PUBLIC HEALTH SERVICE ACT [As Amended Through P.L. 117

PUBLIC HEALTH SERVICE ACT

[As Amended Through P.L. 117–328, Enacted December 29, 2022]

øCurrency: This publication is a compilation of the text of title V of Chapter 373

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øNote: While this publication does not represent an official version of any Federal

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TITLE V—SUBSTANCE ABUSE AND MENTAL HEALTH

SERVICES ADMINISTRATION

ART

A—O

RGANIZATION AND

ENERAL

UTHORITIES

SEC. 501. ø290aa¿ SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES

ADMINISTRATION.

(a) E

STABLISHMENT

.—The Substance Abuse and Mental Health

Services Administration (hereafter referred to in this title as the

‘‘Administration’’) is an agency of the Service.

(b) C

ENTERS

.—The following Centers are agencies of the Ad-

ministration:

(1) The Center for Substance Abuse Treatment.

(2) The Center for Substance Abuse Prevention.

(3) The Center for Mental Health Services.

SSISTANT

ECRETARY AND

EPUTY

SSISTANT

RETARY

.—

(1) A

SSISTANT SECRETARY

.—The Administration shall be

headed by an official to be known as the Assistant Secretary

for Mental Health and Substance Use (hereinafter in this title

referred to as the ‘‘Assistant Secretary’’) who shall be ap-

pointed by the President, by and with the advice and consent

of the Senate.

(2) D

EPUTY ASSISTANT SECRETARY

.—The Assistant Sec-

retary, with the approval of the Secretary, may appoint a Dep-

uty Assistant Secretary and may employ and prescribe the

functions of such officers and employees, including attorneys,

as are necessary to administer the activities to be carried out

through the Administration.

(d) A

UTHORITIES

.—The Secretary, acting through the Assistant

Secretary, shall—

(1) supervise the functions of the Centers of the Adminis-

tration in order to assure that the programs carried out

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As Amended Through P.L. 117-328, Enacted December 29, 2022

2 Sec. 501 PUBLIC HEALTH SERVICE ACT

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 Cen-

ters, 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 pre-

vention services, promote mental health and protect the legal

rights of individuals with mental illnesses and individuals with

substance use disorders;

(3) carry out the administrative and financial manage-

ment, policy development and planning, evaluation, knowledge

dissemination, and public information functions that are re-

quired for the implementation of this title;

(4) assure that the Administration conduct and coordinate

demonstration projects, evaluations, and service system assess-

ments and other activities necessary to improve the avail-

ability and quality of treatment, prevention and related serv-

ices;

(5) support activities that will improve the provision of

treatment, prevention and related services, including the devel-

opment 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 edu-

cational materials and intervention strategies to reduce the

risks of HIV, hepatitis, tuberculosis, and other communicable

diseases among individuals with mental or substance use dis-

orders, and to develop appropriate mental health services for

individuals with such diseases or disorders;

(7) coordinate Federal policy with respect to the provision

of treatment services for substance use disorders, including

services that utilize drugs or devices approved or cleared by

the Food and Drug Administration for the treatment of sub-

stance use disorders;

(8) conduct programs, and assure the coordination of such

programs with activities of the National Institutes of Health

and the Agency for Healthcare Research and Quality, as appro-

priate, to evaluate the process, outcomes and community im-

pact of prevention and treatment services and systems of care

in order to identify the manner in which such services can

most effectively be provided;

(9) collaborate with the Director of the National Institutes

of Health in the development and maintenance of a system by

which the relevant research findings of the National Institute

on Drug Abuse, the National Institute on Alcohol Abuse and

Alcoholism, the National Institute of Mental Health, and, as

appropriate, the Agency for Healthcare Research and Quality

are disseminated to service providers in a manner designed to

improve the delivery and effectiveness of prevention, treat-

ment, and recovery support services and are appropriately in-

corporated into programs carried out by the Administration;

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As Amended Through P.L. 117-328, Enacted December 29, 2022

3 Sec. 501 PUBLIC HEALTH SERVICE ACT

(10) encourage public and private entities that provide

health insurance to provide benefits for substance use disorder

and mental health services;

(11) work with relevant agencies of the Department of

Health and Human Services on integrating mental health pro-

motion and substance use disorder prevention with general

health promotion and disease prevention and integrating men-

tal and substance use disorders treatment services with phys-

ical health treatment services;

(12) monitor compliance by hospitals and other facilities

with the requirements of sections 542 and 543;

(13) with respect to grant programs authorized under this

title or part B of title XIX, or grant programs otherwise funded

by the Administration—

(A) require that all grants that are awarded for the

provision of services are subject to performance and out-

come evaluations;

(B) ensure that the director of each Center of the Ad-

ministration consistently documents the application of cri-

teria when awarding grants and the ongoing oversight of

grantees after such grants are awarded;

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 applica-

tion; and

(ii) is afforded an opportunity to comment on the

merits of the application; and

(D) inform a State when any funds are awarded

through such a grant to any entity within such State;

(14) assure that services provided with amounts appro-

priated under this title are provided bilingually, if appropriate;

(15) improve coordination among prevention programs,

treatment facilities and nonhealth care systems such as em-

ployers, labor unions, and schools, and encourage the adoption

of employee assistance programs and student assistance pro-

grams;

(16) maintain a clearinghouse for substance use disorder

information, including evidence-based and promising best prac-

tices for prevention, treatment, and recovery support services

for individuals with mental and substance use disorders, to as-

sure the widespread dissemination of such information to

States, political subdivisions, educational agencies and institu-

tions, 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, pro-

mote and evaluate substance use disorder services for older

Americans in need of such services, and mental health services

for older Americans who are seriously mentally ill;

(18) promote the coordination of service programs con-

ducted by other departments, agencies, organizations and indi-

viduals that are or may be related to the problems of individ-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

4 Sec. 501 PUBLIC HEALTH SERVICE ACT

uals suffering from mental illness or substance abuse, includ-

ing 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 Edu-

cation, Department of Justice, and other Federal Departments

and offices, as appropriate;

(19) consult with State, local, and tribal governments, non-

governmental entities, and individuals with mental illness,

particularly adults with a serious mental illness, children with

a serious emotional disturbance, and the family members of

such adults and children, with respect to improving commu-

nity-based and other mental health services;

(20) collaborate with the Secretary of Defense and the Sec-

retary of Veterans Affairs to improve the provision of mental

and substance use disorder services provided by the Depart-

ment of Defense and the Department of Veterans Affairs to

members of the Armed Forces, veterans, and the family mem-

bers of such members and veterans, including through the pro-

vision of services using the telehealth capabilities of the De-

partment of Defense and the Department of Veterans Affairs;

(21) collaborate with the heads of relevant Federal agen-

cies and departments, States, communities, and nongovern-

mental experts to improve mental and substance use disorders

services for chronically homeless individuals, including by de-

signing strategies to provide such services in supportive hous-

ing;

(22) work with States and other stakeholders to develop

and support activities to recruit and retain a workforce ad-

dressing mental and substance use disorders;

(23) collaborate with the Attorney General and representa-

tives of the criminal justice system to improve mental and sub-

stance use disorders services for individuals who have been ar-

rested or incarcerated;

(24) support the continued access to, or availability of,

mental health and substance use disorder services during, or

in response to, a public health emergency declared under sec-

tion 319, including in consultation with, as appropriate, the As-

sistant Secretary for Preparedness and Response, the Director

of the Centers for Disease Control and Prevention, and the

heads of other relevant agencies, in preparing for, and respond-

ing to, a public health emergency;

(25) after providing an opportunity for public input, set

standards for grant programs under this title for mental and

substance use disorders services and prevention programs,

which standards may address—

(A) the capacity of the grantee to implement the

award;

(B) requirements for the description of the program

implementation approach;

the grantee as part of its application must explain how the

grantee will reach the population of focus and provide a

statement of need, which may include information on how

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As Amended Through P.L. 117-328, Enacted December 29, 2022

5 Sec. 501 PUBLIC HEALTH SERVICE ACT

Section 1231(3) of division FF of Public Law 117-328 inserted a new paragraph (26) which

resulted in two paragraph (26)’s.

the grantee will increase access to services and a descrip-

tion of measurable objectives for improving outcomes;

(D) the extent to which the grantee must collect and

report on required performance measures; and

(E) the extent to which the grantee is proposing to use

evidence-based practices;

(26) advance, through existing programs, the use of per-

formance metrics, including those based on the recommenda-

tions on performance metrics from the Assistant Secretary for

Planning and Evaluation under section 6021(d) of the Helping

Families in Mental Health Crisis Reform Act of 2016; and

(26)

collaborate with national accrediting entities, recov-

ery housing providers, organizations or individuals with estab-

lished expertise in delivery of recovery housing services,

States, Federal agencies (including the Department of Health

and Human Services, the Department of Housing and Urban

Development, and the agencies listed in section 550(e)(2)(B)),

and other relevant stakeholders, to promote the availability of

high-quality recovery housing and services for individuals with

a substance use disorder.

(e) A

SSOCIATE

DMINISTRATOR FOR

LCOHOL

REVENTION AND

REATMENT

OLICY

.—

(1) I

N GENERAL

.—There may be in the Administration an

Associate Administrator for Alcohol Prevention and Treatment

Policy to whom the Assistant Secretary may delegate the func-

tions of promoting, monitoring, and evaluating service pro-

grams for the prevention and treatment of alcoholism and alco-

hol 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 en-

sure that alcohol prevention, education, and policy strategies

are integrated into all programs of the Centers that address

substance abuse prevention, education, and policy, and that

the Center for Substance Abuse Prevention addresses the

Healthy People 2010 goals and the National Dietary Guide-

lines of the Department of Health and Human Services and

the Department of Agriculture related to alcohol consumption.

(2) P

LAN

.—

(A) The Assistant Secretary, acting through the Asso-

ciate Administrator for Alcohol Prevention and Treatment

Policy, shall develop, and periodically review and as appro-

priate revise, a plan for programs and policies to treat and

prevent alcoholism and alcohol abuse. The plan shall be

developed (and reviewed and revised) in collaboration with

the Directors of the Centers of the Administration and in

consultation with members of other Federal agencies and

public and private entities.

(B) Not later than 1 year after the date of the enact-

ment of the ADAMHA Reorganization Act, the Assistant

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As Amended Through P.L. 117-328, Enacted December 29, 2022

6 Sec. 501 PUBLIC HEALTH SERVICE ACT

Secretary shall submit to the Congress the first plan devel-

oped under subparagraph (A).

(3) R

EPORT

.—

(A) Not less than once during each 2 years, the Assist-

ant Secretary, acting through the Associate Administrator

for Alcohol Prevention and Treatment Policy, shall prepare

a report describing the alcoholism and alcohol abuse pre-

vention and treatment programs undertaken by the Ad-

ministration and its agencies, and the report shall include

a detailed statement of the expenditures made for the ac-

tivities reported on and the personnel used in connection

with such activities.

(B) Each report under subparagraph (A) shall include

a description of any revisions in the plan under paragraph

(2) made during the preceding 2 years.

mitted to the Assistant Secretary for inclusion in the bien-

nial report under subsection (m).

(f) A

SSOCIATE

DMINISTRATOR FOR

OMEN

’

ERVICES

.—

(1) A

PPOINTMENT

.—The Assistant Secretary, with the ap-

proval of the Secretary, shall appoint an Associate Adminis-

trator for Women’s Services who shall report directly to the As-

sistant Secretary.

(2) D

UTIES

.—The Associate Administrator appointed under

paragraph (1) shall—

(A) establish a committee to be known as the Coordi-

nating Committee for Women’s Services (hereafter in this

subparagraph referred to as the ‘‘Coordinating Com-

mittee’’), which shall be composed of the Directors of the

agencies of the Administration (or the designees of the Di-

rectors);

(B) acting through the Coordinating Committee, with

respect to women’s substance abuse and mental health

services—

(i) identify the need for such services, and make

an estimate each fiscal year of the funds needed to

adequately support the services;

(ii) identify needs regarding the coordination of

services;

(iii) encourage the agencies of the Administration

to support such services; and

(iv) assure that the unique needs of minority

women, including Native American, Hispanic, African-

American and Asian women, are recognized and ad-

dressed within the activities of the Administration;

and

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 Assist-

ant Secretary from among physicians, practitioners, treat-

ment providers, and other health professionals, whose clin-

ical practice, specialization, or professional expertise in-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

7 Sec. 501 PUBLIC HEALTH SERVICE ACT

cludes a significant focus on women’s substance abuse and

mental health conditions, that shall—

(i) advise the Associate Administrator on appro-

priate activities to be undertaken by the agencies of

the Administration with respect to women’s substance

abuse and mental health services, including services

which require a multidisciplinary approach;

(ii) collect and review data, including information

provided by the Secretary (including the material re-

ferred to in paragraph (3)), and report biannually to

the Assistant Secretary regarding the extent to which

women are represented among senior personnel, and

make recommendations regarding improvement in the

participation of women in the workforce of the Admin-

istration; and

(iii) prepare, for inclusion in the biennial report

required pursuant to subsection (m), a description of

activities of the Committee, including findings made

by the Committee regarding—

(I) the extent of expenditures made for wom-

en’s substance abuse and mental health services

by the agencies of the Administration; and

(II) the estimated level of funding needed for

substance abuse and mental health services to

meet the needs of women;

(D) improve the collection of data on women’s health

by—

(i) reviewing the current data at the Administra-

tion 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 re-

porting formats, linkages and definitions; and

(iii) reporting to the Assistant Secretary a plan for

incorporating the standards developed under clause

(ii) in all Administration programs and a plan to as-

sure that the data so collected are accessible to health

professionals, providers, researchers, and members of

the public; and

(E) shall establish, maintain, and operate a program

to provide information on women’s substance abuse and

mental health services.

(3) S

TUDY

.—

(A) The Secretary, acting through the Assistant Sec-

retary for Personnel, shall conduct a study to evaluate the

extent to which women are represented among senior per-

sonnel at the Administration.

(B) Not later than 90 days after the date of the enact-

ment of the ADAMHA Reorganization Act, the Assistant

Secretary for Personnel shall provide the Advisory Com-

mittee for Women’s Services with a study plan, including

the methodology of the study and any sampling frames.

Not later than 180 days after such date of enactment, the

Assistant Secretary shall prepare and submit directly to

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As Amended Through P.L. 117-328, Enacted December 29, 2022

8 Sec. 501 PUBLIC HEALTH SERVICE ACT

the Advisory Committee a report concerning the results of

the study conducted under subparagraph (A).

visory Committee for Women’s Services any additional

data as requested.

(4) O

FFICE

.—Nothing in this subsection shall be construed

to preclude the Secretary from establishing within the Sub-

stance Abuse and Mental Health Administration an Office of

Women’s Health.

(5) D

EFINITION

.—For purposes of this subsection, the term

‘‘women’s substance abuse and mental health conditions’’, with

respect to women of all age, ethnic, and racial groups, means

all aspects of substance abuse and mental illness—

(A) unique to or more prevalent among women; or

(B) with respect to which there have been insufficient

services involving women or insufficient data.

(g) C

HIEF

EDICAL

FFICER

.—

(1) I

N GENERAL

.—The Assistant Secretary, with the ap-

proval of the Secretary, shall appoint a Chief Medical Officer

to serve within the Administration.

(2) E

LIGIBLE CANDIDATES

.—The Assistant Secretary shall

select the Chief Medical Officer from among individuals who—

(A) have a doctoral degree in medicine or osteopathic

medicine;

(B) have experience in the provision of mental or sub-

stance use disorder services;

use disorder programs;

(D) have an understanding of biological, psychosocial,

and pharmaceutical treatments of mental or substance use

disorders; and

(E) are licensed to practice medicine in one or more

States.

(3) D

UTIES

.—The Chief Medical Officer shall—

(A) serve as a liaison between the Administration and

providers of mental and substance use disorders preven-

tion, treatment, and recovery services;

(B) assist the Assistant Secretary in the evaluation,

organization, integration, and coordination of programs op-

erated by the Administration;

tices, including culturally and linguistically appropriate

practices, as appropriate, for the prevention and treatment

of, and recovery from, mental and substance use disorders,

including serious mental illness and serious emotional dis-

turbances;

(D) participate in regular strategic planning with the

Administration;

(E) coordinate with the Assistant Secretary for Plan-

ning and Evaluation to assess the use of performance

metrics to evaluate activities within the Administration re-

lated to mental and substance use disorders; and

(F) coordinate with the Assistant Secretary to ensure

mental and substance use disorders grant programs within

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As Amended Through P.L. 117-328, Enacted December 29, 2022

9 Sec. 501 PUBLIC HEALTH SERVICE ACT

Section 4(a)(236) of Public Law 117–286 amends section 501(h) by striking ‘‘The Federal Ad-

visory Committee Act’’ and inserting ‘‘Chapter 10 of title 5, United States Code’’. The stricken

phrase doesn’t appear in subsection (h) but does appear in subsection (i).

the Administration consistently utilize appropriate per-

formance metrics and evaluation designs.

(h) S

ERVICES OF

XPERTS

.—

(1) I

N GENERAL

.—The Assistant Secretary may obtain (in

accordance with section 3109 of title 5, United States Code, but

without regard to the limitation in such section on the number

of days or the period of service) the services of not more than

20 experts or consultants who have professional qualifications.

Such experts and consultants shall be obtained for the Admin-

istration and for each of its agencies.

(2) C

OMPENSATION AND EXPENSES

.—

(A) Experts and consultants whose services are ob-

tained under paragraph (1) shall be paid or reimbursed for

their expenses associated with traveling to and from their

assignment location in accordance with sections 5724,

5724a(a), 5724a(c), and 5726(c) of title 5, United States

Code.

(B) Expenses specified in subparagraph (A) may not be

allowed in connection with the assignment of an expert or

consultant whose services are obtained under paragraph

(1), unless and until the expert or consultant agrees in

writing to complete the entire period of assignment or one

year, whichever is shorter, unless separated or reassigned

for reasons beyond the control of the expert or consultant

that are acceptable to the Secretary. If the expert or con-

sultant 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) P

EER

EVIEW

ROUPS

.—The Assistant Secretary shall, with-

out regard to the provisions of title 5, United States Code, gov-

erning 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 commit-

tees 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 com-

pensation for services as members of such groups. The Federal Ad-

visory Committee Act

shall not apply to the duration of a peer re-

view group appointed under this subsection.

(j) V

OLUNTARY

ERVICES

.—The Assistant Secretary may accept

voluntary and uncompensated services.

(k) A

DMINISTRATION

.—The Assistant Secretary shall ensure

that programs and activities assigned under this title to the Ad-

ministration are fully administered by the respective Centers to

which such programs and activities are assigned.

(l) S

TRATEGIC

LAN

.—

(1) I

N GENERAL

.—Not later than September 30, 2018, and

every 4 years thereafter, the Assistant Secretary shall develop

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10 Sec. 501 PUBLIC HEALTH SERVICE ACT

and carry out a strategic plan in accordance with this sub-

section for the planning and operation of activities carried out

by the Administration, including evidence-based programs.

(2) C

OORDINATION

.—In developing and carrying out the

strategic plan under this subsection, the Assistant Secretary

shall take into consideration the findings and recommenda-

tions of the Assistant Secretary for Planning and Evaluation

under section 6021(d) of the Helping Families in Mental

Health Crisis Reform Act of 2016 and the report of the Inter-

departmental Serious Mental Illness Coordinating Committee

under section 501C.

(3) P

UBLICATION OF PLAN

.—Not later than September 30,

2018, and every 4 years thereafter, the Assistant Secretary

shall—

(A) submit the strategic plan developed under para-

graph (1) to the Committee on Energy and Commerce and

the Committee on Appropriations of the House of Rep-

resentatives and the Committee on Health, Education,

Labor, and Pensions and the Committee on Appropriations

of the Senate; and

(B) post such plan on the Internet website of the Ad-

ministration.

(4) C

ONTENTS

.—The strategic plan developed under para-

graph (1) shall—

(A) identify strategic priorities, goals, and measurable

objectives for mental and substance use disorders activities

and programs operated and supported by the Administra-

tion, including priorities to prevent or eliminate the bur-

den of mental and substance use disorders;

(B) identify ways to improve the quality of services for

individuals with mental and substance use disorders, and

to reduce homelessness, arrest, incarceration, violence, in-

cluding self-directed violence, and unnecessary hospitaliza-

tion of individuals with a mental or substance use dis-

order, including adults with a serious mental illness or

children with a serious emotional disturbance;

cess to effective and evidence-based prevention, diagnosis,

intervention, treatment, and recovery services, including

culturally and linguistically appropriate services, as appro-

priate, for individuals with a mental or substance use dis-

order;

(D) identify opportunities to collaborate with the

Health Resources and Services Administration to develop

or improve—

(i) initiatives to encourage individuals to pursue

careers (especially in rural and underserved areas and

with rural and underserved populations) as psychia-

trists, including child and adolescent psychiatrists,

psychologists, psychiatric nurse practitioners, physi-

cian assistants, clinical social workers, certified peer

support specialists, licensed professional counselors, or

other licensed or certified mental health or substance

use disorder professionals, including such profes-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

11 Sec. 501 PUBLIC HEALTH SERVICE ACT

sionals specializing in the diagnosis, evaluation, or

treatment of adults with a serious mental illness or

children with a serious emotional disturbance; and

(ii) a strategy to improve the recruitment, train-

ing, and retention of a workforce for the treatment of

individuals with mental or substance use disorders, or

co-occurring disorders;

(E) identify opportunities to improve collaboration

with States, local governments, communities, and Indian

tribes and tribal organizations (as such terms are defined

in section 4 of the Indian Self-Determination and Edu-

cation Assistance Act);

(F) specify a strategy to disseminate evidence-based

and promising best practices related to prevention, diag-

nosis, early intervention, treatment, and recovery services

related to mental illness, particularly for adults with a se-

rious mental illness and children with a serious emotional

disturbance, and for individuals with a substance use dis-

order; and

(G) specify a strategy to support the continued access

to, or availability of, mental health and substance use dis-

order services, including to at-risk individuals (as defined

in section 2802(b)(4)), during, or in response to, public

health emergencies declared pursuant to section 319.

(m) B

IENNIAL

EPORT

ONCERNING

CTIVITIES AND

ROGRESS

.—Not later than September 30, 2020, and every 2 years

thereafter, the Assistant Secretary shall prepare and submit to the

Committee on Energy and Commerce and the Committee on Appro-

priations of the House of Representatives and the Committee on

Health, Education, Labor, and Pensions and the Committee on Ap-

propriations of the Senate, and post on the Internet website of the

Administration, a report containing at a minimum—

(1) a review of activities conducted or supported by the Ad-

ministration, including progress toward strategic priorities,

goals, and objectives identified in the strategic plan developed

under subsection (l);

(2) an assessment of programs and activities carried out by

the Assistant Secretary, including the extent to which pro-

grams and activities under this title and part B of title XIX

meet identified goals and performance measures developed for

the respective programs and activities;

(3) a description of the progress made in addressing gaps

in mental and substance use disorders prevention, treatment,

and recovery services and improving outcomes by the Adminis-

tration, including with respect to serious mental illnesses, seri-

ous emotional disturbances, and co-occurring disorders;

(4) a description of the Administration’s activities to sup-

port the continued provision of mental health and substance

use disorder services, as applicable, in response to public

health emergencies declared pursuant to section 319;

(5) a description of the manner in which the Administra-

tion coordinates and partners with other Federal agencies and

departments related to mental and substance use disorders, in-

cluding activities related to—

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12 Sec. 501 PUBLIC HEALTH SERVICE ACT

(A) the implementation and dissemination of research

findings into improved programs, including with respect to

how advances in serious mental illness and serious emo-

tional disturbance research have been incorporated into

programs;

(B) the recruitment, training, and retention of a men-

tal and substance use disorders workforce;

stance use disorder services, and physical health services;

(D) relevant preparedness and response activities;

(E) homelessness; and

(F) veterans;

(6) a description of the manner in which the Administra-

tion promotes coordination by grantees under this title, and

part B of title XIX, with State or local agencies; and

(7) a description of the activities carried out under section

501A(e), with respect to mental and substance use disorders,

including—

(A) the number and a description of grants awarded;

(B) the total amount of funding for grants awarded;

such grants, including outcomes of programs supported;

and

(D) information on how the National Mental Health

and Substance Use Policy Laboratory is consulting with

the Assistant Secretary for Planning and Evaluation and

collaborating with the Center for Substance Abuse Treat-

ment, the Center for Substance Abuse Prevention, the

Center for Behavioral Health Statistics and Quality, and

the Center for Mental Health Services to carry out such

activities; and

(8) recommendations made by the Assistant Secretary for

Planning and Evaluation under section 6021 of the Helping

Families in Mental Health Crisis Reform Act of 2016 to im-

prove programs within the Administration, and actions taken

in response to such recommendations to improve programs

within the Administration.

The Assistant Secretary may meet reporting requirements estab-

lished under this title by providing the contents of such reports as

an addendum to the biennial report established under this sub-

section, notwithstanding the timeline of other reporting require-

ments in this title. Nothing in this subsection shall be construed

to alter the content requirements of such reports or authorize the

Assistant Secretary to alter the timeline of any such reports to be

less frequent than biennially, unless as specified in this title.

(n) A

PPLICATIONS FOR

RANTS AND

ONTRACTS

.—With respect

to awards of grants, cooperative agreements, and contracts under

this title, the Assistant Secretary, or the Director of the Center in-

volved, as the case may be, may not make such an award unless—

(1) an application for the award is submitted to the official

involved;

(2) with respect to carrying out the purpose for which the

award is to be provided, the application provides assurances of

compliance satisfactory to such official; and

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13 Sec. 501A PUBLIC HEALTH SERVICE ACT

(3) the application is otherwise in such form, is made in

such manner, and contains such agreements, assurances, and

information as the official determines to be necessary to carry

out the purpose for which the award is to be provided.

(o) E

MERGENCY

ESPONSE

.—

(1) I

N GENERAL

.—Notwithstanding section 504 and except

as provided in paragraph (2), the Secretary may use not to ex-

ceed 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 enti-

ties to address emergency substance abuse or mental health

needs in local communities.

(2) E

XCEPTIONS

.—Amounts appropriated under part C

shall not be subject to paragraph (1).

(3) E

MERGENCIES

.—The Secretary shall establish criteria

for determining that a substance abuse or mental health emer-

gency exists and publish such criteria in the Federal Register

prior to providing funds under this subsection.

(4) E

MERGENCY RESPONSE

.—Amounts made available for

carrying out this subsection shall remain available through the

end of the fiscal year following the fiscal year for which such

amounts are appropriated.

(p) L

IMITATION ON THE

SE OF

ERTAIN

NFORMATION

.—No in-

formation, if an establishment or person supplying the information

or described in it is identifiable, obtained in the course of activities

undertaken or supported under section 505 may be used for any

purpose other than the purpose for which it was supplied unless

such establishment or person has consented (as determined under

regulations of the Secretary) to its use for such other purpose. Such

information may not be published or released in other form if the

person who supplied the information or who is described in it is

identifiable unless such person has consented (as determined under

regulations of the Secretary) to its publication or release in other

form.

(q) A

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

providing grants, cooperative agreements, and contracts under this

section, there are authorized to be appropriated $25,000,000 for fis-

cal year 2001, and such sums as may be necessary for each of the

fiscal years 2002 and 2003.

SEC. 501A. ø290aa–0¿ NATIONAL MENTAL HEALTH AND SUBSTANCE

USE POLICY LABORATORY.

(a) I

ENERAL

.—There shall be established within the Admin-

istration a National Mental Health and Substance Use Policy Lab-

oratory (referred to in this section as the ‘‘Laboratory’’).

(b) R

ESPONSIBILITIES

.—The Laboratory shall—

(1) continue to carry out the authorities and activities that

were in effect for the Office of Policy, Planning, and Innovation

as such Office existed prior to the date of enactment of the

Helping Families in Mental Health Crisis Reform Act of 2016;

(2) identify, coordinate, and facilitate the implementation

of policy changes likely to have a significant effect on mental

health, mental illness, recovery supports, and the prevention

and treatment of substance use disorder services;

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14 Sec. 501A PUBLIC HEALTH SERVICE ACT

(3) work with the Center for Behavioral Health Statistics

and Quality to collect, as appropriate, information from grant-

ees under programs operated by the Administration in order to

evaluate and disseminate information on evidence-based prac-

tices, including culturally and linguistically appropriate serv-

ices, as appropriate, and service delivery models;

(4) provide leadership in identifying and coordinating poli-

cies and programs, including evidence-based programs, related

to mental and substance use disorders;

(5) periodically review programs and activities operated by

the Administration relating to the diagnosis or prevention of,

treatment for, and recovery from, mental and substance use

disorders to—

(A) identify any such programs or activities that are

duplicative;

(B) identify any such programs or activities that are

not evidence-based, effective, or efficient; and

nating, or improving programs or activities identified

under subparagraph (A) or (B) and merging such programs

or activities into other successful programs or activities;

(6) issue and periodically update information for entities

applying for grants or cooperative agreements from the Sub-

stance Abuse and Mental Health Services Administration in

order to—

(A) encourage the implementation and replication of

evidence-based practices; and

(B) provide technical assistance to applicants for fund-

ing, including with respect to justifications for such pro-

grams and activities; and

(7) carry out other activities as deemed necessary to con-

tinue to encourage innovation and disseminate evidence-based

programs and practices.

VIDENCE

BASED

RACTICES AND

ERVICE

ELIVERY

ELS

.—

(1) I

N GENERAL

.—In carrying out subsection (b)(3), the

Laboratory—

(A) may give preference to models that improve—

(i) the coordination between mental health and

physical health providers;

(ii) the coordination among such providers and the

justice and corrections system; and

(iii) the cost effectiveness, quality, effectiveness,

and efficiency of health care services furnished to

adults with a serious mental illness, children with a

serious emotional disturbance, or individuals in a

mental health crisis; and

(B) may include clinical protocols and practices that

address the needs of individuals with early serious mental

illness.

(2) C

ONSULTATION

.—In carrying out this section, the Lab-

oratory shall consult with—

(A) the Chief Medical Officer appointed under section

501(g);

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15 Sec. 501A PUBLIC HEALTH SERVICE ACT

(B) representatives of the National Institute of Mental

Health, the National Institute on Drug Abuse, and the Na-

tional Institute on Alcohol Abuse and Alcoholism, on an

ongoing basis;

(D) clinical and analytical experts with expertise in

psychiatric medical care and clinical psychological care,

health care management, education, corrections health

care, and mental health court systems, as appropriate; and

(E) other individuals and agencies as determined ap-

propriate by the Assistant Secretary.

(d) D

EADLINE FOR

EGINNING

MPLEMENTATION

.—The Labora-

tory shall begin implementation of this section not later than Janu-

ary 1, 2018.

(e) P

ROMOTING

NNOVATION

.—

(1) I

N GENERAL

.—The Assistant Secretary, in coordination

with the Laboratory, may award grants to States, local govern-

ments, Indian Tribes or Tribal organizations (as such terms

are defined in section 4 of the Indian Self-Determination and

Education Assistance Act), educational institutions, and non-

profit organizations to develop evidence-based interventions,

including culturally and linguistically appropriate services, as

appropriate, for—

(A) evaluating a model that has been scientifically

demonstrated to show promise, but would benefit from fur-

ther applied development, for—

(i) enhancing the prevention, diagnosis, interven-

tion, and treatment of, and recovery from, mental ill-

ness, serious emotional disturbances, substance use

disorders, and co-occurring illness or disorders; or

(ii) integrating or coordinating physical health

services and mental and substance use disorders serv-

ices; and

(B) expanding, replicating, or scaling evidence-based

programs across a wider area to enhance effective screen-

ing, early diagnosis, intervention, and treatment with re-

spect to mental illness, serious mental illness, serious emo-

tional disturbances, and substance use disorders, primarily

by—

(i) applying such evidence-based programs to the

delivery of care, including by training staff in effective

evidence-based treatments; or

(ii) integrating such evidence-based programs into

models of care across specialties and jurisdictions.

(2) C

ONSULTATION

.—In awarding grants under this sub-

section, the Assistant Secretary shall, as appropriate, consult

with the Chief Medical Officer, appointed under section 501(g),

the advisory councils described in section 502, the National In-

stitute of Mental Health, the National Institute on Drug

Abuse, and the National Institute on Alcohol Abuse and Alco-

holism, as appropriate.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there is authorized to be appropriated $10,000,000 for each of

fiscal years 2023 through 2027.

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16 Sec. 501B PUBLIC HEALTH SERVICE ACT

SEC. 501B. ø 290aa-0a ¿ BEHAVIORAL HEALTH CRISIS COORDINATING

OFFICE.

(a) I

ENERAL

.—The Secretary shall establish, within the

Substance Abuse and Mental Health Services Administration, an

office to coordinate work relating to behavioral health crisis care

across the operating divisions and agencies of the Department of

Health and Human Services, including the Substance Abuse and

Mental Health Services Administration, the Centers for Medicare

& Medicaid Services, and the Health Resources and Services Ad-

ministration, and external stakeholders.

(b) D

UTY

.—The office established under subsection (a) shall—

(1) convene Federal, State, Tribal, local, and private part-

ners;

(2) launch and manage Federal workgroups charged with

making recommendations regarding issues related to mental

health and substance use disorder crises, including with re-

spect to health care best practices, workforce development,

health disparities, data collection, technology, program over-

sight, public awareness, and engagement; and

(3) support technical assistance, data analysis, and evalua-

tion functions in order to assist States, localities, Territories,

Indian Tribes, and Tribal organizations in developing crisis

care systems and identifying best practices with the objective

of expanding the capacity of, and access to, local crisis call cen-

ters, mobile crisis care, crisis stabilization, psychiatric emer-

gency services, and rapid post-crisis follow-up care provided

by—

(A) the National Suicide Prevention and Mental

Health Crisis Hotline and Response System;

(B) the Veterans Crisis Line;

section 1861(ff)(3)(B) of the Social Security Act);

(D) certified community behavioral health clinics, as

described in section 223 of the Protecting Access to Medi-

care Act of 2014; and

(E) other community mental health and substance use

disorder providers.

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section $5,000,000 for each of

fiscal years 2023 through 2027.

SEC. 501C. ø 290aa-0b ¿ INTERDEPARTMENTAL SERIOUS MENTAL ILL-

NESS COORDINATING COMMITTEE.

(a) E

STABLISHMENT

.—

(1) I

N GENERAL

.—The Secretary, or the designee of the

Secretary, shall establish a committee to be known as the

Interdepartmental Serious Mental Illness Coordinating Com-

mittee (in this section referred to as the ‘‘Committee’’).

(2) F

EDERAL ADVISORY COMMITTEE ACT

.—Except as pro-

vided in this section, the provisions of the Federal Advisory

Committee Act (5 U.S.C. App.) shall apply to the Committee.

(b) M

EETINGS

.—The Committee shall meet not fewer than 2

times each year.

ESPONSIBILITIES

.—Not later than each of 1 year and 5

years after the date of enactment of this section, the Committee

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17 Sec. 501C PUBLIC HEALTH SERVICE ACT

shall submit to Congress and any other relevant Federal depart-

ment or agency a report including—

(1) a summary of advances in serious mental illness and

serious emotional disturbance research related to the preven-

tion of, diagnosis of, intervention in, and treatment and recov-

ery of serious mental illnesses, serious emotional disturbances,

and advances in access to services and support for adults with

a serious mental illness or children with a serious emotional

disturbance;

(2) an evaluation of the effect Federal programs related to

serious mental illness have on public health, including out-

comes such as—

(A) rates of suicide, suicide attempts, incidence and

prevalence of serious mental illnesses, serious emotional

disturbances, and substance use disorders, overdose, over-

dose deaths, emergency hospitalizations, emergency de-

partment boarding, preventable emergency department

visits, interaction with the criminal justice system, home-

lessness, and unemployment;

(B) increased rates of employment and enrollment in

educational and vocational programs;

treatment services; or

(D) any other criteria as may be determined by the

Secretary; and

(3) specific recommendations for actions that agencies can

take to better coordinate the administration of mental health

services for adults with a serious mental illness or children

with a serious emotional disturbance.

(d) M

EMBERSHIP

.—

(1) F

EDERAL MEMBERS

.—The Committee shall be composed

of the following Federal representatives, or the designees of

such representatives—

(A) the Secretary of Health and Human Services, who

shall serve as the Chair of the Committee;

(B) the Assistant Secretary for Mental Health and

Substance Use;

(D) the Secretary of Veterans Affairs;

(E) the Secretary of Defense;

(F) the Secretary of Housing and Urban Development;

(G) the Secretary of Education;

(H) the Secretary of Labor;

(I) the Administrator of the Centers for Medicare &

Medicaid Services;

(J) the Administrator of the Administration for Com-

munity Living; and

(K) the Commissioner of Social Security.

