more projects under
subsection (a), the State will carry out 1 such project
in a rural area of the State, subject to subparagraph
(B).
``(2) Waiver.--The Secretary shall waive the
requirement established in subparagraph (A) if the
State involved certifies to the Secretary that--
``(A) there is insufficient demand in the
State to carry out a project under subsection
(a) in any rural area of the State; or
``(B) there are no rural areas in the
State.
``(5) Manner of providing services.--With respect to the
provision of early intervention services for HIV disease to an
individual, a funding agreement for a grant under section 1921
for a designated State is that--
``(1) such services will be undertaken voluntarily
by, and with the informed consent of, the individual;
and
``(2) undergoing such services will not be required
as a condition of receiving treatment services for
substance use disorders or any other services.
``(c) Expenditure of Grant for Compliance With Agreements.--
``(1) In general.--A grant under section 1921 may be
expended for purposes of compliance with the agreements
required in this section, subject to paragraph (2).
``(2) Limitation.--A funding agreement for a grant under
section 1921 for a State is that the grant will not be expended
to make payment for any service provided for purposes of
compliance with this section to the extent that payment has
been made, or can reasonably be expected to be made, with
respect to such service--
``(A) under any State compensation program, under
any insurance policy, or under any Federal or State
health benefits program (including the program
established in title XVIII of the Social Security Act
and the program established in title XIX of such Act);
or
``(B) by an entity that provides health services on
a prepaid basis.
``(d) Applicability of Certain Provision.--Section 1930 applies to
this section (and to each other provision of this subpart).
``(e) Definitions.--For purposes of this section:
``(1) Early intervention services.--The term `early
intervention services', with respect to HIV disease, means--
``(A) appropriate pretest counseling;
``(B) testing individuals with respect to such
disease, including tests to confirm the presence of the
disease, tests to diagnose the extent of the deficiency
in the immune system, and tests to provide information
on appropriate therapeutic measures for preventing and
treating the deterioration of the immune system and for
preventing and treating conditions arising from the
disease;
``(C) appropriate post-test counseling; and
``(D) providing the therapeutic measures described
in subparagraph (B).
``(2) HIV disease.--The term `HIV disease' means infection
with the etiologic agent for acquired immune deficiency
syndrome.
``SEC. 1925. GROUP HOMES FOR RECOVERING SUBSTANCE ABUSERS.
``(a) State Revolving Funds for Establishment of Homes.--A State,
using funds available under section 1921, may establish and maintain
the ongoing operation of a revolving fund in accordance with this
section to support group homes for recovering substance abusers as
follows:
``(1) The purpose of the fund is to make loans for the
costs of establishing programs for the provision of housing in
which individuals recovering from alcohol or drug abuse may
reside in groups of not less than 6 individuals. The fund is
established directly by the State or through the provision of a
grant or contract to a nonprofit private entity.
``(2) The programs are carried out in accordance with
guidelines issued under subsection (b).
``(3) Not less than $100,000 is available for the fund.
``(4) Loans made from the revolving fund do not exceed
$4,000 and each such loan is repaid to the revolving fund by
the residents of the housing involved not later than 2 years
after the date on which the loan is made.
``(5) Each such loan is repaid by such residents through
monthly installments, and a reasonable penalty is assessed for
each failure to pay such periodic installments by the date
specified in the loan agreement involved.
``(6) Such loans are made only to nonprofit private
entities agreeing that, in the operation of the program
established pursuant to the loan--
``(A) the use of alcohol or any illegal drug in the
housing provided by the program will be prohibited;
``(B) any resident of the housing who violates such
prohibition will be expelled from the housing;
``(C) the costs of the housing, including fees for
rent and utilities, will be paid by the residents of
the housing; and
``(D) the residents of the housing will, through a
majority vote of the residents, otherwise establish
policies governing residence in the housing, including
the manner in which applications for residence in the
housing are approved.
``(b) Issuance by Secretary of Guidelines.--The Secretary shall
ensure that there are in effect guidelines under this subpart for the
operation of programs described in subsection (a).
``(c) Applicability to Territories.--The requirements established
in subsection (a) shall not apply to any territory of the United States
other than the Commonwealth of Puerto Rico.
``SEC. 1926. STATE LAW REGARDING SALE OF TOBACCO PRODUCTS TO
INDIVIDUALS UNDER AGE OF 18.
``(a) Relevant Law.--The Secretary may make a grant under section
1921 only if the State involved has in effect a law providing that it
is unlawful for any manufacturer, retailer, or distributor of tobacco
products to sell or distribute any such product to any individual under
the age of 18.
``(b) Enforcement.--
``(1) In general.--A funding agreement for a grant under
section 1921 is that the State involved will enforce the law
described in subsection (a) in a manner that can reasonably be
expected to reduce the extent to which tobacco products are
available to individuals under the age of 18.
``(2) Activities and reports regarding enforcement.--A
funding agreement for a grant under section 1921 is that the
State involved will--
``(A) annually conduct random, unannounced
inspections to ensure compliance with the law described
in subsection (a); and
``(B) annually submit to the Secretary a report
describing--
``(i) the activities carried out by the
State to enforce such law during the fiscal
year preceding the fiscal year for which the
State is seeking the grant;
``(ii) the extent of success the State has
achieved in reducing the availability of
tobacco products to individuals under the age
of 18; and
``(iii) the strategies to be utilized by
the State for enforcing such law during the
fiscal year for which the grant is sought.
``(c) Noncompliance of State.--
``(1) In general.--Before making a grant under section 1921
to a State, the Secretary shall make a determination of whether
the State has maintained compliance with subsection (b). If,
after notice to the State and an opportunity for a hearing, the
Secretary determines that the State is not in compliance with
such subsection, the Secretary shall--
``(A) reduce the amount of the allotment under such
section for the State for the fiscal year involved by
an amount equal to 40 percent of the amount determined
under section 1933 for the State for the fiscal year;
or
``(B) require the State to certify to the Secretary
by May 1 of the fiscal year for which the State is
seeking grant funds, that the State will--
``(i) maintain State expenditures in such
fiscal year for tobacco prevention programs and
for compliance activities, including
enforcement, at a level that is not less than
the level of expenditures maintained by the
State for such activities for the previous
fiscal year; and
``(ii) increase State expenditures to
ensure compliance with the State law required
under subsection (a) by an amount equal to the
product of--
``(I) 1 percent of such State's
allocation under section 1921 for the
fiscal year; and
``(II) the number of percentage
points by which the State has failed to
achieve the retailer compliance rate
goal established by the Secretary for
such State under this section.
``(2) Expenditure report.--A State to which paragraph
(1)(B) applies shall, not later than July 31 of the fiscal year
for which such paragraph is being applied, submit to the
Secretary a report concerning--
``(A) all expenditures of the State for tobacco
prevention and compliance activities, including
enforcement, during the fiscal year immediately
preceding such fiscal year; and
``(B) all obligations for such activities (listed
by program) for the fiscal year for which such
paragraph is being applied.
``(3) Discretion of secretary.--The Secretary shall have
discretion relating to the timing of the State's obligation of
the additional funds as required under the State certification
described in paragraph (1)(B)(ii).
``(d) Territories.--A funding agreement for a grant under section
1921 is that a territory involved will submit to the Secretary for
approval, a comprehensive tobacco prevention and control plan to reduce
the availability of tobacco products to minors within the territory.
``(e) Definition.--For purposes of this section:
``(1) State.--The term `State' includes the States, the
District of Columbia, and the Commonwealth of Puerto Rico.
``(2) Territory.--The term `territory' means American
Samoa, the Republic of Palau, the Federated States of
Micronesia, the Marshall Islands, the Commonwealth of the
Northern Mariana Islands, the United States Virgin Islands, and
Guam.
``SEC. 1927. TREATMENT SERVICES FOR PREGNANT WOMEN.
``(a) In General.--A funding agreement for a grant under section
1921 is that the State involved--
``(1) will ensure that each pregnant woman in the State who
seeks or is referred for and would benefit from such services
is given preference in admissions to treatment facilities
receiving funds pursuant to the grant; and
``(2) will, in carrying out paragraph (1), publicize the
availability to such women of services from the facilities and
the fact that the women receive such preference.
``(b) Referrals Regarding States.--A funding agreement for a grant
under section 1921 is that, in carrying out subsection (a)(1)--
``(1) the State involved will require that, in the event
that a treatment facility has insufficient capacity to provide
treatment services to any woman described in such subsection
who seeks the services from the facility, the facility refer
the woman to the State; and
``(2) the State, in the case of each woman for whom a
referral under paragraph (1) is made to the State--
``(A) will refer the woman to a treatment facility
that has the capacity to provide treatment services to
the woman; or
``(B) will, if no treatment facility has the
capacity to admit the woman, make interim services
available to the woman not later than 48 hours after
the women seeks the treatment services.
``SEC. 1928. ADDITIONAL AGREEMENTS.
``(a) Improvement of Process for Appropriate Referrals for
Treatment.--With respect to individuals seeking treatment services, a
funding agreement for a grant under section 1921 is that the State
involved will improve the process in the State for referring the
individuals to treatment facilities that can provide to the individuals
the treatment modality that is most appropriate for the individuals.
``(b) Professional Development.--A funding agreement for a grant
under section 1921 is that the State involved will ensure that
prevention and treatment professionals operating in the State's
substance use disorder prevention and treatment system have an
opportunity to receive training, on an ongoing basis, concerning--
``(1) recent trends in drug abuse in the State;
``(2) improved methods and evidence-based practices for
providing substance use disorder prevention and treatment
services;
``(3) performance-based accountability;
``(4) data collection and reporting requirements;
``(5) any other matters that would serve to further improve
the delivery of substance use disorder prevention and treatment
services with the State; and
``(6) innovative practices developed under section 581.
``(c) Coordination of Various Activities and Services.--A funding
agreement for a grant under section 1921 is that the State involved
will coordinate prevention and treatment activities with the provision
of other appropriate services (including health, social, correctional
and criminal justice, educational, vocational rehabilitation, housing,
and employment services).
``(d) Waiver of Requirement.--
``(1) In general.--Upon the request of a State, the
Secretary may provide to a State a waiver of any or all of the
requirements established in this section if the Secretary
determines that, with respect to services for the prevention
and treatment of substance use disorders, the requirement
involved is unnecessary for maintaining quality in the
provision of such services in the State.
``(2) Date certain for acting upon request.--The Secretary
shall approve or deny a request for a waiver under paragraph
(1) not later than 120 days after the date on which the request
is made.
``(3) Applicability of waiver.--Any waiver provided by the
Secretary under paragraph (1) shall be applicable only to the
fiscal year involved.
``SEC. 1929. MAINTENANCE OF EFFORT REGARDING STATE EXPENDITURES.
``(a) Requirement.--
``(1) In general.--With respect to the principal agency of
a State for carrying out authorized activities, a funding
agreement for a grant under section 1921 for the State for a
fiscal year is that such agency will for such year maintain
aggregate State expenditures for authorized activities at a
level that is not less than the average level of such
expenditures maintained by the State for the 2-year period
preceding the fiscal year for which the State is applying for
the grant.
``(2) Material compliance.--A State shall be deemed to be
in compliance with paragraph (1) for a fiscal year if State
expenditures of the type described in such paragraph for such
fiscal year are at least 97 percent of such State expenditures
for the preceding 2-year period.
``(3) Future obligations.--In applying paragraph (1) to a
State, the Secretary shall determine such State's compliance
with such paragraph based on the amount of State expenditures
that constituted actual compliance, not material compliance (as
provided for in paragraph (2)), or that would have been
required if the State had not been granted a waiver under
subsection (c).
``(b) Exclusion of Certain Funds.--The Secretary may exclude from
the aggregate State expenditures under subsection (a), funds
appropriated to the principle agency for authorized activities which
are of a non-recurring nature and for a specific purpose.
``(c) Waiver.--
``(1) In general.--Upon the request of a State, the
Secretary may waive all or part of the requirement established
in subsection (a)(1)--
``(A) if the Secretary determines that
extraordinary economic conditions in the State in the
fiscal year involved or in the previous fiscal year
justify the waiver; and
``(B) if the State or any part of the State has
experienced an emergency or a natural disaster that has
received a Presidential Disaster Declaration under
section 102 of the Robert T. Stafford Disaster Relief
and Emergency Assistance Act.
``(2) Date certain for acting upon request.--The Secretary
shall approve or deny a request for a waiver under paragraph
(1) not later than 120 days after the date on which the request
is made.
``(3) Applicability of waiver.--Any waiver provided by the
Secretary under paragraph (1) shall be applicable only to the
fiscal year involved.
``(d) Noncompliance by State.--
``(1) In general.--In making a grant under section 1921 to
a State for a fiscal year, the Secretary shall make a
determination of whether, for the previous fiscal year, the
State complied with any agreement made under subsection (a). If
the Secretary determines that a State has failed to maintain
such compliance, the Secretary shall reduce the amount of the
allotment under section 1921 for the State for the year in
which a final determination is made, by an amount equal to the
amount constituting such failure.
``(2) Alternative penalty.--A State that has failed to
comply with this section and that would otherwise be subject to
a reduction in the State's allotment under section 1921, may,
with the approval of the Secretary, in lieu of having the
State's allotment under section 1921 reduced, agree to comply
with a negotiated agreement that is approved by the Secretary
and carried out in accordance with guidelines issued by the
Secretary.
``(3) Submission of information to secretary.--The
Secretary may make a grant under section 1921 for a fiscal year
only if the State involved submits to the Secretary information
sufficient for the Secretary to make the determination required
in paragraph (1).
``SEC. 1930. RESTRICTIONS ON EXPENDITURE OF GRANT.
``(a) In General.--
``(1) Certain restrictions.--A funding agreement for a
grant under section 1921 is that the State involved will not
expend the grant--
``(A) to provide inpatient hospital services,
except as provided in subsection (b);
``(B) to make cash payments to intended recipients
of health services;
``(C) to purchase or improve land, purchase,
construct, or permanently improve (other than minor
remodeling) any building or other facility, or purchase
major medical equipment;
``(D) to satisfy any requirement for the
expenditure of non-Federal funds as a condition for the
receipt of Federal funds;
``(E) to provide financial assistance to any entity
other than a public or nonprofit private entity; or
``(F) to carry out any program prohibited by
section 256(b) of the Health Omnibus Programs Extension
of 1988 (42 U.S.C. 300ee-5).
``(2) Limitation on administrative expenses.--A funding
agreement for a grant under section 1921 is that the State
involved will not expend more than 5 percent of the grant to
pay the costs of administering the grant.
``(3) Limitation regarding penal and correctional
institutions.--A funding agreement for a State for a grant
under section 1921 is that, in expending the grant for the
purpose of providing treatment services in penal or
correctional institutions of the State, the State will not
expend more than an amount equal to the amount expended for
such purpose by the State from the grant made under section
1912A to the State for fiscal year 1991 (as section 1912A was
in effect for such fiscal year).
``(b) Exception Regarding Inpatient Hospital Services.--
``(1) Medical necessity as precondition.--With respect to
compliance with the agreement made under subsection (a), a
State may expend a grant under section 1921 to provide
inpatient hospital services as treatment for substance use
disorders only if it has been determined, in accordance with
guidelines issued by the Secretary, that such treatment is a
medical necessity for the individual involved, and that the
individual cannot be effectively treated in a community-based,
nonhospital, residential program of treatment.
``(2) Rate of payment.--In the case of an individual for
whom a grant under section 1921 is expended to provide
inpatient hospital services described in paragraph (1), a
funding agreement for the grant for the State involved is that
the daily rate of payment provided to the hospital for
providing the services to the individual will not exceed the
comparable daily rate provided for community-based,
nonhospital, residential programs of treatment for substance
use disorders.
``(c) Waiver Regarding Construction of Facilities.--
``(1) In general.--The Secretary may provide to any State a
waiver of the restriction established in subsection (a)(1)(C)
for the purpose of authorizing the State to expend a grant
under section 1921 for the construction of a new facility or
rehabilitation of an existing facility, but not for land
acquisition.
``(2) Standard regarding need for waiver.--The Secretary
may approve a waiver under paragraph (1) only if the State
demonstrates to the Secretary that adequate treatment cannot be
provided through the use of existing facilities and that
alternative facilities in existing suitable buildings are not
available.
``(3) Amount.--In granting a waiver under paragraph (1),
the Secretary shall allow the use of a specified amount of
funds to construct or rehabilitate a specified number of beds
for residential treatment and a specified number of slots for
outpatient treatment, based on reasonable estimates by the
State of the costs of construction or rehabilitation. In
considering waiver applications, the Secretary shall ensure
that the State has carefully designed a program that will
minimize the costs of additional beds.
``(4) Matching funds.--The Secretary may grant a waiver
under paragraph (1) only if the State agrees, with respect to
the costs to be incurred by the State in carrying out the
purpose of the waiver, to make available non-Federal
contributions in cash toward such costs in an amount equal to
not less than $1 for each $1 of Federal funds provided under
section 1921.
``(5) Date certain for acting upon request.--The Secretary
shall act upon a request for a waiver under paragraph (1) not
later than 120 days after the date on which the request is
made.
``SEC. 1931. APPLICATION FOR GRANT; APPROVAL OF STATE PLAN.
``(a) In General.--For purposes of section 1921, an application for
a grant under such section for a fiscal year is in accordance with this
section if, subject to subsection (c)--
``(1) the application is received by the Secretary not
later than October 1 of the fiscal year for which the State is
seeking funds;
``(2) the application contains each funding agreement that
is described in this subpart or subpart III for such a grant
(other than any such agreement that is not applicable to the
State);
``(3) the agreements are made through certification from
the chief executive officer of the State;
``(4) with respect to such agreements, the application
provides assurances of compliance satisfactory to the
Secretary;
``(5) the application contains the information required in
section 1929 and the report required in section 1942;
``(6)(A) the application contains a plan in accordance with
subsection (b) and the plan is approved by the Secretary; and
``(B) the State provides assurances satisfactory to the
Secretary that the State complied with the provisions of the
plan under subparagraph (A) that was approved by the Secretary
for the most recent fiscal year for which the State received a
grant under section 1921; and
``(7) the application (including the plan under paragraph
(6)) is otherwise 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 subpart.