(2) N

FEDERAL MEMBERS

.—The Committee shall also in-

clude not less than 14 non-Federal public members appointed

by the Secretary of Health and Human Services, of which—

(A) at least 2 members shall be an individual who has

received treatment for a diagnosis of a serious mental ill-

ness;

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18 Sec. 501C PUBLIC HEALTH SERVICE ACT

(B) at least 1 member shall be a parent or legal guard-

ian of an adult with a history of a serious mental illness

or a child with a history of a serious emotional disturb-

ance;

leading research, advocacy, or service organization for

adults with a serious mental illness;

(D) at least 2 members shall be—

(i) a licensed psychiatrist with experience in treat-

ing serious mental illnesses;

(ii) a licensed psychologist with experience in

treating serious mental illnesses or serious emotional

disturbances;

(iii) a licensed clinical social worker with experi-

ence treating serious mental illnesses or serious emo-

tional disturbances; or

(iv) a licensed psychiatric nurse, nurse practi-

tioner, or physician assistant with experience in treat-

ing serious mental illnesses or serious emotional dis-

turbances;

(E) at least 1 member shall be a licensed mental

health professional with a specialty in treating children

and adolescents with a serious emotional disturbance;

(F) at least 1 member shall be a mental health profes-

sional who has research or clinical mental health experi-

ence in working with minorities;

(G) at least 1 member shall be a mental health profes-

sional who has research or clinical mental health experi-

ence in working with medically underserved populations;

(H) at least 1 member shall be a State certified mental

health peer support specialist;

(I) at least 1 member shall be a judge with experience

in adjudicating cases related to criminal justice or serious

mental illness;

(J) at least 1 member shall be a law enforcement offi-

cer or corrections officer with extensive experience in inter-

facing with adults with a serious mental illness, children

with a serious emotional disturbance, or individuals in a

mental health crisis; and

(K) at least 1 member shall have experience providing

services for homeless individuals and working with adults

with a serious mental illness, children with a serious emo-

tional disturbance, or individuals in a mental health crisis.

(3) T

ERMS

.—A member of the Committee appointed under

paragraph (2) shall serve for a term of 3 years, and may be re-

appointed for 1 or more additional 3-year terms. Any member

appointed to fill a vacancy for an unexpired term shall be ap-

pointed for the remainder of such term. A member may serve

after the expiration of the member’s term until a successor has

been appointed.

(e) W

ORKING

ROUPS

.—In carrying out its functions, the Com-

mittee may establish working groups. Such working groups shall

be composed of Committee members, or their designees, and may

hold such meetings as are necessary.

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19 Sec. 502 PUBLIC HEALTH SERVICE ACT

(f) S

UNSET

.—The Committee shall terminate on September 30,

2027.

ADVISORY COUNCILS

. 502. ø290aa–1¿ (a) A

PPOINTMENT

.—

(1) I

N 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;

(D) the Center for Mental Health Services.

Each such advisory council shall advise, consult with, and

make recommendations to the Secretary and the Assistant Sec-

retary 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) F

UNCTION AND ACTIVITIES

.—An advisory council—

(A)(i) may on the basis of the materials provided by

the organization respecting activities conducted at the or-

ganization, make recommendations to the Assistant Sec-

retary or Director of the Administration or Center for

which it was established respecting such activities;

(ii) shall review applications submitted for grants and

cooperative agreements for activities for which advisory

council approval is required under section 504(d)(2) and

recommend for approval applications for projects that show

promise of making valuable contributions to the Adminis-

tration’s mission; and

(iii) may review any grant, contract, or cooperative

agreement proposed to be made or entered into by the or-

ganization;

(B) may collect, by correspondence or by personal in-

vestigation, 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 estab-

lished and with the approval of the Assistant Secretary or

Director, whichever is appropriate, make such information

available through appropriate publications for the benefit

of public and private health entities and health professions

personnel and for the information of the general public;

and

shops and conferences.

(b) M

EMBERSHIP

.—

(1) I

N 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) E

X OFFICIO MEMBERS

.—The ex officio members of an

advisory council shall consist of—

(A) the Secretary;

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20 Sec. 502 PUBLIC HEALTH SERVICE ACT

(B) the Assistant Secretary;

established;

(D) the Under Secretary for Health of the Department

of Veterans Affairs;

(E) the Assistant Secretary for Defense for Health Af-

fairs (or the designates of such officers);

(F) the Chief Medical Officer, appointed under section

501(g);

(G) the Director of the National Institute of Mental

Health for the advisory councils appointed under sub-

sections (a)(1)(A) and (a)(1)(D);

(H) the Director of the National Institute on Drug

Abuse for the advisory councils appointed under sub-

sections (a)(1)(A), (a)(1)(B), and (a)(1)(C);

(I) the Director of the National Institute on Alcohol

Abuse and Alcoholism for the advisory councils appointed

under subsections (a)(1)(A), (a)(1)(B), and (a)(1)(C); and

(J) such additional officers or employees of the United

States as the Secretary determines necessary for the advi-

sory council to effectively carry out its functions.

(3) A

PPOINTED MEMBERS

.—Individuals shall be appointed

to an advisory council under paragraph (1) as follows:

(A) Nine of the members shall be appointed by the

Secretary from among the leading representatives of the

health disciplines (including public health and behavioral

and social sciences) relevant to the activities of the Admin-

istration or Center for which the advisory council is estab-

lished.

(B) Three of the members shall be appointed by the

Secretary from the general public and shall include leaders

in fields of public policy, public relations, law, health policy

economics, or management.

council appointed under subsection (a)(1)(D)—

(i) shall—

(I) have a medical degree;

(II) have a doctoral degree in psychology; or

(III) have an advanced degree in nursing or

social work from an accredited graduate school or

be a certified physician assistant; and

(ii) shall specialize in the mental health field.

(D) Not less than half of the members of the advisory

councils appointed under subsections (a)(1)(B) and

(a)(1)(C)—

(i) shall—

(I) have a medical degree;

(II) have a doctoral degree; or

(III) have an advanced degree in nursing,

public health, behavioral or social sciences, or so-

cial work from an accredited graduate school or be

a certified physician assistant; and

(ii) shall have experience in the provision of sub-

stance use disorder services or the development and

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21 Sec. 502 PUBLIC HEALTH SERVICE ACT

implementation of programs to prevent substance mis-

use.

(4) C

OMPENSATION

.—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 re-

maining members of an advisory council shall receive, for each

day (including travel time) they are engaged in the perform-

ance of the functions of the advisory council, compensation at

rates not to exceed the daily equivalent to the annual rate in

effect for grade GS–18 of the General Schedule.

ERMS OF

FFICE

.—

(1) I

N GENERAL

.—The term of office of a member of an ad-

visory council appointed under subsection (b) shall be 4 years,

except that any member appointed to fill a vacancy for an un-

expired 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) R

EAPPOINTMENTS

.—A member who has been appointed

to an advisory council for a term of 4 years may not be re-

appointed to an advisory council during the 2-year period be-

ginning on the date on which such 4-year term expired.

(3) T

IME FOR APPOINTMENT

.—If a vacancy occurs in an ad-

visory council among the members under subsection (b), the

Secretary shall make an appointment to fill such vacancy with-

in 90 days from the date the vacancy occurs.

(d) C

HAIR

.—The Secretary shall select a member of an advisory

council to serve as the chair of the council. The Secretary may so

select an individual from among the appointed members, or may

select the Assistant Secretary or the Director of the Center in-

volved. The term of office of the chair shall be 2 years.

(e) M

EETINGS

.—An advisory council shall meet at the call of

the chairperson or upon the request of the Assistant Secretary or

Director of the Administration or Center for which the advisory

council is established, but in no event less than 2 times during

each fiscal year. The location of the meetings of each advisory coun-

cil shall be subject to the approval of the Assistant Secretary or Di-

rector of Administration or Center for which the council was estab-

lished.

(f) E

XECUTIVE

ECRETARY AND

TAFF

.—The Assistant Sec-

retary or Director of the Administration or Center for which the ad-

visory council is established shall designate a member of the staff

of the Administration or Center for which the advisory council is

established to serve as the Executive Secretary of the advisory

council. The Assistant Secretary or Director shall make available

to the advisory council such staff, information, and other assistance

as it may require to carry out its functions. The Assistant Sec-

retary or Director shall provide orientation and training for new

members of the advisory council to provide for their effective par-

ticipation in the functions of the advisory council.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

22 Sec. 503 PUBLIC HEALTH SERVICE ACT

REPORTS ON ALCOHOLISM

ALCOHOL ABUSE

AND DRUG ABUSE

. 503. ø290aa–2¿ (a) The Secretary shall submit to Con-

gress on or before January 15, 1984, and every three years there-

after a report—

(1) containing current information on the health con-

sequences of using alcoholic beverages,

(2) containing a description of current research findings

made with respect to alcohol abuse and alcoholism, and

(3) containing such recommendations for legislation and

administrative action as the Secretary may deem appropriate.

(b) The Secretary shall submit to Congress on or before Janu-

ary 15, 1984, and every three years thereafter a report—

(1) describing the health consequences and extent of drug

abuse in the United States;

(2) describing current research findings made with respect

to drug abuse, including current findings on the health effects

of marihuana and the addictive property of tobacco; and

(3) containing such recommendations for legislation and

administrative action as the Secretary may deem appropriate.

SEC. 503A. ø290aa–2a¿ REPORT ON INDIVIDUALS WITH CO-OCCURRING

MENTAL ILLNESS AND SUBSTANCE ABUSE DISORDERS.

(a) I

ENERAL

.—Not later than 2 years after the date of the

enactment of this section, the Secretary shall, after consultation

with organizations representing States, mental health and sub-

stance abuse treatment providers, prevention specialists, individ-

uals receiving treatment services, and family members of such indi-

viduals, prepare and submit to the Committee on Health, Edu-

cation, Labor, and Pensions of the Senate and the Committee on

Commerce of the House of Representatives, a report on prevention

and treatment services for individuals who have co-occurring men-

tal illness and substance abuse disorders.

(b) R

EPORT

ONTENT

.—The report under subsection (a) shall be

based on data collected from existing Federal and State surveys re-

garding the treatment of co-occurring mental illness and substance

abuse disorders and shall include—

(1) a summary of the manner in which individuals with co-

occurring disorders are receiving treatment, including the most

up-to-date information available regarding the number of chil-

dren and adults with co-occurring mental illness and substance

abuse disorders and the manner in which funds provided

under sections 1911 and 1921 are being utilized, including the

number of such children and adults served with such funds;

(2) a summary of improvements necessary to ensure that

individuals with co-occurring mental illness and substance

abuse disorders receive the services they need;

(3) a summary of practices for preventing substance abuse

among individuals who have a mental illness and are at risk

of having or acquiring a substance abuse disorder; and

(4) a summary of evidenced-based practices for treating in-

dividuals with co-occurring mental illness and substance abuse

disorders and recommendations for implementing such prac-

tices.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

23 Sec. 505 PUBLIC HEALTH SERVICE ACT

Section 504 appears according to the probable intent of the Congress. Section 3401(b) of Pub-

lic Law 106–310 (114 Stat. 1218) provides that the section ‘‘is amended as follows:’’. No amend-

atory instructions were then given, but a substitute text was provided. The amendment probably

should have instructed that section 504 ‘‘is amended to read as follows:’’.

Section 502 of Public Law 104–237 (110 Stat. 3112) provides as follows:

‘‘The Secretary of Health and Human Services shall develop a public health monitoring pro-

gram to monitor methamphetamine abuse in the United States. The program shall include the

collection and dissemination of data related to methamphetamine abuse which can be used by

public health officials in policy development.’’.

UNDS FOR

EPORT

.—The Secretary may obligate funds to

carry out this section with such appropriations as are available.

SEC. 504.

ø290aa–3¿ PEER REVIEW.

(a) I

ENERAL

.—The Secretary, after consultation with the

Assistant Secretary, shall require appropriate peer review of

grants, cooperative agreements, and contracts to be administered

through the agency which exceed the simple acquisition threshold

as defined in section 4(11) of the Office of Federal Procurement Pol-

icy Act.

(b) M

EMBERS

.—The members of any peer review group estab-

lished 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 employ-

ees of the United States. In the case of any such peer review group

that is reviewing a grant, cooperative agreement, or contract re-

lated to mental illness treatment, not less than half of the mem-

bers of such peer review group shall be licensed and experienced

professionals in the prevention, diagnosis, or treatment of, or recov-

ery from, mental illness or co-occurring mental illness and sub-

stance use disorders and have a medical degree, a doctoral degree

in psychology, or an advanced degree in nursing or social work

from an accredited program, and the Secretary, in consultation

with the Assistant Secretary, shall, to the extent possible, ensure

such peer review groups include broad geographic representation,

including both urban and rural representatives.

DVISORY

OUNCIL

EVIEW

.—If the direct cost of a grant or

cooperative agreement (described in subsection (a)) exceeds the

simple acquisition threshold as defined by section 4(11) of the Of-

fice of Federal Procurement Policy Act, the Secretary may make

such a grant or cooperative agreement only if such grant or cooper-

ative agreement is recommended—

(1) after peer review required under subsection (a); and

(2) by the appropriate advisory council.

(d) C

ONDITIONS

.—The Secretary may establish limited excep-

tions to the limitations contained in this section regarding partici-

pation of Federal employees and advisory council approval. The cir-

cumstances under which the Secretary may make such an excep-

tion shall be made public.

SEC. 505. ø290aa–4¿ CENTER FOR BEHAVIORAL HEALTH STATISTICS

AND QUALITY.

(a) I

ENERAL

.—The Assistant Secretary shall maintain with-

in the Administration a Center for Behavioral Health Statistics

and Quality (in this section referred to as the ‘‘Center’’). The Cen-

ter shall be headed by a Director (in this section referred to as the

‘‘Director’’) appointed by the Secretary from among individuals with

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As Amended Through P.L. 117-328, Enacted December 29, 2022

24 Sec. 505 PUBLIC HEALTH SERVICE ACT

So in law. The period at the end of subparagraph (B) probably should be a semicolon.

extensive experience and academic qualifications in research and

analysis in behavioral health care or related fields. (b) The Director

shall—

(1) coordinate the Administration’s integrated data strategy,

including by collecting data each year on——

(A) the national incidence and prevalence of the var-

ious forms of mental illness and substance abuse; and

(B) the incidence and prevalence of such various forms

in major metropolitan areas selected by the Director.

(2) provide statistical and analytical support for activities

of the Administration;

(3) recommend a core set of performance metrics to evalu-

ate activities supported by the Administration; and

(4) coordinate with the Assistant Secretary, the Assistant

Secretary for Planning and Evaluation, and the Chief Medical

Officer appointed under section 501(g), as appropriate, to im-

prove the quality of services provided by programs of the Ad-

ministration and the evaluation of activities carried out by the

Administration.

ENTAL

EALTH

.—With respect to the activities of the Di-

rector under subsection (b)(1) relating to mental health, the Direc-

tor shall ensure that such activities include, at a minimum, the col-

lection of data on—

(1) the number and variety of public and nonprofit private

treatment programs;

(2) the number and demographic characteristics of individ-

uals receiving treatment through such programs;

(3) the type of care received by such individuals; and

(4) such other data as may be appropriate.

(d) S

UBSTANCE

BUSE

.—

(1) I

N GENERAL

.—With respect to the activities of the Di-

rector under subsection (b)(1) relating to substance abuse, the

Director shall ensure that such activities include, at a min-

imum, the collection of data on—

(A) the number of individuals admitted to the emergency

rooms of hospitals as a result of the abuse of alcohol or other

drugs;

(B) the number of deaths occurring as a result of substance

abuse, as indicated in reports by coroners in coordination with

the Centers for Disease Control and Prevention;

treatment programs, including the number and type of patient

slots available;

(D) the number of individuals seeking treatment through

such programs, the number and demographic characteristics of

individuals receiving such treatment, the percentage of individ-

uals who complete such programs, and, with respect to individ-

uals receiving such treatment, the length of time between an

individual’s request for treatment and the commencement of

treatment;

(E) the number of such individuals who return for treat-

ment after the completion of a prior treatment in such pro-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

25 Sec. 506 PUBLIC HEALTH SERVICE ACT

The heading for paragraph (2) is the result of the amendment made by section 6004(6)(C)

of Public Law 114–255. Such amendment probably should not have been made to strike ‘‘A

NUAL SURVEYS

’’ (initial cap and small caps) and instead should have been ‘‘Annual Surveys’’.

grams and the method of treatment utilized during the prior

treatment;

(F) the number of individuals receiving public assistance

for such treatment programs;

(G) the costs of the different types of treatment modalities

for drug and alcohol abuse and the aggregate relative costs of

each such treatment modality provided within a State in each

fiscal year;

(H) to the extent of available information, the number of

individuals receiving treatment for alcohol or drug abuse who

have private insurance coverage for the costs of such treat-

ment;

(I) the extent of alcohol and drug abuse among high school

students and among the general population; and

(J) the number of alcohol and drug abuse counselors and

other substance abuse treatment personnel employed in public

and private treatment facilities.

(2) A

NNUAL SURVEYS

;

PUBLIC AVAILABILITY OF DATA

.—Annual

survey

s shall be carried out in the collection of data under this

subsection. Summaries and analyses of the data collected shall be

made available to the public.

(e) C

ONSULTATION

.—After consultation with the States and

with appropriate national organizations, the Assistant Secretary

shall use existing standards and best practices to develop uniform

criteria for the collection of data, using the best available tech-

nology, pursuant to this section.

SEC. 506. ø290aa–5¿ GRANTS FOR THE BENEFIT OF HOMELESS INDIVID-

UALS.

(a) I

ENERAL

.—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 car-

rying out this section, the Secretary shall consult with the Inter-

agency Council on the Homeless, established under section 201 of

the Stewart B. McKinney Homeless Assistance Act (42 U.S.C.

11311).

(b) P

REFERENCES

.—In awarding grants, contracts, and coopera-

tive agreements under subsection (a), the Secretary shall give a

preference to—

(1) entities that provide integrated primary health, sub-

stance use disorder, and mental health services to homeless in-

dividuals;

(2) entities that demonstrate effectiveness in serving run-

away, homeless, and street youth;

(3) entities that have experience in providing substance

use disorder and mental health services to homeless individ-

uals;

(4) entities that demonstrate experience in providing hous-

ing for individuals in treatment for or in recovery from mental

illness or a substance use disorder; and

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As Amended Through P.L. 117-328, Enacted December 29, 2022

26 Sec. 506A PUBLIC HEALTH SERVICE ACT

(5) entities that demonstrate effectiveness in serving

homeless veterans.

ERVICES FOR

ERTAIN

NDIVIDUALS

.—In awarding grants,

contracts, and cooperative agreements under subsection (a), the

Secretary shall not—

(1) prohibit the provision of services under such subsection

to homeless individuals who are suffering from a substance use

disorder and are not suffering from a mental health disorder;

and

(2) make payments under subsection (a) to any entity that

has a policy of—

(A) excluding individuals from mental health services

due to the existence or suspicion of a substance use dis-

order; or

(B) has a policy of excluding individuals from sub-

stance use disorder services due to the existence or sus-

picion of mental illness.

(d) T

ERM OF THE

WARDS

.—No entity may receive a grant, con-

tract, or cooperative agreement under subsection (a) for more than

5 years.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section$41,304,000 for each of

fiscal years 2023 through 2027.

SEC. 506A. ø290aa–5a¿ BEHAVIORAL HEALTH AND SUBSTANCE USE DIS-

ORDER RESOURCES FOR NATIVE AMERICANS.

(a) D

EFINITIONS

.—In this section:

(1) The term ‘‘eligible entity’’ means any health program

administered directly by the Indian Health Service, a Tribal

health program, an Indian Tribe, a Tribal organization, an

Urban Indian organization, and a Native Hawaiian health or-

ganization.

(2) The terms ‘‘Indian Tribe’’, ‘‘Tribal health program’’,

‘‘Tribal organization’’, and ‘‘Urban Indian organization’’ have

the meanings given to the terms ‘‘Indian tribe’’, ‘‘Tribal health

program’’, ‘‘tribal organization’’, and ‘‘Urban Indian organiza-

tion’’ in section 4 of the Indian Health Care Improvement Act.

(3) The term ‘‘health program administered directly by the

Indian Health Service’’ means a ‘‘health program administered

by the Service’’ as such term is used in section 4(12)(A) of the

Indian Health Care Improvement Act.

(4) The term ‘‘Native Hawaiian health organization’’ means

‘‘Papa Ola Lokahi’’ as defined in section 12 of the Native Ha-

waiian Health Care Improvement Act.

(b) G

RANT

ROGRAM

.—

(1) I

N GENERAL

.—The Secretary, acting through the Assist-

ant Secretary for Mental Health and Substance Use, and in

consultation with the Director of the Indian Health Service, as

appropriate, shall award funds to eligible entities, in amounts

developed in accordance with paragraph (2), to be used by the

eligible entity to provide services for the prevention of, treat-

ment of, and recovery from mental health and substance use

disorders among American Indians, Alaska Natives, and Na-

tive Hawaiians.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

27 Sec. 506A PUBLIC HEALTH SERVICE ACT

(2) F

ORMULA

.—The Secretary, in consultation with the Di-

rector of the Indian Health Service, using the process described

in subsection (d), shall develop a formula to determine the

amount of an award under paragraph (1).

(3) D

ELIVERY OF FUNDS

.—On request from an Indian Tribe

or Tribal organization, the Secretary, acting through the As-

sistant Secretary for Mental Health and Substance Use and in

coordination with the Director of the Indian Health Service,

may award funds under this section through a contract or com-

pact under, as applicable, title I or V of the Indian Self-Deter-

mination and Education Assistance Act.

ECHNICAL

SSISTANCE AND

ROGRAM

VALUATION

.—

(1) I

N GENERAL

.—The Secretary shall—

(A) provide technical assistance to applicants and

awardees under this section; and

(B) in consultation with Indian Tribes and Tribal orga-

nizations, conference with Urban Indian organizations,

and engagement with a Native Hawaiian health organiza-

tion, identify and establish appropriate mechanisms for In-

dian Tribes and Tribal organizations, Urban Indian orga-

nizations, and a Native Hawaiian health organization to

demonstrate outcomes and report data as required for par-

ticipation in the program under this section.

(2) D

ATA SUBMISSION AND REPORTING

.—As a condition of

receipt of funds under this section, an applicant shall agree to

submit program evaluation data and reports consistent with

the data submission and reporting requirements developed

under this subsection.

(d) C

ONSULTATION

.—The Secretary shall, using an accountable

process, consult with Indian Tribes and Tribal organizations, confer

with Urban Indian organizations, and engage with a Native Hawai-

ian health organization regarding the development of funding allo-

cations pursuant to subsection (b)(2) and program evaluation and

reporting requirements pursuant to subsection (c). In establishing

such requirements, the Secretary shall seek to minimize adminis-

trative burden for eligible entities, as practicable.

(e) A

PPLICATION

.—An entity desiring an award under sub-

section (b) shall submit an application to the Secretary at such

time, in such manner, and accompanied by such information as the

Secretary may reasonably require.

(f) R

EPORT

.—Not later than 3 years after the date of the enact-

ment of the Restoring Hope for Mental Health and Well-Being Act

of 2022, the Secretary shall prepare and submit, to the Committee

on Health, Education, Labor, and Pensions of the Senate, and the

Committee on Energy and Commerce of the House of Representa-

tives, a report describing the services provided pursuant to this sec-

tion.

(g) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section, $80,000,000 for each

of fiscal years 2023 through 2027.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

28 Sec. 507 PUBLIC HEALTH SERVICE ACT

Section 4 of Public Law 108–358 (118 Stat. 1664) authorizes the Secretary of Health and

Human Services to ‘‘award grants to public and nonprofit private entities to enable such entities

to carry out science-based education programs in elementary and secondary schools to highlight

the harmful effects of anabolic steroids’’. Subsection (d) of such section provides that there is

authorized to be appropriated to carry out the section $15,000,000 for each of the fiscal years

2005 through 2010.

ART

B—C

ENTERS AND

ROGRAMS

Subpart 1—Center for Substance Abuse Treatment

CENTER FOR SUBSTANCE ABUSE TREATMENT

. 507. ø290bb¿ (a) E

STABLISHMENT

.—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 individ-

uals with extensive experience or academic qualifications in the

treatment of substance use disorders or in the evaluation of sub-

stance use disorder treatment systems.

(b) D

UTIES

.—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 adoles-

cents in the development of treatment programs;

(3) collaborate with the Attorney General to develop pro-

grams to provide substance use disorder treatment services to

individuals who have had contact with the Justice system, es-

pecially adolescents;

(4) collaborate with the Director of the Center for Sub-

stance Abuse Prevention in order to provide outreach services

to identify individuals in need of treatment services, with em-

phasis on the provision of such services to pregnant and

postpartum women and their infants and to individuals who il-

licitly 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 find-

ings that will improve the delivery and effectiveness of treat-

ment services;

(6) collaborate with the Administrator of the Health Re-

sources 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 treat-

ment services;

(7) evaluate plans submitted by the States pursuant to sec-

tion 1932(a)(6) in order to determine whether the plans ade-

quately provide for the availability, allocation, and effective-

ness of treatment services;

(8) sponsor regional workshops on improving the quality

and availability of treatment services;

(9) provide technical assistance to public and nonprofit pri-

vate entities that provide treatment services, including tech-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

29 Sec. 508 PUBLIC HEALTH SERVICE ACT

nical assistance with respect to the process of submitting to the

Director applications for any program of grants or contracts;

(10) carry out activities to educate individuals on the need

for establishing treatment facilities within their communities;

(11) encourage public and private entities that provide

health insurance to provide benefits for outpatient treatment

services and other nonhospital-based treatment services;

(12) evaluate treatment programs to determine the quality

and appropriateness of various forms of treatment, which shall

be carried out through grants, contracts, or cooperative agree-

ments provided to public or nonprofit private entities;

(13) ensure the consistent documentation of the application

of criteria when awarding grants and the ongoing oversight of

grantees after such grants are awarded;

(14) work with States, providers, and individuals in recov-

ery, and their families, to promote the expansion of recovery

support services and systems of care oriented toward recovery;

(15) in cooperation with the Secretary, implement and dis-

seminate, as appropriate, the recommendations in the report

entitled ‘‘Protecting Our Infants Act: Final Strategy’’ issued by

the Department of Health and Human Services in 2017; and

(16) in cooperation with relevant stakeholders, and

through public-private partnerships, encourage education

about substance use disorders for pregnant women and health

care providers who treat pregnant women and babies.

RANTS AND

ONTRACTS

.—In carrying out the duties estab-

lished in subsection (b), the Director may make grants to and enter

into contracts and cooperative agreements with public and non-

profit private entities.

RESIDENTIAL TREATMENT PROGRAMS FOR PREGNANT AND

POSTPARTUM WOMEN

. 508. ø290bb–1¿ (a) I

ENERAL

.—The Director of the

Center for Substance Abuse Treatment (referred to in this section

as the ‘‘Director’’) shall provide awards of grants, including the

grants under subsection (r), cooperative agreements or contracts to

public and nonprofit private entities for the purpose of providing to

pregnant and postpartum women treatment for substance use dis-

orders 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) A

VAILABILITY OF

ERVICES FOR

ACH

ARTICIPANT

.—A

funding agreement for an award under subsection (a) for an appli-

cant is that, in the program operated pursuant to such sub-

section—

(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

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As Amended Through P.L. 117-328, Enacted December 29, 2022

30 Sec. 508 PUBLIC HEALTH SERVICE ACT

(2) the services will be made available to each woman ad-

mitted to the program and her children.

NDIVIDUALIZED

LAN OF

ERVICES

.—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 provi-

sion of services for the woman and her children; and

(2) treatment services under the plan will include—

(A) individual, group, and family counseling, as appro-

priate, regarding substance use disorders; and

(B) follow-up services to assist the woman in pre-

venting a relapse into such a disorder.

(d) R

EQUIRED

UPPLEMENTAL

ERVICES

.—In the case of an eli-

gible woman, the services referred to in subsection (a)(3) are as fol-

lows:

(1) Prenatal and postpartum health care.

(2) Referrals for necessary hospital services.

(3) For the infants and children of the woman—

(A) pediatric health care, including treatment for any

perinatal effects of a maternal substance use disorder and

including screenings regarding the physical and mental de-

velopment of the infants and children;

(B) counseling and other mental health services, in the

case of children; and

(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 activi-

ties.

(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 im-

portance of graduating from a secondary school.

(9) Reasonable efforts to preserve and support the family

unit of the woman, including promoting the appropriate in-

volvement of parents and others, and counseling the children

of the woman.

(10) Planning for and counseling to assist reentry into soci-

ety, 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 chil-

dren of the woman.

(11) Case management services, including—

(A) assessing the extent to which authorized services

are appropriate for the woman and any child of such

woman;

(B) in the case of the services that are appropriate, en-

suring that the services are provided in a coordinated

manner;

under Federal, State, and local programs providing health

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As Amended Through P.L. 117-328, Enacted December 29, 2022

31 Sec. 508 PUBLIC HEALTH SERVICE ACT

services, mental health services, housing services, employ-

ment services, educational services, or social services; and

(D) family reunification with children in kinship or

foster care arrangements, where safe and appropriate.

(e) M

INIMUM

UALIFICATIONS

ECEIPT OF

WARD

.—

(1) C

ERTIFICATION BY RELEVANT STATE AGENCY

.—With re-

spect to the principal agency of the State involved that admin-

isters programs relating to substance use disorders, the Direc-

tor 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 pro-

gram 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

plicant will provide authorized services, meets all applica-

ble State licensure or certification requirements regarding

the provision of the services involved.

(2) S

TATUS AS MEDICAID PROVIDER

.—

(A) I

N 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 avail-

able 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) W

AIVER OF PARTICIPATION AGREEMENTS

.—

(i) I

N GENERAL

.—In the case of an entity making

an agreement pursuant to subparagraph (A)(ii) regard-

ing the provision of services, the requirement estab-

lished 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) D

ONATIONS

.—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.

ONAPPLICATION OF CERTAIN REQUIREMENTS

.—

With respect to any authorized service that is available

pursuant to the State plan described in subparagraph (A),

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32 Sec. 508 PUBLIC HEALTH SERVICE ACT

the requirements established in such subparagraph shall

not apply to the provision of any such service by an insti-

tution for mental diseases to an individual who has at-

tained 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) R

EQUIREMENT OF

ATCHING

UNDS

.—

(1) I

N 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 dona-

tions 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 re-

ceives 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

than $1 for each $3 of Federal funds provided in the

award.

(2) D

ETERMINATION OF AMOUNT CONTRIBUTED

.—Non-Fed-

eral contributions required in paragraph (1) may be in cash or

in kind, fairly evaluated, including plant, equipment, or serv-

ices. 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) O

UTREACH

.—A funding agreement for an award under sub-

section (a) for an applicant is that the applicant will provide out-

reach services in the community involved to identify women who

have a substance use disorder and to encourage the women to un-

dergo treatment for such disorder.

(h) A

CCESSIBILITY OF

ROGRAM

; C

ULTURAL

ONTEXT OF

ERV

ICES

.—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 preg-

nant and postpartum women; and

(2) authorized services will be provided in the language

and the cultural context that is most appropriate.

(i) C

ONTINUING

DUCATION

.—A funding agreement for an

award under subsection (a) is that the applicant involved will pro-

vide for continuing education in treatment services for the individ-

uals who will provide treatment in the program to be operated by

the applicant pursuant to such subsection.

(j) I

MPOSITION OF

HARGES

.—A funding agreement for an

award under subsection (a) for an applicant is that, if a charge is

imposed for the provision of authorized services to or on behalf of

an eligible woman, such charge—

(1) will be made according to a schedule of charges that is

made available to the public;

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33 Sec. 508 PUBLIC HEALTH SERVICE ACT

(2) will be adjusted to reflect the income of the woman in-

volved; and

(3) will not be imposed on any such woman with an income

of less than 185 percent of the official poverty line, as estab-

lished 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) R

EPORTS TO

IRECTOR

.—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 deter-

mines to be appropriate.

(l) R

EQUIREMENT OF

PPLICATION

.—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 ap-

plication 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) A

LLOCATION OF

WARDS

.—In making awards under sub-

section (a), the Director shall give priority to an applicant that

agrees to use the award for a program serving an area that is a

rural area, an area designated under section 332 by the Secretary

as a health professional shortage area, or an area determined by

the Director to have a shortage of family-based substance use dis-

order treatment options.

(n) D

URATION OF

WARD

.—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) E

VALUATIONS

; D

ISSEMINATION OF

INDINGS

.—The Director

shall, directly or through contract, provide for the conduct of eval-

uations of programs carried out pursuant to subsection (a). The Di-

rector shall disseminate to the States the findings made as a result

of the evaluations.

(p) R

EPORTS TO

ONGRESS

.—Not later than October 1, 1994,

the Director shall submit to the Committee on Energy and Com-

merce of the House of Representatives, and to the Committee on

Labor and Human Resources of the Senate, a report describing pro-

grams carried out pursuant to this section (other than subsection

(r)). Every 2 years thereafter, the Director shall prepare a report

describing such programs carried out during the preceding 2 years,

and shall submit the report to the Assistant Secretary for inclusion

in the biennial report under section 501(m). Each report under this

subsection shall include a summary of any evaluations conducted

under subsection (m) during the period with respect to which the

report is prepared.

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34 Sec. 508 PUBLIC HEALTH SERVICE ACT

(q) D

EFINITIONS

.—For purposes of this section:

(1) The term ‘‘authorized services’’ means treatment serv-

ices and supplemental services.

(2) The term ‘‘eligible woman’’ means a woman who has

been admitted to a program operated pursuant to subsection

(a).

(3) The term ‘‘funding agreement’’, with respect to an

award under subsection (a), means that the Director may make

the award only if the applicant makes the agreement involved.

(4) The term ‘‘treatment services’’ means treatment for a

substance use disorder, including the counseling and services

described in subsection (c)(2).

(5) The term ‘‘supplemental services’’ means the services

described in subsection (d).

(r) P

ILOT

ROGRAM FOR

TATE

UBSTANCE

BUSE

GENCIES

.—

(1) I

N GENERAL

.—From amounts made available under

subsection (s), the Director of the Center for Substance Abuse

Treatment shall carry out a pilot program under which com-

petitive grants are made by the Director to State substance

abuse agencies—

(A) to enhance flexibility in the use of funds designed

to support family-based services for pregnant and

postpartum women with a primary diagnosis of a sub-

stance use disorder, including opioid use disorders;

(B) to help State substance abuse agencies address

identified gaps in services furnished to such women along

the continuum of care, including services provided to

women in nonresidential-based settings; and

State system managed by State substance abuse agencies

by encouraging new approaches and models of service de-

livery.

(2) R

EQUIREMENTS

.—In carrying out the pilot program

under this subsection, the Director shall—

(A) require State substance abuse agencies to submit

to the Director applications, in such form and manner and

containing such information as specified by the Director, to

be eligible to receive a grant under the program;

(B) identify, based on such submitted applications,

State substance abuse agencies that are eligible for such

grants;

such a grant to support family-based treatment and other

services for pregnant and postpartum women with a pri-

mary diagnosis of a substance use disorder, including

opioid use disorders;

(D) not require that services furnished through such a

grant be provided solely to women that reside in facilities;

(E) not require that grant recipients under the pro-

gram make available through use of the grant all the serv-

ices described in subsection (d); and

(F) consider not applying the requirements described

in paragraphs (1) and (2) of subsection (f) to an applicant,

depending on the circumstances of the applicant.

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35 Sec. 508 PUBLIC HEALTH SERVICE ACT

(3) R

EQUIRED SERVICES

.—

(A) I

N GENERAL

.—The Director shall specify a min-

imum set of services required to be made available to eligi-

ble women through a grant awarded under the pilot pro-

gram under this subsection. Such minimum set of serv-

ices—

(i) shall include the services requirements de-

scribed in subsection (c) and be based on the rec-

ommendations submitted under subparagraph (B); and

(ii) may be selected from among the services de-

scribed in subsection (d) and include other services as

appropriate.

(B) S

TAKEHOLDER INPUT

.—The Director shall convene

and solicit recommendations from stakeholders, including

State substance abuse agencies, health care providers, per-

sons in recovery from substance abuse, and other appro-

priate individuals, for the minimum set of services de-

scribed in subparagraph (A).

(4) E

VALUATION AND REPORT TO CONGRESS

.—

(A) I

N GENERAL

.—The Director of the Center for Be-

havioral Health Statistics and Quality shall evaluate the

pilot program at the conclusion of the first grant cycle

funded by the pilot program.

(B) R

EPORT

.—Not later than September 30, 2026, the

Director of the Center for Behavioral Health Statistics and

Quality, in coordination with the Director of the Center for

Substance Abuse Treatment shall submit to the Com-

mittee on Health, Education, Labor, and Pensions of the

Senate and the Committee on Energy and Commerce of

the House of Representatives a report on the evaluation

under subparagraph (A). The report shall include, at a

minimum—

(i) outcomes information from the pilot program,

including any resulting reductions in the use of alcohol

and other drugs;

(ii) engagement in treatment services;

(iii) retention in the appropriate level and dura-

tion of services;

(iv) increased access to the use of medications ap-

proved by the Food and Drug Administration for the

treatment of substance use disorders in combination

with counseling; and

(v) other appropriate measures.

ECOMMENDATION

.—The report under subpara-

graph (B) shall include a recommendation by the Director

of the Center for Substance Abuse Treatment as to wheth-

er the pilot program under this subsection should be ex-

tended.

(5) S

TATE SUBSTANCE ABUSE AGENCIES DEFINED

.—For pur-

poses of this subsection, the term ‘‘State substance abuse agen-

cy’’ means, with respect to a State, the agency in such State

that manages the Substance Abuse Prevention and Treatment

Block Grant under part B of title XIX.

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36 Sec. 509 PUBLIC HEALTH SERVICE ACT

(s) A

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

carrying out this section, there are authorized to be appropriated

$29,931,000 for each of fiscal years 2019 through 2023. Of the

amounts made available for a year pursuant to the previous sen-

tence to carry out this section, not more than 25 percent of such

amounts shall be made available for such year to carry out sub-

section (r), other than paragraph (5) of such subsection. Notwith-

standing the preceding sentence, no funds shall be made available

to carry out subsection (r) for a fiscal year unless the amount made

available to carry out this section for such fiscal year is more than

the amount made available to carry out this section for fiscal year

2016.

SEC. 509. ø290bb–2¿ PRIORITY SUBSTANCE USE DISORDER TREATMENT

NEEDS OF REGIONAL AND NATIONAL SIGNIFICANCE.

(a) P

ROJECTS

.—The Secretary shall address priority substance

use disorder treatment needs of regional and national significance

(as determined under subsection (b)) through the provision of or

through assistance for—

(1) knowledge development and application projects for

treatment and rehabilitation and the conduct or support of

evaluations of such projects;

(2) training and technical assistance; and

(3) targeted capacity response programs that permit

States, local governments, communities, and Indian Tribes and

Tribal organizations (as such terms are defined in section 4 of

the Indian Self-Determination and Education Assistance Act)

to focus on emerging trends in substance use disorders and co-

occurrence of substance use disorders with mental illness or

other conditions.

The Secretary may carry out the activities described in this section

directly or through grants, contracts, or cooperative agreements

with States, political subdivisions of States, Indian tribes or tribal

organizations (as such terms are defined in section 4 of the Indian

Self-Determination and Education Assistance Act), health facilities,

or programs operated by or in accordance with a contract or grant

with the Indian Health Service, or other public or nonprofit private

entities.

(b) P

RIORITY

UBSTANCE

ISORDER

REATMENT

EEDS

.—

(1) I

N GENERAL

.—Priority substance use disorder treat-

ment needs of regional and national significance shall be deter-

mined 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 pro-

gram priorities.

(2) S

PECIAL CONSIDERATION

.—In developing program prior-

ities under paragraph (1), the Secretary shall give special con-

sideration to promoting the integration of substance use dis-

order treatment services into primary health care systems.

EQUIREMENTS

.—

(1) I

N GENERAL

.—Recipients of grants, contracts, or cooper-

ative agreements under this section shall comply with informa-

tion and application requirements determined appropriate by

the Secretary.

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37 Sec. 513 PUBLIC HEALTH SERVICE ACT

Sections 510 through 512 were repealed by section 3301(c) of Public Law 106–310 (114 Stat.

1209).

(2) D

URATION OF AWARD

.—With respect to a grant, con-

tract, 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) M

ATCHING 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 deter-

mined 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) M

AINTENANCE OF EFFORT

.—With respect to activities

for which a grant, contract, or cooperative agreement is award-

ed under this section, the Secretary may require that recipi-

ents 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 main-

tained by the entity for the fiscal year preceding the fiscal year

for which the entity receives such a grant, contract, or coopera-

tive agreement.

(d) E

VALUATION

.—The Secretary shall evaluate each project

carried out under subsection (a)(1) and shall disseminate the find-

ings with respect to each such evaluation to appropriate public and

private entities.

(e) I

NFORMATION AND

DUCATION

.—The Secretary shall estab-

lish comprehensive information and education programs to dissemi-

nate and apply the findings of the knowledge development and ap-

plication, training and technical assistance programs, and targeted

capacity response programs under this section to the general pub-

lic, to health professionals and other interested groups. The Sec-

retary shall make every effort to provide linkages between the find-

ings of supported projects and State agencies responsible for car-

rying out substance use disorder prevention and treatment pro-

grams.

(f) A

UTHORIZATION OF

PPROPRIATION

.—There are authorized

to be appropriated to carry out this section, $521,517,000 for each

of fiscal years 2023 through 2027.

ACTION BY NATIONAL INSTITUTE ON DRUG ABUSE AND STATES

CONCERNING MILITARY FACILITIES

. 513.

ø290bb–6¿ (a) C

ENTER FOR

UBSTANCE

BUSE

REATMENT

.—The Director of the Center for Substance Abuse

Treatment shall—

(1) coordinate with the agencies represented on the Com-

mission on Alternative Utilization of Military Facilities the uti-

lization of military facilities or parts thereof, as identified by

such Commission, established under the National Defense Au-

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38 Sec. 514 PUBLIC HEALTH SERVICE ACT

thorization 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) S

TATES

.—With regard to military facilities or parts thereof,

as identified by the Commission on Alternative Utilization of Mili-

tary 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 per-

sons 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 individ-

uals at such facilities;

(2) select treatment providers to provide drug abuse treat-

ment at such facilities;

(3) provide assistance to treatment providers selected

under paragraph (2) to assist such providers in securing fi-

nancing to fund the cost of the programs at such facilities; and

(4) establish, regulate, and coordinate with the military of-

ficial in charge of the facility, work programs for individuals

receiving treatment at such facilities.

ESERVATION OF

PACE

.—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 re-

search or demonstration projects.

SEC. 514. ø290bb–7¿ SUBSTANCE USE DISORDER TREATMENT AND

EARLY INTERVENTION SERVICES FOR CHILDREN, ADO-

LESCENTS, AND YOUNG ADULTS.

(a) I

ENERAL

.—The Secretary shall award grants, contracts,

or cooperative agreements to public and private nonprofit entities,

including Indian Tribes or Tribal organizations (as such terms are

defined in section 4 of the Indian Self-Determination and Edu-

cation Assistance Act), or health facilities or programs operated by

or in accordance with a contract or grant with the Indian Health

Service, for the purpose of—

(1) providing early identification and services to meet the

needs of children, adolescents, and young adults who are at

risk of substance use disorders;

(2) providing substance use disorder treatment services for

children, adolescents, and young adults, includingchildren, ado-

lescents, and young adults with co-occurring mental illness and

substance use disorders; and

(3) providing assistance to pregnant women, and parenting

women, with substance use disorders, in obtaining treatment

services, linking mothers to community resources to support

independent family lives, and staying in recovery so that chil-

dren are in safe, stable home environments and receive appro-

priate health care services.

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39 Sec. 514B PUBLIC HEALTH SERVICE ACT

(b) P

RIORITY

.—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, juve-

nile justice, child welfare, substance abuse, and mental health

agencies;

(3) provide a continuum of integrated treatment services,

including case management, for children, adolescents, and

young adults with substance use disorders, including children,

adolescents, and young adults with co-occurring mental illness

and substance use disorders, and their families;

(4) provide treatment that is gender-specific and culturally

appropriate;

(5) involve and work with families of children, adolescents,

and young adults receiving services; and

(6) provide aftercare services for children, adolescents, and

young adults and their families after completion of treatment.

URATION OF

RANTS

.—The Secretary shall award grants,

contracts, or cooperative agreements under subsection (a) for peri-

ods not to exceed 5 fiscal years.

(d) A

PPLICATION

.—An entity desiring a grant, contract, or coop-

erative 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) E

VALUATION

.—An entity that receives a grant, contract, or

cooperative agreement under subsection (a) shall submit, in the ap-

plication 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 eval-

uation at the completion of such project as the Secretary deter-

mines to be appropriate.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section, $29,605,000 for each

of fiscal years 2023 through 2027.

øSection 514A was repealed by section 9017 of Public Law

114–255.¿

SEC. 514B. ø290bb–10¿ EVIDENCE-BASED PRESCRIPTION OPIOID AND

HEROIN TREATMENT AND INTERVENTIONS DEMONSTRA-

TION.

(a) G

RANTS TO

XPAND

CCESS

.—

(1) A

UTHORITY TO AWARD GRANTS

.—The Secretary shall

award grants, contracts, or cooperative agreements to State

substance use disorder agencies, units of local government,

nonprofit organizations, and Indian Tribes and Tribal organi-

zations (as defined in section 4 of the Indian Self-Determina-

tion and Education Assistance Act) that have a high rate, or

have had a rapid increase, in the use of heroin or other opioids,

in order to permit such entities to expand activities, including

an expansion in the availability of evidence-based medication-

assisted treatment and other clinically appropriate services,

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As Amended Through P.L. 117-328, Enacted December 29, 2022

40 Sec. 515 PUBLIC HEALTH SERVICE ACT

with respect to the treatment of substance use disorders in the

specific geographical areas of such entities where there is a

high rate or rapid increase in the use of heroin or other

opioids, such as in rural areas.

(2) N

ATURE OF ACTIVITIES

.—Funds awarded under para-

graph (1) shall be used for activities that are based on reliable

scientific evidence of efficacy in the treatment of problems re-

lated to heroin or other opioids.

(b) A

PPLICATION

.—To be eligible for a grant, contract, or coop-

erative agreement under subsection (a), an entity shall submit an

application to the Secretary at such time, in such manner, and ac-

companied by such information as the Secretary may reasonably

require.

VALUATION

.—An entity that receives a grant, contract, or

cooperative agreement under subsection (a) shall submit, in the ap-

plication for such grant, contract, or agreement a plan for the eval-

uation of any project undertaken with funds provided under this

section. Such entity shall provide the Secretary with periodic eval-

uations of the progress of such project and an evaluation at the

completion of such project as the Secretary determines to be appro-

priate.

(d) G

EOGRAPHIC

ISTRIBUTION

.—In awarding grants, contracts,

and cooperative agreements under this section, the Secretary shall

ensure that not less than 15 percent of funds are awarded to eligi-

ble entities that are not located in metropolitan statistical areas (as

defined by the Office of Management and Budget). The Secretary

shall take into account the unique needs of rural communities, in-

cluding communities with an incidence of individuals with opioid

use disorder that is above the national average and communities

with a shortage of prevention and treatment services.

(e) A

DDITIONAL

CTIVITIES

.—In administering grants, con-

tracts, and cooperative agreements under subsection (a), the Sec-

retary shall—

(1) evaluate the activities supported under such sub-

section;

(2) disseminate information, as appropriate, derived from

evaluations as the Secretary considers appropriate;

(3) provide States, Indian Tribes and Tribal organizations,

and providers with technical assistance in connection with the

provision of treatment of problems related to heroin and other

opioids; and

(4) fund only those applications that specifically support

recovery services as a critical component of the program in-

volved.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there are authorized to be appropriated $25,000,000 for each

of fiscal years 2023 through 2027.

Subpart 2—Center for Substance Abuse Prevention

CENTER FOR SUBSTANCE ABUSE PREVENTION

. 515. ø290bb–21¿ (a) There is established in the Adminis-

tration a Center for Substance Abuse Prevention (hereafter re-

ferred to in this part as the ‘‘Prevention Center’’). The Prevention

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41 Sec. 515 PUBLIC HEALTH SERVICE ACT

Center shall be headed by a Director appointed by the Secretary

from individuals with extensive experience or academic qualifica-

tions in the prevention of drug or alcohol abuse.

(b) The Director of the Prevention Center shall—

(1) sponsor regional workshops on the prevention of drug

and alcohol abuse through the reduction of risk and the pro-

motion of resiliency;

(2) coordinate the findings of research sponsored by agen-

cies of the Service on the prevention of drug and alcohol abuse;

(3) collaborate with the Director of the National Institute

on Drug Abuse, the Director of the National Institute on Alco-

hol Abuse and Alcoholism, and States to promote the study of

substance abuse prevention and the dissemination and imple-

mentation of research findings that will improve the delivery

and effectiveness of substance abuse prevention activities;

(4) develop effective drug and alcohol abuse prevention lit-

erature (including educational information on the effects of

drugs abused by individuals, including drugs that are emerg-

ing as abused drugs);

(5) in cooperation with the Secretary of Education, assure

the widespread dissemination of prevention materials among

States, political subdivisions, and school systems;

(6) support clinical training programs for health profes-

sionals who provide substance use and misuse prevention and

treatment services and other health professionals involved in

illicit drug use education and prevention;

(7) in cooperation with the Director of the Centers for Dis-

ease Control and Prevention, develop and disseminate edu-

cational materials to increase awareness for individuals at

greatest risk for substance use disorders to prevent the trans-

mission of communicable diseases, such as HIV, hepatitis, tu-

berculosis, and other communicable diseases;

(8) conduct training, technical assistance, data collection,

and evaluation activities of programs supported under the

Drug Free Schools and Communities Act of 1986;

(9) support the development of model, innovative, commu-

nity-based programs that reduce the risk of alcohol and drug

abuse among young people and promote resiliency;

(10) collaborate with the Attorney General of the Depart-

ment of Justice to develop programs to prevent drug abuse

among high risk youth;

(11) prepare for distribution documentary films and public

service announcements for television and radio to educate the

public, especially adolescent audiences, concerning the dangers

to health resulting from the consumption of alcohol and drugs

and, to the extent feasible, use appropriate private organiza-

tions and business concerns in the preparation of such an-

nouncements;

(12) develop and support innovative demonstration pro-

grams designed to identify and deter the improper use or

abuse of anabolic steroids by students, especially students in

secondary schools;

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42 Sec. 516 PUBLIC HEALTH SERVICE ACT

(13) ensure the consistent documentation of the application

of criteria when awarding grants and the ongoing oversight of

grantees after such grants are awarded;

(14) assist and support States in preventing illicit drug

use, including emerging illicit drug use issues; and

(15) in consultation with relevant stakeholders and in col-

laboration with the Director of the Centers for Disease Control

and Prevention, develop educational materials for clinicians to

use with pregnant women for shared decision making regard-

ing pain management and the prevention of substance use dis-

orders during pregnancy.

cooperative agreements in carrying out subsection (b).

(d) The Director of the Prevention Center shall establish a na-

tional data base providing information on programs for the preven-

tion of substance abuse. The data base shall contain information

appropriate for use by public entities and information appropriate

for use by nonprofit private entities.

SEC. 516. ø290bb–22¿ PRIORITY SUBSTANCE USE DISORDER PREVEN-

TION NEEDS OF REGIONAL AND NATIONAL SIGNIFI-

CANCE.

(a) P

ROJECTS

.—The Secretary shall address priority substance

use disorder prevention needs of regional and national significance

(as determined under subsection (b)) through the provision of or

through assistance for—

(1) knowledge development and application projects for

prevention and the conduct or support of evaluations of such

projects;

(2) training and technical assistance; and

(3) targeted capacity response programs, including such

programs that focus on emerging drug use issues.

The Secretary may carry out the activities described in this section

directly or through grants, contracts, or cooperative agreements

with States, political subdivisions of States, Indian Tribes or Tribal

organizations (as such terms are defined in section 4 of the Indian

Self-Determination and Education Assistance Act), health facilities,

or programs operated by or in accordance with a contract or grant

with the Indian Health Service, or other public or nonprofit private

entities.

(b) P

RIORITY

UBSTANCE

ISORDER

REVENTION

EEDS

.—

(1) I

N GENERAL

.—Priority substance use disorder preven-

tion needs of regional and national significance shall be deter-

mined 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 pro-

gram priorities.

(2) S

PECIAL CONSIDERATION

.—In developing program prior-

ities under paragraph (1), the Secretary shall give special con-

sideration to—

(A) applying the most promising strategies and re-

search-based primary prevention approaches;

(B) promoting the integration of substance use dis-

order prevention information and activities into primary

health care systems; and

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43 Sec. 519B PUBLIC HEALTH SERVICE ACT

groups.

EQUIREMENTS

.—

(1) I

N GENERAL

.—Recipients of grants, contracts, and coop-

erative agreements under this section shall comply with infor-

mation and application requirements determined appropriate

by the Secretary.

(2) D

URATION OF AWARD

.—With respect to a grant, con-

tract, 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) M

ATCHING 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 deter-

mined 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) M

AINTENANCE OF EFFORT

.—With respect to activities

for which a grant, contract, or cooperative agreement is award-

ed under this section, the Secretary may require that recipi-

ents 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 main-

tained by the entity for the fiscal year preceding the fiscal year

for which the entity receives such a grant, contract, or coopera-

tive agreement.

(d) E

VALUATION

.—The Secretary shall evaluate each project

carried out under subsection (a)(1) and shall disseminate the find-

ings with respect to each such evaluation to appropriate public and

private entities.

(e) I

NFORMATION AND

DUCATION

.—The Secretary shall estab-

lish comprehensive information and education programs to dissemi-

nate 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 pro-

vide linkages between the findings of supported projects and State

agencies responsible for carrying out substance use disorder pre-

vention and treatment programs.

(f) A

UTHORIZATION OF

PPROPRIATION

.—There are authorized

to be appropriated to carry out this section, $218,219,000 for each

of fiscal years 2023 through 2027.

øSection 517 was repealed by section 9017 of Public Law 114–

255. Section 518 was repealed by section 3202(b) of Public Law

106–310 (114 Stat. 1210). Section 519A was repealed by section

9017 of Public Law 114–255.¿

SEC. 519B. ø290bb–25b¿ PROGRAMS TO REDUCE UNDERAGE DRINKING.

(a) D

EFINITIONS

.—For purposes of this section:

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44 Sec. 519B PUBLIC HEALTH SERVICE ACT

(1) The term ‘‘alcohol beverage industry’’ means the brew-

ers, vintners, distillers, importers, distributors, and retail or

online outlets that sell or serve beer, wine, and distilled spirits.

(2) The term ‘‘school-based prevention’’ means programs,

which are institutionalized, and run by staff members or

school-designated persons or organizations in any grade of

school, kindergarten through 12th grade.

(3) The term ‘‘youth’’ means persons under the age of 21.

(b) S

ENSE OF

ONGRESS

.—It is the sense of the Congress that:

(1) A multi-faceted effort is needed to more successfully ad-

dress 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 Fed-

eral support for State activities.

(2) The Secretary of Health and Human Services shall con-

tinue 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 univer-

sities, are encouraged to adopt comprehensive prevention ap-

proaches, including—

(A) evidence-based screening, programs and curricula;

(B) brief intervention strategies;

(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 un-

suitable alcohol content.

(6) The National Collegiate Athletic Association, its mem-

ber 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 Gov-

ernment. States have primary authority to regulate alcohol dis-

tribution and sale, and the Federal Government should sup-

port and supplement these State efforts. States also have a re-

sponsibility to fight youth access to alcohol and reduce under-

age drinking. Continued State regulation and licensing of the

manufacture, importation, sale, distribution, transportation

and storage of alcoholic beverages are clearly in the public in-

terest 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, maintain-

ing industry integrity and an orderly marketplace, and fur-

thering effective State tax collection.

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45 Sec. 519B PUBLIC HEALTH SERVICE ACT

NTERAGENCY

OORDINATING

OMMITTEE

; A

NNUAL

EPORT

TATE

NDERAGE

RINKING

REVENTION AND

NFORCEMENT

CTIVITIES

.—

(1) I

NTERAGENCY COORDINATING COMMITTEE ON THE PRE

VENTION OF UNDERAGE DRINKING

.—

(A) I

N GENERAL

.—The Secretary, in collaboration with

the Federal officials specified in subparagraph (B), shall

continue to support and enhance the efforts of the inter-

agency coordinating committee, that began operating in

2004, focusing on underage drinking (referred to in this

subsection as the ‘‘Committee’’).

(B) O

THER AGENCIES

.—The officials referred to in sub-

paragraph (A) are the Secretary of Education, the Attorney

General, the Secretary of Transportation, the Secretary of

the Treasury, the Secretary of Defense, the Surgeon Gen-

eral, the Director of the Centers for Disease Control and

Prevention, the Director of the National Institute on Alco-

hol Abuse and Alcoholism, the Assistant Secretary for

Mental Health and Substance Use, the Director of the Na-

tional Institute on Drug Abuse, the Assistant Secretary for

Children and Families, the Director of the Office of Na-

tional Drug Control Policy, the Administrator of the Na-

tional Highway Traffic Safety Administration, the Admin-

istrator of the Office of Juvenile Justice and Delinquency

Prevention, the Chairman of the Federal Trade Commis-

sion, and such other Federal officials as the Secretary of

Health and Human Services determines to be appropriate.

HAIR

.—The Secretary of Health and Human Serv-

ices shall serve as the chair of the Committee.

(D) D

UTIES

.—The Committee shall guide policy and

program development across the Federal Government with

respect to underage drinking, provided, however, that

nothing in this section shall be construed as transferring

regulatory or program authority from an agency to the

Committee.

(E) C

ONSULTATIONS

.—The Committee shall actively

seek the input of and shall consult with all appropriate

and interested parties, including States, public health re-

search and interest groups, foundations, and alcohol bev-

erage industry trade associations and companies.

(F) A

NNUAL REPORT

.—

(i) I

N 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 agen-

cies designed to prevent and reduce underage

drinking, including such programs and policies

that support State efforts to prevent or reduce un-

derage drinking;

(II) the extent of progress in preventing and

reducing underage drinking at State and national

levels;

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46 Sec. 519B PUBLIC HEALTH SERVICE ACT

(III) data that the Secretary shall collect with

respect to the information specified in clause (ii);

and

(IV) such other information regarding under-

age drinking as the Secretary determines to be ap-

propriate.

(ii) C

ERTAIN 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 Na-

tional 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 ad-

vertising, social media, and the entertainment

media.

(IV) Surveillance data, including, to the ex-

tent such information is available, information on

the onset and prevalence of underage drinking,

consumption patterns and beverage preferences,

trends related to drinking among different age

groups, including between youth and adults, the

means of underage access, including trends over

time, for these surveillance data, and other data,

as appropriate. The Secretary shall develop a plan

to improve the collection, measurement, and con-

sistency of reporting Federal underage alcohol

data.

(V) Any additional findings resulting from re-

search conducted or supported under subsection

(g).

(VI) Evidence-based best practices to prevent

and reduce underage drinking and provide treat-

ment services to those youth who need such serv-

ices.

(2) A

NNUAL REPORT ON STATE UNDERAGE DRINKING PRE

VENTION AND ENFORCEMENT ACTIVITIES

.—

(A) I

N GENERAL

.—The Secretary shall, with input and

collaboration from other appropriate Federal agencies,

States, Indian Tribes, territories, and public health, con-

sumer, and alcohol beverage industry groups, annually

issue a report on each State’s performance in enacting, en-

forcing, and creating laws, regulations, programs, and

other actions to prevent or reduce underage drinking based

on the best practices identified pursuant to paragraph

(1)(F)(ii)(VI). For purposes of this paragraph, each such re-

port, with respect to a year, shall be referred to as the

‘‘State Report’’. Each State Report may be used as a re-

source to inform the identification and implementation of

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47 Sec. 519B PUBLIC HEALTH SERVICE ACT

activities to prevent underage drinking, as determined to

be appropriate by such State or other applicable entity.

(B) C

ONTENTS

.—

(i) P

ERFORMANCE MEASURES

.—The Secretary shall

develop, in consultation with the Committee, a set of

measures to be used in preparing the State Report on

best practices, including as they relate to State laws,

regulations, other actions, and enforcement practices.

(ii) S

TATE REPORT CONTENT

.—The State Report

shall include updates on State laws, regulations, and

other actions, including those described in previous re-

ports to Congress, including with respect to the fol-

lowing:

(I) Whether or not the State has comprehen-

sive anti-underage drinking laws such as for the

illegal sale, purchase, attempt to purchase, con-

sumption, or possession of alcohol; illegal use of

fraudulent ID; illegal furnishing or obtaining of al-

cohol 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 comprehen-

sive liability statutes pertaining to underage ac-

cess to alcohol such as dram shop, social host, and

house party laws, and the prevalence of enforce-

ment 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 out-

lets, such as random compliance checks and shoul-

der 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 alco-

hol for all sellers and servers of alcohol as a condi-

tion of employment.

(V) Whether or not the State has policies and

regulations with regard to direct sales to con-

sumers and home delivery of alcoholic beverages.

(VI) Whether or not the State has programs

or laws to deter adults from purchasing alcohol for

minors; and the number of adults targeted by

these programs.

(VII) Whether or not the State has enacted

graduated drivers licenses and the extent of those

provisions.

(VIII) Whether or not the State has adopted

any other policies consistent with evidence-based

practices related to the prevention of underage al-

cohol use, which may include any such practices

described in relevant reports issued by the Sur-

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48 Sec. 519B PUBLIC HEALTH SERVICE ACT

geon General and practices related to youth expo-

sure to alcohol-related products and information.

(IX) A description of the degree to which the

practices of local jurisdictions within the State

vary from one another.

(3) A

UTHORIZATION OF APPROPRIATIONS

.—There is author-

ized to be appropriated to carry out this subsection $1,000,000

for each of fiscal years 2023 through 2027.

(d) N

ATIONAL

EDIA

AMPAIGN TO

REVENT

NDERAGE

RINK

ING

.—

(1) I

N GENERAL

.—The Secretary, in consultation with the

National Highway Traffic Safety Administration, shall develop

or continue an intensive, multifaceted national media cam-

paign aimed at adults to reduce underage drinking.

(2) P

URPOSE

.—The purpose of the national media cam-

paign described in this section shall be to achieve the following

objectives:

(A) Promote community awareness of, and a commit-

ment to, reducing underage drinking.

(B) Encourage activities, including activities carried

out by adults, that inhibit the illegal use of alcohol by

youth.

out by adults, that promote the illegal use of alcohol by

youth.

(3) C

OMPONENTS

.—When implementing the national media

campaign described in this section, the Secretary shall—

(A) educate the public about the public health and

safety benefits of evidence-based strategies to reduce un-

derage drinking, including existing laws related to the

minimum legal drinking age, and engage the public and

parents in the implementation of such strategies;

(B) educate the public about the negative con-

sequences of underage drinking;

inhibit underage drinking;

(D) discourage adult conduct that tends to facilitate

underage drinking;

(E) establish collaborative relationships with local and

national organizations and institutions to further the goals

of the campaign and assure that the messages of the cam-

paign are disseminated from a variety of sources;

(F) conduct the campaign through multi-media

sources; and

(G) take into consideration demographics and other

relevant factors to most effectively reach target audiences.

(4) C

ONSULTATION REQUIREMENT

.—In developing and im-

plementing the national media campaign described in this sec-

tion, the Secretary shall review recommendations for reducing

underage drinking, including those published by the National

Academies of Sciences, Engineering, and Medicine and the Sur-

geon General. The Secretary shall also consult with interested

parties including the alcohol beverage industry, medical, public

health, and consumer and parent groups, law enforcement, in-

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49 Sec. 519B PUBLIC HEALTH SERVICE ACT

stitutions of higher education, community-based organizations

and coalitions, and other relevant stakeholders.

(5) A

NNUAL REPORT

.—The Secretary shall produce an an-

nual report on the progress of the development or implementa-

tion of the media campaign described in this subsection, in-

cluding expenses and projected costs, and, as such information

is available, report on the effectiveness of such campaign in af-

fecting adult attitudes toward underage drinking and adult

willingness to take actions to decrease underage drinking.

(6) R

ESEARCH ON YOUTH

ORIENTED CAMPAIGN

.—The Sec-

retary may, based on the availability of funds, conduct or sup-

port research on the potential success of a youth-oriented na-

tional media campaign to reduce underage drinking. The Sec-

retary shall report to Congress any such results and any re-

lated recommendations.

(7) A

DMINISTRATION

.—The Secretary may enter into an

agreement with another Federal agency to delegate the author-

ity for execution and administration of the adult-oriented na-

tional media campaign.

(8) A

UTHORIZATION OF APPROPRIATIONS

.—There is author-

ized to be appropriated to carry out this section $2,500,000 for

each of fiscal years 2023 through 2027.

(e) C

OMMUNITY

BASED

OALITION

NHANCEMENT

RANTS TO

REVENT

NDERAGE

RINKING

.—

(1) A

UTHORIZATION OF PROGRAM

.—The Assistant Secretary

for Mental Health and Substance Use, in consultation with the

Director of the Office of National Drug Control Policy, shall

award enhancement grants to eligible entities to design, imple-

ment, evaluate, and disseminate comprehensive strategies to

maximize the effectiveness of community-wide approaches to

preventing and reducing underage drinking. This subsection is

subject to the availability of appropriations.

(2) P

URPOSES

.—The purposes of this subsection are to—

(A) prevent and reduce alcohol use among youth in

communities throughout the United States;

(B) strengthen collaboration among communities, the

Federal Government, Tribal Governments, and State and

local governments;

nation on the issue of alcohol use among youth;

(D) serve as a catalyst for increased citizen participa-

tion and greater collaboration among all sectors and orga-

nizations of a community that first demonstrates a long-

term commitment to reducing alcohol use among youth;

(E) implement evidence-based strategies to prevent

and reduce underage drinking in communities; and

(F) enhance, not supplant, effective local community

initiatives for preventing and reducing alcohol use among

youth.

(3) A

PPLICATION

.—An eligible entity desiring an enhance-

ment grant under this subsection shall submit an application

to the Assistant Secretary at such time, and in such manner,

and accompanied by such information and assurances, as the

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50 Sec. 519B PUBLIC HEALTH SERVICE ACT

Assistant Secretary may require. Each application shall in-

clude—

(A) a complete description of the entity’s current un-

derage alcohol use prevention initiatives and how the

grant will appropriately enhance the focus on underage

drinking issues; or

(B) a complete description of the entity’s current ini-

tiatives, and how it will use the grant to enhance those ini-

tiatives by adding a focus on underage drinking preven-

tion.

(4) U

SES OF FUNDS

.—Each eligible entity that receives a

grant under this subsection shall use the grant funds to carry

out the activities described in such entity’s application sub-

mitted pursuant to paragraph (3) and obtain specialized train-

ing and technical assistance by the entity funded under section

4 of Public Law 107–82, as amended (21 U.S.C. 1521 note).

Grants under this subsection shall not exceed $60,000 per year

and may not exceed four years.

(5) S

UPPLEMENT NOT SUPPLANT

.—Grant funds provided

under this subsection shall be used to supplement, not sup-

plant, Federal and non-Federal funds available for carrying out

the activities described in this subsection.

(6) E

VALUATION

.—Grants under this subsection shall be

subject to the same evaluation requirements and procedures as

the evaluation requirements and procedures imposed on recipi-

ents of drug-free community grants.

(7) D

EFINITIONS

.—For purposes of this subsection, the

term ‘‘eligible entity’’ means an organization that is currently

receiving or has received grant funds under the Drug-Free

Communities Act of 1997.

(8) A

DMINISTRATIVE EXPENSES

.—Not more than 6 percent

of a grant under this subsection may be expended for adminis-

trative expenses.

(9) A

UTHORIZATION OF APPROPRIATIONS

.—There is author-

ized to be appropriated to carry out this subsection $11,500,000

for each of fiscal years 2023 through 2027.

(f) G

RANTS TO

RGANIZATIONS

EPRESENTING

EDIATRIC

VIDERS AND

THER

ELATED

EALTH

ROFESSIONALS TO

EDUCE

NDERAGE

RINKING

HROUGH

CREENING AND

RIEF

NTERVEN

TIONS

.—

(1) I

N GENERAL

.—The Secretary, acting through the Assist-

ant Secretary for Mental Health and Substance Use, shall

make awards to one or more entities representing pediatric

providers and other related health professionals with dem-

onstrated ability to increase among the members of such enti-

ties effective practices to reduce the prevalence of alcohol use

among individuals under the age of 21, including college stu-

dents.

(2) P

URPOSES

.—Grants under this subsection shall be

made to improve—

(A) screening adolescents for alcohol use;

(B) offering brief interventions to adolescents to dis-

courage such use;

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51 Sec. 519B PUBLIC HEALTH SERVICE ACT

ods of discouraging such use;

(D) diagnosing and treating alcohol use disorders; and

(E) referring patients, when necessary, to other appro-

priate care.

(3) U

SE OF FUNDS

.—An entity receiving a grant under this

section may use the grant funding to promote the practices

specified in paragraph (2) among its members by—

(A) providing training to health care providers;

(B) disseminating best practices, including culturally

and linguistically appropriate best practices, and devel-

oping and distributing materials; and

priate by the Assistant Secretary.

(4) A

PPLICATION

.—To be eligible to receive a grant under

this subsection, an entity shall submit an application to the

Assistant Secretary at such time, and in such manner, and ac-

companied by such information and assurances as the Sec-

retary may require. Each application shall include—

(A) a description of the entity;

(B) a description of the activities to be completed that

will promote the practices specified in paragraph (2);

forming such activities; and

(D) a timeline for the completion of such activities.

(5) D

EFINITIONS

.—For the purpose of this subsection:

(A) B

RIEF INTERVENTION

.—The term ‘‘brief interven-

tion’’ means, after screening a patient, providing the pa-

tient with brief advice and other brief motivational en-

hancement techniques designed to increase the insight of

the patient regarding the patient’s alcohol use, and any re-

alized or potential consequences of such use to effect the

desired related behavioral change.

(B) S

CREENING

.—The term ‘‘screening’’ means using

validated patient interview techniques to identify and as-

sess the existence and extent of alcohol use in a patient.

(6) A

UTHORIZATION OF APPROPRIATIONS

.—There is author-

ized to be appropriated to carry out this subsection $3,000,000

for each of fiscal years 2023 through 2027.

(g) D

ATA

OLLECTION AND

ESEARCH

.—

(1) A

DDITIONAL RESEARCH ON UNDERAGE DRINKING

.—

(A) I

N GENERAL

.—The Secretary shall, subject to the

availability of appropriations, support the collection of

data, and conduct or support research that is not duplica-

tive of research currently being conducted or supported by

the Department of Health and Human Services, on under-

age drinking, with respect to the following:

(i) The evaluation, which may include through the

development of relevant capabilities of expertise with-

in a State, of the effectiveness of comprehensive com-

munity-based programs or strategies and statewide

systems to prevent and reduce underage drinking,

across the underage years from early childhood to age

21, such as programs funded and implemented by gov-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

52 Sec. 519D PUBLIC HEALTH SERVICE ACT

ernmental entities, public health interest groups and

foundations, and alcohol beverage companies and

trade associations.

(ii) Obtaining and reporting more precise informa-

tion than is currently collected on the scope of the un-

derage drinking problem and patterns of underage al-

cohol consumption, including improved knowledge

about the problem and progress in preventing, reduc-

ing, and treating underage drinking, as well as infor-

mation on the rate of exposure of youth to advertising

and other media messages encouraging and discour-

aging alcohol consumption.

(iii) The development and identification of evi-

dence-based or evidence-informed strategies to reduce

underage drinking, which may include through

translational research.

(iv) Improving and conducting public health data

collection on alcohol use and alcohol-related conditions

in States, which may include by increasing the use of

surveys, such as the Behavioral Risk Factor Surveil-

lance System, to monitor binge and excessive drinking

and related harms among individuals who are at least

18 years of age, but not more than 20 years of age, in-

cluding harm caused to self or others as a result of al-

cohol use that is not duplicative of research currently

being conducted or supported by the Department of

Health and Human Services.

(B) A

UTHORIZATION OF APPROPRIATIONS

.—There is au-

thorized to be appropriated to carry out this paragraph

$5,000,000 for each of fiscal years 2023 through 2027.

(2) N

ATIONAL ACADEMIES OF SCIENCES

ENGINEERING

AND

MEDICINE STUDY

.—

(A) I

N GENERAL

.—Not later than 12 months after the

date of enactment of the Restoring Hope for Mental Health

and Well-Being Act of 2022, the Secretary shall—

(i) contract with the National Academies of

Sciences, Engineering, and Medicine to study develop-

ments in research on underage drinking and the im-

plications of these developments; and

(ii) report to the Congress on the results of such

review.

(B) A

UTHORIZATION OF APPROPRIATIONS

.—There is au-

thorized to be appropriated to carry out this paragraph

$500,000 for fiscal year 2023.

SEC. 519D. ø290bb–25d¿ CENTERS OF EXCELLENCE ON SERVICES FOR

INDIVIDUALS WITH FETAL ALCOHOL SYNDROME AND AL-

COHOL-RELATED BIRTH DEFECTS AND TREATMENT FOR

INDIVIDUALS WITH SUCH CONDITIONS AND THEIR FAMI-

LIES.

(a) I

ENERAL

.—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 inno-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

53 Sec. 519D PUBLIC HEALTH SERVICE ACT

So in law. Probably should read ‘‘; and’’. See section 3110 of Public Law 106–310 (114 Stat.

1185).

vative clinical interventions and service delivery improvements for

the provision of comprehensive services to individuals with fetal al-

cohol syndrome or alcohol-related birth defects and their families

and for providing training on such conditions.

(b) U

SE OF

UNDS

.—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 de-

fects and their families;

(2) identify communities which have an exemplary com-

prehensive system of care for such individuals so that they can

provide technical assistance to other communities attempting

to set up such a system of care;

(3) provide technical assistance to communities who do not

have a comprehensive system of care for such individuals and

their families;

(4) train community leaders, mental health and substance

abuse professionals, families, law enforcement personnel,

judges, health professionals, persons working in financial as-

sistance programs, social service personnel, child welfare pro-

fessionals, 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;

(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.

EPORT

.—

(1) I

N GENERAL

.—A recipient of an award under subsection

(a) shall at the end of the period of funding report to the Sec-

retary on any innovative techniques that have been discovered

for preventing alcohol use among women of child bearing

years.

(2) D

ISSEMINATION OF FINDINGS

.—The Secretary shall upon

receiving a report under paragraph (1) disseminate the find-

ings to appropriate public and private entities.