``(b) State Plans.--
``(1) In general.--In order for a State to be in compliance
with subsection (a)(6), the State shall submit to the
Secretary, every 3 years, a plan that, at a minimum, includes
the following:
``(A) A description of the State's system of care
that--
``(i) identifies the single State agency
responsible for the administration of the
program, including any third party who
administers substance use disorder services and
is responsible for complying with the
requirements of the grant;
``(ii) provides information on the need for
substance use disorder prevention and treatment
services in the State by age, sex, race, and
ethnicity including estimates on the number of
individuals who need treatment, who are women,
who are pregnant, who are women with children,
who are individuals with a co-occurring mental
health and substance use disorder, who are
intravenous drug users and who are homeless
individuals;
``(iii) provides a description of
consequences and consumption patterns by
location, age, sex, race, and ethnicity;
``(iv) provides information on the current
number of individuals in treatment within the
State by age, sex, race, and ethnicity
including the number of such individuals who
are women, who are pregnant, who have children,
individuals with a co-occurring mental health
and substance use disorder, intravenous drug
users and who are homeless individuals;
``(v) provides a description of the system
that is available to provide services by
modality, including the provision of recovery
support services;
``(vi) provides an assessment on the
adequacy of the system to respond to the need;
``(vii) provides the latest performance
outcome data, including outcome data determined
in accordance with section 504(b);
``(viii) provides a description of the
State's comprehensive statewide prevention
effort, including the number of individuals
being served in the system, and provides a
description of the amount of funds from the
prevention set-aside expended on primary
prevention;
``(ix) identifies target populations and
priority needs for prevention services;
``(x) provides a description of the
resources available in the State to pay for the
services, including funding under Medicaid,
title XXVI, and other Federal programs such as
grants to the State, local jurisdiction of the
State or nonprofit private entities awarded
under title V and how the State is maximizing
these resources;
``(xi) provides a description of the manner
in which the State and local entities
coordinate prevention and treatment services
with other agencies, including health, mental
health, juvenile justice, law enforcement,
education, social services, and child welfare;
``(xii) describes the existing mental
health and substance use disorders workforce,
including data on the number of individuals who
serve in the system of care designated by
profession, the need for additional
professionals and paraprofessionals, the
efforts of the State to recruit and retain a
qualified mental health and substance use
disorders workforce, and a copy of the
standards the State uses in certifying or
licensing facilities and counselors for
prevention and treatment facilities;
``(xiii) includes a description of how the
State promotes evidenced-based practices; and
``(xiv) a description of how the State
integrates mental health and substance use
disorder services and primary health care,
which may include providing mental health and
substance use disorder services in primary care
settings or providing primary and specialty
care services in community-based mental health
and substance use disorder service settings.
``(B) An analysis of the system that identifies the
strengths and weaknesses of the system of care, and an
assessment of the adequacy of the system to respond to
the need for services.
``(C) The establishment of goals and objectives,
including goals and objectives for the outcome measures
established under section 504(b), for the period of the
plan including targets and milestones that are intended
to be met and the activities that will be undertaken to
achieve those targets.
``(D) A description of how the State will comply
with each funding agreement for a grant under section
1921 that is applicable to the State, including a
description of the manner in which the State intends to
expend the grant.
``(E) Data on the percentage of grant funds
expended for primary prevention services.
``(2) Authority of the secretary regarding modifications.--
As a condition of awarding a grant under section 1921 to a
State for a fiscal year, the Secretary may require that the
State modify any provision of the plan submitted by the State
under subsection (a)(6) (including provisions on priorities in
carrying out authorized activities) only after significant
dialogue and negotiations between the State and the Secretary
concerning the identified modifications. If the Secretary
approves the plan and awards the grant to the State for the
fiscal year, the Secretary may not during such year require the
State to modify the plan.
``(3) State request for modification.--If the State
determines that modifications to the plan are necessary, the
State may request the Secretary to approve such modifications
through its annual report required under section 1942.
``(4) Substance use disorder emergency response.--
``(A) Requirements.--The State plan under this
section shall includes the State's plan for addressing
the mental health and substance use disorder needs of
individuals in the State in the event of an emergency
or major disaster.
``(B) Demonstration.--The State shall demonstrate
how the mental health and substance use disorder plan
under subparagraph (A) for providing for the substance
use disorder health needs of individuals in the event
of an emergency or major disaster is incorporated into
the State's All-Hazards Public Health Emergency
Preparedness and Response Plan required under section
319C-1. If the substance use disorder emergency
response plan under subparagraph (A) is not so
incorporated, the State shall describe how such plan
will be incorporated into the State Emergency Response
Plan during the period that the State plan under this
section is in effect.
``(C) Definitions.--In this paragraph, the terms
`emergency' and `major disaster' have the meanings
given such terms in section 102 of the Robert T.
Stafford Disaster Relief and Emergency Assistance Act.
``(c) Waivers Regarding Certain Territories.--In the case of any
territory of the United States except Puerto Rico, the Secretary may
waive such provisions of this subpart and subpart III as the Secretary
determines to be appropriate, other than the provisions of section
1930.
``(d) Issuance of Regulations.--The Secretary shall establish
standards specifying the circumstances in which the Secretary will
consider an application for a grant under section 1921 to be in
accordance with this section.
``SEC. 1932. DETERMINATION OF AMOUNT OF ALLOTMENT.
``(a) States.--
``(1) In general.--Subject to subsection (b), the Secretary
shall determine the amount of the allotment required in section
1921 for a State for a fiscal year as follows:
``(A) The formula established in paragraph (1) of
section 1918(a) shall apply to this subsection to the
same extent and in the same manner as the formula
applies for purposes of section 1918(a), except that,
in the application of such formula for purposes of this
subsection, the modifications described in subparagraph
(B) shall apply.
``(B) For purposes of subparagraph (A), the
modifications described in this subparagraph are as
follows:
``(i) The amount specified in paragraph
(2)(A) of section 1918(a) is deemed to be the
amount appropriated under section 1935(a) for
allotments under section 1921 for the fiscal
year involved.
``(ii) The term `P' is deemed to have the
meaning given in paragraph (2) of this
subsection. Section 1918(a)(5)(B) applies to
the data used in determining such term for the
States.
``(iii) The factor determined under
paragraph (8) of section 1918(a) is deemed to
have the purpose of reflecting the differences
that exist between the State involved and other
States in the costs of providing authorized
services.
``(2) Determination of term `p'.--For purposes of this
subsection, the term `P' means the percentage that is the
arithmetic mean of the percentage determined under subparagraph
(A) and the percentage determined under subparagraph (B), as
follows:
``(A) The percentage constituted by the ratio of--
``(i) an amount equal to the sum of the
total number of individuals who reside in the
State involved and are between 18 and 24 years
of age (inclusive) and the number of
individuals in the State who reside in
urbanized areas of the State and are between
such years of age; to
``(ii) an amount equal to the total of the
respective sums determined for the States under
clause (i).
``(B) The percentage constituted by the ratio of--
``(i) the total number of individuals in
the State who are between 25 and 64 years of
age (inclusive); to
``(ii) an amount equal to the sum of the
respective amounts determined for the States
under clause (i).
``(b) Minimum Allotments for States.--
``(1) In general.--With respect to fiscal year 2000, and
each subsequent fiscal year, the amount of the allotment of a
State under section 1921 shall not be less than the amount the
State received under such section for the previous fiscal year
increased by an amount equal to 30.65 percent of the percentage
by which the aggregate amount allotted to all States for such
fiscal year exceeds the aggregate amount allotted to all States
for the previous fiscal year.
``(2) Limitations.--
``(A) In general.--Except as provided in
subparagraph (B), a State shall not receive an
allotment under section 1921 for a fiscal year in an
amount that is less than an amount equal to 0.375
percent of the amount appropriated under section
1935(a) for such fiscal year.
``(B) Exception.--In applying subparagraph (A), the
Secretary shall ensure that no State receives an
increase in its allotment under section 1921 for a
fiscal year (as compared to the amount allotted to the
State in the prior fiscal year) that is in excess of an
amount equal to 300 percent of the percentage by which
the amount appropriated under section 1935(a) for such
fiscal year exceeds the amount appropriated for the
prior fiscal year.
``(3) Decrease in or equal appropriations.--If the amount
appropriated under section 1935(a) for a fiscal year is equal
to or less than the amount appropriated under such section for
the prior fiscal year, the amount of the State allotment under
section 1921 shall be equal to the amount that the State
received under section 1921 in the prior fiscal year decreased
by the percentage by which the amount appropriated for such
fiscal year is less than the amount appropriated or such
section for the prior fiscal year.
``(c) Territories.--
``(1) Determination under formula.--Subject to paragraphs
(2) and (4), the amount of an allotment under section 1921 for
a territory of the United States for a fiscal year shall be the
product of--
``(A) an amount equal to the amounts reserved under
paragraph (3) for the fiscal year; and
``(B) a percentage equal to the quotient of--
``(i) the civilian population of the
territory, as indicated by the most recently
available data; divided by
``(ii) the aggregate civilian population of
the territories of the United States, as
indicated by such data.
``(2) Minimum allotment for territories.--The amount of an
allotment under section 1921 for a territory of the United
States for a fiscal year shall be the greater of--
``(A) the amount determined under paragraph (1) for
the territory for the fiscal year;
``(B) $50,000; and
``(C) with respect to fiscal years 1993 and 1994,
an amount equal to 79.4 percent of the amount received
by the territory from allotments made pursuant to this
part for fiscal year 1992.
``(3) Reservation of amounts.--The Secretary shall each
fiscal year reserve for the territories of the United States
1.5 percent of the amounts appropriated under section 1935(a)
for allotments under section 1921 for the fiscal year.
``(4) Availability of data on population.--With respect to
data on the civilian population of the territories of the
United States, if the Secretary determines for a fiscal year
that recent such data for purposes of paragraph (1)(B) do not
exist regarding a territory, the Secretary shall for such
purposes estimate the civilian population of the territory by
modifying the data on the territory to reflect the average
extent of change occurring during the ensuing period in the
population of all territories with respect to which recent such
data do exist.
``(5) Applicability of certain provisions.--For purposes of
subsections (a) and (b), the term `State' does not include the
territories of the United States.
``(d) Indian Tribes and Tribal Organizations.--
``(1) In general.--If the Secretary--
``(A) receives a request from the governing body of
an Indian tribe or tribal organization within any State
that funds under this subpart be provided directly by
the Secretary to such tribe or organization; and
``(B) makes a determination that the members of
such tribe or tribal organization would be better
served by means of grants made directly by the
Secretary under this;
the Secretary shall reserve from the allotment under section
1921 for the State for the fiscal year involved an amount that
bears the same ratio to the allotment as the amount provided
under this subpart to the tribe or tribal organization for
fiscal year 1991 for activities relating to the prevention and
treatment of the abuse of alcohol and other drugs bore to the
amount of the portion of the allotment under this subpart for
the State for such fiscal year that was expended for such
activities.
``(2) Tribe or tribal organization as grantee.--The amount
reserved by the Secretary on the basis of a determination under
this paragraph shall be granted to the Indian tribe or tribal
organization serving the individuals for whom such a
determination has been made.
``(3) Application.--In order for an Indian tribe or tribal
organization to be eligible for a grant for a fiscal year under
this paragraph, it shall submit to the Secretary a plan for
such fiscal year that meets such criteria as the Secretary may
prescribe.
``(4) Definition.--The terms `Indian tribe' and `tribal
organization' have the same meaning given such terms in
subsections (b) and (c) of section 4 of the Indian Self-
Determination and Education Assistance Act.
``SEC. 1933. DEFINITIONS.
``For purposes of this subpart:
``(1) The term `authorized activities', subject to section
1931, means the activities described in section 1921(b).
``(2) The term `funding agreement', with respect to a grant
under section 1921 to a State, means that the Secretary may
make such a grant only if the State makes the agreement
involved.
``(3) The term `prevention activities', subject to section
1931, means activities to prevent substance use disorders.
``(4) The term `substance use disorder' means the abuse of
alcohol or other drugs.
``(5) The term `treatment activities' means treatment
services and, subject to section 1931, authorized activities
that are related to treatment services.
``(6) The term `treatment facility' means an entity that
provides treatment services.
``(7) The term `treatment services', subject to section
1931, means treatment for substance use disorder.
``SEC. 1934. FUNDING.
``(a) Authorization of Appropriations.--For the purpose of carrying
out this subpart, subpart III and section 504 with respect to substance
use disorders and section 1945(g) with respect to investigations, there
are authorized to be appropriated $2,000,000,000 for fiscal year 2011,
and such sums as may be necessary for each of the fiscal years 2012
through 2015.
``(b) Allocations for Technical Assistance, National Data Base,
Data Collection, and Program Evaluations.--
``(1) In general.--
``(A) For the purpose of carrying out section
1948(a) with respect to substance use disorders,
section 1945(g), and the purposes specified in
subparagraphs (B) and (C), the Secretary shall obligate
5 percent of the amounts appropriated under subsection
(a) each fiscal year.
``(B) The purpose specified in this subparagraph is
the collection of data in this paragraph is carrying
out section 504 with respect to substance use
disorders.
``(C) The purpose specified in this subparagraph is
the conduct of evaluations of authorized activities to
determine methods for improving the availability and
quality of such activities.
``(2) Activities of center for substance abuse
prevention.--Of the amounts reserved under paragraph (1) for a
fiscal year, the Secretary, acting through the Director of the
Center for Substance Abuse Prevention, shall obligate 20
percent for carrying out paragraph (1)(C), section 1948(a) with
respect to prevention activities, and section 1945(g).
``Subpart III--General Provisions
``SEC. 1941. OPPORTUNITY FOR PUBLIC COMMENT ON STATE PLANS.
``A funding agreement for a grant under section 1911 or 1921 is
that the State involved will make the plan required in section 1912,
and the plan required in section 1931, respectively, public within the
State in such manner as to facilitate comment from any person
(including any Federal or other public agency) during the development
of the plan (including any revisions) and after the submission of the
plan to the Secretary.
``SEC. 1942. REQUIREMENT OF REPORTS AND AUDITS BY STATES.
``(a) Report.--A funding agreement for a grant under section 1911
or 1921 is that the State involved will submit to the Secretary an
annual report in such form and containing such information as the
Secretary determines (after consultation with the States) to be
necessary for securing a record, including--
``(1) a description of the purposes for which the grant
received by the State for the preceding fiscal year under the
program involved were expended and a description of the
activities of the State under the program;
``(2) a list of providers, and contact information for such
providers, who are receiving funds under the program whether
directly from the State or a third party (including another
State, a local government, or some other agent of the State
including an administrative services organization or a managed
care program);
``(3) an evaluation of the progress being made towards
meeting the goals and objectives of the State plans required in
sections 1912(b) and 1931(a)(6)(A), an assessment as to whether
the activities described in such plans are helping to meet such
goals and objectives, and any obstacles the State is
encountering in meeting specific targets established to achieve
such goals; and
``(4) information to enable the Secretary to determine
State compliance with all of the funding agreements in each
grant.
``(b) Review, Determination, and Enforcement.--
``(1) Review.--With respect to grants under sections 1911
and 1921, the Secretary shall review the annual reports
submitted by the States under subsection (a).
``(2) Determination.--
``(A) In general.--Based on the information
provided by a State in a report submitted under
subsection (a), information obtained through monitoring
visits, and any other public information made
available, the Secretary shall evaluate the performance
of the State in meeting its goals and objectives, as
established in the State plan under section 1912(b) and
1931(b), respectively, for the year involved, and make
a determination as to whether the State--
``(i) has met such goals and objectives;
``(ii) is making a serious effort to meet
such goals and objectives but requires
technical assistance; or
``(iii) has failed to make a serious effort
to meet such goals and objectives.
``(B) Technical assistance.--If the Secretary makes
a determination under subparagraph (A)(ii), the
Secretary, in conjunction with the State, shall make an
additional determination of what technical assistance
is needed and either provide such assistance or advise
the State on where such assistance may be obtained.
``(C) Failure of effort by state.--If the Secretary
makes a determination under subparagraph (A)(iii) with
respect to a State for 3 consecutive years, the
Secretary shall require the State to meet with the
Secretary to develop a corrective action plan that
includes the redirection of funds to meet State goals
and objectives, and that contains deadlines for State
action.
``(D) Failure to comply with corrective action
plan.--If the Secretary determines that a State has
failed to comply with a corrective action plan under
subparagraph (C), the Secretary may suspend, terminate,
or withhold funds in accordance with section 1945.
``(E) Notice.--Prior to taking action under
subparagraph (C) or (D), the Secretary shall provide
the State with adequate notice and an opportunity for a
hearing.
``(c) Audits.--A funding agreement for a grant under section 1911
or 1921 is that the State will, with respect to the grant, comply with
chapter 75 of title 31, United States Code.
``(d) Availability to Public.--A funding agreement for a grant
under section 1911 or 1921 is that the State involved will--
``(1) make copies of the reports and audits described in
this section available for public inspection within the State;
and
``(2) provide copies of the report under subsection (a),
upon request, to any interested person (including any public
agency).
``SEC. 1943. PATIENT RECORDS.
``The Secretary may make a grant under section 1911 or 1921 only if
the State involved has in effect a system to protect from inappropriate
disclosure patient records maintained by the State in connection with
an activity funded under the program involved or by any entity which is
receiving amounts from the grant.
``SEC. 1944. DISPOSITION OF CERTAIN FUNDS APPROPRIATED FOR ALLOTMENTS.
``(a) In General.--Amounts described in subsection (b) and
available for a fiscal year pursuant to section 1911 or 1921, shall be
allotted by the Secretary and paid to the States receiving a grant
under the program involved, other than any State referred to in
subsection (b) with respect to such program. Such amounts shall be
allotted in a manner equivalent to the manner in which the allotment
under the program involved was determined.