(d) D

URATION OF

WARDS

.—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) E

VALUATION

.—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 pri-

vate entities.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

carrying out this section, there are authorized to be appropriated

$5,000,000 for fiscal year 2001, and such sums as may be necessary

for each of the fiscal years 2002 and 2003.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

54 Sec. 520 PUBLIC HEALTH SERVICE ACT

Subpart 3—Center for Mental Health Services

CENTER FOR MENTAL HEALTH SERVICES

. 520. ø290bb–31¿ (a) E

STABLISHMENT

.—There is estab-

lished 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 individ-

uals with extensive experience or academic qualifications in the

provision of mental health services or in the evaluation of mental

health service systems.

(b) D

UTIES

.—The Director of the Center shall—

(1) design national goals and establish national priorities

for—

(A) the prevention of mental illness; and

(B) the promotion of mental health;

(2) encourage and assist local entities and State agencies

to achieve the goals and priorities described in paragraph (1);

(3) collaborate with the Director of the National Institute

of Mental Health and the Chief Medical Officer, appointed

under section 501(g), to ensure that, as appropriate, programs

related to the prevention and treatment of mental illness and

the promotion of mental health and recovery support are car-

ried out in a manner that reflects the best available science

and evidence-based practices, including culturally and linguis-

tically appropriate services, as appropriate;

(4) collaborate with the Department of Education and the

Department of Justice to develop programs to assist local com-

munities in addressing violence among children and adoles-

cents;

(5) develop and coordinate Federal prevention policies and

programs and to assure increased focus on the prevention of

mental illness and the promotion of mental health, including

through programs that reduce risk and promote resiliency;

(6) in collaboration with the Director of the National Insti-

tute of Mental Health, develop improved methods of treating

individuals with mental health problems and improved meth-

ods of assisting the families of such individuals;

(7) administer the mental health services block grant pro-

gram authorized in section 1911;

(8) promote policies and programs at Federal, State, and

local levels and in the private sector that foster independence,

increase meaningful participation of individuals with mental

illness in programs and activities of the Administration, and

protect the legal rights of persons with mental illness, includ-

ing carrying out the provisions of the Protection and Advocacy

of Mentally Ill Individuals Act;

(9) carry out the programs under part C;

(10) carry out responsibilities for the Human Resource De-

velopment program, and programs of clinical training for

health paraprofessional personnel and health professionals;

(11) conduct services-related assessments, including eval-

uations of the organization and financing of care, self-help and

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As Amended Through P.L. 117-328, Enacted December 29, 2022

55 Sec. 520A PUBLIC HEALTH SERVICE ACT

consumer-run programs, mental health economics, mental

health service systems, rural mental health and tele-mental

health, and improve the capacity of State to conduct evalua-

tions of publicly funded mental health programs;

(12) disseminate mental health information, including evi-

dence-based practices, to States, political subdivisions, edu-

cational agencies and institutions, treatment and prevention

service providers, and the general public, including information

concerning the practical application of research supported by

the National Institute of Mental Health that is applicable to

improving the delivery of services;

(13) provide technical assistance to public and private enti-

ties that are providers of mental health services;

(14) monitor and enforce obligations incurred by commu-

nity mental health centers pursuant to the Community Mental

Health Centers Act (as in effect prior to the repeal of such Act

on August 13, 1981, by section 902(e)(2)(B) of Public Law 97–

35 (95 Stat. 560));

(15) conduct surveys with respect to mental health, such

as the National Reporting Program;

(16) assist States in improving their mental health data

collection; and

(17) ensure the consistent documentation of the application

of criteria when awarding grants and the ongoing oversight of

grantees after such grants are awarded.

RANTS AND

ONTRACTS

.—In carrying out the duties estab-

lished in subsection (b), the Director may make grants to and enter

into contracts and cooperative agreements with public and non-

profit private entities.

SEC. 520A. ø290bb–32¿ PRIORITY MENTAL HEALTH NEEDS OF RE-

GIONAL AND NATIONAL SIGNIFICANCE.

(a) P

ROJECTS

.—The Secretary shall address priority mental

health needs of regional and national significance (as determined

under subsection (b)) through the provision of or through assist-

ance 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 net-

work grants and client-oriented and consumer run self-help ac-

tivities, which may include technical assistance centers.

The Secretary may carry out the activities described in this sub-

section directly or through grants, contracts, or cooperative agree-

ments with States, political subdivisions of States, Indian Tribes or

Tribal organizations (as such terms are defined in section 4 of the

Indian Self-Determination and Education Assistance Act), health

facilities, or programs operated by or in accordance with a contract

or grant with the Indian Health Service, or, other public or private

nonprofit entities.

(b) P

RIORITY

ENTAL

EALTH

EEDS

.—

(1) D

ETERMINATION OF NEEDS

.—Priority mental health

needs of regional and national significance shall be determined

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As Amended Through P.L. 117-328, Enacted December 29, 2022

56 Sec. 520A PUBLIC HEALTH SERVICE ACT

by the Secretary in consultation with States and other inter-

ested groups. The Secretary shall meet with the States and in-

terested groups on an annual basis to discuss program prior-

ities.

(2) S

PECIAL CONSIDERATION

.—In developing program prior-

ities described in paragraph (1), the Secretary shall give spe-

cial consideration to promoting the integration of mental

health services into primary health care systems.

EQUIREMENTS

.—

(1) I

N GENERAL

.—Recipients of grants, contracts, and coop-

erative agreements under this section shall comply with infor-

mation and application requirements determined appropriate

by the Secretary.

(2) D

URATION OF AWARD

.—With respect to a grant, con-

tract, 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) M

ATCHING 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 deter-

mined 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) M

AINTENANCE OF EFFORT

.—With respect to activities

for which a grant, contract or cooperative agreement is award-

ed under this section, the Secretary may require that recipi-

ents 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 main-

tained by the entity for the fiscal year preceding the fiscal year

for which the entity receives such a grant, contract, or coopera-

tive agreement.

(d) E

VALUATION

.—The Secretary shall evaluate each project

carried out under subsection (a)(1) and shall disseminate the find-

ings with respect to each such evaluation to appropriate public and

private entities.

(e) I

NFORMATION AND

DUCATION

.—

(1) I

N 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 find-

ings of supported projects and State agencies responsible for

carrying out mental health services.

(2) R

URAL AND UNDERSERVED AREAS

.—In disseminating in-

formation on evidence-based practices in the provision of chil-

dren’s mental health services under this subsection, the Sec-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

57 Sec. 520B PUBLIC HEALTH SERVICE ACT

retary shall ensure that such information is distributed to

rural and medically underserved areas.

(3) G

ERIATRIC MENTAL DISORDERS

.—The Secretary shall, as

appropriate, provide technical assistance to grantees regarding

evidence-based practices for the prevention and treatment of

geriatric mental disorders and co-occurring mental health and

substance use disorders among geriatric populations, as well as

disseminate information about such evidence-based practices to

States and nongrantees throughout the United States.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section $599,036,000 for each

of fiscal years 2023 through 2027.

SEC. 520B. ø290bb–33¿ STUDENT SUICIDE AWARENESS AND PREVEN-

TION TRAINING.

(a) I

ENERAL

.—In awarding funds under section 520A, the

Secretary shall give priority to applications under such section

from a State educational agency, local educational agency, or Tribal

educational agency, submitted directly or through a State or Indian

Tribe, for funding for activities in secondary schools, where such

agency has implemented, or includes in such application a plan to

implement, a student suicide awareness and prevention training

policy, which may include applicable youth suicide early interven-

tion and prevention strategies implemented through section 520E—

(1) establishing and implementing a school-based student

suicide awareness and prevention training policy in accordance

with subsection (c);

(2) consulting with stakeholders (including principals,

teachers, parents, local Tribal officials, and other relevant ex-

perts) and, as appropriate, utilizing information, models, and

other resources made available by the Suicide Prevention Tech-

nical Assistance Center authorized under section 520C in the

development of the policy under paragraph (1); and

(3) collecting and reporting information in accordance with

subsection (d).

(b) C

ONSIDERATION

.—In giving priority to applicants as de-

scribed in subsection (a), the Secretary shall, as appropriate, take

into consideration the incidence and prevalence of suicide in the

applicable jurisdiction and the costs of establishing and imple-

menting, as applicable, a school-based student suicide awareness

and prevention training policy.

CHOOL

-B

ASED

TUDENT

UICIDE

WARENESS AND

REVEN

TION

RAINING

OLICY

.—A school-based student suicide awareness

and prevention training policy implemented pursuant to subsection

(a)(1) shall—

(1) be evidence-based;

(2) be culturally- and linguistically-appropriate;

(3) provide evidence-based training to students in grades 6

through 12, in coordination with school-based mental health

resources, as applicable, regarding—

(A) suicide prevention education and awareness, in-

cluding associated risk factors;

(B) methods that students can use to seek help; and

vention; and

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As Amended Through P.L. 117-328, Enacted December 29, 2022

58 Sec. 520C PUBLIC HEALTH SERVICE ACT

(4) provide for periodic retraining of such students.

(d) C

OLLECTION OF

NFORMATION AND

EPORTING

.—Each State

educational agency, local educational agency, and Tribal edu-

cational agency that receives priority to implement a new training

policy pursuant to subsection (a)(1) shall report to the Secretary

the following aggregated information, in a manner that protects

personal privacy, consistent with applicable Federal and State pri-

vacy laws:

(1) The number of trainings conducted, including the num-

ber of student trainings conducted, and the training delivery

method used.

(2) The number of students trained, disaggregated by age

and grade level.

(3) The number of help-seeking reports made by students

after implementation of such policy.

(e) E

VIDENCE

-B

ASED

ROGRAM

VAILABILITY

.—The Secretary

shall coordinate with the Secretary of Education and the Secretary

of the Interior to—

(1) make publicly available the policies established by

State educational agencies, local educational agencies, and

Tribal educational agencies pursuant to this section and the

training that is available to students and teams pursuant to

such policies, in accordance with section 543A; and

(2) provide technical assistance and disseminate best prac-

tices on student suicide awareness and prevention training

policies, including through the Suicide Prevention Technical

Assistance Center authorized under section 520C, as applica-

ble, to State educational agencies, local educational agencies,

and Tribal agencies.

(f) I

MPLEMENTATION

.—Not later than September 30, 2024, the

Secretary shall report to the Committee on Health, Education,

Labor, and Pensions of the Senate and the Committee on Energy

and Commerce of the House of Representatives the number of re-

cipients of funds under section 520A who have implemented train-

ing policies described in subsection (a)(1) and a summary of the in-

formation received under subsection (d).

(g) D

EFINITIONS

.—In this section:

(1) The term ‘‘evidence-based’’ has the meaning given such

term in section 8101 of the Elementary and Secondary Edu-

cation Act of 1965.

(2) The term ‘‘local educational agency’’ has the meaning

given to such term in section 8101 of the Elementary and Sec-

ondary Education Act of 1965.

(3) The term ‘‘State educational agency’’ has the meaning

given to such term in section 8101 of the Elementary and Sec-

ondary Education Act of 1965.

(4) The term ‘‘Tribal educational agency’’ has the meaning

given to the term ‘‘tribal educational agency’’ in section 6132

of the Elementary and Secondary Education Act of 1965.

SEC. 520C. ø290bb–34¿ SUICIDE PREVENTION TECHNICAL ASSISTANCE

CENTER.

(a) P

ROGRAM

UTHORIZED

.—

(1) I

N GENERAL

.—The Secretary, acting through the Assist-

ant Secretary, shall establish a research, training, and tech-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

59 Sec. 520C PUBLIC HEALTH SERVICE ACT

nical assistance resource center to provide appropriate infor-

mation, training, and technical assistance to States, political

subdivisions of States, federally recognized Indian Tribes, Trib-

al organizations, institutions of higher education, public orga-

nizations, or private nonprofit organizations regarding the pre-

vention of suicide among all ages, particularly among groups

that are at a high risk for suicide.

(2) C

OLLABORATION

.—In carrying out this subsection, as

applicable with respect to assistance to entities serving mem-

bers of the Armed Forces and veterans, the Secretary shall, as

appropriate, collaborate with the Secretary of Defense and the

Secretary of Veterans Affairs.

(b) R

ESPONSIBILITIES OF THE

ENTER

.—The center established

under subsection (a) shall conduct activities for the purpose of—

(1) developing and continuing statewide or Tribal suicide

early intervention and prevention strategies for all ages, par-

ticularly among groups that are at a high risk for suicide;

(2) ensuring the surveillance of suicide early intervention

and prevention strategies for all ages, particularly among

groups that are at a high risk for suicide;

(3) studying the costs and effectiveness of statewide and

tribalsuicide early intervention and prevention strategies in

order to provide information concerning relevant issues of im-

portance to State, Tribal, and national policymakers;

(4) further identifying and understanding causes and asso-

ciated risk factors for suicide;

(5) analyzing the efficacy of new and existing suicide early

intervention and prevention techniques and technology;

(6) ensuring the surveillance of suicidal behaviors and

nonfatal suicidal attempts;

(7) studying the effectiveness of State-sponsored statewide

and Tribal suicide early intervention and prevention strategies

on the overall wellness and health promotion strategies related

to suicide attempts;

(8) promoting the sharing of data regarding suicide with

Federal agencies involved with suicide early intervention and

prevention, and State-sponsored statewide or Tribal suicide

early intervention and prevention strategies for the purpose of

identifying previously unknown mental health causes and asso-

ciated risk factors for suicide;

(9) evaluating and disseminating outcomes and best prac-

tices of mental health and substance use disorder services at

institutions of higher education; and

(10) conducting other activities determined appropriate by

the Secretary.

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

carrying out this section, there are authorized to be appropriated

$9,000,000 for each of fiscal years 2023 through 2027.

(d) A

NNUAL

EPORT

.—Not later than 2 years after the date of

the enactment of the Restoring Hope for Mental Health and Well-

Being Act of 2022, the Secretary shall submit to the Committee on

Health, Education, Labor, and Pensions of the Senate and the

Committee on Energy and Commerce of the House of Representa-

tives a report on the activities carried out by the center established

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As Amended Through P.L. 117-328, Enacted December 29, 2022

60 Sec. 520E PUBLIC HEALTH SERVICE ACT

under subsection (a) during the year involved, including the poten-

tial effects of such activities, and the States, organizations, and in-

stitutions that have worked with the center.

øSection 520D was repealed by section 9017 of Public Law

114–255.¿

SEC. 520E. ø290bb–36¿ YOUTH SUICIDE EARLY INTERVENTION AND

PREVENTION STRATEGIES.

(a) I

ENERAL

.—The Secretary, acting through the Assistant

Secretary for Mental Health and Substance Use, shall award

grants or cooperative agreements to eligible entities to—

(1) develop and implement State-sponsored statewide or

Tribal youth suicide early intervention and prevention strate-

gies in schools, educational institutions, juvenile justice sys-

tems, substance use disorder programs, mental health pro-

grams, foster care systems, pediatric health programs, and

other child and youth support organizations;

(2) support public organizations and private nonprofit or-

ganizations actively involved in State-sponsored statewide or

Tribal youth suicide early intervention and prevention strate-

gies and in the development and continuation of State-spon-

sored statewide youth suicide early intervention and preven-

tion strategies;

(3) provide grants to institutions of higher education to co-

ordinate the implementation of State-sponsored statewide or

Tribal youth suicide early intervention and prevention strate-

gies;

(4) collect and analyze data on State-sponsored statewide

or Tribal youth suicide early intervention and prevention serv-

ices that can be used to monitor the effectiveness of such serv-

ices and for research, technical assistance, and policy develop-

ment; and

(5) assist eligible entities, through State-sponsored state-

wide 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) E

LIGIBLE

NTITY

.—

(1) D

EFINITION

.—In this section, the term ‘‘eligible entity’’

means—

(A) a State;

(B) a public organization or private nonprofit organiza-

tion designated by a State or Indian Tribe (as defined in

section 4 of the Indian Self-Determination and Education

Assistance Act) to develop or direct the State-sponsored

statewide or Tribal youth suicide early intervention and

prevention strategy; or

nization (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 continu-

ation of a Tribal youth suicide early intervention and pre-

vention strategy.

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61 Sec. 520E PUBLIC HEALTH SERVICE ACT

(2) L

IMITATION

.—In carrying out this section, the Secretary

shall ensure that a State does not receive more than 1 grant

or cooperative agreement under this section at any 1 time. For

purposes of the preceding sentence, a State shall be considered

to have received a grant or cooperative agreement if the eligi-

ble entity involved is the State or an entity designated by the

State under paragraph (1)(B). Nothing in this paragraph shall

be construed to apply to entities described in paragraph (1)(C).

(3) C

ONSIDERATION

.—In awarding grants under this sec-

tion, the Secretary shall take into consideration the extent of

the need of the applicant, including the incidence and preva-

lence of suicide in the State and among the populations of

focus, including rates of suicide determined by the Centers for

Disease Control and Prevention for the State or population of

focus.

(4) C

ONSULTATION

.—An entity described in paragraph

(1)(A) or (1)(B) that applies for a grant or cooperative agree-

ment under this section shall agree to consult or confer with

entities described in paragraph (1)(C) and Native Hawaiian

Health Care Systems, as applicable, in the applicable State

with respect to the development and implementation of a state-

wide early intervention strategy.

REFERENCE

.—In providing assistance under a grant or co-

operative 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, in-

cluding screening programs, to youth who are at risk for men-

tal or emotional disorders that may lead to a suicide attempt,

and that are integrated with school systems, educational insti-

tutions, juvenile justice systems, substance use disorder pro-

grams, mental health programs, foster care systems, pediatric

health programs, and other child and youth support organiza-

tions;

(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 insti-

tutions, juvenile justice systems, substance use disorder pro-

grams, mental health programs, foster care systems, pediatric

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62 Sec. 520E PUBLIC HEALTH SERVICE ACT

health programs, and other child and youth support organiza-

tions of youth who recently completed suicide;

(8) offer continuous and up-to-date information and aware-

ness campaigns that target parents, family members, child

care professionals, community care providers, and the general

public and highlight the risk factors associated with youth sui-

cide 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 preven-

tion services, use effective communication mechanisms that are

targeted to and reach youth, families, schools, educational in-

stitutions, pediatric health programs, and youth organizations;

(10) provide a timely response system to ensure that child-

serving professionals and providers are properly trained in

youth suicide early intervention and prevention strategies and

that child-serving professionals and providers involved in early

intervention and prevention services are properly trained in ef-

fectively 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 ac-

tivities, including consulting with interested families and advo-

cacy organizations;

(13) provide services in areas or regions with rates of

youth suicide that exceed the national average as determined

by the Centers for Disease Control and Prevention;

(14) obtain informed written consent from a parent or legal

guardian of an at-risk child before involving the child in a

youth suicide early intervention and prevention program; and

(15) provide to parents, legal guardians, and family mem-

bers of youth, supplies to securely store means commonly used

in suicide, if applicable, within the household.

(d) R

EQUIREMENT FOR

UICIDE

REVENTION

CTIVITIES

.—Not

less than 85 percent of grant funds received under this section

shall be used to provide suicide prevention activities.

(e) C

OORDINATION AND

OLLABORATION

.—

(1) I

N GENERAL

.—In carrying out this section, the Sec-

retary shall collaborate with relevant Federal agencies and sui-

cide working groups responsible for early intervention and pre-

vention services relating to youth suicide.

(2) C

ONSULTATION

.—In carrying out this section, the Sec-

retary shall consult with—

(A) State and local agencies, including agencies re-

sponsible for early intervention and prevention services

under title XIX of the Social Security Act, the State Chil-

dren’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;

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As Amended Through P.L. 117-328, Enacted December 29, 2022

63 Sec. 520E PUBLIC HEALTH SERVICE ACT

education specialty organizations;

(D) youth who are at risk for suicide, who have sur-

vived 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 cur-

rently receiving care from early intervention and preven-

tion 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) P

OLICY DEVELOPMENT

.—In carrying out this section,

the Secretary shall—

(A) coordinate and collaborate on policy development

at the Federal level with the relevant Department of

Health and Human Services agencies and suicide working

groups and the Department of Education, as appropriate;

and

(B) consult on policy development at the Federal level

with the private sector, including consumer, medical, sui-

cide 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) R

ULE OF

ONSTRUCTION

; R

ELIGIOUS AND

ORAL

CCOMMO

DATION

.—Nothing in this section shall be construed to require sui-

cide 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) E

VALUATIONS AND

EPORT

.—

(1) E

VALUATIONS BY ELIGIBLE ENTITIES

.—Not later than 24

months after receiving a grant or cooperative agreement under

this section, an eligible entity shall submit to the Secretary the

results of an evaluation to be conducted by the entity con-

cerning the effectiveness of the activities carried out under the

grant or agreement.

(2) R

EPORT

.—Not later than December 31, 2025, the Sec-

retary 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 ana-

lyze the effectiveness and efficacy of the activities con-

ducted with grants, collaborations, and consultations

under this section.

(h) R

ULE OF

ONSTRUCTION

; S

TUDENT

EDICATION

.—Nothing

in this section or section 520E–1 shall be construed to allow school

personnel to require that a student obtain any medication as a con-

dition of attending school or receiving services.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

64 Sec. 520E–1 PUBLIC HEALTH SERVICE ACT

The probable intent of the Congress is that the heading be ‘‘SUICIDE PREVENTION FOR

YOUTH’’. See the amendment described in section 3(b)(1)(A) of Public Law 108–355 (118 Stat.

1407). The amendment cannot be executed because the matter in the heading to be struck does

not appear, as the amendatory instruction used the wrong font. The amendment referred to

(i) P

ROHIBITION

.—Funds appropriated to carry out this section,

section 520C, section 520E–1, or section 520E–2 shall not be used

to pay for or refer for abortion.

(j) P

ARENTAL CONSENT

.—States and entities receiving funding

under this section and section 520E–1 shall obtain prior written,

informed consent from the child’s parent or legal guardian for as-

sessment services, school-sponsored programs, and treatment in-

volving medication related to youth suicide conducted in elemen-

tary and secondary schools. The requirement of the preceding sen-

tence 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 paren-

tal consent cannot reasonably be obtained.

(k) R

ELATION TO

DUCATION

ROVISIONS

.—Nothing in this sec-

tion or section 520E–1 shall be construed to supersede section 444

of the General Education Provisions Act, including the requirement

of prior parental consent for the disclosure of any education

records. Nothing in this section or section 520E–1 shall be con-

strued to modify or affect parental notification requirements for

programs authorized under the Elementary and Secondary Edu-

cation Act of 1965 (as amended by the No Child Left Behind Act

of 2001; Public Law 107–110).

(l) D

EFINITIONS

.—In this section:

(1) E

ARLY 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) E

DUCATIONAL INSTITUTION

;

INSTITUTION OF HIGHER

EDUCATION

;

SCHOOL

.—The term—

(A) ‘‘educational institution’’ means a school or institu-

tion 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

school (as such terms are defined in section 8101 of the El-

ementary and Secondary Education Act of 1965).

(3) P

REVENTION

.—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) Y

OUTH

.—The term ‘‘youth’’ means individuals who are

up to 24 years of age.

(m) A

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

carrying out this section, there are authorized to be appropriated

$40,000,000 for each of fiscal years 2023 through 2027.

SEC. 520E–1. ø290bb–36a¿ SUICIDE PREVENTION FOR CHILDREN AND

ADOLESCENTS

(a) I

ENERAL

.—The Secretary shall award grants or

cooperative agreements to public organizations, private nonprofit

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As Amended Through P.L. 117-328, Enacted December 29, 2022

65 Sec. 520E–1 PUBLIC HEALTH SERVICE ACT

‘‘CHILDREN AND ADOLESCENTS’’ rather than ‘‘CHILDREN AND ADOLESCENTS’’. (The

amendment is directed to section ‘‘520E’’. Section 520E–1 above formerly was section 520E, and

was redesignated by section 3(b)(2) of such Public Law.)

So in law. Probably should include ‘‘and’’ after the semicolon at the end of paragraph (9).

See section 3(b)(1)(D)(ix) of Public Law 108–355 (118 Stat. 1408).

organizations, political subdivisions, consortia of political subdivi-

sions, consortia of States, or Federally recognized Indian tribes or

tribal organizations to design early intervention and prevention

strategies that will complement the State-sponsored statewide or

tribal youth suicide early intervention and prevention strategies

developed pursuant to section 520E.

(b) C

OLLABORATION

.—In carrying out subsection (a), the Sec-

retary shall ensure that activities under this section are coordi-

nated with the relevant Department of Health and Human Services

agencies and suicide working groups.

EQUIREMENTS

.—A public organization, private nonprofit

organization, political subdivision, consortium of political subdivi-

sions, consortium of States, or federally recognized Indian tribe or

tribal organization desiring a grant, contract, or cooperative agree-

ment under this section shall demonstrate that the suicide preven-

tion program such entity proposes will—

(1)(A) comply with the State-sponsored statewide early

intervention and prevention strategy as developed under sec-

tion 520E; and

(B) in the case of a consortium of States, receive the sup-

port of all States involved;

(2) provide for the timely assessment, treatment, or refer-

ral for mental health or substance abuse services of youth at

risk for suicide;

(3) be based on suicide prevention practices and strategies

that are adapted to the local community;

(4) integrate its suicide prevention program into the exist-

ing health care system in the community including general,

mental, and behavioral health services, and substance abuse

services;

(5) be integrated into other systems in the community that

address the needs of youth including the school systems, edu-

cational institutions, juvenile justice system, substance abuse

programs, mental health programs, foster care systems, and

community child and youth support organizations;

(6) use primary prevention methods to educate and raise

awareness in the local community by disseminating evidence-

based information about suicide prevention;

(7) include suicide prevention, mental health, and related

information and services for the families and friends of those

who completed suicide, as needed;

(8) offer access to services and care to youth with diverse

linguistic and cultural backgrounds;

(9) conduct annual self-evaluations of outcomes and activi-

ties, including consulting with interested families and advocacy

organizations;

(10) ensure that staff used in the program are trained in

suicide prevention and that professionals involved in the sys-

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66 Sec. 520E–1 PUBLIC HEALTH SERVICE ACT

So in law. Probably should be ‘‘grant or cooperative agreement’’. See the amendments made

by section 3(b) of Public Law 108–355 (118 Stat. 1407).

tem of care have received training in identifying persons at

risk of suicide.

(d) U

SE OF

UNDS

.—Amounts provided under a grant or coop-

erative agreement under this section shall be used to supplement,

and not supplant, Federal and non-Federal funds available for car-

rying out the activities described in this section. Applicants shall

provide financial information to demonstrate compliance with this

section.

(e) C

ONDITION

.—An applicant for a grant or cooperative agree-

ment under subsection (a) shall demonstrate to the Secretary that

the application complies with the State-sponsored statewide early

intervention and prevention strategy as developed under section

520E and the applicant has the support of the local community and

relevant public health officials.

(f) S

PECIAL

OPULATIONS

.—In awarding grants and cooperative

agreements under subsection (a), the Secretary shall ensure that

such awards are made in a manner that will focus on the needs

of communities or groups that experience high or rapidly rising

rates of suicide.

(g) A

PPLICATION

.—A public organization, private nonprofit or-

ganization, political subdivision, consortium of political subdivi-

sions, consortium of States, or Federally recognized Indian tribe or

tribal organization receiving a grant or cooperative agreement

under subsection (a) shall prepare and submit an application to the

Secretary at such time, in such manner, and containing such infor-

mation as the Secretary may reasonably require. Such application

shall include a plan for the rigorous evaluation of activities funded

under the grant or cooperative agreement, including a process and

outcome evaluation.

(h) D

ISTRIBUTION OF

WARDS

.—In awarding grants and cooper-

ative agreements under subsection (a), the Secretary shall ensure

that such awards are distributed among the geographical regions

of the United States and between urban and rural settings.

(i) E

VALUATION

.—A public organization, private nonprofit orga-

nization, political subdivision, consortium of political subdivisions,

consortium of States, or Federally recognized Indian tribe or tribal

organization receiving a grant or cooperative agreement under sub-

section (a) shall prepare and submit to the Secretary at the end of

the program period, an evaluation of all activities funded under

this section.

(j) D

ISSEMINATION AND

DUCATION

.—The Secretary shall en-

sure that findings derived from activities carried out under this

section are disseminated to State, county and local governmental

agencies and public and private nonprofit organizations active in

promoting suicide prevention and family support activities.

(k) D

URATION OF

ROJECTS

.—With respect to a grant, contract,

or cooperative agreement

awarded under this section, the period

during which payments under such award may be made to the re-

cipient may not exceed 3 years.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

67 Sec. 520E–2 PUBLIC HEALTH SERVICE ACT

(l) S

TUDY

.—Within 1 year after the date of the enactment of

this section, the Secretary shall, directly or by grant or contract,

initiate a study to assemble and analyze data to identify—

(1) unique profiles of children under 13 who attempt or

complete suicide;

(2) unique profiles of youths between ages 13 and 24 who

attempt or complete suicide; and

(3) a profile of services available to these groups and the

use of these services by children and youths from paragraphs

(1) and (2).

(m) D

EFINITIONS

.—In this section, the terms ‘‘early interven-

tion’’, ‘‘educational institution’’, ‘‘institution of higher education’’,

‘‘prevention’’, ‘‘school’’, and ‘‘youth’’ have the meanings given to

those terms in section 520E.

(n) A

UTHORIZATION OF

PPROPRIATION

.—For purposes of car-

rying out this section, there is authorized to be appropriated

$75,000,000 for fiscal year 2001 and such sums as may be nec-

essary for each of the fiscal years 2002 through 2003.

SEC. 520E–2. ø290bb–36b¿ MENTAL HEALTH AND SUBSTANCE USE DIS-

ORDER SERVICES FOR STUDENTS IN HIGHER EDU-

CATION.

(a) I

ENERAL

.—The Secretary, acting through the Director of

the Center for Mental Health Services and in consultation with the

Secretary of Education, may award grants on a competitive basis

to institutions of higher education to enhance services for students

with mental health or substance use disorders that can lead to

school failure, such as depression, substance use disorders, and sui-

cide attempts, prevent mental and substance use disorders, reduce

stigma, and improve the identification and treatment for students

at risk, so that students will successfully complete their studies.

(b) U

SE OF

UNDS

.—The Secretary may not make a grant to

an institution of higher education under this section unless the in-

stitution agrees to use the grant only for one or more of the fol-

lowing:

(1) Educating students, families, faculty, and staff to in-

crease awareness of mental health and substance use disorders

and promote resiliency.

(2) The operation of hotlines.

(3) Preparing informational material.

(4) Providing outreach services to notify students about

available mental health and substance use disorder resources

and services.

(5) Administering voluntary mental health and substance

use disorder screenings and assessments.

(6) Supporting the training of students, faculty, and staff

to recognize and respond effectively and appropriately to stu-

dents experiencing mental health and substance use disorders.

(7) Creating a network infrastructure to link institutions of

higher education with health care providers who treat mental

health and substance use disorders.

(8) Providing mental health and substance use. disorders

prevention and treatment services to students, which may in-

clude recovery support services and programming and early

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As Amended Through P.L. 117-328, Enacted December 29, 2022

68 Sec. 520E–2 PUBLIC HEALTH SERVICE ACT

intervention, treatment, and management, including through

the use of telehealth services.

(9) Conducting research through a counseling or health

center at the institution of higher education involved to im-

prove the behavioral health of students through clinical serv-

ices, outreach, prevention, promotion of mental health, or aca-

demic success, in a manner that is in compliance with all ap-

plicable personal privacy laws.

(10) Supporting student groups on campus, including ath-

letic teams, that engage in activities to educate students, in-

cluding activities to reduce stigma surrounding mental and be-

havioral health disorders, and promote mental health.

(11) Employing appropriately trained staff.

(12) Developing and supporting evidence-based and emerg-

ing best practices, including a focus on culturally and linguis-

tically appropriate best practices, and trauma-informed prac-

tices.

LIGIBLE GRANT RECIPIENTS

.—Any institution of higher edu-

cation 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) A

PPLICATION

.—To be eligible to receive a grant under this

section, an institution of higher education shall prepare and submit

an application to the Secretary at such time and in such manner

as the Secretary may require. At a minimum, the application shall

include the following:

(1) A description of the population to be targeted by the

program carried out under the grant, including veterans when-

ever possible and appropriate, and of identified mental health

and substance use disorder needs of students at the institution

of higher education.

(2) A description of Federal, State, local, private, and insti-

tutional resources currently available to address the needs de-

scribed in paragraph (1) at the institution of higher education,

which may include, as appropriate and in accordance with sub-

section (b)(7), a plan to seek input from relevant stakeholders

in the community, including appropriate public and private en-

tities, in order to carry out the program under the grant.

(3) A description of the outreach strategies of the institu-

tion of higher education for promoting mental health and ac-

cess 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 de-

scription 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 activi-

ties.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

69 Sec. 520E–2 PUBLIC HEALTH SERVICE ACT

(6) An outline of the objectives of the program carried out

under the grant.

(7) For an institution of higher education proposing to use

the grant for an activity described in paragraph (8) or (9) of

subsection (b), a description of the policies and procedures of

the institution of higher education that are related to applica-

ble laws regarding access to, and sharing of, treatment records

of students at any campus-based mental health center or part-

ner organization, including the policies and State laws gov-

erning when such records can be accessed and shared for non-

treatment purposes and a description of the process used by

the institution of higher education to notify students of these

policies and procedures, including the extent to which written

consent is required.

(8) An assurance that grant funds will be used to supple-

ment and not supplant any other Federal, State, or local funds

available to carry out activities of the type carried out under

the grant.

(e) R

EQUIREMENT OF

ATCHING

UNDS

.—

(1) I

N GENERAL

.—The Secretary may make a grant under

this section to an institution of higher education only if the in-

stitution agrees to make available (directly or through dona-

tions 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 car-

ried 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) D

ETERMINATION OF AMOUNT CONTRIBUTED

.—Non-Fed-

eral 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) W

AIVER

.—The Secretary may waive the requirement

established in paragraph (1) with respect to an institution of

higher education if the Secretary determines that extraor-

dinary need at the institution justifies the waiver.

(f) R

EPORTS

.—For each fiscal year that grants are awarded

under this section, the Secretary shall conduct a study on the re-

sults of the grants and submit to the Committee on Energy and

Commerce of the House of Representatives and the Committee on

Health, Education, Labor, and Pensions of the Senate a report on

such results that includes the following:

(1) An evaluation of the grant program outcomes, includ-

ing a summary of activities carried out with the grant and the

results achieved through those activities.

(2) Recommendations on how to improve access to mental

health and substance use disorder services at institutions of

higher education, including through prevention, early detec-

tion, early intervention, and efforts to reduce the incidence of

suicide and substance use disorders.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

70 Sec. 520E–3 PUBLIC HEALTH SERVICE ACT

(3) An assessment of the mental health and substance use

disorder needs of the populations served by recipients of grants

under this section.

(g) D

EFINITION

.—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) T

ECHNICAL

SSISTANCE

.—The Secretary may provide tech-

nical assistance to grantees in carrying out this section.

(i) A

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

carrying out this section, there are authorized to be appropriated

$7,000,000 for each of fiscal years 2023 through 2027.

SEC. 520E–3. ø290bb–36c¿ NATIONAL SUICIDE PREVENTION LIFELINE

PROGRAM.

(a) I

ENERAL

.—The Secretary, acting through the Assistant

Secretary, shall maintain the National Suicide Prevention Lifeline

program (referred to in this section as the ‘‘program’’), authorized

under section 520A and in effect prior to the date of enactment of

the Helping Families in Mental Health Crisis Reform Act of 2016.

(b) A

CTIVITIES

.—In maintaining the program, the activities of

the Secretary shall include—

(1) supporting and coordinating a network of crisis centers

across the United States for providing suicide prevention and

mental health crisis intervention services, including appro-

priate follow-up services, to individuals seeking help at any

time, day or night;

(2) maintaining a suicide prevention hotline to link callers

to local emergency, mental health, and social services re-

sources;

(3) consulting with the Secretary of Veterans Affairs to en-

sure that veterans calling the suicide prevention hotline have

access to a specialized veterans’ suicide prevention hotline;

(4) improving awareness of the program for suicide preven-

tion and mental health crisis intervention services, including

by conducting an awareness initiative and ongoing outreach to

the public; and

(5) improving the collection and analysis of demographic

information, in a manner that protects personal privacy, con-

sistent with applicable Federal and State privacy laws, in

order to understand disparities in access to the program among

individuals who are seeking help.

LAN

.—

(1) I

N GENERAL

.—For purposes of supporting the crisis cen-

ters under subsection (b)(1) and maintaining the suicide pre-

vention hotline under subsection (b)(2), the Secretary shall de-

velop and implement a plan to ensure the provision of high-

quality services.

(2) C

ONTENTS

.—The plan required by paragraph (1) shall

include the following:

(A) Program evaluation, including performance meas-

ures to assess progress toward the goals and objectives of

the program and to improve the responsiveness and per-

formance of the hotline, including at all backup call cen-

ters.

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71 Sec. 520E–4 PUBLIC HEALTH SERVICE ACT

(B) Requirements that crisis centers and backup cen-

ters must meet—

(i) to participate in the network under subsection

(b)(1); and

(ii) to ensure that each telephone call and applica-

ble other communication received by the hotline, in-

cluding at backup call centers, is answered in a timely

manner, consistent with evidence-based guidance or

other guidance or best practices, as appropriate.

menting evidence-based practices, including with respect

to followup and communicating the availability of re-

sources in the community for individuals in need.

(D) Criteria for carrying out periodic testing of the hot-

line during each fiscal year, including at crisis centers and

backup centers, to identify and address any problems in a

timely manner.

(3) C

ONSULTATION

.—In developing requirements under

paragraph (2)(B), the Secretary shall consult with State de-

partments of health, local governments, Indian Tribes, and

Tribal organizations.