``(b) Specification of Amounts.--The amounts referred to in
subsection (a) are any amounts that--
``(1) are not paid to States under the program involved as
a result of--
``(A) the failure of any State to submit an
application in accordance with the program;
``(B) the failure of any State to prepare such
application in compliance with the program; or
``(C) any State informing the Secretary that the
State does not intend to expend the full amount of the
allotment made to the State under the program;
``(2) are terminated, repaid, or offset under section 1945;
``(3) in the case of the program established in section
1911, are available as a result of reductions in allotments
under such section pursuant to section 1915(b); or
``(4) in the case of the program established in section
1921, are available as a result of reductions in allotments
under such section pursuant to section 1926 or 1929.
``SEC. 1945. FAILURE TO COMPLY WITH AGREEMENTS.
``(a) Suspension or Termination of Payments.--Subject to subsection
(e), if the Secretary determines that a State has materially failed to
comply with the agreements or other conditions required for the receipt
of a grant under the program involved, the Secretary may in whole or in
part suspend payments under the grant, terminate the grant for cause,
or employ such other remedies (including the remedies provided for in
subsections (b) and (c)) as may be legally available and appropriate in
the circumstances involved.
``(b) Repayment of Payments.--
``(1) In general.--Subject to subsection (e), the Secretary
may require a State to repay with interest any payments
received by the State under section 1911 or 1921 that the
Secretary determines were not expended by the State in
accordance with the agreements required under the program
involved.
``(2) Offset against payments.--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 the program involved.
``(c) Withholding of Payments.--
``(1) In general.--Subject to subsections (e) and (g)(3),
the Secretary may withhold payments due under section 1911 or
1921 if the Secretary determines that the State involved is not
expending amounts received under the program involved in
accordance with the agreements required under the program.
``(2) Termination of withholding.--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 the program
involved in accordance with the agreements required under the
program.
``(d) Applicability of Remedies to Certain Violations.--
``(1) In general.--With respect to agreements or other
conditions for receiving a grant under the program involved, in
the case of the failure of a State to maintain material
compliance with a condition referred to in paragraph (2), the
provisions for noncompliance with the condition that are
provided in the section establishing the condition shall apply
in lieu of subsections (a) through (c) of this section.
``(2) Relevant conditions.--For purposes of paragraph (1):
``(A) In the case of the program established in
section 1911, a condition referred to in this paragraph
is the condition established in section 1915(b).
``(B) In the case of the program established in
section 1921, a condition referred to in this paragraph
is the condition established in section 1926 and the
condition established in section 1929.
``(e) Opportunity for Hearing.--Before taking action against a
State under any of subsections (a) through (c) (or under a section
referred to in subsection (d)(2), as the case may be), the Secretary
shall provide to the State involved adequate notice and an opportunity
for a hearing.
``(f) Requirement of Hearing in Certain Circumstances.--
``(1) In general.--If the Secretary receives a complaint
that a State has failed to maintain material compliance with
the agreements or other conditions required for receiving a
grant under the program involved (including any condition
referred to for purposes of subsection (d)), and there appears
to be reasonable evidence to support the complaint, the
Secretary shall promptly conduct a hearing with respect to the
complaint.
``(2) Finding of material noncompliance.--If in a hearing
under paragraph (1) the Secretary finds that the State involved
has failed to maintain material compliance with the agreement
or other condition involved, the Secretary shall take such
action under this section as may be appropriate to ensure that
material compliance is so maintained, or such action as may be
required in a section referred to in subsection (d)(2), as the
case may be.
``(g) Certain Investigations.--
``(1) Requirement regarding secretary.--The Secretary shall
in fiscal year 1994 and each subsequent fiscal year conduct in
not less than 10 States investigations of the expenditure of
grants received by the States under section 1911 or 1921 in
order to evaluate compliance with the agreements required under
the program involved.
``(2) Provision of records etc. upon request.--Each State
receiving a grant under section 1911 or 1921, and each entity
receiving funds from the grant, shall make appropriate books,
documents, papers, and records available to the Secretary or
the Comptroller General, or any of their duly authorized
representatives, for examination, copying, or mechanical
reproduction on or off the premises of the appropriate entity
upon a reasonable request therefore.
``(3) Limitations on authority.--The Secretary may not
institute proceedings under subsection (c) unless the Secretary
has conducted an investigation concerning whether the State has
expended payments under the program involved in accordance with
the agreements required under the program. Any such
investigation shall be conducted within the State by qualified
investigators.
``SEC. 1946. PROHIBITIONS REGARDING RECEIPT OF FUNDS.
``(a) Establishment.--
``(1) Certain false statements and representations.--A
person shall not knowingly and willfully 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 payments may be made by a State from a grant made to the
State under section 1911 or 1921.
``(2) Concealing or failing to disclose certain events.--A
person with knowledge of the occurrence of any event affecting
the initial or continued right of the person to receive any
payments from a grant made to a State under section 1911 or
1921 shall not conceal or fail to disclose any such event with
an intent fraudulently to secure such payment either in a
greater amount than is due or when no such amount is due.
``(b) Criminal Penalty for Violation of Prohibition.--Any person
who violates any prohibition established in subsection (a) shall for
each violation be fined in accordance with title 18, United States
Code, or imprisoned for not more than 5 years, or both.
``SEC. 1947. 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 1911 or 1921 shall be
considered to be programs and activities receiving Federal
financial assistance.
``(2) Prohibition.--No person shall on the ground of sex
(including, in the case of a woman, on the ground that the
woman is pregnant), or on the ground of 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 1911 or 1921.
``(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 1911 or 1921, 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. 1948. TECHNICAL ASSISTANCE AND PROVISION OF SUPPLIES AND
SERVICES IN LIEU OF GRANT FUNDS.
``(a) Technical Assistance.--The Secretary shall, without charge to
a State receiving a grant under section 1911 or 1921, provide to the
State (or to any public or nonprofit private entity within the State)
technical assistance with respect to the planning, development, and
operation of any program or service carried out pursuant to the program
involved. The Secretary may provide such technical assistance directly,
through contract, or through grants.
``(b) Provision of Supplies and Services in Lieu of Grant Funds.--
``(1) In general.--Upon the request of a State receiving a
grant under section 1911 or 1921, the Secretary may, subject to
paragraph (2), provide supplies, equipment, and services for
the purpose of aiding the State in carrying out the program
involved and, for such purpose, may detail to the State any
officer or employee of the Department of Health and Human
Services.
``(2) Corresponding reduction in payments.--With respect to
a request described in paragraph (1), the Secretary shall
reduce the amount of payments under the program involved to the
State by an amount equal to the costs of detailing personnel
and the fair market value of any supplies, equipment, or
services provided by the Secretary. The Secretary shall, for
the payment of expenses incurred in complying with such
request, expend the amounts withheld.
``SEC. 1949. RULE OF CONSTRUCTION REGARDING DELEGATION OF AUTHORITY TO
STATES.
``With respect to States receiving grants under section 1911 or
1921, this part may not be construed to authorize the Secretary to
delegate to the States the primary responsibility for interpreting the
governing provisions of this part.
``SEC. 1950. SOLICITATION OF VIEWS OF CERTAIN ENTITIES.
``In carrying out this part, the Secretary, as appropriate, shall
solicit the views of the States and other appropriate entities.
``SEC. 1951. AVAILABILITY TO STATES OF GRANT PAYMENTS.
``Any amounts paid to a State for a fiscal year under section 1911
or 1921 shall be available for obligation and expenditure until the end
of the fiscal year following the fiscal year for which the amounts were
paid.
``SEC. 1952. CONTINUATION OF CERTAIN PROGRAMS.
``(a) In General.--Of the amount allotted to the State of Hawaii
under section 1911, and the amount allotted to such State under section
1921, an amount equal to the proportion of Native Hawaiians residing in
the State to the total population of the State shall be available,
respectively, for carrying out the program involved for Native
Hawaiians.
``(b) Expenditure of Amounts.--The amount made available under
subsection (a) may be expended only through contracts entered into by
the State of Hawaii with public and private nonprofit organizations to
enable such organizations to plan, conduct, and administer
comprehensive substance use disorder and treatment programs for the
benefit of Native Hawaiians. In entering into contracts under this
section, the State of Hawaii shall give preference to Native Hawaiian
organizations and Native Hawaiian health centers.
``(c) Definitions.--For the purposes of this subsection, the terms
`Native Hawaiian', `Native Hawaiian organization', and `Native Hawaiian
health center' have the meaning given such terms in section 2308 of
subtitle D of title II of the Anti-Drug Abuse Act of 1988.
``SEC. 1953. DEFINITIONS.
``(a) Definitions for Subpart III.--For purposes of this subpart:
``(1) The term `program involved' means the program of
grants established in section 1911 or 1921, or both, as
indicated by whether the State involved is receiving or is
applying to receive a grant under section 1911 or 1921, or
both.
``(2)(A) The term `funding agreement', with respect to a
grant under section 1911, has the meaning given such term in
section 1919.
``(B) The term `funding agreement', with respect to a grant
under section 1921, has the meaning given such term in section
1934.
``(b) Definitions for Part B.--For purposes of this part:
``(1) The term `Comptroller General' means the Comptroller
General of the United States.
``(2) The term `State', except as provided in sections
1918(c)(5) and 1932(c)(5), means each of the several States,
the District of Columbia, and each of the territories of the
United States.