(4) I

NITIAL PLAN

;

UPDATES

.—The Secretary shall—

(A) not later than 1 year after the date of enactment

of the Restoring Hope for Mental Health and Well-Being

Act of 2022, complete development of the initial plan under

paragraph (1) and make such plan publicly available; and

(B) periodically thereafter, update such plan and make

the updated plan publicly available.

(d) I

MPROVING

PIDEMIOLOGICAL

ATA

.—The Secretary shall,

as appropriate, formalize and strengthen agreements between the

Suicide Prevention Lifeline program and the Centers for Disease

Control and Prevention with respect to the secure sharing of de-

identified epidemiological data. Such agreements shall include ap-

propriate privacy and security protections that meet the require-

ments of applicable Federal law, at a minimum.

(e) D

ATA TO

SSIST

TATE AND

OCAL

UICIDE

REVENTION

TIVITIES

.—The Secretary shall ensure that the aggregated informa-

tion collected and any applicable analyses conducted under sub-

section (b)(5), including from local call centers, as applicable, are

made available in a usable format to State and local agencies in

order to inform suicide prevention activities.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there are authorized to be appropriated $101,621,000 for each

of fiscal years 2023 through 2027.

SEC. 520E–4. ø290bb-36d¿ TREATMENT REFERRAL ROUTING SERVICE.

(a) I

ENERAL

.—The Secretary, acting through the Assistant

Secretary, shall maintain the National Treatment Referral Routing

Service (referred to in this section as the ‘‘Routing Service’’) to as-

sist individuals and families in locating mental and substance use

disorders treatment providers.

(b) A

CTIVITIES OF THE

ECRETARY

.—To maintain the Routing

Service, the activities of the Assistant Secretary shall include ad-

ministering—

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Section 1262(b)(3) of division FF of Public Law 117-328 attempted to amend subsection (c)

by strinking ‘‘information on any qualified practitioner that is certified to prescribe medication

for opioid dependency under section 303(g)(2)(B) of the Controlled Substances Act’’ and inserting

‘‘information on any practitioner who prescribes narcotic drugs in schedule III, IV, or V of sec-

tion 202 of the Controlled Substances Act for the purpose of maintenance or detoxification treat-

ment’’. The text being struck does not appear in law.

(1) a nationwide, telephone number providing year-round

access to information that is updated on a regular basis re-

garding local behavioral health providers and community-

based organizations in a manner that is confidential, without

requiring individuals to identify themselves, is in languages

that include at least English and Spanish, and is at no cost to

the individual using the Routing Service; and

(2) an Internet website to provide a searchable, online

treatment services locator of behavioral health treatment pro-

viders and community-based organizations, which shall include

information on the name, location, contact information, and

basic services provided by such providers and organizations.

EMOVING

RACTITIONER

ONTACT

NFORMATION

.—In the

event that the Internet website described in subsection (b)(2) con-

tains information on any qualified practitioner that is certified to

prescribe medication for opioid dependency under section

303(h)(2)(B) of the Controlled Substances Act

, the Assistant Sec-

retary—

(1) shall provide an opportunity to such practitioner to

have the contact information of the practitioner removed from

the website at the request of the practitioner; and

(2) may evaluate other methods to periodically update the

information displayed on such website.

(d) R

ULE OF

ONSTRUCTION

.—Nothing in this section shall be

construed to prevent the Assistant Secretary from using any unob-

ligated amounts otherwise made available to the Administration to

maintain the Routing Service.

SEC. 520F. ø290bb–37¿ MENTAL HEALTH CRISIS RESPONSE PARTNER-

SHIP PILOT PROGRAM.

(a) I

ENERAL

.—The Secretary shall establish a pilot program

under which the Secretary will award competitive grants to States,

localities, territories, Indian Tribes, and Tribal organizations to es-

tablish new, or enhance existing, mobile crisis response teams that

divert the response for mental health and substance use disorder

crises from law enforcement to mobile crisis teams, as described in

subsection (b).

(b) M

OBILE

RISIS

EAMS

ESCRIBED

.—A mobile crisis team,

for purposes of this section, is a team of individuals—

(1) that is available to respond to individuals in mental

health and substance use disorder crises and provide imme-

diate stabilization, referrals to community-based mental health

and substance use disorder services and supports, and triage

to a higher level of care if medically necessary;

(2) which may include licensed counselors, clinical social

workers, physicians, paramedics, crisis workers, peer support

specialists, or other qualified individuals; and

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73 Sec. 520G PUBLIC HEALTH SERVICE ACT

(3) which may provide support to divert mental health and

substance use disorder crisis calls from the 9–1–1 system to

the 9–8–8 system.

RIORITY

.—In awarding grants under this section, the Sec-

retary shall prioritize applications which account for the specific

needs of the communities to be served, including children and fami-

lies, veterans, rural and underserved populations, and other groups

at increased risk of death from suicide or overdose.

(d) R

EPORT

.—

(1) I

NITIAL REPORT

.—Not later than September 30, 2024,

the Secretary shall submit to Congress a report on steps taken

by States, localities, territories, Indian Tribes, and Tribal orga-

nizations prior to the date of enactment of this section to

strengthen the partnerships among mental health providers,

substance use disorder treatment providers, primary care phy-

sicians, mental health and substance use disorder crisis teams,

paramedics, law enforcement officers, and other first respond-

ers.

(2) P

ROGRESS REPORTS

.—Not later than one year after the

date on which the first grant is awarded to carry out this sec-

tion, and for each year thereafter, the Secretary shall submit

to Congress a report on the grants made during the year cov-

ered by the report, which shall include—

(A) impact data on the teams and people served by

such programs, including demographic information of indi-

viduals served, volume, and types of service utilization;

(B) outcomes of the number of linkages made to com-

munity-based resources or short-term crisis receiving and

stabilization facilities, as applicable, and diversion from

law enforcement or hospital emergency department set-

tings;

ments for continuous evaluation and quality improvement,

and other relevant data as determined by the Secretary;

(D) identification and, where appropriate, rec-

ommendations of best practices from States and localities

providing mobile crisis response and stabilization services

for youth and adults; and

(E) identification of any opportunities for improve-

ments to the program established under this section.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section, $10,000,000 for each

of fiscal years 2023 through 2027.

SEC. 520G. ø290bb–38¿ GRANTS FOR JAIL DIVERSION PROGRAMS.

(a) P

ROGRAM

UTHORIZED

.—The Secretary shall make grants

to States, political subdivisions of States, and Indian Tribes and

Tribal organizations (as the terms ‘‘Indian tribes’’ and ‘‘tribal orga-

nizations’’ are defined in section 4 of the Indian Self-Determination

and Education Assistance Act), acting directly or through agree-

ments with other public or nonprofit entities, or a health facility

or program operated by or in accordance with a contract or grant

with the Indian Health Service, to develop and implement pro-

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74 Sec. 520G PUBLIC HEALTH SERVICE ACT

grams to divert individuals with a mental illness from the criminal

justice system to community-based services.

(b) A

DMINISTRATION

.—

(1) C

ONSULTATION

.—The Secretary shall consult with the

Attorney General and any other appropriate officials in car-

rying out this section.

(2) R

EGULATORY 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).

PPLICATIONS

.—

(1) I

N GENERAL

.—To receive a grant under subsection (a),

the chief executive of a State, chief executive of a subdivision

of a State, an Indian Tribe or Tribal organization, a health fa-

cility or program described in subsection (a), or a public or non-

profit entity referred to in subsection (a) shall prepare and sub-

mit an application to the Secretary at such time, in such man-

ner, and containing such information as the Secretary shall

reasonably require.

(2) C

ONTENT

.—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 re-

search findings, include case management, assertive

community treatment, medication management and

access, integrated mental health and co-occurring sub-

stance use disorder treatment, peer recovery support

services, and psychiatric rehabilitation, and will be co-

ordinated with social services, including life skills

training, housing placement, vocational training, edu-

cation job placement, and health care;

(ii) there has been relevant interagency collabora-

tion 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 in-

tegrated with an existing system of care for those with

mental illness;

gram 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) S

PECIAL

ONSIDERATION

EGARDING

ETERANS

.—In award-

ing grants under subsection (a), the Secretary shall, as appropriate,

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As Amended Through P.L. 117-328, Enacted December 29, 2022

75 Sec. 520H PUBLIC HEALTH SERVICE ACT

give special consideration to entities proposing to use grant funding

to support jail diversion services for veterans.

(e) U

SE OF

UNDS

.—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 sys-

tem of care;

(2) create or expand community-based mental health and

co-occurring mental illness and substance use disorder services

to accommodate the diversion program;

(3) train professionals and paraprofessionals involved in

the system of care, and law enforcement officers, attorneys,

and judges;

(4) provide community outreach and crisis intervention;

and

(5) develop programs to divert individuals prior to booking,

arrest, or release.

(f) F

EDERAL

HARE

.—

(1) I

N GENERAL

.—The Secretary shall pay to a State, polit-

ical 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) F

EDERAL 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) N

FEDERAL SHARE

.—The non-Federal share of pay-

ments 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 contribu-

tions.

(g) G

EOGRAPHIC

ISTRIBUTION

.—The Secretary shall ensure

that such grants awarded under subsection (a) are equitably dis-

tributed among the geographical regions of the United States and

between urban and rural populations.

(h) T

RAINING AND

ECHNICAL

SSISTANCE

.—Training and tech-

nical assistance may be provided by the Secretary to assist a State,

political subdivision of a State, Indian Tribe, or Tribal organization

receiving a grant under subsection (a) in establishing and operating

a diversion program.

(i) E

VALUATIONS

.—The programs described in subsection (a)

shall be evaluated not less than one time in every 12-month period

using the methodology and outcome measures identified in the

grant application.

(j) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section $14,000,000 for each of

fiscal years 2023 through 2027.

SEC. 520H. ø 290bb-39 ¿ PEER-SUPPORTED MENTAL HEALTH SERVICES.

(a) G

RANTS

UTHORIZED

.—The Secretary, acting through the

Assistant Secretary for Mental Health and Substance Use, shall

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76 Sec. 520H–1 PUBLIC HEALTH SERVICE ACT

award grants to eligible entities to enable such entities to develop,

expand, and enhance access to mental health peer-delivered serv-

ices.

(b) U

SE OF

UNDS

.—Grants awarded under subsection (a) shall

be used to develop, expand, and enhance national, statewide, or

community-focused programs, including virtual peer-support serv-

ices and technology-related capabilities, including by—

(1) carrying out workforce development, recruitment, and

retention activities, to train, recruit, and retain peer-support

providers;

(2) building connections between mental health treatment

programs, including between community organizations and

peer-support networks, including virtual peer-support net-

works, and with other mental health support services;

(3) reducing stigma associated with mental health dis-

orders;

(4) expanding and improving virtual peer mental health

support services, including through the adoption of tech-

nologies and capabilities to expand access to virtual peer men-

tal health support services, such as by acquiring equipment

and software necessary to efficiently run virtual peer-support

services; and

(5) conducting research on issues relating to mental illness

and the impact peer-support has on resiliency, including identi-

fying—

(A) the signs of mental illness;

(B) the resources available to individuals with mental

illness and to their families; and

living with mental illness.

PECIAL

ONSIDERATION

.—In carrying out this section, the

Secretary shall give special consideration to the unique needs of

rural areas.

(d) D

EFINITION

.—In this section, the term ‘‘eligible entity’’

means—

(1) a consumer-run nonprofit organization that—

(A) is principally governed by people living with a

mental health condition; and

(B) mobilizes resources within and outside of the men-

tal health community, which may include through peer-

support networks, to increase the prevalence and quality of

long-term wellness of individuals living with a mental

health condition, including those with a co-occurring sub-

stance use disorder; or

(2) an Indian Tribe, Tribal organization, Urban Indian or-

ganization, or consortium of Tribes or Tribal organizations.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section $13,000,000 for each of

fiscal years 2023 through 2027.

SEC. 520H–1. ø 290bb-39a ¿ BEST PRACTICES FOR BEHAVIORAL AND

MENTAL HEALTH INTERVENTION TEAMS.

(a) I

ENERAL

.—The Secretary, acting through the Assistant

Secretary for Mental Health and Substance Use, and in consulta-

tion with the Secretary of Education, shall submit to the Health

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Education, Labor, and Pensions Committee of the Senate and the

Energy and Commerce Committee of the House of Representatives

a report that identifies best practices related to using behavioral

and mental health intervention teams, which may be used to assist

elementary schools, secondary schools, and institutions of higher

education interested in voluntarily establishing and using such

teams to support students exhibiting behaviors interfering with

learning at school or who are at risk of harm to self or others.

(b) E

LEMENTS

.—The report under subsection (a) shall assess

evidence supporting such best practices and, as appropriate, in-

clude consideration of the following:

(1) How behavioral and mental health intervention teams

might operate effectively from an evidence-based, objective per-

spective while protecting the constitutional and civil rights and

privacy of individuals.

(2) The use of behavioral and mental health intervention

teams—

(A) to identify and support students exhibiting behav-

iors interfering with learning or posing a risk of harm to

self or others; and

(B) to implement evidence-based interventions to meet

the behavioral and mental health needs of such students.

(3) How behavioral and mental health intervention teams

can—

(A) access evidence-based professional development to

support students described in paragraph (2)(A); and

(B) ensure that such teams—

(i) are composed of trained, diverse stakeholders

with expertise in child and youth development, behav-

ioral and mental health, and disability; and

(ii) use cross validation by a wide-range of indi-

vidual perspectives on the team.

(4) How behavioral and mental health intervention teams

can help mitigate inappropriate referral to mental health serv-

ices or law enforcement by implementing evidence-based inter-

ventions that meet student needs.

ONSULTATION

.—In carrying out subsection (a), the Sec-

retary shall consult with—

(1) the Secretary of Education;

(2) the Director of the National Threat Assessment Center

of the United States Secret Service;

(3) the Attorney General;

(4) teachers (which shall include special education teach-

ers), principals and other school leaders, school board mem-

bers, behavioral and mental health professionals (including

school-based mental health professionals), and parents of stu-

dents;

(5) local law enforcement agencies and campus law en-

forcement administrators;

(6) privacy, disability, and civil rights experts; and

(7) other education and mental health professionals as the

Secretary deems appropriate.

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78 Sec. 520I PUBLIC HEALTH SERVICE ACT

(d) P

UBLICATION

.—The Secretary shall publish the report

under subsection (a) in an accessible format on the internet website

of the Department of Health and Human Services.

(e) D

EFINITIONS

.—In this section:

(1) The term ‘‘behavioral and mental health intervention

team’’ means a multidisciplinary team of trained individuals

who—

(A) are trained to identify and assess the behavioral

health needs of children and youth and who are respon-

sible for identifying, supporting, and connecting students

exhibiting behaviors interfering with learning at school, or

who are at risk of harm to self or others, with appropriate

behavioral health services; and

(B) develop and facilitate implementation of evidence-

based interventions to—

(i) mitigate the threat of harm to self or others

posed by a student described in subparagraph (A);

(ii) meet the mental and behavioral health needs

of such students; and

(iii) support positive, safe, and supportive learning

environments.

(2) The terms ‘‘elementary school’’, ‘‘parent’’, and ‘‘sec-

ondary school’’ have the meanings given to such terms in sec-

tion 8101 of the Elementary and Secondary Education Act of

1965.

(3) The term ‘‘institution of higher education’’ has the

meaning given to such term in section 102 of the Higher Edu-

cation Act of 1965.

SEC. 520I. ø290bb–40¿ GRANTS FOR THE INTEGRATED TREATMENT OF

SERIOUS MENTAL ILLNESS AND CO-OCCURRING SUB-

STANCE ABUSE.

(a) I

ENERAL

.—The Secretary shall award grants, contracts,

or cooperative agreements to States, political subdivisions of

States, Indian tribes, tribal organizations, and private nonprofit or-

ganizations for the development or expansion of programs to pro-

vide integrated treatment services for individuals with a serious

mental illness and a co-occurring substance abuse disorder.

(b) P

RIORITY

.—In awarding grants, contracts, and cooperative

agreements under subsection (a), the Secretary shall give priority

to applicants that emphasize the provision of services for individ-

uals with a serious mental illness and a co-occurring substance

abuse disorder who—

(1) have a history of interactions with law enforcement or

the criminal justice system;

(2) have recently been released from incarceration;

(3) have a history of unsuccessful treatment in either an

inpatient or outpatient setting;

(4) have never followed through with outpatient services

despite repeated referrals; or

(5) are homeless.

SE OF

UNDS

.—A State, political subdivision of a State, In-

dian tribe, tribal organization, or private nonprofit organization

that receives a grant, contract, or cooperative agreement under

subsection (a) shall use funds received under such grant—

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79 Sec. 520J PUBLIC HEALTH SERVICE ACT

(1) to provide fully integrated services rather than serial or

parallel services;

(2) to employ staff that are cross-trained in the diagnosis

and treatment of both serious mental illness and substance

abuse;

(3) to provide integrated mental health and substance

abuse services at the same location;

(4) to provide services that are linguistically appropriate

and culturally competent;

(5) to provide at least 10 programs for integrated treat-

ment of both mental illness and substance abuse at sites that

previously provided only mental health services or only sub-

stance abuse services; and

(6) to provide services in coordination with other existing

public and private community programs.

(d) C

ONDITION

.—The Secretary shall ensure that a State, polit-

ical subdivision of a State, Indian tribe, tribal organization, or pri-

vate nonprofit organization that receives a grant, contract, or coop-

erative agreement under subsection (a) maintains the level of effort

necessary to sustain existing mental health and substance abuse

programs for other populations served by mental health systems in

the community.

(e) D

ISTRIBUTION OF

WARDS

.—The Secretary shall ensure that

grants, contracts, or cooperative agreements awarded under sub-

section (a) are equitably distributed among the geographical re-

gions of the United States and between urban and rural popu-

lations.

(f) D

URATION

.—The Secretary shall award grants, contract, or

cooperative agreements under this subsection for a period of not

more than 5 years.

(g) A

PPLICATION

.—A State, political subdivision of a State, In-

dian 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 evalua-

tion.

(h) E

VALUATION

.—A State, political subdivision of a State, In-

dian 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 evalua-

tion of the program funded under such grant, contract, or agree-

ment, including both process and outcomes evaluation, and the

submission of an evaluation at the end of the project period.

(i) A

UTHORIZATION OF

PPROPRIATION

.—There is authorized to

be appropriated to carry out this subsection $40,000,000 for fiscal

year 2001, and such sums as may be necessary for fiscal years 2002

through 2003.

SEC. 520J. ø290bb–41¿ MENTAL HEALTH AWARENESS TRAINING

GRANTS.

(a) I

ENERAL

.—The Secretary shall award grants in accord-

ance with the provisions of this section.

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80 Sec. 520J PUBLIC HEALTH SERVICE ACT

(b) M

ENTAL

EALTH

WARENESS

RAINING

RANTS

.—

(1) I

N GENERAL

.—The Secretary shall award grants to

States, political subdivisions of States, Indian Tribes, Tribal or-

ganizations, 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 nec-

essary, to train emergency services personnel veterans, law en-

forcement, and other categories of individuals, as determined

by the Secretary, to identify and appropriately respond to per-

sons 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) E

MERGENCY SERVICES PERSONNEL

.—In this subsection,

the term ‘‘emergency services personnel’’ includes paramedics,

firefighters, and emergency medical technicians.

(3) D

ISTRIBUTION 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) A

PPLICATION

.—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 ap-

plication to the Secretary at such time, in such manner, and

containing such information as the Secretary may require, in-

cluding a plan for the rigorous evaluation of activities that are

carried out with funds received under a grant under this sub-

section.

(5) U

SE OF

UNDS

.—A State, political subdivision of a

State, Indian Tribe, Tribal organization, or nonprofit private

entity receiving a grant under this subsection shall use funds

from such grant for evidence-based programs that provide

training and education in accordance with paragraph (1) on

matters including—

(A) recognizing the signs and symptoms of mental ill-

ness;

(B)(i) resources available in the community for individ-

uals with a mental illness and other relevant resources; or

(ii) safely de-escalating crisis situations involving indi-

viduals with a mental illness; and

(6) E

VALUATION

.—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) T

ECHNICAL ASSISTANCE

.—The Secretary may provide

technical assistance to grantees in carrying out this section,

which may include assistance with—

(A) program evaluation and related activities, includ-

ing related data collection and reporting;

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81 Sec. 520K PUBLIC HEALTH SERVICE ACT

(B) implementing and disseminating evidence-based

practices and programs; and

(8) A

UTHORIZATION OF

PPROPRIATIONS

.—There is author-

ized to be appropriated to carry out this subsection$24,963,000

for each of fiscal years 2023 through 2027.

SEC. 520K. ø290bb–42¿ IMPROVING UPTAKE AND PATIENT ACCESS TO

INTEGRATED CARE SERVICES.

(a) D

EFINITIONS

.—In this section:

(1) E

LIGIBLE ENTITY

.—The term ‘‘eligible entity’’ means a

State, or an appropriate State agency, in collaboration with—

(A) 1 or more qualified community programs as de-

scribed in section 1913(b)(1); or

(B) 1 or more health centers (as defined in section

330(a)), rural health clinics (as defined in section 1861(aa)

of the Social Security Act), or Federally qualified health

centers (as defined in such section), or primary care prac-

tices serving adult or pediatric patients or both.

(2) I

NTEGRATED CARE

;

BIDIRECTIONAL INTEGRATED CARE

.—

(A) The term ‘‘integrated care’’ means collaborative

models, including the psychiatric collaborative care model

and other evidence-based or evidence-informed models, or

practices for coordinating and jointly delivering behavioral

and physical health services, which may include practices

that share the same space in the same facility.

(B) The term ‘‘bidirectional integrated care’’ means the

integration of behavioral health care and specialty physical

health care, and the integration of primary and physical

health care within specialty behavioral health settings, in-

cluding within primary health care settings.

(3) P

SYCHIATRIC COLLABORATIVE CARE MODEL

.—The term

‘‘psychiatric collaborative care model’’ means the evidence-

based, integrated behavioral health service delivery method

that includes—

(A) care directed by the primary care team;

(B) structured care management;

opmentally appropriate, validated tools; and

(D) modification of treatment as appropriate.

(4) S

PECIAL POPULATION

.—The term ‘‘special population’’

means—

(A) adults with a serious mental illness or adults who

have co-occurring mental illness and physical health condi-

tions or chronic disease;

(B) children and adolescents with a serious emotional

disturbance who have a co-occurring physical health condi-

tion or chronic disease;

(D) individuals with a mental illness who have a co-

occurring substance use disorder.

(b) G

RANTS AND

OOPERATIVE

GREEMENTS

.—

(1) I

N GENERAL

.—The Secretary may award grants and co-

operative agreements to eligible entities to support the im-

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82 Sec. 520K PUBLIC HEALTH SERVICE ACT

provement of integrated care for physical and behavioral

health care in accordance with paragraph (2).

(2) U

SE OF FUNDS

.—A grant or cooperative agreement

awarded under this section shall be used—

(A) to promote full integration and collaboration in

clinical practices between physical and behavioral health

care, including for special populations;

(B) to support the improvement of integrated care

models for physical and behavioral health care to improve

overall wellness and physical health status, including for

special populations;

of bidirectional integrated care services provided at enti-

ties described in subsection (a)(1), including evidence-

based or evidence-informed screening, assessment, diag-

nosis, prevention, treatment, and recovery services for

mental and substance use disorders, and co-occurring

physical health conditions and chronic diseases; and

(D) in the case of an eligible entity that is collabo-

rating with a primary care practice, to support the imple-

mentation of evidence-based or evidence-informed inte-

grated care models, including the psychiatric collaborative

care model, including—

(i) by hiring staff;

(ii) by identifying and formalizing contractual re-

lationships with other health care providers or other

relevant entities offering care management and behav-

ioral health consultation to facilitate the adoption of

integrated care, including, as applicable, providers

who will function as psychiatric consultants and be-

havioral health care managers in providing behavioral

health integration services through the collaborative

care model;

(iii) by purchasing or upgrading software and

other resources, as applicable, needed to appropriately

provide behavioral health integration, including re-

sources needed to establish a patient registry and im-

plement measurement-based care; and

(iv) for such other purposes as the Secretary de-

termines to be applicable and appropriate.

PPLICATIONS

.—

(1) I

N GENERAL

.—An eligible entity that is seeking a grant

or cooperative agreement under this section shall submit an

application to the Secretary at such time, in such manner, and

accompanied by such information as the Secretary may re-

quire, including the contents described in paragraph (2).

(2) C

ONTENTS FOR AWARDS

.—Any such application of an el-

igible entity seeking a grant or cooperative agreement under

this section shall include, as applicable—

(A) a description of a plan to achieve fully collabo-

rative agreements to provide bidirectional integrated care

to special populations;

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83 Sec. 520K PUBLIC HEALTH SERVICE ACT

(B) a summary of the policies, if any, that are barriers

to the provision of integrated care, and the specific steps,

if applicable, that will be taken to address such barriers;

ments with local health care providers to provide services

to special populations and, as applicable, in areas with

demonstrated need, such as Tribal, rural, or other medi-

cally underserved communities, such as those with a work-

force shortage of mental health and substance use dis-

order, pediatric mental health, or other related profes-

sionals;

(D) an agreement and plan to report to the Secretary

performance measures necessary to evaluate patient out-

comes and facilitate evaluations across participating

projects; and

(E) a description of the plan or progress in imple-

menting the psychiatric collaborative care model, as appli-

cable and appropriate;

(F) a description of the plan or progress of evidence-

based or evidence-informed integrated care models other

than the psychiatric collaborative care model implemented

by primary care practices, as applicable and appropriate;

and

(G) a plan for sustainability beyond the grant or coop-

erative agreement period under subsection (e).

(d) G

RANT AND

OOPERATIVE

GREEMENT

MOUNTS

.—

(1) T

ARGET AMOUNT

.—The target amount that an eligible

entity may receive for a year through a grant or cooperative

agreement under this section shall be no more than

$2,000,000.

(2) A

DJUSTMENT PERMITTED

.—The Secretary, taking into

consideration the quality of an eligible entity’s application and

the number of eligible entities that received grants under this

section prior to the date of enactment of the Restoring Hope for

Mental Health and Well-Being Act of 2022, may adjust the tar-

get amount that an eligible entity may receive for a year

through a grant or cooperative agreement under this section.

(3) L

IMITATION

.—An eligible entity that is receiving fund-

ing under subsection (b)—

(A) may not allocate more than 10 percent of the funds

awarded to such eligible entity under this section to ad-

ministrative functions; and

(B) shall allocate the remainder of such funding to

health facilities that provide integrated care.

(e) D

URATION

.—A grant or cooperative agreement under this

section shall be for a period not to exceed 5 years.

(f) R

EPORT ON

ROGRAM

UTCOMES

.—An eligible entity receiv-

ing a grant or cooperative agreement under this section shall sub-

mit an annual report to the Secretary. Such annual report shall in-

clude—

(1) the progress made to reduce barriers to integrated care

as described in the entity’s application under subsection (c);

(2) a description of outcomes with respect to each special

population listed in subsection (a)(4), including outcomes re-

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84 Sec. 520K PUBLIC HEALTH SERVICE ACT

lated to education, employment, and housing, or, as applicable

and appropriate, outcomes for such populations receiving be-

havioral health care through the psychiatric collaborative care

model in primary care practices; and

(3) progress in meeting performance metrics and other rel-

evant benchmarks; and

(4) such other information that the Secretary may require.

(g) T

ECHNICAL

SSISTANCE FOR

RIMARY

BEHAVIORAL

EALTH

ARE

NTEGRATION

.—

(1) C

ERTAIN RECIPIENTS

.—The Secretary may provide ap-

propriate information, training, and technical assistance to eli-

gible entities that receive a grant or cooperative agreement

under subsection (b)(2), in order to help such entities meet the

requirements of this section, including assistance with—

(A) development and selection of integrated care mod-

els;

(B) dissemination of evidence-based interventions in

integrated care;

port operational and administrative success; and

(D) as appropriate, appropriate information, training,

and technical assistance in implementing the psychiatric

collaborative care model when an eligible entity is collabo-

rating with 1 or more primary care practices for the pur-

poses of implementing the psychiatric collaborative care

model.

(2) A

DDITIONAL DISSEMINATION OF TECHNICAL INFORMA

TION

.—In addition to providing the assistance described in

paragraph (1) to recipients of a grant or cooperative agreement

under this section, the Secretary may also provide such assist-

ance to other States and political subdivisions of States, Indian

Tribes and Tribal organizations, as those terms are defined in

section 4 of the Indian Self-Determination and Education As-

sistance Act, outpatient mental health and addiction treatment

centers, community mental health centers that meet the cri-

teria under section 1913(c), certified community behavioral

health clinics described in section 223 of the Protecting Access

to Medicare Act of 2014, primary care organizations such as

Federally qualified health centers or rural health clinics as de-

fined in section 1861(aa) of the Social Security Act, primary

health care practices, the community-based organizations, and

other entities engaging in integrated care activities, as the Sec-

retary determines appropriate.

(h) R

EPORT TO

ONGRESS

.—Not later than 18 months after the

date of enactment of the Restoring Hope for Mental Health and

Well-Being Act of 2022, and annually thereafter, the Secretary

shall submit a report to the Committee on Health, Education,

Labor, and Pensions of the Senate and the Committee on Energy

and Commerce of the House of Representatives summarizing the

information submitted in reports to the Secretary under subsection

(f), including progress made in meeting performance metrics and

the uptake of integrated care models, any adjustments made to tar-

get amounts pursuant to subsection (d)(2), and any other relevant

information.

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85 Sec. 520L PUBLIC HEALTH SERVICE ACT

(i) F

UNDING

.—

(1) A

UTHORIZATION OF APPROPRIATIONS

.—To carry out this

section, there is authorized to be appropriated $60,000,000 for

each of fiscal years 2023 through 2027.

(2) I

NCREASING UPTAKE OF THE PSYCHIATRIC COLLABO

RATIVE CARE MODEL BY PRIMARY CARE PRACTICES

.—Not less

than 10 percent of funds appropriated to carry out this section

shall be for the purposes of implementing the psychiatric col-

laborative care model implemented by primary care practices

under subsection (b).

(3) F

UNDING CONTINGENCY

.—Paragraph (2) shall not apply

to a fiscal year unless the amount made available to carry out

this section for such fiscal year exceeds the amount appro-

priated to carry out this section (as in effect before the date of

enactment of the Restoring Hope for Mental Health and Well-

Being Act of 2022) for fiscal year 2022.

SEC. 520L. ø290bb–43¿ ADULT SUICIDE PREVENTION.

(a) G

RANTS

.—

(1) I

N GENERAL

.—The Assistant Secretary shall award

grants to eligible entities described in paragraph (2) to imple-

ment suicide prevention and intervention programs, for adult

individuals, that are designed to raise awareness of suicide

prevention, establish referral processes, and improve care and

outcomes for such individuals who are at risk of suicide.

(2) E

LIGIBLE ENTITIES

.—To be eligible to receive a grant

under this section, an entity shall be a community-based pri-

mary care or behavioral health care setting, an emergency de-

partment, a State mental health agency (or State health agen-

cy with mental or behavioral health functions), public health

agency, a territory of the United States, or an Indian Tribe or

Tribal organization (as the terms ‘‘Indian Tribe’’ and ‘‘Tribal

organization’’ are defined in section 4 of the Indian Self-Deter-

mination and Education Assistance Act).

(3) U

SE OF FUNDS

.—The grants awarded under paragraph

(1) shall be used to implement programs, in accordance with

such paragraph, that include one or more of the following com-

ponents:

(A) Screening for suicide risk, suicide intervention

services, and services for referral for treatment for individ-

uals at risk for suicide.

(B) Implementing evidence-based practices to provide

treatment for individuals at risk for suicide, including ap-

propriate followup services.

and promoting help seeking among those at risk for sui-

cide.

(b) E

VALUATIONS AND

ECHNICAL

SSISTANCE

.—The Assistant

Secretary shall—

(1) evaluate the activities supported by grants awarded

under subsection (a), and disseminate, as appropriate, the find-

ings from the evaluation;

(2) provide appropriate information, training, and technical

assistance, as appropriate, to eligible entities that receive a

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86 Sec. 520M PUBLIC HEALTH SERVICE ACT

grant under this section, in order to help such entities to meet

the requirements of this section, including assistance with se-

lection and implementation of evidence-based interventions

and frameworks to prevent suicide; and

(3) identify best practices, as applicable, to improve the

identification, assessment, treatment, and timely transition, as

appropriate, to additional or follow-up care for individuals in

emergency departments who are at risk for suicide and en-

hance the coordination of care for such individuals during and

after discharge, in support of activities under subsection (a).

URATION

.—A grant under this section shall be for a period

of not more than 5 years.

(d) A

UTHORIZATION OF

PPROPRIATIONS

.—There are authorized

to be appropriated to carry out this section $30,000,000 for each of

fiscal years 2023 through 2027.

SEC. 520M. ø290bb–44¿ ASSERTIVE COMMUNITY TREATMENT GRANT

PROGRAM.

(a) I

ENERAL

.—The Assistant Secretary shall award grants

to eligible entities—

(1) to establish assertive community treatment programs

for adults with a serious mental illness; or

(2) to maintain or expand such programs.

(b) E

LIGIBLE

NTITIES

.—To be eligible to receive a grant under

this section, an entity shall be a State, political subdivision of a

State, Indian Tribe or Tribal organization (as such terms are de-

fined in section 4 of the Indian Self-Determination and Education

Assistance Act), mental health system, health care facility, or any

other entity the Assistant Secretary deems appropriate.

PECIAL

ONSIDERATION

.—In selecting among applicants for

a grant under this section, the Assistant Secretary may give special

consideration to the potential of the applicant’s program to reduce

hospitalization, homelessness, and involvement with the criminal

justice system while improving the health and social outcomes of

the patient.

(d) A

DDITIONAL

CTIVITIES

.—The Assistant Secretary shall—

(1) not later than the end of fiscal year 2026, submit a re-

port to the Committee on Health, Education, Labor, and Pen-

sions of the Senate and the Committee on Energy and Com-

merce of the House of Representatives on the grant program

under this section, including an evaluation of—

(A) any cost savings and public health outcomes such

as mortality, suicide, substance use disorders, hospitaliza-

tion, and use of services;

(B) rates of involvement with the criminal justice sys-

tem of patients;

(D) patient and family satisfaction with program par-

ticipation; and

(2) provide appropriate information, training, and technical

assistance to grant recipients under this section to help such

recipients to establish, maintain, or expand their assertive

community treatment programs.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—

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87 Sec. 520N PUBLIC HEALTH SERVICE ACT

(1) I

N GENERAL

.—To carry out this section, there is author-

ized to be appropriated $9,000,000 for each of fiscal years 2023

through 2027.

(2) U

SE OF CERTAIN FUNDS

.—Of the funds appropriated to

carry out this section in any fiscal year, not more than 5 per-

cent shall be available to the Assistant Secretary for carrying

out subsection (d).

SEC. 520N. ø 290bb-45 ¿ CENTER OF EXCELLENCE FOR EATING DIS-

ORDERS FOR EDUCATION AND TRAINING ON EATING DIS-

ORDERS.

(a) I

ENERAL

.—The Secretary, acting through the Assistant

Secretary, shall maintain, by competitive grant or contract, a Cen-

ter of Excellence for Eating Disorders (referred to in this section as

the ‘‘Center’’) to improve the identification of, interventions for, and

treatment of eating disorders in a manner that is developmentally,

culturally, and linguistically appropriate.

(b) S

UBGRANTS AND

UBCONTRACTS

.—The Center shall coordi-

nate and implement the activities under subsection (c), in whole or

in part, which may include by awarding competitive subgrants or

subcontracts—

(1) across geographical regions; and

(2) in a manner that is not duplicative.

CTIVITIES

.—The Center—

(1) shall—

(A) provide training and technical assistance, includ-

ing for—

(i) primary care and mental health providers to

carry out screening, brief intervention, and referral to

treatment for individuals experiencing, or at risk for,

eating disorders; and

(ii) other paraprofessionals and relevant individ-

uals providing nonclinical community services to iden-

tify and support individuals with, or at dispropor-

tionate risk for, eating disorders;

(B) facilitate the development of, and provide training

materials to, health care providers (including primary care

and mental health professionals) regarding the effective

treatment and ongoing support of individuals with eating

disorders, including children and marginalized populations

at disproportionate risk for eating disorders;

other centers of excellence, technical assistance centers,

and psychiatric consultation lines of the Substance Abuse

and Mental Health Services Administration and the

Health Resources and Services Administration regarding

eating disorders;

(D) coordinate with the Director of the Centers for Dis-

ease Control and Prevention and the Administrator of the

Health Resources and Services Administration, and other

Federal agencies, as appropriate, to disseminate training

to primary care and mental health care providers; and

(E) support other activities, as determined appropriate

by the Secretary; and

(2) may—

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As Amended Through P.L. 117-328, Enacted December 29, 2022

88 Sec. 521 PUBLIC HEALTH SERVICE ACT

(A) support the integration of protocols pertaining to

screening, brief intervention, and referral to treatment for

individuals experiencing, or at risk for, eating disorders,

with health information technology systems;

(B) develop and provide training materials to health

care providers, including primary care and mental health

providers, to provide screening, brief intervention, and re-

ferral to treatment for members of the military and vet-

erans experiencing, or at risk for, eating disorders; and

fense and the Secretary of Veterans Affairs on prevention,

identification, intervention for, and treatment of eating

disorders.