``(3) The term `territories of the United States' means
each of the Commonwealth of Puerto Rico, American Samoa, Guam,
the Commonwealth of the Northern Mariana Islands, the Virgin
Islands, Palau, the Marshall Islands, and Micronesia.
``(4) The term `interim services', in the case of an
individual in need of treatment for substance use disorders who
has been denied admission to a program of such treatment on the
basis of the lack of the capacity of the program to admit the
individual, means services for reducing the adverse health
effects of such abuse, for promoting the health of the
individual, and for reducing the risk of transmission of
disease, which services are provided until the individual is
admitted to such a program.
``SEC. 1955. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.
``States may use funds available for treatment under sections 1911
and 1921 to treat persons with co-occurring substance use disorders and
mental disorders as long as funds available under such sections are
used for the purposes for which they were authorized by law and can be
tracked for accounting purposes.
``SEC. 1956. PUBLIC HEALTH EMERGENCY DECLARATION.
``In the case of a public health emergency as defined in section
319, the Administrator, on a State by State basis, may defer the
application deadline and compliance with any other requirements of
sections 521, 1911, 1921, and the Protection and Advocacy for
Individuals with a Mental Illness Act.
``PART C--CERTAIN PROGRAMS REGARDING MENTAL HEALTH AND SUBSTANCE USE
DISORDERS
``SEC. 1961. INTERIM MAINTENANCE TREATMENT.
``(a) Requirement Regarding Secretary.--Subject to the following
subsections of this section, for the purpose of reducing the incidence
of the transmission of HIV disease pursuant to the intravenous use of
heroin or other morphine-like drugs, the Secretary, in establishing
conditions for the use of methadone in public or nonprofit private
programs of treatment for dependence on such drugs, shall authorize
such programs--
``(1) to dispense methadone for treatment purposes to
individuals who--
``(A) meet the conditions for admission to such
programs that dispense methadone as part of
comprehensive treatment for such dependence; and
``(B) are seeking admission to such programs that
so dispense methadone, but as a result of the limited
capacity of the programs, will not gain such admission
until 14 or more days after seeking admission to the
programs; and
``(2) in dispensing methadone to such individuals, to
provide only minimum ancillary services during the period in
which the individuals are waiting for admission to programs of
comprehensive treatment.
``(b) Inapplicability of Requirement in Certain Circumstances.--
``(1) In general.--The requirement established in
subsection (a) for the Secretary does not apply if any or all
of the following conditions are met:
``(A) The preponderance of scientific research
indicates that the risk of the transmission of HIV
disease pursuant to the injecting abuse of drugs is
minimal.
``(B) The preponderance of scientific research
indicates that the medically supervised dispensing of
methadone is not an effective method of reducing the
extent of dependence on heroin and other morphine-like
drugs.
``(C) The preponderance of available data indicates
that, of treatment programs that dispense methadone as
part of comprehensive treatment, a substantial majority
admit all individuals seeking services to the programs
not later than 14 days after the individuals seek
admission to the programs.
``(2) Evaluation by secretary.--In evaluating whether any
or all of the conditions described in paragraph (1) have been
met, the Secretary shall consult with the National Commission
on Acquired Immune Deficiency Syndrome.
``(c) Conditions for Obtaining Authorization From Secretary.--
``(1) In general.--In carrying out the requirement
established in subsection (a), the Secretary shall, after
consultation with the National Commission on Acquired Immune
Deficiency Syndrome, by regulation issue such conditions for
treatment programs to obtain authorization from the Secretary
to provide interim maintenance treatment as may be necessary to
carry out the purpose described in such subsection. Such
conditions shall include conditions for preventing the
unauthorized use of methadone.
``(2) Counseling on hiv disease.--The regulations issued
under paragraph (1) shall provide that an authorization
described in such paragraph may not be issued to a treatment
program unless the program provides to recipients of the
treatment counseling on preventing exposure to and the
transmission of HIV disease.
``(3) Permission of relevant state as condition of
authorization.--The regulations issued under paragraph (1)
shall provide that the Secretary may not provide an
authorization described in such paragraph to any treatment
program in a State unless the chief public health officer of
the State has certified to the Secretary that--
``(A) such officer does not object to the provision
of such authorizations to treatment programs in the
State; and
``(B) the provision of interim maintenance services
in the State will not reduce the capacity of
comprehensive treatment programs in the State to admit
individuals to the programs (relative to the date on
which such officer so certifies).
``(4) Date certain for issuance of regulations; failure of
secretary.--The Secretary shall issue the final rule for
purposes of the regulations required in paragraph (1), and such
rule shall be effective, not later than the expiration of the
180-day period beginning on July 10, 1992. If the Secretary
fails to meet the requirement of the preceding sentence, the
proposed rule issued on March 2, 1989, with respect to part 291
of title 21, Code of Federal Regulations (docket numbered 88N-
0444; 54 Fed. Reg. 8973 et seq.) is deemed to take effect as a
final rule upon the expiration of such period, and the
provisions of paragraph (3) of this subsection are deemed to be
incorporated into such rule.
``(d) Definitions.--For purposes of this section:
``(1) The term `interim maintenance services' means the
provision of methadone in a treatment program under the
circumstances described in paragraphs (1) and (2) of subsection
(a).
``(2) The term `HIV disease' means infection with the
etiologic agent for acquired immune deficiency syndrome.
``(3) The term `treatment program' means a public or
nonprofit private program of treatment for dependence on heroin
or other morphine-like drugs.''.
(b) Technical Amendments.--Section 1955 of the Public Health
Service Act (42 U.S.C. 300x-65), as added by section 3305 of Public Law
106-310 (114 Stat. 1212), is amended--
(1) by redesignating such section as section 1954; and
(2) by transferring such section so as to appear after
section 1953 (as so designated by the amendment made by
subsection (a)).
SEC. 4. REPEAL.
Section 330K of the Public Health Service Act (42 U.S.C. 254c-16)
is repealed.
SEC. 5. AMENDMENTS TO THE PROTECTION AND ADVOCACY FOR INDIVIDUALS WITH
MENTAL ILLNESS ACT.
(a) Definition of Facilities.--Section 102(3) of the Protection and
Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10802(3))
is amended by striking ``community facilities'' and inserting
``residential or non-residential community facilities''.
(b) System Requirements.--Section 105(a) of the Protection and
Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10805(a))
is amended--
(1) in paragraph (1)(C)(ii), by striking the comma and
inserting a semicolon; and
(2) in paragraph (4)(A), by striking ``who is a client of
the system''.
(c) Allotments.--Section 112(a) of the Protection and Advocacy for
Individuals with Mental Illness Act (42 U.S.C. 10822(a)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by inserting after
``State'' in clauses (i) and (ii) the following: ``and
the American Indian Consortium''; and
(B) in subparagraph (B)--
(i) by inserting after ``income of the
State'' the following: ``or the American Indian
Consortium''; and
(ii) by striking ``if the State is Guam''
and inserting ``for the American Indian
Consortium and the territories of Guam''; and
(2) in paragraph (2)(B)(i), by striking ``for American
Samoa'' and inserting ``for the American Indian Consortium,
American Samoa''.
(d) Regulations.--Section 116(b) of the Protection and Advocacy for
Individuals with Mental Illness Act (42 U.S.C. 10826(b)) is amended by
striking ``enactment of this subsection'' and inserting ``enactment of
the SAMHSA Modernization Act of 2010''.
(e) Authorization of Appropriations.--Section 117 of the Protection
and Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10827)
is amended by striking `$19,500,000'' and all that follows through the
period and inserting ``$37,000,000 for fiscal year 2011, and such sums
as may be necessary for each of fiscal years 2012 through 2015.''.
SEC. 6. STUDY OF THE DISTRIBUTION OF FUNDS UNDER THE SUBSTANCE ABUSE
PREVENTION AND TREATMENT BLOCK GRANT AND THE COMMUNITY
MENTAL HEALTH SERVICES BLOCK GRANT.
(a) In General.--The Secretary of Health and Human Services, acting
through the Administrator of the Substance Abuse and Mental Health
Services Administration, shall, directly or through a grant or
contract, conduct a study to examine whether the funds under the
substance abuse prevention and treatment block grant and the community
mental health services block grant under title XIX of the Public Health
Service Act (42 U.S.C. 300w et seq.) are being distributed to States
and territories according to need and to recommend changes in the
distribution if necessary. Such study shall include--
(1) an analysis of whether the distributions under such
block grants accurately reflect the need for the services under
the grants in such States and territories;
(2) an examination of whether the indices used under the
formulas for distribution of funds under such block grants are
appropriate, and if not, alternatives recommended by the
Secretary;
(3) where recommendations are included under paragraph (2)
for the use of different indices, a description of the
variables and data sources that should be used to determine the
indices;
(4) an evaluation of the variables and data sources that
are currently being used for each of the indices involved, and
whether such variables and data sources accurately represent
the need for services, the cost of providing services, and the
ability of the States to pay for such services;
(5) the impact that the minimum allotment provisions under
each such block grant have on each State's final allotment and
its effect, if any, on each State's formula-based allotment;
(6) recommendations for modifications to the minimum
allotment provisions to ensure an appropriate distribution of
funds; and
(7) any other information that the Secretary determines
appropriate.