(d) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there is authorized to be appropriated $1,000,000 for each of

fiscal years 2023 through 2027.

ART

C—P

ROJECTS FOR

SSISTANCE IN

RANSITION

ROM

OMELESSNESS

SEC. 521. ø290cc–21¿ FORMULA GRANTS TO STATES.

For the purpose of carrying out section 522, the Secretary, act-

ing through the Director of the Center for Mental Health Services,

shall for each of the fiscal years 2023 through 2027 make an allot-

ment for each State in an amount determined in accordance with

section 524. The Secretary shall make payments, as grants, each

such fiscal year to each State from the allotment for the State if

the Secretary approves for the fiscal year involved an application

submitted by the State pursuant to section 529.

SEC. 522. ø290cc–22¿ PURPOSE OF GRANTS.

(a) I

ENERAL

.—The Secretary may not make payments

under section 521 unless the State involved agrees that the pay-

ments will be expended solely for making grants to political sub-

divisions of the State, and to nonprofit private entities (including

community-based veterans organizations and other community or-

ganizations), for the purpose of providing the services specified in

subsection (b) to individuals who—

(1)(A) are suffering from serious mental illness; or

(B) are suffering from serious mental illness and from a

substance use disorder; and

(2) are homeless or at imminent risk of becoming home-

less.

(b) S

PECIFICATION OF

ERVICES

.—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—

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As Amended Through P.L. 117-328, Enacted December 29, 2022

89 Sec. 522 PUBLIC HEALTH SERVICE ACT

(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 ac-

tivities, personal financial planning, transportation serv-

ices, and habilitation and rehabilitation services,

prevocational and vocational services, and housing serv-

ices;

vidual in obtaining income support services, including

housing assistance, supplemental nutrition assistance pro-

gram benefits, and supplemental security income benefits;

(D) referring the eligible homeless individual for such

other services as may be appropriate; and

(E) providing representative payee services in accord-

ance 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 set-

tings;

(9) referrals for primary health services, job training, edu-

cational services, and relevant housing services;

(10) subject to subsection (h)(1)—

(A) minor renovation, expansion, and repair of hous-

ing;

(B) planning of housing;

ance;

(D) improving the coordination of housing services;

(E) security deposits;

(F) the costs associated with matching eligible home-

less individuals with appropriate housing situations; and

(G) 1-time rental payments to prevent eviction; and

(11) other appropriate services, as determined by the Sec-

retary.

OORDINATION

.—The Secretary may not make payments

under section 521 unless the State involved agrees to make grants

pursuant to subsection (a) only to entities that have the capacity

to provide, directly or through arrangements, the services specified

in section 522(b), including coordinating the provision of services in

order to meet the needs of eligible homeless individuals who are

both mentally ill and suffering from a substance use disorder.

(d) S

PECIAL

ONSIDERATION

EGARDING

ETERANS

.—The Sec-

retary may not make payments under section 521 unless the State

involved agrees that, in making grants to entities pursuant to sub-

section (a), the State will give special consideration to entities with

a demonstrated effectiveness in serving homeless veterans.

(e) S

PECIAL

ULES

.—The Secretary may not make payments

under section 521 unless the State involved agrees that grants pur-

suant to subsection (a) will not be made to any entity that—

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90 Sec. 523 PUBLIC HEALTH SERVICE ACT

(1) has a policy of excluding individuals from mental

health services due to the existence or suspicion of a substance

use disorder; or

(2) has a policy of excluding individuals from substance

use disorder services due to the existence or suspicion of men-

tal illness.

(f) A

DMINISTRATIVE

XPENSES

.—The Secretary may not make

payments under section 521 unless the State involved agrees that

not more than 4 percent of the payments will be expended for ad-

ministrative expenses regarding the payments.

(g) R

ESTRICTIONS ON

SE OF

UNDS

.—The Secretary may not

make payments under section 521 unless the State involved agrees

that—

(1) not more than 20 percent of the payments will be ex-

pended 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 inpa-

tient substance use disorder treatment costs; or

mental health or substance use disorder services.

(h) W

AIVER FOR

ERRITORIES

.—With respect to the United

States Virgin Islands, Guam, American Samoa, Palau, the Mar-

shall Islands, and the Commonwealth of the Northern Mariana Is-

lands, the Secretary may waive the provisions of this part that the

Secretary determines to be appropriate.

SEC. 523. ø290cc–23¿ REQUIREMENT OF MATCHING FUNDS.

(a) I

ENERAL

.—The Secretary may not make payments

under section 521 unless, with respect to the costs of providing

services pursuant to section 522, the State involved agrees to make

available, directly or through donations from public or private enti-

ties, 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) D

ETERMINATION OF

MOUNT

.—Non-Federal contributions

required in subsection (a) may be in cash or in kind, fairly evalu-

ated, 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.

IMITATION

EGARDING

RANTS BY

TATES

.—The Secretary

may not make payments under section 521 unless the State in-

volved agrees that the State will not require the entities to which

grants are provided pursuant to section 522(a) to provide non-Fed-

eral contributions in excess of the non-Federal contributions de-

scribed in subsection (a).

SEC. 524. ø290cc–24¿ DETERMINATION OF AMOUNT OF ALLOTMENT.

(a) M

INIMUM

LLOTMENT

.—The allotment for a State under

section 521 for a fiscal year shall be the greater of—

(1) $300,000 for each of the several States, the District of

Columbia, and the Commonwealth of Puerto Rico, and $50,000

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91 Sec. 526 PUBLIC HEALTH SERVICE ACT

So in law. Subparagraphs (A) through (C) probably should be redesignated as paragraphs

(1) through (3), respectively. See section 511 of Public Law 104–645 (104 Stat. 4729).

for each of Guam, the Virgin Islands, American Samoa, and

the Commonwealth of the Northern Mariana Islands; and

(2) an amount determined in accordance with subsection

(b).

(b) D

ETERMINATION

NDER

ORMULA

.—The amount referred to

in subsection (a)(2) is the product of—

(1) an amount equal to the amount appropriated under

section 535(a) for the fiscal year; and

(2) a percentage equal to the quotient of—

(A) an amount equal to the population living in urban-

ized 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 urban-

ized areas of the United States, as indicated by the sum

of the respective amounts determined for the States under

subparagraph (A).

SEC. 525. ø290cc–25¿ CONVERSION TO CATEGORICAL PROGRAM IN

EVENT OF FAILURE OF STATE REGARDING EXPENDITURE

OF GRANTS.

(a) I

ENERAL

.—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 eligi-

ble homeless individuals the services specified in section 522(b).

(b)

PECIFICATION OF

UNDS

.—The amounts referred to in

subsection (a) are any amounts made available in appropriations

Acts for allotments under section 521 that are not paid to a State

as a result of—

(A) the failure of the State to submit an application

under section 529;

(B) the failure of the State, in the determination of the

Secretary, to prepare the application in accordance with

such section or to submit the application within a reason-

able period of time; or

does not intend to expend the full amount of the allotment

made to the State.

EQUIREMENT OF

ROVISION OF

ERVICES IN

TATE

VOLVED

.—With respect to grants under subsection (a), amounts

made available under subsection (b) as a result of the State in-

volved shall be available only for grants to provide services in such

State.

SEC. 526. ø290cc–26¿ PROVISION OF CERTAIN INFORMATION FROM

STATE.

The Secretary may not make payments under section 521 to a

State unless, as part of the application required in section 529, the

State submits to the Secretary a statement—

(1) identifying existing programs providing services and

housing to eligible homeless individuals and identify gaps in

the delivery systems of such programs;

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92 Sec. 527 PUBLIC HEALTH SERVICE ACT

(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 indi-

viduals; and

(B) includes documentation that suitable housing for

eligible homeless individuals will accompany the provision

of services to such individuals;

(3) describes the source of the non-Federal contributions

described in section 523;

(4) contains assurances that the non-Federal contributions

described in section 523 will be available at the beginning of

the grant period;

(5) describe any voucher system that may be used to carry

out this part; and

(6) contain such other information or assurances as the

Secretary may reasonably require.

SEC. 527. ø290cc–27¿ DESCRIPTION OF INTENDED EXPENDITURES OF

GRANT.

(a) I

ENERAL

.—The Secretary may not make payments

under section 521 unless—

(1) as part of the application required in section 529, the

State involved submits to the Secretary a description of the in-

tended 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 individ-

uals 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 pro-

vided, including information relating to coordinating such pro-

grams and activities with any similar programs and activities

of public and private entities; and

(4) the State agrees that such description will be revised

throughout the year as may be necessary to reflect substantial

changes in the programs and activities assisted by the State

pursuant to section 522.

(b) O

PPORTUNITY FOR

UBLIC

OMMENT

.—The Secretary may

not make payments under section 521 unless the State involved

agrees that, in developing and carrying out the description required

in subsection (a), the State will provide public notice with respect

to the description (including any revisions) and such opportunities

as may be necessary to provide interested persons, such as family

members, consumers, and mental health, substance use disorder,

and housing agencies, an opportunity to present comments and rec-

ommendations with respect to the description.

ELATIONSHIP TO

TATE

OMPREHENSIVE

ENTAL

EALTH

ERVICES

LAN

.—

(1) I

N GENERAL

.—The Secretary may not make payments

under section 521 unless the services to be provided pursuant

to the description required in subsection (a) are consistent with

the State comprehensive mental health services plan required

in subpart 2 of part B of title XIX.

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93 Sec. 531 PUBLIC HEALTH SERVICE ACT

(2) S

PECIAL RULE

.—The Secretary may not make payments

under section 521 unless the services to be provided pursuant

to the description required in subsection (a) have been consid-

ered in the preparation of, have been included in, and are con-

sistent with, the State comprehensive mental health services

plan referred to in paragraph (1).

SEC. 528. ø290cc–28¿ REQUIREMENT OF REPORTS BY STATES.

(a) I

ENERAL

.—The Secretary may not make payments

under section 521 unless the State involved agrees that, by not

later than January 31 of each fiscal year, the State will prepare

and submit to the Secretary a report in such form and containing

such information as the Secretary determines (after consultation

with the Assistant Secretary for Mental Health and Substance Use)

to be necessary for—

(1) securing a record and a description of the purposes for

which amounts received under section 521 were expended dur-

ing 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) A

VAILABILITY TO

UBLIC OF

EPORTS

.—The Secretary may

not make payments under section 521 unless the State involved

agrees to make copies of the reports described in subsection (a)

available for public inspection.

VALUATIONS BY

OMPTROLLER

ENERAL

.—The Assistant

Secretary for Mental Health and Substance Use shall evaluate at

least once every 3 years the expenditures of grants under this part

by eligible entities in order to ensure that expenditures are con-

sistent with the provisions of this part, and shall include in such

evaluation recommendations regarding changes needed in program

design or operations.

SEC. 529. ø290cc–29¿ REQUIREMENT OF APPLICATION.

The Secretary may not make payments under section 521 un-

less the State involved—

(1) submits to the Secretary an application for the pay-

ments containing agreements and information in accordance

with this part;

(2) the agreements are made through certification from the

chief executive officer of the State; and

(3) the application otherwise is in such form, is made in

such manner, and contains such agreements, assurances, and

information as the Secretary determines to be necessary to

carry out this part.

SEC. 530. ø290cc–30¿ TECHNICAL ASSISTANCE.

The Secretary, acting through the Assistant Secretary, shall

provide technical assistance to eligible entities in developing plan-

ning and operating programs in accordance with the provisions of

this part.

SEC. 531. ø290cc–31¿ FAILURE TO COMPLY WITH AGREEMENTS.

(a) R

EPAYMENT OF

AYMENTS

.—

(1) The Secretary may, subject to subsection (c), require a

State to repay any payments received by the State under sec-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

94 Sec. 532 PUBLIC HEALTH SERVICE ACT

tion 521 that the Secretary determines were not expended by

the State in accordance with the agreements required to be

contained in the application submitted by the State pursuant

to section 529.

(2) If a State fails to make a repayment required in para-

graph (1), the Secretary may offset the amount of the repay-

ment against the amount of any payment due to be paid to the

State under section 521.

(b) W

ITHHOLDING OF

AYMENTS

.—

(1) The Secretary may, subject to subsection (c), withhold

payments due under section 521 if the Secretary determines

that the State involved is not expending amounts received

under such section in accordance with the agreements required

to be contained in the application submitted by the State pur-

suant to section 529.

(2) The Secretary shall cease withholding payments from

a State under paragraph (1) if the Secretary determines that

there are reasonable assurances that the State will expend

amounts received under section 521 in accordance with the

agreements referred to in such paragraph.

(3) The Secretary may not withhold funds under para-

graph (1) from a State for a minor failure to comply with the

agreements referred to in such paragraph.

PPORTUNITY FOR

EARING

.—Before requiring repayment of

payments under subsection (a)(1), or withholding payments under

subsection (b)(1), the Secretary shall provide to the State an oppor-

tunity for a hearing.

(d) R

ULE OF

ONSTRUCTION

.—Notwithstanding any other pro-

vision of this part, a State receiving payments under section 521

may not, with respect to any agreements required to be contained

in the application submitted under section 529, be considered to be

in violation of any such agreements by reason of the fact that the

State, in the regular course of providing services under section

522(b) to eligible homeless individuals, incidentally provides serv-

ices to homeless individuals who are not eligible homeless individ-

uals.

SEC. 532. ø290cc–32¿ PROHIBITION AGAINST CERTAIN FALSE STATE-

MENTS.

(a) I

ENERAL

.—

(1) A person may not knowingly make or cause to be made

any false statement or representation of a material fact in con-

nection with the furnishing of items or services for which

amounts may be paid by a State from payments received by

the State under section 521.

(2) A person with knowledge of the occurrence of any event

affecting the right of the person to receive any amounts from

payments made to the State under section 521 may not conceal

or fail to disclose any such event with the intent of securing

such an amount that the person is not authorized to receive or

securing such an amount in an amount greater than the

amount the person is authorized to receive.

(b) C

RIMINAL

ENALTY FOR

IOLATION OF

ROHIBITION

.—Any

person who violates a prohibition established in subsection (a) may

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95 Sec. 534 PUBLIC HEALTH SERVICE ACT

for each violation be fined in accordance with title 18, United

States Code, or imprisoned for not more than 5 years, or both.

SEC. 533. ø290cc–33¿ NONDISCRIMINATION.

(a) I

ENERAL

.—

(1) R

ULE OF CONSTRUCTION REGARDING CERTAIN CIVIL

RIGHTS LAWS

.—For the purpose of applying the prohibitions

against discrimination on the basis of age under the Age Dis-

crimination Act of 1975, on the basis of handicap under section

504 of the Rehabilitation Act of 1973, on the basis of sex under

title IX of the Education Amendments of 1972, or on the basis

of race, color, or national origin under title VI of the Civil

Rights Act of 1964, programs and activities funded in whole or

in part with funds made available under section 521 shall be

considered to be programs and activities receiving Federal fi-

nancial assistance.

(2) P

ROHIBITION

.—No person shall on the ground of sex or

religion be excluded from participation in, be denied the bene-

fits of, or be subjected to discrimination under, any program or

activity funded in whole or in part with funds made available

under section 521.

(b) E

NFORCEMENT

.—

(1) R

EFERRALS TO ATTORNEY GENERAL AFTER NOTICE

.—

Whenever the Secretary finds that a State, or an entity that

has received a payment pursuant to section 521, has failed to

comply with a provision of law referred to in subsection (a)(1),

with subsection (a)(2), or with an applicable regulation (includ-

ing one prescribed to carry out subsection (a)(2)), the Secretary

shall notify the chief executive officer of the State and shall re-

quest the chief executive officer to secure compliance. If within

a reasonable period of time, not to exceed 60 days, the chief ex-

ecutive officer fails or refuses to secure compliance, the Sec-

retary may—

(A) refer the matter to the Attorney General with a

recommendation that an appropriate civil action be insti-

tuted;

(B) exercise the powers and functions provided by the

Age Discrimination Act of 1975, section 504 of the Reha-

bilitation Act of 1973, title IX of the Education Amend-

ments of 1972, or title VI of the Civil Rights Act of 1964,

as may be applicable; or

law.

(2) A

UTHORITY 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 viola-

tion 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 injunc-

tive relief.

SEC. 534. ø290cc–34¿ DEFINITIONS.

For purposes of this part:

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96 Sec. 535 PUBLIC HEALTH SERVICE ACT

(1) E

LIGIBLE HOMELESS INDIVIDUAL

.—The term ‘‘eligible

homeless individual’’ means an individual described in section

522(a).

(2) H

OMELESS INDIVIDUAL

.—The term ‘‘homeless indi-

vidual’’ has the meaning given such term in section 330(h)(5).

(3) S

TATE

.—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) S

UBSTANCE USE DISORDER SERVICES

.—The term ‘‘sub-

stance use disorder services’’ has the meaning given the term

‘‘substance abuse services’’ in section 330(h)(5)(C).

SEC. 535. ø290cc–35¿ FUNDING.

(a) A

UTHORIZATION OF

PPROPRIATIONS

.—For the purpose of

carrying out this part, there is authorized to be appropriated

$64,635,000 for each of fiscal years 2023 through 2027.

(b) E

FFECT OF

NSUFFICIENT

PPROPRIATIONS FOR

INIMUM

LLOTMENTS

.—

(1) I

N GENERAL

.—If the amounts made available under

subsection (a) for a fiscal year are insufficient for providing

each State with an allotment under section 521 of not less than

the applicable amount under section 524(a)(1), the Secretary

shall, from such amounts as are made available under such

subsection, make grants to the States for providing to eligible

homeless individuals the services specified in section 522(b).

(2) R

ULE OF CONSTRUCTION

.—Paragraph (1) may not be

construed to require the Secretary to make a grant under such

paragraph to each State.

ART

D—M

ISCELLANEOUS

ROVISIONS

ELATING TO

UBSTANCE

BUSE AND

ENTAL

EALTH

SEC. 541. ø290dd¿ SUBSTANCE ABUSE AMONG GOVERNMENT AND

OTHER EMPLOYEES.

(a) P

ROGRAMS AND

ERVICES

.—

(1) D

EVELOPMENT

.—The Secretary, acting through the As-

sistant Secretary for Mental Health and Substance Use, shall

be responsible for fostering substance abuse prevention and

treatment programs and services in State and local govern-

ments and in private industry.

(2) M

ODEL PROGRAMS

.—

(A) I

N GENERAL

.—Consistent with the responsibilities

described in paragraph (1), the Secretary, acting through

the Assistant Secretary for Mental Health and Substance

Use, shall develop a variety of model programs suitable for

replication on a cost-effective basis in different types of

business concerns and State and local governmental enti-

ties.

(B) D

ISSEMINATION OF INFORMATION

.—The Secretary,

acting through the Assistant Secretary for Mental Health

and Substance Use, shall disseminate information and ma-

terials relative to such model programs to the State agen-

cies responsible for the administration of substance abuse

prevention, treatment, and rehabilitation activities and

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97 Sec. 542 PUBLIC HEALTH SERVICE ACT

shall, to the extent feasible provide technical assistance to

such agencies as requested.

(b) D

EPRIVATION OF

MPLOYMENT

.—

(1) P

ROHIBITION

.—No person may be denied or deprived of

Federal civilian employment or a Federal professional or other

license or right solely on the grounds of prior substance abuse.

(2) A

PPLICATION

.—This subsection shall not apply to em-

ployment in—

(A) the Central Intelligence Agency;

(B) the Federal Bureau of Investigation;

(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 reg-

ulations prescribed by the head of such agency or depart-

ment to be a sensitive position.

(3) R

EHABILITATION

.—The inapplicability of the prohi-

bition described in paragraph (1) to the employment described

in paragraph (2) shall not be construed to reflect on the appli-

cability of the Rehabilitation Act of 1973 or other anti-discrimi-

nation laws to such employment.

ONSTRUCTION

.—This section shall not be construed to pro-

hibit the dismissal from employment of a Federal civilian employee

who cannot properly function in his employment.

SEC. 542. ø290dd–1¿ ADMISSION OF SUBSTANCE ABUSERS TO PRIVATE

AND PUBLIC HOSPITALS AND OUTPATIENT FACILITIES.

(a) N

ONDISCRIMINATION

.—Substance abusers who are suffering

from medical conditions shall not be discriminated against in ad-

mission or treatment, solely because of their substance abuse, by

any private or public general hospital, or outpatient facility (as de-

fined 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) R

EGULATIONS

.—

(1) I

N 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 regula-

tions shall include procedures for determining (after oppor-

tunity for a hearing if requested) if a violation of subsection (a)

has occurred, notification of failure to comply with such sub-

section, and opportunity for a violator to comply with such sub-

section. If the Secretary determines that a hospital or out-

patient facility subject to such regulations has violated sub-

section (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 pro-

gram administered by the Secretary. The Secretary may con-

sult with the officials responsible for the administration of any

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98 Sec. 543 PUBLIC HEALTH SERVICE ACT

other Federal program from which such hospital or outpatient

facility receives support of any kind, with respect to the sus-

pension or revocation of such other Federal support for such

hospital or outpatient facility.

(2) D

EPARTMENT 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, pre-

scribe regulations making applicable the regulations prescribed

by the Secretary under paragraph (1) to the provision of hos-

pital care, nursing home care, domiciliary care, and medical

services under such title 38 to veterans suffering from sub-

stance abuse. In prescribing and implementing regulations

pursuant to this paragraph, the Secretary shall, from time to

time, consult with the Secretary of Health and Human Serv-

ices in order to achieve the maximum possible coordination of

the regulations, and the implementation thereof, which they

each prescribe.

SEC. 543. ø290dd–2¿ CONFIDENTIALITY OF RECORDS.

(a) R

EQUIREMENT

.—Records of the identity, diagnosis, prog-

nosis, or treatment of any patient which are maintained in connec-

tion 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 di-

rectly or indirectly assisted by any department or agency of the

United States shall, except as provided in subsection (e), be con-

fidential and be disclosed only for the purposes and under the cir-

cumstances expressly authorized under subsection (b).

(b) P

ERMITTED

ISCLOSURE

.—

(1) C

ONSENT

.—The following shall apply with respect to

the contents of any record referred to in subsection (a):

(A) Such contents may be used or disclosed in accord-

ance with the prior written consent of the patient with re-

spect to whom such record is maintained.

(B) Once prior written consent of the patient has been

obtained, such contents may be used or disclosed by a cov-

ered entity, business associate, or a program subject to

this section for purposes of treatment, payment, and

health care operations as permitted by the HIPAA regula-

tions. Any information so disclosed may then be redis-

closed in accordance with the HIPAA regulations. Section

13405(c) of the Health Information Technology and Clin-

ical Health Act (42 U.S.C. 17935(c)) shall apply to all dis-

closures pursuant to subsection (b)(1) of this section.

consent to be given once for all such future uses or disclo-

sures for purposes of treatment, payment, and health care

operations, until such time as the patient revokes such

consent in writing.

(D) Section 13405(a) of the Health Information Tech-

nology and Clinical Health Act (42 U.S.C. 17935(a)) shall

apply to all disclosures pursuant to subsection (b)(1) of this

section.

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99 Sec. 543 PUBLIC HEALTH SERVICE ACT

(2) M

ETHOD FOR DISCLOSURE

.—Whether or not the patient,

with respect to whom any given record referred to in sub-

section (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 con-

ducting 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 other-

wise disclose patient identities in any manner.

competent jurisdiction granted after application showing

good cause therefor, including the need to avert a substan-

tial 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 serv-

ices. Upon the granting of such order, the court, in deter-

mining the extent to which any disclosure of all or any

part of any record is necessary, shall impose appropriate

safeguards against unauthorized disclosure.

(D) To a public health authority, so long as such con-

tent meets the standards established in section 164.514(b)

of title 45, Code of Federal Regulations (or successor regu-

lations) for creating de-identified information.

SE OF

ECORDS IN

RIMINAL

, C

IVIL

DMINISTRATIVE

ONTEXTS

.—Except as otherwise authorized by a court order under

subsection (b)(2)(C) or by the consent of the patient, a record re-

ferred to in subsection (a), or testimony relaying the information

contained therein, may not be disclosed or used in any civil, crimi-

nal, administrative, or legislative proceedings conducted by any

Federal, State, or local authority, against a patient, including with

respect to the following activities:

(1) Such record or testimony shall not be entered into evi-

dence in any criminal prosecution or civil action before a Fed-

eral or State court.

(2) Such record or testimony shall not form part of the

record for decision or otherwise be taken into account in any

proceeding before a Federal, State, or local agency.

(3) Such record or testimony shall not be used by any Fed-

eral, State, or local agency for a law enforcement purpose or

to conduct any law enforcement investigation.

(4) Such record or testimony shall not be used in any ap-

plication for a warrant.

(d) A

PPLICATION

.—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 pa-

tient.

(e) N

ONAPPLICABILITY

.—The prohibitions of this section do not

apply to any interchange of records—

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As Amended Through P.L. 117-328, Enacted December 29, 2022

100 Sec. 543 PUBLIC HEALTH SERVICE ACT

(1) within the Uniformed Services or within those compo-

nents 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) P

ENALTIES

.—The provisions of sections 1176 and 1177 of the

Social Security Act shall apply to a violation of this section to the

extent and in the same manner as such provisions apply to a viola-

tion of part C of title XI of such Act. In applying the previous sen-

tence—

(1) the reference to ‘‘this subsection’’ in subsection (a)(2) of

such section 1176 shall be treated as a reference to ‘‘this sub-

section (including as applied pursuant to section 543(f) of the

Public Health Service Act)’’; and

(2) in subsection (b) of such section 1176—

(A) each reference to ‘‘a penalty imposed under sub-

section (a)’’ shall be treated as a reference to ‘‘a penalty

imposed under subsection (a) (including as applied pursu-

ant to section 543(f) of the Public Health Service Act)’’; and

(B) each reference to ‘‘no damages obtained under sub-

section (d)’’ shall be treated as a reference to ‘‘no damages

obtained under subsection (d) (including as applied pursu-

ant to section 543(f) of the Public Health Service Act)’’.

(g) R

EGULATIONS

.—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 proce-

dures and criteria for the issuance and scope of orders under sub-

section (b)(2)(C), as in the judgment of the Secretary are necessary

or proper to effectuate the purposes of this section, to prevent cir-

cumvention or evasion thereof, or to facilitate compliance there-

with.

(h) A

PPLICATION TO

EPARTMENT OF

ETERANS

FFAIRS

.—The

Secretary of Veterans Affairs, acting through the Chief Medical Di-

rector, shall, to the maximum feasible extent consistent with their

responsibilities under title 38, United States Code, prescribe regu-

lations making applicable the regulations prescribed by the Sec-

retary of Health and Human Services under subsection (g) of this

section to records maintained in connection with the provision of

hospital care, nursing home care, domiciliary care, and medical

services under such title 38 to veterans suffering from substance

use disorder. In prescribing and implementing regulations pursu-

ant to this subsection, the Secretary of Veterans Affairs shall, from

time to time, consult with the Secretary of Health and Human

Services in order to achieve the maximum possible coordination of

the regulations, and the implementation thereof, which they each

prescribe.

(i) A

NTIDISCRIMINATION

.—

(1) I

N GENERAL

.—No entity shall discriminate against an

individual on the basis of information received by such entity

pursuant to an inadvertent or intentional disclosure of records,

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101 Sec. 543A PUBLIC HEALTH SERVICE ACT

The discrepancy in the paragraph heading and definition in paragraph (9) is so in law. See

amendment made by section 3121(d) of division A of Public Law 116–136.

or information contained in records, described in subsection (a)

in—

(A) admission, access to, or treatment for health care;

(B) hiring, firing, or terms of employment, or receipt

of worker’s compensation;

(D) access to Federal, State, or local courts; or

(E) access to, approval of, or maintenance of social

services and benefits provided or funded by Federal, State,

or local governments.

(2) R

ECIPIENTS OF FEDERAL FUNDS

.—No recipient of Fed-

eral funds shall discriminate against an individual on the basis

of information received by such recipient pursuant to an inten-

tional or inadvertent disclosure of such records or information

contained in records described in subsection (a) in affording ac-

cess to the services provided with such funds.

(j) N

OTIFICATION IN

ASE OF

REACH

.—The provisions of sec-

tion 13402 of the HITECH Act (42 U.S.C. 17932) shall apply to a

program or activity described in subsection (a), in case of a breach

of records described in subsection (a), to the same extent and in the

same manner as such provisions apply to a covered entity in the

case of a breach of unsecured protected health information.

(k) D

EFINITIONS

.—For purposes of this section:

(1) B

REACH

.—The term ‘‘breach’’ has the meaning given

such term for purposes of the HIPAA regulations.

(2) B

USINESS ASSOCIATE

.—The term ‘‘business associate’’

has the meaning given such term for purposes of the HIPAA

regulations.

(3) C

OVERED ENTITY

.—The term ‘‘covered entity’’ has the

meaning given such term for purposes of the HIPAA regula-

tions.

(4) H

EALTH CARE OPERATIONS

.—The term ‘‘health care op-

erations’’ has the meaning given such term for purposes of the

HIPAA regulations.

(5) HIPAA

REGULATIONS

.—The term ‘‘HIPAA regulations’’

has the meaning given such term for purposes of parts 160 and

164 of title 45, Code of Federal Regulations.

(6) P

AYMENT

.—The term ‘‘payment’’ has the meaning given

such term for purposes of the HIPAA regulations.

(7) P

UBLIC HEALTH AUTHORITY

.—The term ‘‘public health

authority’’ has the meaning given such term for purposes of the

HIPAA regulations.

(8) T

REATMENT

.—The term ‘‘treatment’’ has the meaning

given such term for purposes of the HIPAA regulations.

(9)

NSECURED PROTECTED HEALTH INFORMATION

.—The

term ‘‘unprotected health information’’ has the meaning given

such term for purposes of the HIPAA regulations.

SEC. 543A. ø290dd–2a¿ PROMOTING ACCESS TO INFORMATION ON EVI-

DENCE-BASED PROGRAMS AND PRACTICES.

(a) I

ENERAL

.—The Assistant Secretary shall, as appro-

priate, improve access to reliable and valid information on evi-

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102 Sec. 544 PUBLIC HEALTH SERVICE ACT

dence-based programs and practices, including information on the

strength of evidence associated with such programs and practices,

related to mental and substance use disorders for States, local com-

munities, nonprofit entities, and other stakeholders, by posting on

the Internet website of the Administration information on evidence-

based programs and practices that have been reviewed by the As-

sistant Secretary in accordance with the requirements of this sec-

tion.

(b) A

PPLICATIONS

.—

(1) A

PPLICATION PERIOD

.—In carrying out subsection (a),

the Assistant Secretary may establish a period for the submis-

sion of applications for evidence-based programs and practices

to be posted publicly in accordance with subsection (a).

(2) N

OTICE

.—In establishing the application period under

paragraph (1), the Assistant Secretary shall provide for the

public notice of such application period in the Federal Register.

Such notice may solicit applications for evidence-based pro-

grams and practices to address gaps in information identified

by the Assistant Secretary, the National Mental Health and

Substance Use Policy Laboratory established under section

501A, or the Assistant Secretary for Planning and Evaluation,

including pursuant to the evaluation and recommendations

under section 6021 of the Helping Families in Mental Health

Crisis Reform Act of 2016 or priorities identified in the stra-

tegic plan under section 501(l).

EQUIREMENTS

.—The Assistant Secretary may establish

minimum requirements for the applications submitted under sub-

section (b), including applications related to the submission of re-

search and evaluation.

(d) R

EVIEW AND

ATING

.—

(1) I

N GENERAL

.—The Assistant Secretary shall review ap-

plications prior to public posting in accordance with subsection

(a), and may prioritize the review of applications for evidence-

based programs and practices that are related to topics in-

cluded in the notice provided under subsection (b)(2).

(2) S

YSTEM

.—In carrying out paragraph (1), the Assistant

Secretary may utilize a rating and review system, which may

include information on the strength of evidence associated with

the evidence-based programs and practices and a rating of the

methodological rigor of the research supporting the applica-

tions.

(3) P

UBLIC ACCESS TO METRICS AND RATING

.—The Assistant

Secretary shall make the metrics used to evaluate applications

under this section, and any resulting ratings of such applica-

tions, publicly available.

SEC. 544. ø290dd–3¿ GRANTS FOR REDUCING OVERDOSE DEATHS.

(a) E

STABLISHMENT

.—

(1) I

N GENERAL

.—The Secretary shall award grants to eli-

gible entities to expand access to drugs or devices approved,

cleared, or otherwise legally marketed under the Federal Food,

Drug, and Cosmetic Act for emergency treatment of known or

suspected opioid overdose.

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103 Sec. 544 PUBLIC HEALTH SERVICE ACT

(2) E

LIGIBLE ENTITY

.—For purposes of this section, the

term ‘‘eligible entity’’ means a State, Territory, locality, or In-

dian Tribe or Tribal organization (as those terms are defined

in section 4 of the Indian Self-Determination and Education

Assistance Act).

(3) S

UBGRANTS

.—For the purposes for which a grant is

awarded under this section, the eligible entity receiving the

grant may award subgrants to a Federally qualified health

center (as defined in section 1861(aa) of the Social Security

Act), an opioid treatment program (as defined in section 8.2 of

title 42, Code of Federal Regulations (or any successor regula-

tions)), any practitioner dispensing narcotic drugs for the pur-

pose of maintenance or detoxification treatment, or any non-

profit organization that the Secretary deems appropriate,

which may include Urban Indian organizations (as defined in

section 4 of the Indian Health Care Improvement Act).

(4) P

RESCRIBING

.—For purposes of this section, the term

‘‘prescribing’’ means, with respect to a drug or device approved,

cleared, or otherwise legally marketed under the Federal Food,

Drug, and Cosmetic Act for emergency treatment of known or

suspected opioid overdose, the practice of prescribing such drug

or device—

(A) in conjunction with an opioid prescription for pa-

tients at an elevated risk of overdose, including patients

prescribed both an opioid and a benzodiazepine;

(B) in conjunction with an opioid agonist approved

under section 505 of the Federal Food, Drug, and Cosmetic

Act for the treatment of opioid use disorder;

an elevated risk of overdose from opioids; or

(D) in other circumstances in which a provider identi-

fies a patient is at an elevated risk for an intentional or

unintentional overdose from heroin or prescription opioid

therapies.

(b) A

PPLICATION

.—To be eligible to receive a grant under this

section, an eligible entity shall submit to the Secretary, in such

form and manner as specified by the Secretary, an application that

describes—

(1) the extent to which the area to which the entity will

furnish services through use of the grant is experiencing sig-

nificant morbidity and mortality caused by opioid abuse;

(2) the criteria that will be used to identify eligible pa-

tients to participate in such program; and

(3) a plan for sustaining the program after Federal support

for the program has ended.

SE OF

UNDS

.—An eligible entity receiving a grant under

this section may use amounts under the grant for any of the fol-

lowing activities, but may use not more than 20 percent of the

grant funds for activities described in paragraphs (3) and (4):

(1) To establish a program for prescribing a drug or device

approved, cleared, or otherwise legally marketed under the

Federal Food, Drug, and Cosmetic Act for emergency treatment

of known or suspected opioid overdose.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

104 Sec. 544 PUBLIC HEALTH SERVICE ACT

(2) To train and provide resources for health care providers

and pharmacists on the prescribing of drugs or devices ap-

proved, cleared, or otherwise legally marketed under the Fed-

eral Food, Drug, and Cosmetic Act for emergency treatment of

known or suspected opioid overdose.

(3) To purchase drugs or devices approved, cleared, or oth-

erwise legally marketed under the Federal Food, Drug, and

Cosmetic Act for emergency treatment of known or suspected

opioid overdose, for distribution under the program described

in paragraph (1).

(4) To offset the co-payments and other cost sharing associ-

ated with drugs or devices approved, cleared, or otherwise le-

gally marketed under the Federal Food, Drug, and Cosmetic

Act for emergency treatment of known or suspected opioid

overdose.

(5) To establish protocols to connect patients who have ex-

perienced an overdose with appropriate treatment, including

overdose reversal medications, medication assisted treatment,

and appropriate counseling and behavioral therapies.

(d) I

MPROVING

CCESS TO

VERDOSE

REATMENT

.—

(1) I

NFORMATION ON BEST PRACTICES

.—

(A) H

EALTH AND HUMAN SERVICES

.—The Secretary of

Health and Human Services may provide information to

States, localities, Indian Tribes, Tribal organizations, and

Urban Indian organizations on best practices for pre-

scribing or co-prescribing a drug or device approved,

cleared, or otherwise legally marketed under the Federal

Food, Drug, and Cosmetic Act for emergency treatment of

known or suspected opioid overdose, including for patients

receiving chronic opioid therapy and patients being treated

for opioid use disorders.

(B) D

EFENSE

.—The Secretary of Health and Human

Services may, as appropriate, consult with the Secretary of

Defense regarding the provision of information to pre-

scribers within Department of Defense medical facilities on

best practices for prescribing or co-prescribing a drug or

device approved, cleared, or otherwise legally marketed

under the Federal Food, Drug, and Cosmetic Act for emer-

gency treatment of known or suspected opioid overdose, in-

cluding for patients receiving chronic opioid therapy and

patients being treated for opioid use disorders.