(b) Report.--Not later than 24 months after the date of enactment
of this Act, the Secretary of Health and Human Services 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 containing the findings and recommendations
of the study conducted under subsection (a).
SEC. 7. TASK FORCE ON BEHAVIORAL AND MENTAL HEALTH IN MEDICAL
EDUCATION.
Part E of title VII of the Public Health Service Act (42 U.S.C.
294n et seq.) is amended by inserting after section 762 the following:
``SEC. 762A. TASK FORCE ON BEHAVIORAL AND MENTAL HEALTH IN MEDICAL
EDUCATION.
``(a) Establishment.--There is established the Task Force on
Behavioral and Mental Health in Medical Education (in this section
referred to as the `Task Force'). The Task Force--
``(1) shall coordinate its activities with the activities
of the Council on Graduate Medical Education established under
section 762; and
``(2) shall develop and publish not later than 1 year after
the date of the enactment of this section, and may periodically
revise as appropriate thereafter, a comprehensive plan for the
purpose of strengthening the capacity of graduates of
accredited schools of allopathic or osteopathic medicine to
deliver integrated, comprehensive health care.
``(b) Plan Contents.--The plan under subsection (a)(2) shall
identify the specific behavioral and mental health education that
should be--
``(1) required for graduation from accredited schools of
allopathic or osteopathic medicine; and
``(2) integrated into medical curricula, continuing medical
education, licensing examinations, and training for students
and graduates of accredited schools of allopathic or
osteopathic medicine.
``(c) Members.--
``(1) Composition; voting; chair.--The Task Force shall be
composed of the ex officio members specified in paragraph (2)
and the members appointed under paragraph (3). Subject to
paragraph (2)(B), all of the members of the Task Force shall be
voting members. The Task Force shall elect a chair from among
its voting members.
``(2) Ex officio members.--The Task Force shall include the
following ex officio members (or their designees):
``(A) Each member serving on the Graduate Medical
Education Council pursuant to an appointment under
paragraph (1), (2), or (3) of section 762(b).
``(B) Each member serving on the Graduate Medical
Education Council pursuant to an appointment under
paragraph (4), (5), or (6) of section 762(b). Any
member serving on the Task Force under this
subparagraph shall be a nonvoting member.
``(C) The Administrator of the Substance Abuse and
Mental Health Services Administration.
``(D) The Deputy Director of the Office of National
Drug Control Policy.
``(E) The Director of the National Institute on
Drug Abuse.
``(F) The Director of the National Institute on
Mental Health.
``(G) The Director of the National Institute on
Alcohol Abuse and Alcoholism.
``(3) Appointed members.--
``(A) In general.--The Task Force shall include
members to be appointed by the Secretary (without
regard to the civil service laws) who are not employees
of the Federal Government. Such members shall include
the following:
``(i) One mental health care consumer.
``(ii) One individual in recovery from a
behavioral health addiction (including any
substance use disorder).
``(iii) One individual who is a faculty
member at an accredited program of training in
mental health.
``(iv) One individual who is a faculty
member at an accredited program of training in
behavioral health.
``(v) One primary care physician
specializing in internal medicine, family
practice, pediatrics, emergency medicine, or
obstetrics and gynecology.
``(vi) Two allopathic or osteopathic
physicians with experience in medical school
curriculum or graduate medical education.
``(vii) One allopathic or osteopathic
physician who spends a significant portion of
his professional activity in direct patient
care and is board certified in addiction
medicine by the American Board of Addiction
Medicine.
``(viii) One allopathic or osteopathic
physician who spends a significant portion of
his professional activity in direct patient
care and is board certified in psychiatry by
the American Board of Psychiatry and Neurology.
``(ix) Four individuals selected from among
individuals serving in the various fields
charged with carrying out medical education and
behavioral and mental health disorder services,
including psychiatry, addiction medicine,
psychology, social work, psychiatric nursing,
counseling, marriage and family therapy,
pastoral counseling, psychosocial
rehabilitation, and substance use treatment
counseling and recovery coaching.
``(x) One individual with demonstrated
achievements in clinical or basic science
research relevant to mental health.
``(xi) One individual with demonstrated
achievements in clinical or basic science
research relevant to behavioral health
disorders.
``(xii) Two individuals, each from a
separate nonprofit association representing
accredited medical schools.
``(xiii) Three individuals, each from a
separate national, independent, nonprofit
organization charged with developing national
medical licensing examinations and assessments
for health professionals in osteopathic or
allopathic medicine.
``(B) Other selection criteria.--In appointing
members of the Task Force under this paragraph, the
Secretary shall ensure--
``(i) the inclusion of both urban and rural
members;
``(ii) a range of members from a variety of
practice settings and having expertise in
prevention and treatment across the lifespan;
``(iii) adequate representation of racial,
ethnic, religious, and economic diversity; and
``(iv) an equal distribution of the members
appointed under subparagraph (A)(ix) between
those specializing in mental health services
and those specializing in behavioral health
(including substance use disorder services).
``(C) Terms.--
``(i) In general.--Subject to subparagraph
(D)(ii), each member of the Task Force under
this paragraph shall be appointed for a term of
4 years.
``(ii) Vacancies.--Any member of the Task
Force appointed to fill a vacancy occurring
before the expiration of the term for which the
member's predecessor was appointed shall be
appointed only for the remainder of that term.
A member may serve after the expiration of that
member's term until a successor has taken
office.
``(D) Initial members.--
``(i) Appointment.--The Secretary shall
appoint the initial members of the Task Force
under this paragraph not less than 90 days
after the date of the enactment of this
section.
``(ii) Terms.--As designated by the
Secretary at the time of appointment, of the
initial members of the Task Force under this
paragraph, \1/4\ shall be appointed for terms
of 1 year, \1/4\ shall be appointed for terms
of 2 years, \1/4\ shall be appointed for terms
of 3 years, and \1/4\ shall be appointed for
terms of 4 years.
``(d) Staff.--The Secretary shall provide the Task Force with such
professional and clerical staff, such information, and the services of
such consultants as may be necessary to assist the Task Force in
carrying out effectively its functions under this section.
``(e) Compensation.--
``(1) Rates of compensation.--To the extent or in the
amounts made available in advance in appropriations Acts, and
except as provided in paragraph (2), members of the Task Force
shall each be entitled to receive the daily equivalent of the
annual rate of basic pay for grade GS-15 of the General
Schedule for each day (including travel time) during which they
are engaged in the actual performance of duties vested in the
Task Force.
``(2) Prohibition against compensation of federal
employees.--Members of the Task Force who are officers or
employees of the Federal Government shall not receive
additional pay, allowances, or benefits by reason of their
service on the Task Force.
``(f) Meetings.--The Task Force shall conduct at least 3 meetings
each year.
``(g) Reporting.--
``(1) By task force.--On an annual basis, the Task Force
shall submit to the Secretary and make publicly available a
report on the plan under subsection (a)(2) and its
implementation. Each such report shall include--
``(A) a description of current and future needs
pertaining to behavioral and mental health workforce,
education, and training;
``(B) an identification of goals, outcome measures,
and a time frame for addressing such needs;
``(C) recommendations on the specific behavioral
and mental health education components identified in
the plan developed under subsection (a)(2); and
``(D) an evaluation of the extent to which the
goals and recommendations in the plan developed under
subsection (a)(2) (including the goals and
recommendations described in subparagraphs (B) and (C))
have been met.
``(2) By secretary.--On an annual basis, the Secretary
shall submit a report to the Congress on the activities of the
Task Force, the plan under subsection (a)(2), and the plan's
implementation.
``(h) Assistance.--The Task Force shall collaborate with private
sector coalitions to facilitate and implement the Task Force's
recommendations in the plan under subsection (a)(2).
``(i) Definition.--In this section, any reference to behavioral
health includes substance use health.
``(j) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2011 through 2016.
``(k) Termination.--The Task Force shall terminate at the end of
fiscal year 2016.''.
SEC. 8. COUNCIL ON INTEGRATION OF HEALTH CARE EDUCATION.
(a) Establishment and Responsibilities of Council.--
(1) Establishment.--There is established in the Office of
the Secretary the Council on Integration of Health Care
Education.
(2) Recommendations.--The Council shall develop and publish
not later than 1 year after the date of the enactment of this
Act, and may periodically revise as appropriate thereafter,
recommendations for the purpose of strengthening the capacity
of health care professionals and behavioral health providers to
deliver integrated, comprehensive health care. The
recommendations shall identify--
(A) the core competencies to be required of each
type of health care professional and behavioral health
provider with respect to mental health and substance
use prevention and treatment services in order to carry
out their respective scope of practice;
(B) the appropriate methods for incorporating such
competencies into the curricula of institutions of
higher education, and of continuing education, for
health care professionals and behavioral health
providers;
(C) the appropriate methods for incorporating such
competencies into the licensure and certification
requirements for health care professionals and
behavioral health providers; and
(D) the appropriate methods for incorporating such
competencies into the accreditation process for
institutions of higher education providing terminal
education for health care professionals and behavioral
health providers.
(3) Reporting.--
(A) By the council.--Not later than 1 year after
the date of the enactment of this Act, and annually
thereafter, the Council shall submit to the Secretary
and the appropriate committees of the Congress, and to
the Council on Graduate Medical Education when
appropriate, and make publicly available, a report on
the recommendations under paragraph (2) and the
implementation of such recommendations. Each such
report shall include--
(i) a description of current and future
needs related to the successful integration
core competencies for mental health and
substance use disorders into health care
professional and behavioral health provider
education and education curricula beyond
medical education;
(ii) an identification of goals, outcome
measures, and timeframes for addressing the
needs described in clause (i);
(iii) a detailed plan for implementing the
recommendations under paragraph (2); and
(iv) an evaluation of the extent to which
such plan has been implemented.
(B) By the secretary.--Not later than 1 year after
the date of the enactment of this Act, and annually
thereafter, the Secretary shall submit a report to the
Congress on the activities of the Council.
(4) Members.--
(A) Composition; voting; chair.--The Council shall
be composed of the ex officio members specified in
subparagraph (B) and the members appointed under
subparagraph (C). All of the members of the Council
shall be voting members. The Council shall elect a
chair from among its members.
(B) Ex officio members.--The Council shall include
the following ex officio members (or their designees)--
(i) the Secretary;
(ii) the Administrator of the Health
Resources and Services Administration;
(iii) the Administrator of the Centers for
Medicare & Medicaid Services;
(iv) the Administrator of the Substance
Abuse and Mental Health Services
Administration; and
(v) the Director of the Office of National
Drug Control Policy.
(C) Appointed members.--
(i) In general.--The Council shall include
members to be appointed by the Secretary (in
consultation with the other ex officio members
of the Council and without regard to the civil
service laws) who are not employees of the
Federal Government. The Secretary shall appoint
a sufficient number of members under this
clause to ensure that the Council is composed
of not less than 20 members, including both ex
officio members under subparagraph (B) and
members appointed under this subparagraph.
(ii) Other selection criteria.--In
appointing members of the Council under this
subparagraph, the Secretary shall ensure--
(I) inclusion of both urban and
rural members;
(II) adequate representation of men
and women;
(III) a range of members from a
variety of practice settings and having
expertise in prevention and treatment
across the lifespan;
(IV) adequate representation of
racial, ethnic, religious, and economic
diversity;
(V) an equal distribution of the
members appointed under clause (i)
between those specializing in mental
health services and those specializing
in substance use disorders;
(VI) diverse representation from
addition and psychiatry specialty
sectors;
(VII) diverse representation of
allopathic and osteopathic physicians;
(VIII) adequate representation of
health care professionals and
behavioral health providers who provide
direct patient care to individuals with
co-occurring mental health or substance
use disorders and physical health
conditions;
(IX) adequate representation of
health care and behavioral health
(including substance use) faculty who
have demonstrated expertise in
curriculum development; and
(X) inclusion of a health or
behavioral health (including substance
use) consumer.
(iii) Terms.--
(I) In general.--Subject to clause
(iv)(II), each member of the Council
under this subparagraph shall be
appointed for a term of 4 years.
(II) Vacancies.--Any member of the
Council appointed to fill a vacancy
occurring before the expiration of the
term for which the member's predecessor
was appointed shall be appointed only
for the remainder of that term. A
member may serve after the expiration
of that member's term until a successor
has taken office.
(iv) Initial members.--
(I) Appointment.--The Secretary
shall appoint the initial members of
the Council under this subparagraph not
less than 90 days after the date of the
enactment of this Act.
(II) Terms.--As designated by the
Secretary at the time of appointment,
of the initial members of the Council
under this subparagraph, \1/4\ shall be
appointed for terms of 1 year, \1/4\
shall be appointed for terms of 2
years, \1/4\ shall be appointed for
terms of 3 years, and \1/4\ shall be
appointed for terms of 4 years.
(5) Staff.--The Secretary shall provide the Council with
such professional and clerical staff, such information, and the
services of such consultants as may be necessary to assist the
Council in carrying out effectively its functions under this
subsection.
(6) Administration.--
(A) Travel expenses.--Members shall receive travel
expenses, including per diem in lieu of subsistence, in
accordance with sections 5702 and 5703 of title 5,
United States Code, while away from their homes or
regular places of business in performance of services
for the Council.
(B) Other resources.--The Council shall have
reasonable access to materials, resources, statistical
data, and other information such Council determines to
be necessary to carry out its duties from agencies of
the executive and legislative branches of the Federal
Government. The chair of the Council shall make
requests for such access in writing when necessary.
(C) Prohibition against compensation of federal
employees.--Members of the Council who are officers or
employees of the Federal Government shall not receive
additional pay, allowances, or benefits by reason of
their service on the Council.
(7) Meetings.--The Council shall conduct at least 3
meetings each year.
(8) Authorization of appropriations.--To carry out this
subsection, there are authorized to be appropriated such sums
as may be necessary for each of fiscal years 2011 through 2016.
(b) Implementation of Recommendations of the Council.--
(1) Health care and behavioral health workforce continuing
education.--
(A) In general.--Beginning 1 year after submission
of the first report of the Council under subsection
(a)(3)(A), the Secretary may make grants, contracts, or
cooperative agreements to public or private nonprofit
entities for the purpose of implementing the
recommendations of the Council on continuing education
for health care professionals and behavioral health
providers.
(B) Eligibility.--To receive a grant, contract, or
cooperative agreement under this paragraph, a public or
private nonprofit entity shall demonstrate expertise in
providing continuing education for health care
professionals and behavioral health providers.
(C) Priority.--In awarding grants, contracts, and
cooperative agreements under this paragraph, the
Secretary shall give priority to entities that propose
to implement continuing education--
(i) in interdisciplinary settings; or
(ii) in collaboration with a diverse
representation of health care professionals and
behavioral health providers who have no direct
affiliation with the receiving entity as
determined by the Secretary.
(D) Geographic distribution.--The Secretary shall
ensure that grants, contracts, and cooperative
agreements under this paragraph are awarded to entities
throughout the United States to ensure the availability
of continuing education in mental health and substance
abuse prevention and treatment services.
(E) Duration of awards.--The period of a grant,
contract, or cooperative agreement under this paragraph
shall not exceed 3 years.
(F) Authorization of appropriations.--There are
authorized to be appropriated $5,000,000 for fiscal
year 2012 and such sums as may be necessary for each of
fiscal years 2013 through 2016.
(2) Health care and behavioral health workforce education
curricula.--
(A) In general.--The Secretary shall make grants,
contracts, or cooperative agreements to public or
nonprofit private institutions of higher education for
the purpose of implementing the recommendations of the
Council on education curricula for health care
professionals and behavioral health providers.
(B) Priority.--In awarding grants, contracts, and
cooperative agreements under this paragraph, the
Secretary shall give priority to applicants that
demonstrate willingness--
(i) to integrate the recommendations of the
Council on curricula across academic
disciplines;
(ii) to coordinate the use of Federal and
non-Federal resources for purposes of such
integration; or
(iii) to incorporate other evidence-based
recommendations that further the integration of
behavioral health in health care.
(C) Geographic distribution.--The Secretary shall
ensure that grants, contracts, and cooperative
agreements under this paragraph are awarded to
institutions of higher education throughout the United
States to ensure the availability and improvement of
education curricula for health care professionals and
behavioral health providers.
(D) Duration of awards.--The period of a grant,
contract, or cooperative agreement under this paragraph
shall not exceed 3 years.
(E) Authorization of appropriations.--There are
authorized to be appropriated $5,000,000 for fiscal
year 2012 and such sums as may be necessary for each of
fiscal years 2013 through 2016
(c) Definitions.--In this section:
(1) Behavioral health provider.--The term ``behavioral
health provider''--
(A) means an individual who provides clinical care
(in accordance with applicable State law) specializing
in the diagnosis or treatment of behavioral health,
including such an individual specializing in substance
use, addiction, and dependence disorders; and
(B) includes a psychiatrist, nurse practitioner (as
defined in section 1861(aa)(5)(A) of the Social
Security Act), physician assistant (as defined in
section 1861(aa)(5)(A) of such Act), clinical
psychologist (as used in section 1861(ii) of such Act),
clinical social worker (as defined in section 1861(hh)
of such Act), psychiatric nurse, licensed professional
counselor, marriage and family therapist, pastoral
counselor, psychosocial rehabilitation specialist, and
any other individual determined to be appropriate by
the Secretary.
(2) Council.--The term ``Council'' means the Council on
Integration of Health Care Education.
(3) Health care professional.--The term ``health care
professional''--
(A) means an individual who provides clinical
health care (in accordance with applicable State law)
other than a behavioral health provider; and
(B) includes (other than a behavioral health
provider) a physician (as defined in section 1861(r) of
the Social Security Act), nurse practitioner (as
defined in section 1861(aa)(5)(A) of the Social
Security Act), physician assistant (as defined in
section 1861(aa)(5)(A) of the Social Security Act),
clinical nurse specialist (as defined in section
1861(aa)(5)(B) of the Social Security Act), certified
nurse-midwife (as defined in section 1861(gg) of the
Social Security Act), and any other individual
determined to be appropriate by the Secretary.
(4) Institution of higher education.--The term
``institution of higher education'' has the same meaning given
such term in section 101 of the Higher Education Act of 1965
(20 U.S.C. 1001).
(5) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
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Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
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