ETERANS AFFAIRS

.—The Secretary of Health and

Human Services may, as appropriate, consult with the Sec-

retary of Veterans Affairs regarding the provision of infor-

mation to prescribers within Department of Veterans Af-

fairs medical facilities on best practices for prescribing or

co-prescribing a drug or device approved, cleared, or other-

wise legally marketed under the Federal Food, Drug, and

Cosmetic Act for emergency treatment of known or sus-

pected opioid overdose, including for patients receiving

chronic opioid therapy and patients being treated for

opioid use disorders.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

105 Sec. 545 PUBLIC HEALTH SERVICE ACT

(2) R

ULE OF CONSTRUCTION

.—Nothing in this subsection

shall be construed as establishing or contributing to a medical

standard of care.

(e) E

VALUATIONS BY

ECIPIENTS

.—As a condition of receipt of

a grant under this section, an eligible entity shall, for each year for

which the grant is received, submit to the Secretary an evaluation

of activities funded by the grant which contains such information

as the Secretary may reasonably require.

(f) R

EPORTS BY THE

ECRETARY

.—Not later than 5 years after

the date on which the first grant under this section is awarded, the

Secretary shall submit to the appropriate committees of the House

of Representatives and of the Senate a report aggregating the in-

formation received from the grant recipients for such year under

subsection (e) and evaluating the outcomes achieved by the pro-

grams funded by grants awarded under this section.

(g) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section, $5,000,000 for the pe-

riod of fiscal years 2023 through 2027.

SEC. 545. ø290ee¿ OPIOID OVERDOSE REVERSAL MEDICATION ACCESS,

EDUCATION, AND CO-PRESCRIBING GRANT PROGRAMS.

(a) G

RANTS

.—The Secretary shall make grants to States, local-

ities, Indian Tribes, and Tribal organizations (as those terms are

defined in section 4 of the Indian Self-Determination and Edu-

cation Assistance Act) to—

(1) implement strategies that increase access to drugs or

devicesapproved, cleared, or otherwise legally marketed under

the Federal Food, Drug, and Cosmetic Act for emergency treat-

ment of known or suspected opioid overdose, as appropriate,

pursuant to a standing order;

(2) encourage pharmacies to dispense opioid overdose re-

versal medication pursuant to a standing order;

(3) encourage health care providers to co-prescribe, as ap-

propriate, drugs or devices approved, cleared, or otherwise le-

gally marketed under the Federal Food, Drug, and Cosmetic

Act for emergency treatment of known or suspected opioid

overdose;

(4) develop or provide training materials that persons au-

thorized to prescribe or dispense a drug or device approved,

cleared, or otherwise legally marketed under the Federal Food,

Drug, and Cosmetic Act for emergency treatment of known or

suspected opioid overdose may use to educate the public con-

cerning—

(A) when and how to safely administer such drug or

device; and

(B) steps to be taken after administering such drug or

device; and

(5) educate the public concerning the availability of drugs

or devices approved, cleared, or otherwise legally marketed

under the Federal Food, Drug, and Cosmetic Act for emergency

treatment of known or suspected opioid overdose without a

person-specific prescription.

(b) C

ERTAIN

EQUIREMENT

.—A grant may be made under this

section only if the State involved has authorized standing orders to

be issued for drugs or devices approved, cleared, or otherwise le-

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106 Sec. 545 PUBLIC HEALTH SERVICE ACT

gally marketed under the Federal Food, Drug, and Cosmetic Act for

emergency treatment of known or suspected opioid overdose.

REFERENCE IN

AKING

RANTS

.—In making grants under

this section, the Secretary may give preference to States that have

a significantly higher rate of opioid overdoses than the national av-

erage, and that—

(1) have not implemented standing orders regarding drugs

or devices approved, cleared, or otherwise legally marketed

under the Federal Food, Drug, and Cosmetic Act for emergency

treatment of known or suspected opioid overdose;

(2) authorize standing orders to be issued that permit com-

munity-based organizations, substance abuse programs, or

other nonprofit entities to acquire, dispense, or administer

drugs or devices approved, cleared, or otherwise legally mar-

keted under the Federal Food, Drug, and Cosmetic Act for

emergency treatment of known or suspected opioid overdose; or

(3) authorize standing orders to be issued that permit po-

lice, fire, or emergency medical services agencies to acquire

and administer drugs or devices approved, cleared, or other-

wise legally marketed under the Federal Food, Drug, and Cos-

metic Act for emergency treatment of known or suspected

opioid overdose.

(d) G

RANT

ERMS

.—

(1) N

UMBER

.—A State may not receive more than one

grant under this section at a time.

(2) P

ERIOD

.—A grant under this section shall be for a pe-

riod of 5 years.

(3) L

IMITATIONS

.—A State may—

(A) use not more than 10 percent of a grant under this

section for educating the public pursuant to subsection

(a)(5); and

(B) use not less than 20 percent of a grant under this

section to offset cost-sharing for distribution and dis-

pensing of drugs or devices approved, cleared, or otherwise

legally marketed under the Federal Food, Drug, and Cos-

metic Act for emergency treatment of known or suspected

opioid overdose.

(e) A

PPLICATIONS

.—To be eligible to receive a grant under this

section, a State shall submit an application to the Secretary in

such form and manner and containing such information as the Sec-

retary may reasonably require, including detailed proposed expend-

itures of grant funds.

(f) R

EPORTING

.—A State that receives a grant under this sec-

tion shall, at least annually for the duration of the grant, submit

a report to the Secretary evaluating the progress of the activities

supported through the grant. Such reports shall include informa-

tion on the number of pharmacies in the State that dispense a drug

or device approved, cleared, or otherwise legally marketed under

the Federal Food, Drug, and Cosmetic Act for emergency treatment

of known or suspected opioid overdose under a standing order, and

other information as the Secretary determines appropriate to

evaluate the use of grant funds.

(g) D

EFINITIONS

.—In this section the term ‘‘standing order’’

means a document prepared by a person authorized to prescribe

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107 Sec. 546 PUBLIC HEALTH SERVICE ACT

medication that permits another person to acquire, dispense, or ad-

minister medication without a person-specific prescription.

(h) A

UTHORIZATION OF

PPROPRIATIONS

.—

(1) I

N GENERAL

.—To carry out this section, there are au-

thorized to be appropriated $5,000,000 for the period of fiscal

years 2023 through 2027.

(2) A

DMINISTRATIVE COSTS

.—Not more than 3 percent of

the amounts made available to carry out this section may be

used by the Secretary for administrative expenses of carrying

out this section.

SEC. 546. ø290ee–1¿ FIRST RESPONDER TRAINING.

(a) P

ROGRAM

UTHORIZED

.—The Secretary shall make grants

to States, local governmental entities, and Indian tribes and tribal

organizations (as defined in section 4 of the Indian Self-Determina-

tion and Education Assistance Act) to allow first responders and

members of other key community sectors to administer a drug or

device approved or cleared under the Federal Food, Drug, and Cos-

metic Act for emergency treatment of known or suspected opioid

overdose.

(b) A

PPLICATION

.—

(1) I

N GENERAL

.—An entity seeking a grant under this sec-

tion shall submit an application to the Secretary—

(A) that meets the criteria under paragraph (2); and

(B) at such time, in such manner, and accompanied by

such information as the Secretary may require.

(2) C

RITERIA

.—An entity, in submitting an application

under paragraph (1), shall—

(A) describe the evidence-based methodology and out-

come measurements that will be used to evaluate the pro-

gram funded with a grant under this section, and specifi-

cally explain how such measurements will provide valid

measures of the impact of the program;

(B) describe how the program could be broadly rep-

licated if demonstrated to be effective;

with which the entity will coordinate to implement the

program; and

(D) describe how the entity will ensure that law en-

forcement agencies will coordinate with their cor-

responding State substance abuse and mental health agen-

cies to identify protocols and resources that are available

to overdose victims and families, including information on

treatment and recovery resources.

SE OF

UNDS

.—An entity shall use a grant received under

this section to—

(1) make a drug or device approved or cleared under the

Federal Food, Drug, and Cosmetic Act for emergency treatment

of known or suspected opioid overdose available to be carried

and administered by first responders and members of other

key community sectors;

(2) train and provide resources for first responders and

members of other key community sectors on carrying and ad-

ministering a drug or device approved or cleared under the

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108 Sec. 546 PUBLIC HEALTH SERVICE ACT

Federal Food, Drug, and Cosmetic Act for emergency treatment

of known or suspected opioid overdose;

(3) establish processes, protocols, and mechanisms for re-

ferral to appropriate treatment, which may include an out-

reach coordinator or team to connect individuals receiving

opioid overdose reversal drugs to followup services; and

(4) train and provide resources for first responders and

members of other key community sectors on safety around

fentanyl, carfentanil, and other dangerous licit and illicit drugs

to protect themselves from exposure to such drugs and respond

appropriately when exposure occurs.

(d) T

ECHNICAL

SSISTANCE

RANTS

.—The Secretary shall make

a grant for the purpose of providing technical assistance and train-

ing on the use of a drug or device approved or cleared under the

Federal Food, Drug, and Cosmetic Act for emergency treatment of

known or suspected opioid overdose, mechanisms for referral to ap-

propriate treatment, and safety around fentanyl, carfentanil, and

other dangerous licit and illicit drugs.

(e) G

EOGRAPHIC

ISTRIBUTION

.—In making grants under this

section, the Secretary shall ensure that not less than 20 percent of

grant funds are awarded to eligible entities that are not located in

metropolitan statistical areas (as defined by the Office of Manage-

ment and Budget). The Secretary shall take into account the

unique needs of rural communities, including communities with an

incidence of individuals with opioid use disorder that is above the

national average and communities with a shortage of prevention

and treatment services.

(f) E

VALUATION

.—The Secretary shall conduct an evaluation of

grants made under this section to determine—

(1) the number of first responders and members of other

key community sectors equipped with a drug or device ap-

proved or cleared under the Federal Food, Drug, and Cosmetic

Act for emergency treatment of known or suspected opioid

overdose;

(2) the number of opioid and heroin overdoses reversed by

first responders and members of other key community sectors

receiving training and supplies of a drug or device approved or

cleared under the Federal Food, Drug, and Cosmetic Act for

emergency treatment of known or suspected opioid overdose,

through a grant received under this section;

(3) the number of responses to requests for services by the

entity or subgrantee, to opioid and heroin overdose;

(4) the extent to which overdose victims and families re-

ceive information about treatment services and available data

describing treatment admissions; and

(5) the number of first responders and members of other

key community sectors trained on safety around fentanyl,

carfentanil, and other dangerous licit and illicit drugs.

(g) O

THER

OMMUNITY

ECTORS

.—In this section, the term

‘‘other key community sectors’’ includes substance use disorder

treatment providers, emergency medical services agencies, agencies

and organizations working with prison and jail populations and of-

fender reentry programs, health care providers, harm reduction

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109 Sec. 547 PUBLIC HEALTH SERVICE ACT

groups, pharmacies, community health centers, tribal health facili-

ties, and mental health providers.

(h) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there are authorized to be appropriated $36,000,000 for each

of fiscal years 2019 through 2023.

SEC. 547. ø290ee–2¿ BUILDING COMMUNITIES OF RECOVERY.

(a) D

EFINITION

.—In this section, the term ‘‘recovery community

organization’’ means an independent nonprofit organization that—

(1) mobilizes resources within and outside of the recovery

community, which may include through a peer support net-

work, to increase the prevalence and quality of long-term re-

covery from substance use disorders; and

(2) is wholly or principally governed by people in recovery

for substance use disorders who reflect the community served.

(b) G

RANTS

UTHORIZED

.—The Secretary shall award grants to

recovery community organizations to enable such organizations to

develop, expand, and enhance recovery services.

EDERAL

HARE

.—The Federal share of the costs of a pro-

gram funded by a grant under this section may not exceed 85 per-

cent.

(d) U

SE OF

UNDS

.—Grants awarded under subsection (b)—

(1) shall be used to develop, expand, and enhance commu-

nity and statewide recovery support services; and

(2) may be used to—

(A) build connections between recovery networks, in-

cluding between recovery community organizations and

peer support networks, and with other recovery support

services, including—

(i) behavioral health providers;

(ii) primary care providers and physicians;

(iii) educational and vocational schools;

(iv) employers;

(v) housing services;

(vi) child welfare agencies; and

(vii) other recovery support services that facilitate

recovery from substance use disorders, including non-

clinical community services;

(B) reduce stigma associated with substance use dis-

orders; and

use disorders and recovery, including—

(i) identifying the signs of substance use disorder;

(ii) the resources available to individuals with

substance use disorder and to families of an individual

with a substance use disorder, including programs

that mentor and provide support services to children;

(iii) the resources available to help support indi-

viduals in recovery; and

(iv) related medical outcomes of substance use dis-

orders, the potential of acquiring an infection com-

monly associated with illicit drug use, and neonatal

abstinence syndrome among infants exposed to opioids

during pregnancy.

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110 Sec. 547A PUBLIC HEALTH SERVICE ACT

(e) S

PECIAL

ONSIDERATION

.—In carrying out this section, the

Secretary shall give special consideration to the unique needs of

rural areas, including areas with an age-adjusted rate of drug over-

dose deaths that is above the national average and areas with a

shortage of prevention and treatment services.

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized to

be appropriated to carry out this section $5,000,000 for each of fis-

cal years 2019 through 2023.

SEC. 547A. ø290ee–2a¿ PEER SUPPORT TECHNICAL ASSISTANCE CEN-

TER.

(a) E

STABLISHMENT

.—The Secretary, acting through the Assist-

ant Secretary, shall establish or operate a National Peer-Run

Training and Technical Assistance Center for Addiction Recovery

Support (referred to in this section as the ‘‘Center’’).

(b) F

UNCTIONS

.—The Center established under subsection (a)

shall provide technical assistance and support to recovery commu-

nity organizations and peer support networks, including such as-

sistance and support related to—

(1) training on identifying—

(A) signs of substance use disorder;

(B) resources to assist individuals with a substance

use disorder, or resources for families of an individual with

a substance use disorder; and

services;

(2) the provision of translation services, interpretation, or

other such services for clients with limited English speaking

proficiency;

(3) data collection to support research, including for

translational research;

(4) capacity building; and

(5) evaluation and improvement, as necessary, of the effec-

tiveness of such services provided by recovery community orga-

nizations.

EST

RACTICES

.—The Center established under subsection

(a) shall periodically issue best practices for use by recovery com-

munity organizations and peer support networks.

(d) R

ECOVERY

OMMUNITY

RGANIZATION

.—In this section, the

term ‘‘recovery community organization’’ has the meaning given

such term in section 547.

(e) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section $1,000,000 for each of

fiscal years 2019 through 2023.

SEC. 548. ø290ee–3¿ STATE DEMONSTRATION GRANTS FOR COM-

PREHENSIVE OPIOID ABUSE RESPONSE.

(a) D

EFINITIONS

.—In this section:

(1) D

ISPENSER

.—The term ‘‘dispenser’’ has the meaning

given the term in section 102 of the Controlled Substances Act

(21 U.S.C. 802).

(2) P

RESCRIBER

.—The term ‘‘prescriber’’ means a dispenser

who prescribes a controlled substance, or the agent of such a

dispenser.

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111 Sec. 548 PUBLIC HEALTH SERVICE ACT

(3) P

RESCRIBER OF A SCHEDULE II

III

OR IV CONTROLLED

SUBSTANCE

.—The term ‘‘prescriber of a schedule II, III, or IV

controlled substance’’ does not include a prescriber of a sched-

ule II, III, or IV controlled substance that dispenses the sub-

stance—

(A) for use on the premises on which the substance is

dispensed;

(B) in a hospital emergency room, when the substance

is in short supply;

(D) in other situations as the Secretary may reason-

ably determine.

(4) S

CHEDULE II

III

OR IV CONTROLLED SUBSTANCE

.—The

term ‘‘schedule II, III, or IV controlled substance’’ means a con-

trolled substance that is listed on schedule II, schedule III, or

schedule IV of section 202(c) of the Controlled Substances Act.

(b) G

RANTS FOR

OMPREHENSIVE

PIOID

BUSE

ESPONSE

.—

(1) I

N GENERAL

.—The Secretary shall award grants to

States, and combinations of States, to implement an integrated

opioid abuse response initiative.

(2) P

URPOSES

.—A State receiving a grant under this sec-

tion shall establish a comprehensive response plan to opioid

abuse, which may include—

(A) education efforts around opioid use, treatment, and

addiction recovery, including education of residents, med-

ical students, and physicians and other prescribers of

schedule II, III, or IV controlled substances on relevant

prescribing guidelines, the prescription drug monitoring

program of the State described in subparagraph (B), and

overdose prevention methods;

(B) establishing, maintaining, or improving a com-

prehensive prescription drug monitoring program to track

dispensing of schedule II, III, or IV controlled substances,

which may—

(i) provide for data sharing with other States; and

(ii) allow all individuals authorized by the State to

write prescriptions for schedule II, III, or IV controlled

substances to access the prescription drug monitoring

program of the State;

tion drug and opioid addiction treatment programs by—

(i) expanding the availability of treatment for pre-

scription drug and opioid addiction, including medica-

tion-assisted treatment and behavioral health therapy,

as appropriate;

(ii) developing, implementing, or expanding

screening for individuals in treatment for prescription

drug and opioid addiction for hepatitis C and HIV, and

treating or referring those individuals if clinically ap-

propriate; or

(iii) developing, implementing, or expanding recov-

ery support services and programs at high schools or

institutions of higher education;

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112 Sec. 548 PUBLIC HEALTH SERVICE ACT

(D) developing, implementing, and expanding efforts to

prevent overdose death from opioid abuse or addiction to

prescription medications and opioids; and

(E) advancing the education and awareness of the pub-

lic, providers, patients, consumers, and other appropriate

entities regarding the dangers of opioid abuse, safe dis-

posal of prescription medications, and detection of early

warning signs of opioid use disorders.

(3) A

PPLICATION

.—A State seeking a grant under this sec-

tion shall submit to the Secretary an application in such form,

and containing such information, as the Secretary may reason-

ably require.

(4) U

SE OF FUNDS

.—A State that receives a grant under

this section shall use the grant for the cost, including the cost

for technical assistance, training, and administration expenses,

of carrying out an integrated opioid abuse response initiative

as outlined by the State’s comprehensive response plan to

opioid abuse established under paragraph (2).

(5) P

RIORITY CONSIDERATIONS

.—In awarding grants under

this section, the Secretary shall, as appropriate, give priority

to a State that—

(A)(i) provides civil liability protection for first re-

sponders, health professionals, and family members who

have received appropriate training in administering a drug

or device approved or cleared under the Federal Food,

Drug, and Cosmetic Act for emergency treatment of known

or suspected opioid overdose; and

(ii) submits to the Secretary a certification by the at-

torney general of the State that the attorney general has—

(I) reviewed any applicable civil liability protec-

tion law to determine the applicability of the law with

respect to first responders, health care professionals,

family members, and other individuals who—

(aa) have received appropriate training in ad-

ministering a drug or device approved or cleared

under the Federal Food, Drug, and Cosmetic Act

for emergency treatment of known or suspected

opioid overdose; and

(bb) may administer a drug or device ap-

proved or cleared under the Federal Food, Drug,

and Cosmetic Act for emergency treatment of

known or suspected opioid overdose; and

(II) concluded that the law described in subclause

(I) provides adequate civil liability protection applica-

ble to such persons;

(B) has a process for enrollment in services and bene-

fits necessary by criminal justice agencies to initiate or

continue treatment in the community, under which an in-

dividual who is incarcerated may, while incarcerated, en-

roll in services and benefits that are necessary for the indi-

vidual to continue treatment upon release from incarcer-

ation;

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113 Sec. 549 PUBLIC HEALTH SERVICE ACT

States, where applicable, such as by making data available

to a prescription monitoring hub;

(D) ensures that data recorded in the prescription

drug monitoring program database of the State are regu-

larly updated, to the extent possible;

(E) ensures that the prescription drug monitoring pro-

gram of the State notifies prescribers and dispensers of

schedule II, III, or IV controlled substances when overuse

or misuse of such controlled substances by patients is sus-

pected; and

(F) has in effect one or more statutes or implements

policies that maximize use of prescription drug monitoring

programs by individuals authorized by the State to pre-

scribe schedule II, III, or IV controlled substances.

(6) E

VALUATION

.—In conducting an evaluation of the pro-

gram under this section pursuant to section 701 of the Com-

prehensive Addiction and Recovery Act of 2016, with respect to

a State, the Secretary shall report on State legislation or poli-

cies related to maximizing the use of prescription drug moni-

toring programs and the incidence of opioid use disorders and

overdose deaths in such State.

(7) S

TATES WITH LOCAL PRESCRIPTION DRUG MONITORING

PROGRAMS

.—

(A) I

N GENERAL

.—In the case of a State that does not

have a prescription drug monitoring program, a county or

other unit of local government within the State that has

a prescription drug monitoring program shall be treated as

a State for purposes of this section, including for purposes

of eligibility for grants under paragraph (1).

(B) P

LAN FOR INTEROPERABILITY

.—In submitting an

application to the Secretary under paragraph (3), a county

or other unit of local government shall submit a plan out-

lining the methods such county or unit of local government

shall use to ensure the capability of data sharing with

other counties and units of local government within the

state and with other States, as applicable.

UTHORIZATION OF

UNDING

.—For the purpose of carrying

out this section, there are authorized to be appropriated $5,000,000

for each of fiscal years 2017 through 2021.

SEC. 549. ø290ee–4¿ MENTAL AND BEHAVIORAL HEALTH OUTREACH

AND EDUCATION AT INSTITUTIONS OF HIGHER EDU-

CATION.

(a) P

URPOSE

.—It is the purpose of this section to increase ac-

cess to, and reduce the stigma associated with, mental health serv-

ices to ensure that students at institutions of higher education

have the support necessary to successfully complete their studies.

(b) N

ATIONAL

UBLIC

DUCATION

AMPAIGN

.—The Secretary,

acting through the Assistant Secretary and in collaboration with

the Director of the Centers for Disease Control and Prevention,

shall convene an interagency, public-private sector working group

to plan, establish, and begin coordinating and evaluating a tar-

geted public education campaign that is designed to focus on men-

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114 Sec. 549 PUBLIC HEALTH SERVICE ACT

tal and behavioral health on the campuses of institutions of higher

education. Such campaign shall be designed to—

(1) improve the general understanding of mental health

and mental disorders;

(2) encourage help-seeking behaviors relating to the pro-

motion of mental health, prevention of mental disorders, and

treatment of such disorders;

(3) make the connection between mental and behavioral

health and academic success; and

(4) assist the general public in identifying the early warn-

ing signs and reducing the stigma of mental illness.

OMPOSITION

.—The working group convened under sub-

section (b) shall include—

(1) mental health consumers, including students and fam-

ily members;

(2) representatives of institutions of higher education, in-

cluding minority-serving institutions as described in section

371(a) of the Higher Education Act of 1965 (20 U.S.C. 1067q)

and community colleges;

(3) representatives of national mental and behavioral

health associations and associations of institutions of higher

education;

(4) representatives of health promotion and prevention or-

ganizations at institutions of higher education;

(5) representatives of mental health providers, including

community mental health centers; and

(6) representatives of private-sector and public-sector

groups with experience in the development of effective public

health education campaigns.

(d) P

LAN

.—The working group under subsection (b) shall de-

velop a plan that—

(1) targets promotional and educational efforts to the age

population of students at institutions of higher education and

individuals who are employed in settings of institutions of

higher education, including through the use of roundtables;

(2) develops and proposes the implementation of research-

based public health messages and activities;

(3) provides support for local efforts to reduce stigma by

using the National Health Information Center as a primary

point of contact for information, publications, and service pro-

gram referrals; and

(4) develops and proposes the implementation of a social

marketing campaign that is targeted at the population of stu-

dents attending institutions of higher education and individ-

uals who are employed in settings of institutions of higher edu-

cation.

(e) D

EFINITION

.—In this section, the term ‘‘institution of higher

education’’ has the meaning given such term in section 101 of the

Higher Education Act of 1965 (20 U.S.C. 1001).

(f) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there are authorized to be appropriated $1,000,000 for the pe-

riod of fiscal years 2023 through 2027.

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115 Sec. 550 PUBLIC HEALTH SERVICE ACT

SEC. 550. ø290ee–5¿ NATIONAL RECOVERY HOUSING BEST PRACTICES.

(a) B

EST

RACTICES FOR

PERATING

ECOVERY

OUSING

.—

(1) I

N GENERAL

.—The Secretary, in consultation with the

individuals and entities specified in paragraph (2), shall con-

tinue activities to identify, facilitate the development of, and

periodically update consensus-based best practices, which may

include model laws for implementing suggested minimum

standards for operating, and promoting the availability of,

high-quality recovery housing.

(2) C

ONSULTATION

.—In carrying out the activities de-

scribed in paragraph (1), the Secretary shall consult with, as

appropriate—

(A) officials representing the agencies described in

subsection (e)(2);

(B) directors or commissioners, as applicable, of State

health departments, Tribal health departments, State

Medicaid programs, and State insurance agencies;

(D) national accrediting entities and reputable pro-

viders of, and analysts of, recovery housing services, in-

cluding Indian Tribes, Tribal organizations, and Tribally

designated housing entities that provide recovery housing

services, as applicable;

(E) individuals with a history of substance use dis-

order; and

(F) other stakeholders identified by the Secretary.

(3) A

VAILABILITY

.—The best practices referred to in para-

graph (1) shall be—

(A) made publicly available; and

(B) published on the public website of the Substance

Abuse and Mental Health Services Administration.

(4) E

XCLUSION OF GUIDELINE ON TREATMENT SERVICES

.—In

facilitating the development of best practices under paragraph

(1), the Secretary may not include any best practices with re-

spect to substance use disorder treatment services.

(b) I

DENTIFICATION OF

RAUDULENT

ECOVERY

OUSING

PER

ATORS

.—

(1) I

N GENERAL

.—The Secretary, in consultation with the

individuals and entities described in paragraph (2), shall iden-

tify or facilitate the development of common indicators that

could be used to identify potentially fraudulent recovery hous-

ing operators.

(2) C

ONSULTATION

.—In carrying out the activities de-

scribed in paragraph (1), the Secretary shall consult with, as

appropriate, the individuals and entities specified in subsection

(a)(2) and the Attorney General of the United States.

(3) R

EQUIREMENTS

.—

(A) P

RACTICES FOR IDENTIFICATION AND REPORTING

.—

In carrying out the activities described in paragraph (1),

the Secretary shall consider how law enforcement, public

and private payers, and the public can best identify and

report fraudulent recovery housing operators.

(B) F

ACTORS TO BE CONSIDERED

.—In carrying out the

activities described in paragraph (1), the Secretary shall

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116 Sec. 550 PUBLIC HEALTH SERVICE ACT

identify or develop indicators, which may include indica-

tors related to—

(i) unusual billing practices;

(ii) average lengths of stays;

(iii) excessive levels of drug testing (in terms of

cost or frequency); and

(iv) unusually high levels of recidivism.

ISSEMINATION

.—The Secretary shall, as appropriate, dis-

seminate the best practices identified or developed under sub-

section (a) and the common indicators identified or developed under

subsection (b) to—

(1) State agencies, which may include the provision of

technical assistance to State agencies seeking to adopt or im-

plement such best practices;

(2) Indian Tribes, Tribal organizations, and tribally des-

ignated housing entities;

(3) the Attorney General of the United States;

(4) the Secretary of Labor;

(5) the Secretary of Housing and Urban Development;

(6) State and local law enforcement agencies;

(7) health insurance issuers;

(8) recovery housing entities; and

(9) the public.

(d) R

EQUIREMENTS

.—In carrying out the activities described in

subsections (a) and (b), the Secretary, in consultation with appro-

priate individuals and entities described in subsections (a)(2) and

(b)(2), shall consider how recovery housing is able to support recov-

ery and prevent relapse, recidivism, or overdose (including overdose

death), including by improving access and adherence to treatment,

including medication-assisted treatment.

(e) C

OORDINATION OF

EDERAL

CTIVITIES TO

ROMOTE THE

VAILABILITY OF

OUSING FOR

NDIVIDUALS

XPERIENCING

OME

LESSNESS

, I

NDIVIDUALS

ITH A

ENTAL

LLNESS

AND

NDIVIDUALS

ITH A

UBSTANCE

ISORDER

.—

(1) I

N GENERAL

.—The Secretary, acting through the Assist-

ant Secretary, and the Secretary of Housing and Urban Devel-

opment shall convene an interagency working group for the fol-

lowing purposes:

(A) To increase collaboration, cooperation, and con-

sultation among the Department of Health and Human

Services, the Department of Housing and Urban Develop-

ment, and the Federal agencies listed in paragraph (2)(B),

with respect to promoting the availability of housing, in-

cluding high-quality recovery housing, for individuals ex-

periencing homelessness, individuals with mental ill-

nesses, and individuals with substance use disorder.

(B) To align the efforts of such agencies and avoid du-

plication of such efforts by such agencies.

plan for supporting State, Tribal, and local efforts with re-

spect to the operation of high-quality recovery housing that

is consistent with the best practices developed under this

section.

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117 Sec. 550 PUBLIC HEALTH SERVICE ACT

(D) To improve information on the quality of recovery

housing.

(2) C

OMPOSITION

.—The interagency working group under

paragraph (1) shall be composed of—

(A) the Secretary, acting through the Assistant Sec-

retary, and the Secretary of Housing and Urban Develop-

ment, who shall serve as the co-chairs; and

(B) representatives of each of the following Federal

agencies:

(i) The Centers for Medicare & Medicaid Services.

(ii) The Substance Abuse and Mental Health Serv-

ices Administration.

(iii) The Health Resources and Services Adminis-

tration.

(iv) The Office of the Inspector General of the De-

partment of Health and Human Services.

(v) The Indian Health Service.

(vi) The Department of Agriculture.

(vii) The Department of Justice.

(viii) The Office of National Drug Control Policy.

(ix) The Bureau of Indian Affairs.

(x) The Department of Labor.

(xi) The Department of Veterans Affairs.

(xii) Any other Federal agency as the co-chairs de-

termine appropriate.

(3) M

EETINGS

.—The working group shall meet on a quar-

terly basis.

(4) R

EPORTS TO CONGRESS

.—Not later than 4 years after

the date of the enactment of this section, the working group

shall submit to the Committee on Health, Education, Labor,

and Pensions, the Committee on Agriculture, Nutrition, and

Forestry, and the Committee on Finance of the Senate and the

Committee on Energy and Commerce, the Committee on Ways

and Means, the Committee on Agriculture, and the Committee

on Financial Services of the House of Representatives a report

describing the work of the working group and any rec-

ommendations of the working group to improve Federal, State,

and local coordination with respect to recovery housing and

other housing resources and operations for individuals experi-

encing homelessness, individuals with a mental illness, and in-

dividuals with a substance use disorder.

(f) G

RANTS FOR

MPLEMENTING

ATIONAL

ECOVERY

OUSING

EST

RACTICES

.—

(1) I

N GENERAL

.—The Secretary shall award grants to

States (and political subdivisions thereof), Indian Tribes, and

territories—

(A) for the provision of technical assistance to imple-

ment the guidelines and recommendations developed

under subsection (a); and

(B) to promote—

(i) the availability of recovery housing for individ-

uals with a substance use disorder; and

(ii) the maintenance of recovery housing in accord-

ance with best practices developed under this section.

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118 Sec. 550A PUBLIC HEALTH SERVICE ACT

(2) S

TATE PROMOTION PLANS

.—Not later than 90 days after

receipt of a grant under paragraph (1), and every 2 years

thereafter, each State (or political subdivisions thereof,) Indian

Tribe, or territory receiving a grant under paragraph (1) shall

submit to the Secretary, and publish on a publicly accessible

internet website of the State (or political subdivisions thereof),

Indian Tribe, or territory—

(A) the plan of the State (or political subdivisions

thereof), Indian Tribe, or territory, with respect to the pro-

motion of recovery housing for individuals with a sub-

stance use disorder located within the jurisdiction of such

State (or political subdivisions thereof), Indian Tribe, or

territory; and

(B) a description of how such plan is consistent with

the best practices developed under this section.

(g) R

ULE OF

ONSTRUCTION

.—Nothing in this section shall be

construed to provide the Secretary with the authority to require

States to adhere to minimum standards in the State oversight of

recovery housing.

(h) D

EFINITIONS

.—In this section:

(1) The term ‘‘recovery housing’’ means a shared living en-

vironment free from alcohol and illicit drug use and centered

on peer support and connection to services that promote sus-

tained recovery from substance use disorders.

(2) The terms ‘‘Indian Tribe’’ and ‘‘Tribal organization’’

have the meanings given those terms in section 4 of the Indian

Self-Determination and Education Assistance Act (25 U.S.C.

5304).

(3) The term ‘‘tribally designated housing entity’’ has the

meaning given that term in section 4 of the Native American

Housing Assistance and Self-Determination Act of 1996 (25

U.S.C. 4103).

(i) A

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there is authorized to be appropriated $5,000,000 for the pe-

riod of fiscal years 2023 through 2027.

SEC. 550A. ø290ee-10¿ SOBRIETY TREATMENT AND RECOVERY TEAMS.

(a) I

ENERAL

.—The Secretary may make grants to States,

units of local government, or tribal governments to establish or ex-

pand Sobriety Treatment And Recovery Team (referred to in this

section as ‘‘START’’) or other similar programs to determine the ef-

fectiveness of pairing social workers or mentors with families that

are struggling with a substance use disorder and child abuse or ne-

glect in order to help provide peer support, intensive treatment,

and child welfare services to such families.

(b) A

LLOWABLE

SES

.—A grant awarded under this section

may be used for one or more of the following activities:

(1) Training eligible staff, including social workers, social

services coordinators, child welfare specialists, substance use

disorder treatment professionals, and mentors.

(2) Expanding access to substance use disorder treatment

services and drug testing.

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119 Sec. 551 PUBLIC HEALTH SERVICE ACT

(3) Enhancing data sharing with law enforcement agen-

cies, child welfare agencies, substance use disorder treatment

providers, judges, and court personnel.

(4) Program evaluation and technical assistance.

ROGRAM

EQUIREMENTS

.—A State, unit of local govern-

ment, or tribal government receiving a grant under this section

shall—

(1) serve only families for which—

(A) there is an open record with the child welfare

agency; and

(B) substance use disorder was a reason for the record

or finding described in paragraph (1); and

(2) coordinate any grants awarded under this section with

any grant awarded under section 437(f) of the Social Security

Act focused on improving outcomes for children affected by

substance abuse.

(d) T

ECHNICAL

SSISTANCE

.—The Secretary may reserve not

more than 5 percent of funds provided under this section to provide

technical assistance on the establishment or expansion of programs

funded under this section from the National Center on Substance

Abuse and Child Welfare.

SEC. 551. ø290ee–6¿ REGIONAL CENTERS OF EXCELLENCE IN SUB-

STANCE USE DISORDER EDUCATION.

(a) I

ENERAL

.—The Secretary, in consultation with appro-

priate agencies, shall award cooperative agreements to eligible en-

tities for the designation of such entities as Regional Centers of Ex-

cellence in Substance Use Disorder Education for purposes of im-

proving health professional training resources with respect to sub-

stance use disorder prevention, treatment, and recovery.

(b) E

LIGIBILITY

.—To be eligible to receive a cooperative agree-

ment under subsection (a), an entity shall—

(1) be an accredited entity that offers education to students

in various health professions, which may include—

(A) a teaching hospital;

(B) a medical school;

(D) any other health professions school, school of pub-

lic health, or Cooperative Extension Program at institu-

tions of higher education, as defined in section 101 of the

Higher Education Act of 1965, engaged in the prevention,

treatment, or recovery of substance use disorders;

(2) demonstrate community engagement and partnerships

with community stakeholders, including entities that train

health professionals, mental health counselors, social workers,

peer recovery specialists, substance use treatment programs,

community health centers, physician offices, certified behav-

ioral health clinics, research institutions, and law enforcement;

and

(3) submit to the Secretary an application containing such

information, at such time, and in such manner, as the Sec-

retary may require.

CTIVITIES

.—An entity receiving an award under this sec-

tion shall develop, evaluate, and distribute evidence-based re-

sources regarding the prevention and treatment of, and recovery

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120 Sec. 552 PUBLIC HEALTH SERVICE ACT

from, substance use disorders. Such resources may include informa-

tion on—

(1) the neurology and pathology of substance use disorders;

(2) advancements in the treatment of substance use dis-

orders;

(3) techniques and best practices to support recovery from

substance use disorders;

(4) strategies for the prevention and treatment of, and re-

covery from substance use disorders across patient populations;

and

(5) other topic areas that are relevant to the objectives de-

scribed in subsection (a).

(d) G

EOGRAPHIC

ISTRIBUTION

.—In awarding cooperative

agreements under subsection (a), the Secretary shall take into ac-

count regional differences among eligible entities and shall make

an effort to ensure geographic distribution.

(e) E

VALUATION

.—The Secretary shall evaluate each project

carried out by an entity receiving an award under this section and

shall disseminate the findings with respect to each such evaluation

to appropriate public and private entities.

(f) F

UNDING

.—There is authorized to be appropriated to carry

out this section, $4,000,000 for each of fiscal years 2019 through

2023.

SEC. 552. ø290ee–7¿ COMPREHENSIVE OPIOID RECOVERY CENTERS.

(a) I

ENERAL

.—The Secretary shall award grants on a com-

petitive basis to eligible entities to establish or operate a com-

prehensive opioid recovery center (referred to in this section as a

‘‘Center’’). A Center may be a single entity or an integrated deliv-

ery network.

(b) G

RANT

ERIOD

.—

(1) I

N GENERAL

.—A grant awarded under subsection (a)

shall be for a period of not less than 3 years and not more than

5 years.

(2) R

ENEWAL

.—A grant awarded under subsection (a) may

be renewed, on a competitive basis, for additional periods of

time, as determined by the Secretary. In determining whether

to renew a grant under this paragraph, the Secretary shall

consider the data submitted under subsection (h).

INIMUM

UMBER OF

ENTERS

.—The Secretary shall allo-

cate the amounts made available under subsection (j) such that not

fewer than 10 grants may be awarded. Not more than one grant

shall be made to entities in a single State for any one period.

(d) A

PPLICATION

.—

(1) E

LIGIBLE ENTITY

.—An entity is eligible for a grant

under this section if the entity offers treatment and other serv-

ices for individuals with a substance use disorder.

(2) S

UBMISSION OF APPLICATION

.—In order to be eligible for

a grant under subsection (a), an entity shall submit an applica-

tion to the Secretary at such time and in such manner as the

Secretary may require. Such application shall include—

(A) evidence that such entity carries out, or is capable

of coordinating with other entities to carry out, the activi-

ties described in subsection (g); and

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121 Sec. 552 PUBLIC HEALTH SERVICE ACT

(B) such other information as the Secretary may re-

quire.

(e) P

RIORITY

.—In awarding grants under subsection (a), the

Secretary shall give priority to eligible entities—

(1) located in a State with an age-adjusted rate of drug

overdose deaths that is above the national overdose mortality

rate, as determined by the Director of the Centers for Disease

Control and Prevention; or

(2) serving an Indian Tribe (as defined in section 4 of the

Indian Self-Determination and Education Assistance Act) with

an age-adjusted rate of drug overdose deaths that is above the

national overdose mortality rate, as determined through appro-

priate mechanisms determined by the Secretary in consultation

with Indian Tribes.

(f) P

REFERENCE

.—In awarding grants under subsection (a), the

Secretary may give preference to eligible entities utilizing tech-

nology-enabled collaborative learning and capacity building models,

including such models as defined in section 2 of the Expanding Ca-

pacity for Health Outcomes Act (Public Law 114–270; 130 Stat.

1395), to conduct the activities described in this section.

(g) C

ENTER

CTIVITIES

.—Each Center shall, at a minimum,

carry out the following activities directly, through referral, or

through contractual arrangements, which may include carrying out

such activities through technology-enabled collaborative learning

and capacity building models described in subsection (f):

(1) T

REATMENT AND RECOVERY SERVICES

.—Each Center

shall—

(A) Ensure that intake, evaluations, and periodic pa-

tient assessments meet the individualized clinical needs of

patients, including by reviewing patient placement in

treatment settings to support meaningful recovery.

(B) Provide the full continuum of treatment services,

including—

(i) all drugs and devices approved or cleared under

the Federal Food, Drug, and Cosmetic Act and all bio-

logical products licensed under section 351 of this Act

to treat substance use disorders or reverse overdoses,

pursuant to Federal and State law;

(ii) medically supervised withdrawal management,

that includes patient evaluation, stabilization, and

readiness for and entry into treatment;

(iii) counseling provided by a program counselor or

other certified professional who is licensed and quali-

fied by education, training, or experience to assess the

psychological and sociological background of patients,

to contribute to the appropriate treatment plan for the

patient, and to monitor patient progress;

(iv) treatment, as appropriate, for patients with

co-occurring substance use and mental disorders;

(v) testing, as appropriate, for infections com-

monly associated with illicit drug use;

(vi) residential rehabilitation, and outpatient and

intensive outpatient programs;

(vii) recovery housing;

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122 Sec. 552 PUBLIC HEALTH SERVICE ACT

(viii) community-based and peer recovery support

services;

(ix) job training, job placement assistance, and

continuing education assistance to support reintegra-

tion into the workforce; and

(x) other best practices to provide the full con-

tinuum of treatment and services, as determined by

the Secretary.

clude medication-assisted treatment, as appropriate, and

do not exclude individuals receiving medication-assisted

treatment from any service.

(D) Periodically conduct patient assessments to sup-

port sustained and clinically significant recovery, as de-

fined by the Assistant Secretary for Mental Health and

Substance Use.

(E) Provide onsite access to medication, as appro-

priate, and toxicology services; for purposes of carrying out

this section.

(F) Operate a secure, confidential, and interoperable

electronic health information system.

(G) Offer family support services such as child care,

family counseling, and parenting interventions to help sta-

bilize families impacted by substance use disorder, as ap-

propriate.

(2) O

UTREACH

.—Each Center shall carry out outreach ac-

tivities regarding the services offered through the Centers,

which may include—

(A) training and supervising outreach staff, as appro-

priate, to work with State and local health departments,

health care providers, the Indian Health Service, State

and local educational agencies, schools funded by the In-

dian Bureau of Education, institutions of higher education,

State and local workforce development boards, State and

local community action agencies, public safety officials,

first responders, Indian Tribes, child welfare agencies, as

appropriate, and other community partners and the public,

including patients, to identify and respond to community

needs;

(B) ensuring that the entities described in subpara-

graph (A) are aware of the services of the Center; and

cluding through the internet, evidence-based resources

that educate professionals and the public on opioid use dis-

order and other substance use disorders, including co-oc-

curring substance use and mental disorders.

(h) D

ATA

EPORTING AND

ROGRAM

VERSIGHT

.—With respect

to a grant awarded under subsection (a), not later than 90 days

after the end of the first year of the grant period, and annually

thereafter for the duration of the grant period (including the dura-

tion of any renewal period for such grant), the entity shall submit

data, as appropriate, to the Secretary regarding—

(1) the programs and activities funded by the grant;

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123 Sec. 561 PUBLIC HEALTH SERVICE ACT

(2) health outcomes of the population of individuals with

a substance use disorder who received services from the Cen-

ter, evaluated by an independent program evaluator through

the use of outcomes measures, as determined by the Secretary;

(3) the retention rate of program participants; and

(4) any other information that the Secretary may require

for the purpose of—ensuring that the Center is complying with

all the requirements of the grant, including providing the full

continuum of services described in subsection (g)(1)(B).

(i) P

RIVACY

.—The provisions of this section, including with re-

spect to data reporting and program oversight, shall be subject to

all applicable Federal and State privacy laws.

(j) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized to

be appropriated $10,000,000 for each of fiscal years 2019 through

2023 for purposes of carrying out this section.

ART

E—C

HILDREN

ITH

ERIOUS

MOTIONAL

ISTURBANCES

SEC. 561. ø290ff¿ COMPREHENSIVE COMMUNITY MENTAL HEALTH

SERVICES FOR CHILDREN WITH SERIOUS EMOTIONAL

DISTURBANCES.

(a) G

RANTS TO

ERTAIN

UBLIC

NTITIES

.—

(1) I

N GENERAL

.—The Secretary, acting through the Direc-

tor of the Center for Mental Health Services, shall make

grants to public entities for the purpose of providing com-

prehensive community mental health services to children with

a serious emotional disturbance, which may include efforts to

identify and serve children at risk.

(2) D

EFINITION 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 organiza-

tion (as defined in section 4(b) and section 4(c) of the Indian

Self-Determination and Education Assistance Act).

(b) C

ONSIDERATIONS IN

AKING

RANTS

.—

(1) R

EQUIREMENT 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 sub-

division of a State, the State in which the political subdivi-

sion is located is such a grantee; and

tribe or tribal organization, the State in which the tribe or

tribal organization is located is such a grantee.

(2) R

EQUIREMENT 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 serv-

ice directly, and the entity has entered into a partici-

pation agreement under the State plan and is quali-

fied to receive payments under such plan; or

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124 Sec. 561 PUBLIC HEALTH SERVICE ACT

(ii) the public entity will enter into an agreement

with an organization under which the organization

will provide the service, and the organization has en-

tered into such a participation agreement and is quali-

fied to receive such payments.

(B)(i) In the case of an organization making an agree-

ment 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 in-

surance policy or under any Federal or State health bene-

fits program.

(ii) A determination by the Secretary of whether an or-

ganization 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 re-

garding the provision of services to the public.

(3) C

ERTAIN CONSIDERATIONS

.—In making grants under

subsection (a), the Secretary shall—

(A) equitably allocate such assistance among the prin-

cipal geographic regions of the United States;

(B) consider the extent to which the public entity in-

volved has a need for the grant; and

subdivision of a State or that is an Indian tribe or tribal

organization—

(i) shall consider any comments regarding the ap-

plication of the entity for such a grant that are re-

ceived 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-Fed-

eral contributions required in subsection (c) regarding

such a grant.

ATCHING

UNDS

.—

(1) I

N GENERAL

.—A funding agreement for a grant under

subsection (a) is that the public entity involved will, with re-

spect to the costs to be incurred by the entity in carrying out

the purpose described in such subsection, make available (di-

rectly 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 re-

ceives 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;

for each $1 of Federal funds provided in the grant; and

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125 Sec. 562 PUBLIC HEALTH SERVICE ACT

(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) D

ETERMINATION 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 contribu-

tions made by the public entity involved toward the pur-

pose described in subsection (a) for the 2-year period pre-

ceding the first fiscal year for which the entity receives a

grant under such section.

SEC. 562. ø290ff–1¿ REQUIREMENTS WITH RESPECT TO CARRYING OUT

PURPOSE OF GRANTS.

(a) S

YSTEMS OF

OMPREHENSIVE

ARE

.—

(1) I

N GENERAL

.—A funding agreement for a grant under

section 561(a) is that, with respect to children with a serious

emotional disturbance, the public entity involved will carry out

the purpose described in such section only through establishing

and operating 1 or more systems of care for making each of the

mental health services specified in subsection (c) available to

each child provided access to the system. In providing for such

a system, the public entity may make grants to, and enter into

contracts with, public and nonprofit private entities.

(2) S

TRUCTURE OF SYSTEM

.—A funding agreement for a

grant under section 561(a) is that a system of care under para-

graph (1) will—

(A) be established in a community selected by the pub-

lic entity involved;

(B) consist of such public agencies and nonprofit pri-

vate entities in the community as are necessary to ensure

that each of the services specified in subsection (c) is avail-

able to each child provided access to the system;

public entity enters into with the agencies and entities de-

scribed in subparagraph (B);

(D) coordinate the provision of the services of the sys-

tem; 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) C

OLLABORATION OF LOCAL PUBLIC ENTITIES

.—A funding

agreement for a grant under section 561(a) is that, for pur-

poses of the establishment and operation of a system of care

under paragraph (1), the public entity involved will seek col-

laboration among all public agencies that provide human serv-

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126 Sec. 562 PUBLIC HEALTH SERVICE ACT

ices in the community in which the system is established, in-

cluding but not limited to those providing mental health serv-

ices, educational services, child welfare services, or juvenile

justice services.

(b) L

IMITATION ON

GE OF

HILDREN

ROVIDED

CCESS TO

TEM

.—A funding agreement for a grant under section 561(a) is that

a system of care under subsection (a) will provide an individual

with access to the system through the age of 21 years.

EQUIRED

ENTAL

EALTH

ERVICES OF

YSTEM

.—A fund-

ing agreement for a grant under section 561(a) is that mental

health services provided by a system of care under subsection (a)

will include, with respect to a serious emotional disturbance in a

child—

(1) diagnostic and evaluation services;

(2) outpatient services provided in a clinic, office, school or

other appropriate location, including individual, group and

family counseling services, professional consultation, and re-

view 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 thera-

peutic 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) R

EQUIRED

RRANGEMENTS

EGARDING

THER

PPROPRIATE

ERVICES

.—

(1) I

N GENERAL

.—A funding agreement for a grant under

section 561(a) is that—

(A) a system of care under subsection (a) will enter

into a memorandum of understanding with each of the

providers specified in paragraph (2) in order to facilitate

the availability of the services of the provider involved to

each child provided access to the system; and

(B) the grant under such section 561(a), and the non-

Federal contributions made with respect to the grant, will

not be expended to pay the costs of providing such non-

mental health services to any individual.

(2) S

PECIFICATION OF NON

MENTAL HEALTH SERVICES

.—The

providers referred to in paragraph (1) are providers of medical

services other than mental health services, providers of edu-

cational services, providers of vocational counseling and voca-

tional rehabilitation services, and providers of protection and

advocacy services with respect to mental health.

(3) F

ACILITATION OF SERVICES OF CERTAIN PROGRAMS

.—A

funding agreement for a grant under section 561(a) is that a

system of care under subsection (a) will, for purposes of para-

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127 Sec. 562 PUBLIC HEALTH SERVICE ACT

graph (1), enter into a memorandum of understanding regard-

ing facilitation of—

(A) services available pursuant to title XIX of the So-

cial Security Act, including services regarding early peri-

odic screening, diagnosis, and treatment;

(B) services available under parts B and C of the Indi-

viduals with Disabilities Education Act; and

grams, as identified by the Secretary.

(e) G

ENERAL

ROVISIONS

EGARDING

ERVICES OF

YSTEM

.—

(1) C

ASE MANAGEMENT SERVICES

.—A funding agreement

for a grant under section 561(a) is that a system of care under

subsection (a) will provide for the case management of each

child provided access to the system in order to ensure that—

(A) the services provided through the system to the

child are coordinated and that the need of each such child

for the services is periodically reassessed;

(B) information is provided to the family of the child

on the extent of progress being made toward the objectives

established for the child under the plan of services imple-

mented for the child pursuant to section 563; and

(i) establishing the eligibility of the child, and the

family of the child, for financial assistance and serv-

ices 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 ap-

propriate services available under such programs.

(2) O

THER PROVISIONS

.—A funding agreement for a grant

under section 561(a) is that a system of care under subsection

(a), in providing the services of the system, will—

(A) provide the services of the system in the cultural

context that is most appropriate for the child and family

involved;

(B) ensure that individuals providing such services to

the child can effectively communicate with the child and

family in the most direct manner;

the child or the family of the child on the basis of race, re-

ligion, 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, in-

cluding identifying children with a serious emotional dis-

turbance who are in the early stages of such disturbance.

(3) R

ULE OF CONSTRUCTION

.—An agreement made under

paragraph (2) may not be construed—

(A) with respect to subparagraph (C) of such para-

graph—

(i) to prohibit a system of care under subsection

(a) from requiring that, in housing provided by the

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128 Sec. 563 PUBLIC HEALTH SERVICE ACT

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 para-

graph, to authorize the system of care to expend the grant

under section 561(a) (or the non-Federal contributions

made with respect to the grant) to provide legal services

or any service with respect to which expenditures regard-

ing the grant are prohibited under subsection (d)(1)(B).

(f) R

ESTRICTIONS ON

SE OF

RANT

.—A funding agreement for

a grant under section 561(a) is that the grant, and the non-Federal

contributions made with respect to the grant, will not be ex-

pended—

(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 ex-

penditures associated with care of children in residential treat-

ment 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;

(4) to provide for the training of any individual, except

training authorized in section 564(a)(2) and training provided

through any appropriate course in continuing education whose

duration does not exceed 2 days.

(g) W

AIVERS

.—The Secretary may waive one or more of the re-

quirements of subsection (c) for a public entity that is an Indian

Tribe or tribal organization, or American Samoa, Guam, the Mar-

shall Islands, the Federated States of Micronesia, the Common-

wealth of the Northern Mariana Islands, the Republic of Palau, or

the United States Virgin Islands if the Secretary determines, after

peer review, that the system of care is family-centered and uses the

least restrictive environment that is clinically appropriate.

SEC. 563. ø290ff–2¿ INDIVIDUALIZED PLAN FOR SERVICES.

(a) I

ENERAL

.—A funding agreement for a grant under sec-

tion 561(a) is that a system of care under section 562(a) will de-

velop 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) M

ULTIDISCIPLINARY

EAM

.—A funding agreement for a

grant under section 561(a) is that the plan required in subsection

(a) will be developed, and reviewed and as appropriate revised not

less than once each year, by a multidisciplinary team of appro-

priately qualified individuals who provide services through the sys-

tem, including as appropriate mental health services, other health

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As Amended Through P.L. 117-328, Enacted December 29, 2022

129 Sec. 564 PUBLIC HEALTH SERVICE ACT

So in law. See section 119 of Public Law 102–321 (106 Stat. 349). Probably should be a pe-

riod.

services, educational services, social services, and vocational coun-

seling and rehabilitation;

OORDINATION

ITH

ERVICES

NDER

NDIVIDUALS WITH

ISABILITIES

DUCATION

.—A funding agreement for a grant

under section 561(a) is that, with respect to a plan under sub-

section (a) for a child, the multidisciplinary team required in sub-

section (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 Dis-

abilities Education Act;

(2) ensure that the plan is consistent with such individual-

ized education program and provides for coordinating services

under the plan with services under such program; and

(3) ensure that the memorandum of understanding entered

into under section 562(d)(3)(B) regarding such Act includes

provisions regarding compliance with this subsection.

(d) C

ONTENTS OF

LAN

.—A funding agreement for a grant

under section 561(a) is that the plan required in subsection (a) for

a child will—

(1) identify and state the needs of the child for the services

available pursuant to section 562 through the system;

(2) provide for each of such services that is appropriate to

the circumstances of the child, including, except in the case of

children who are less than 14 years of age, the provision of ap-

propriate vocational counseling and rehabilitation, and transi-

tion services (as defined in section 602 of the Individuals with

Disabilities Education Act);

(3) establish objectives to be achieved regarding the needs

of the child and the methodology for achieving the objectives;

and

(4) designate an individual to be responsible for providing

the case management required in section 562(e)(1) or certify

that case management services will be provided to the child as

part of the individualized education program of the child under

the Individuals with Disabilities Education Act.

SEC. 564. ø290ff–3¿ ADDITIONAL PROVISIONS.

(a) O

PTIONAL

ERVICES

.—In addition to services described in

subsection (c) of section 562, a system of care under subsection (a)

of such section may, in expending a grant under section 561(a),

provide for—

(1) preliminary assessments to determine whether a child

should be provided access to the system;

(2) training in—

(A) the administration of the system;

(B) the provision of intensive home-based services

under paragraph (4) of section 562(c), intensive day treat-

ment under paragraph (5) of such section, and foster care

or group homes under paragraph (7) of such section; and

poses of section 563;

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As Amended Through P.L. 117-328, Enacted December 29, 2022

130 Sec. 564 PUBLIC HEALTH SERVICE ACT

(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) C

OMPREHENSIVE

LAN

.—The Secretary may make a grant

under section 561(a) only if, with respect to the jurisdiction of the

public entity involved, the entity has submitted to the Secretary,

and has had approved by the Secretary, a plan for the development

of a jurisdiction-wide system of care for community-based services

for children with a serious emotional disturbance that specifies the

progress the public entity has made in developing the jurisdiction-

wide system, the extent of cooperation across agencies serving chil-

dren in the establishment of the system, the Federal and non-Fed-

eral resources currently committed to the establishment of the sys-

tem, and the current gaps in community services and the manner

in which the grant under section 561(a) will be expended to ad-

dress such gaps and establish local systems of care.

IMITATION ON

MPOSITION OF

EES FOR

ERVICES

.—A fund-

ing agreement for a grant under section 561(a) is that, if a charge

is imposed for the provision of services under the grant, such

charge—

(1) will be made according to a schedule of charges that is

made available to the public;

(2) will be adjusted to reflect the income of the family of

the child involved; and

(3) will not be imposed on any child whose family has in-

come 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 ac-

cordance with section 673(2) of the Omnibus Budget Reconcili-

ation Act of 1981.

(d) R

ELATIONSHIP TO

TEMS AND

ERVICES

NDER

THER

GRAMS

.—A funding agreement for a grant under section 561(a) is

that the grant, and the non-Federal contributions made with re-

spect 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 in-

surance policy, or under any Federal or State health benefits

program; or

(2) by an entity that provides health services on a prepaid

basis.

(e) L

IMITATION ON

DMINISTRATIVE

XPENSES

.—A funding

agreement for a grant under section 561(a) is that not more than

2 percent of the grant will be expended for administrative expenses

incurred with respect to the grant by the public entity involved.

(f) R

EPORTS TO

ECRETARY

.—A funding agreement for a grant

under section 561(a) is that the public entity involved will annually

submit to the Secretary (and provide a copy to the State involved)

a report on the activities of the entity under the grant that in-

cludes a description of the number of children provided access to

systems of care operated pursuant to the grant, the demographic

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As Amended Through P.L. 117-328, Enacted December 29, 2022

131 Sec. 565 PUBLIC HEALTH SERVICE ACT

characteristics of the children, the types and costs of services pro-

vided 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 re-

spect to the grant.

(g) D

ESCRIPTION OF

NTENDED

SES OF

RANT

.—The Secretary

may make a grant under section 561(a) only if—

(1) the public entity involved submits to the Secretary a

description of the purposes for which the entity intends to ex-

pend the grant;

(2) the description identifies the populations, areas, and lo-

calities 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 co-

ordinated with any similar services or activities of public or

nonprofit entities.

(h) R

EQUIREMENT OF

PPLICATION

.—The Secretary may make

a grant under section 561(a) only if an application for the grant is

submitted to the Secretary, the application contains the description

of intended uses required in subsection (g), and the application is

in such form, is made in such manner, and contains such agree-

ments, assurances, and information as the Secretary determines to

be necessary to carry out this section.

SEC. 565. ø290ff–4¿ GENERAL PROVISIONS.

(a) D

URATION OF

UPPORT

.—The period during which pay-

ments are made to a public entity from a grant under section

561(a) may not exceed 6 fiscal years.

(b) T

ECHNICAL

SSISTANCE

.—

(1) I

N GENERAL

.—The Secretary shall, upon the request of

a public entity, regardless of whether such public entity is re-

ceiving a grant under section 561(a)—

(A) provide technical assistance to the entity regarding

the process of submitting to the Secretary applications for

grants under section 561(a); and

(B) provide to the entity training and technical assist-

ance with respect to the planning, development, and oper-

ation of systems of care described in section 562.

(2) A

UTHORITY FOR GRANTS AND CONTRACTS

.—The Sec-

retary may provide technical assistance under subsection (a)

directly or through grants to, or contracts with, public and non-

profit private entities.

VALUATIONS AND

EPORTS BY

ECRETARY

.—

(1) I

N GENERAL

.—The Secretary shall, directly or through

contracts with public or private entities, provide for annual

evaluations of programs carried out pursuant to section 561(a).

The evaluations shall assess the effectiveness of the systems of

care operated pursuant to such section, including longitudinal

studies of outcomes of services provided by such systems, other

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As Amended Through P.L. 117-328, Enacted December 29, 2022

132 Sec. 565 PUBLIC HEALTH SERVICE ACT

Indentation is so in law. See section 1411(b)(1) of division FF of Public Law 117-328. Such

amendment should have been made to paragraph (2), not paragraph (1).

Indentation is so in law. See section 2017(2)(C)(ii) of Public Law 103–43 (107 Stat. 218).

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 inter-

agency collaboration in providing community-based services to

children with a serious emotional disturbance, and assess-

ments by parents of the effectiveness of the systems of care.

(2) R

EPORT TO CONGRESS

.—The Secretary shall, not later

than 1 year after the date on which amounts are first appro-

priated 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 legisla-

tive initiatives with respect to this section as the Secretary de-

termines to be appropriate.

(d) D

EFINITIONS

.—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 ac-

cess to a system of care under section 562(a), means—

(A) the legal guardian of the child; and

(B) as appropriate regarding mental health services

for the child, the parents of the child (biological or adop-

tive, as the case may be), kinship caregivers of the child,

and any foster parents of the child.

(3) The term ‘‘funding agreement’’, with respect to a grant

under section 561(a) to a public entity, means that the Sec-

retary 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 dis-

order.

(e) R

ULE OF

ONSTRUCTION

.—Nothing in this part shall be con-

strued as limiting the rights of a child with a serious emotional dis-

turbance under the Individuals with Disabilities Education Act.

(f) F

UNDING

.—

(1)

UTHORIZATION OF APPROPRIATIONS

.—For the

purpose of carrying out this part, there are authorized to

be appropriated $125,000,000 for each of fiscal years 2023

through 2027.

(2)

IMITATION REGARDING TECHNICAL ASSISTANCE

.—Not

more than 10 percent of the amounts appropriated under para-

graph (1) for a fiscal year may be expended for carrying out sub-

section (b).

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As Amended Through P.L. 117-328, Enacted December 29, 2022

133 Sec. 581 PUBLIC HEALTH SERVICE ACT

The part designation and heading for part F are so in law. Part F formerly consisted of

section 571. That section was repealed by section 3301(c)(4) of Public Law 106–310 (114 Stat.

1209), but there was no conforming amendment to strike the designation and heading for part

There is another part G in this title, which also begins with a section 581. See page 677.

That part G relates to services provided through religious organizations.

ART

F—M

ODEL

OMPREHENSIVE

ROGRAM FOR

REATMENT OF

UBSTANCE

BUSE

ART

—P

ROJECTS FOR

HILDREN AND

IOLENCE

SEC. 581.

ø290hh¿ CHILDREN AND VIOLENCE.

(a) I

ENERAL

.—The Secretary, in consultation with the Sec-

retary of Education and the Attorney General, shall carry out di-

rectly or through grants, contracts or cooperative agreements with

public entities a program to assist local communities in developing

ways to assist children in dealing with violence.

(b) A

CTIVITIES

.—Under the program under subsection (a), the

Secretary may—

(1) provide financial support to enable local communities to

implement programs to foster the health and development of

children;

(2) provide technical assistance to local communities with

respect to the development of programs described in paragraph

(1);

(3) provide assistance to local communities in the develop-

ment of policies to address violence when and if it occurs;

(4) assist in the creation of community partnerships among

law enforcement, education systems and mental health and

substance abuse service systems; and

(5) establish mechanisms for children and adolescents to

report incidents of violence or plans by other children or ado-

lescents to commit violence.

EQUIREMENTS

.—An application for a grant, contract or co-

operative agreement under subsection (a) shall demonstrate that—

(1) the applicant will use amounts received to create a

partnership described in subsection (b)(4) to address issues of

violence in schools;

(2) the activities carried out by the applicant will provide

a comprehensive method for addressing violence, that will in-

clude—

(A) security;

(B) educational reform;

(D) alcohol and drug abuse prevention and early inter-

vention services;

(E) mental health prevention and treatment services;

and

(F) early childhood development and psychosocial serv-

ices; and

(3) the applicant will use amounts received only for the

services described in subparagraphs (D), (E), and (F) of para-

graph (2).

(d) G

EOGRAPHICAL

ISTRIBUTION

.—The Secretary shall ensure

that grants, contracts or cooperative agreements under subsection

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As Amended Through P.L. 117-328, Enacted December 29, 2022

134 Sec. 582 PUBLIC HEALTH SERVICE ACT

(a) will be distributed equitably among the regions of the country

and among urban and rural areas.

(e) D

URATION OF

WARDS

.—With respect to a grant, contract or

cooperative agreement under subsection (a), the period during

which payments under such an award will be made to the recipient

may not exceed 5 years.

(f) E

VALUATION

.—The Secretary shall conduct an evaluation of

each project carried out under this section and shall disseminate

the results of such evaluations to appropriate public and private

entities.

(g) I

NFORMATION AND

DUCATION

.—The Secretary shall estab-

lish comprehensive information and education programs to dissemi-

nate the findings of the knowledge development and application

under this section to the general public and to health care profes-

sionals.

(h) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized

to be appropriated to carry out this section, $100,000,000 for fiscal

year 2001, and such sums as may be necessary for each of fiscal

years 2002 and 2003.

SEC. 582. ø290hh–1¿ GRANTS TO ADDRESS THE PROBLEMS OF PER-

SONS WHO EXPERIENCE VIOLENCE RELATED STRESS.

(a) I

ENERAL

.—The Secretary shall award grants, contracts

or cooperative agreements to public and nonprofit private entities,

as well as to Indian tribes and tribal organizations, for the purpose

of developing and maintaining programs that provide for—

(1) the continued operation of the National Child Trau-

matic Stress Initiative (referred to in this section as the

‘‘NCTSI’’), which includes a cooperative agreement with a co-

ordinating center, that focuses on the mental, behavioral, and

biological aspects of psychological trauma response, prevention

of the long-term consequences of child trauma, and early inter-

vention services and treatment to address the long-term con-

sequences of child trauma; and

(2) the development of knowledge with regard to evidence-

based practices for identifying and treating mental, behavioral,

and biological disorders of children and youth resulting from

witnessing or experiencing a traumatic event.

(b) P

RIORITIES

.—In awarding grants, contracts or cooperative

agreements under subsection (a)(2) (related to the development of

knowledge on evidence-based practices for treating mental, behav-

ioral, and biological disorders associated with psychological trau-

ma), the Secretary shall give priority to universities, hospitals,

mental health agencies, and other programs that have established

clinical expertise and research experience in the field of trauma-re-

lated mental disorders.

HILD

UTCOME

ATA

.—The NCTSI coordinating center de-

scribed in subsection (a)(1) shall collect, analyze, report, and make

publicly available, as appropriate, NCTSI-wide child treatment

process and outcome data regarding the early identification and de-

livery of evidence-based treatment and services for children and

families served by the NCTSI grantees.

(d) T

RAINING

.—The NCTSI coordinating center shall facilitate

the coordination of training initiatives in evidence-based and trau-

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As Amended Through P.L. 117-328, Enacted December 29, 2022

135 Sec. 591 PUBLIC HEALTH SERVICE ACT

ma-informed treatments, interventions, and practices offered to

NCTSI grantees, providers, and partners.

(e) D

ISSEMINATION AND

OLLABORATION

.—The NCTSI coordi-

nating center shall, as appropriate, collaborate with—

(1) the Secretary, in the dissemination of evidence-based

and trauma-informed interventions, treatments, products, and

other resources to appropriate stakeholders; and

(2) appropriate agencies that conduct or fund research

within the Department of Health and Human Services, for pur-

poses of sharing NCTSI expertise, evaluation data, and other

activities, as appropriate.

(f) R

EVIEW

.—The Secretary shall, consistent with the peer-re-

view process, ensure that NCTSI applications are reviewed by ap-

propriate experts in the field as part of a consensus-review process.

The Secretary shall include review criteria related to expertise and

experience in child trauma and evidence-based practices.

(g) G

EOGRAPHICAL

ISTRIBUTION

.—The Secretary shall ensure

that grants, contracts or cooperative agreements under subsection

(a) are distributed equitably among the regions of the United

States and among urban and rural areas.

(h) E

VALUATION

.—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, con-

tract or agreement, including both process and outcomes evalua-

tion, and the submission of an evaluation at the end of the project

period.

(i) D

URATION OF

WARDS

.—With respect to a grant, contract or

cooperative agreement under subsection (a), the period during

which payments under such an award will be made to the recipient

shall not be less than 4 years, but shall not exceed 5 years. Such

grants, contracts or agreements may be renewed.

(j) A

UTHORIZATION OF

PPROPRIATIONS

.—There is authorized to

be appropriated to carry out this section, $63,887,000 for each of

fiscal years 2019 through 2023.

(k) S

HORT

ITLE

.—This section may be cited as the ‘‘Donald J.

Cohen National Child Traumatic Stress Initiative’’.

PART H—REQUIREMENT RELATING TO THE

RIGHTS OF RESIDENTS OF CERTAIN FACILI-

TIES

SEC. 591. ø290ii¿ REQUIREMENT RELATING TO THE RIGHTS OF RESI-

DENTS OF CERTAIN FACILITIES.

(a) I

ENERAL

.—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 se-

clusions imposed for purposes of discipline or convenience.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

136 Sec. 592 PUBLIC HEALTH SERVICE ACT

Probably should be Protection and Advocacy for Individuals with Mental Illness Act. See

section 3206(a) of Public Law 106–310 (114 Stat. 1193).

(b) R

EQUIREMENTS

.—Restraints and seclusion may only be im-

posed 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 per-

mitted 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 cir-

cumstances specified by the Secretary until such an order

could reasonably be obtained).

URRENT

.—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 re-

straint.

(d) D

EFINITIONS

.—In this section:

(1) R

ESTRAINTS

.—The term ‘‘restraints’’ means—

(A) any physical restraint that is a mechanical or per-

sonal 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 de-

vices, 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 fall-

ing 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 move-

ment that is not a standard treatment for the resident’s

medical or psychiatric condition.

(2) S

ECLUSION

.—The term ‘‘seclusion’’ means a behavior

control technique involving locked isolation. Such term does

not include a time out.

(3) P

HYSICAL 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) T

IME 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. ø290ii–1¿ REPORTING REQUIREMENT.

(a) I

ENERAL

.—Each facility to which the Protection and Ad-

vocacy for Mentally Ill Individuals Act of 1986

applies shall no-

tify the appropriate agency, as determined by the Secretary, of

each death that occurs at each such facility while a patient is re-

strained or in seclusion, of each death occurring within 24 hours

after the patient has been removed from restraints and seclusion,

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As Amended Through P.L. 117-328, Enacted December 29, 2022

137 Sec. 595 PUBLIC HEALTH SERVICE ACT

Section 593 appears according to the probable intent of the Congress. Section 3207 of Public

Law 106–310 (114 Stat. 1196) added sections 591 and 592, and closing quotations were provided

at the end of section 592. Immediately following that section, however, section 593 appeared in

quotations, and closing quotations were provided at the end of the section. The probable intent

of the Congress is that closing quotations should not have been provided at the end of section

592.

or where it is reasonable to assume that a patient’s death is a re-

sult 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 in-

volved.

(b) F

ACILITY

.—In this section, the term ‘‘facility’’ has the mean-

ing 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.

ø290ii–3¿ REGULATIONS AND ENFORCEMENT.

(a) T

RAINING

.—Not later than 1 year after the date of the en-

actment of this part, the Secretary, after consultation with appro-

priate State and local protection and advocacy organizations, physi-

cians, 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 sub-

section (b).

(b) R

EQUIREMENTS

.—The regulations promulgated under sub-

section (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 treat-

ment 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 notifica-

tion of deaths, as required under section 592(a).

NFORCEMENT

.—A facility to which this part applies that

fails to comply with any requirement of this part, including a fail-

ure to provide appropriate training, shall not be eligible for partici-

pation in any program supported in whole or in part by funds ap-

propriated to any Federal department or agency.

PART I—REQUIREMENT RELATING TO THE

RIGHTS OF RESIDENTS OF CERTAIN NON-

MEDICAL, COMMUNITY-BASED FACILITIES

FOR CHILDREN AND YOUTH

SEC. 595. ø290jj¿ REQUIREMENT RELATING TO THE RIGHTS OF RESI-

DENTS OF CERTAIN NON-MEDICAL, COMMUNITY-BASED

FACILITIES FOR CHILDREN AND YOUTH.

(a) P

ROTECTION OF

IGHTS

.—

(1) I

N GENERAL

.—A public or private non-medical, commu-

nity-based facility for children and youth (as defined in regula-

tions to be promulgated by the Secretary) that receives support

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As Amended Through P.L. 117-328, Enacted December 29, 2022

138 Sec. 595 PUBLIC HEALTH SERVICE ACT

in any form from any program supported in whole or in part

with funds appropriated under this Act shall protect and pro-

mote the rights of each resident of the facility, including the

right to be free from physical or mental abuse, corporal punish-

ment, and any restraints or involuntary seclusions imposed for

purposes of discipline or convenience.

(2) N

ONAPPLICABILITY

.—Notwithstanding this part, a facil-

ity 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 Secu-

rity Act, shall comply with the requirements of part H.

(3) A

PPLICABILITY OF MEDICAID PROVISIONS

.—A non-med-

ical, community-based facility for children and youth funded

under the Medicaid program under title XIX of the Social Secu-

rity Act shall continue to meet all existing requirements for

participation in such program that are not affected by this

part.

(b) R

EQUIREMENTS

.—

(1) I

N GENERAL

.—Physical restraints and seclusion may

only be imposed on a resident of a facility described in sub-

section (a) if—

(A) the restraints or seclusion are imposed only in

emergency circumstances and only to ensure the imme-

diate physical safety of the resident, a staff member, or

others and less restrictive interventions have been deter-

mined to be ineffective; and

(B) the restraints or seclusion are imposed only by an

individual trained and certified, by a State-recognized body

(as defined in regulation promulgated by the Secretary)

and pursuant to a process determined appropriate by the

State and approved by the Secretary, in the prevention

and use of physical restraint and seclusion, including the

needs and behaviors of the population served, relationship

building, alternatives to restraint and seclusion, de-esca-

lation methods, avoiding power struggles, thresholds for

restraints and seclusion, the physiological and psycho-

logical impact of restraint and seclusion, monitoring phys-

ical signs of distress and obtaining medical assistance,

legal issues, position asphyxia, escape and evasion tech-

niques, time limits, the process for obtaining approval for

continued restraints, procedures to address problematic re-

straints, documentation, processing with children, and fol-

low-up with staff, and investigation of injuries and com-

plaints.

(2) I

NTERIM PROCEDURES RELATING TO TRAINING AND CER

TIFICATION

.—

(A) I

N GENERAL

.—Until such time as the State devel-

ops a process to assure the proper training and certifi-

cation of facility personnel in the skills and competencies

referred in paragraph (1)(B), the facility involved shall de-

velop and implement an interim procedure that meets the

requirements of subparagraph (B).

(B) R

EQUIREMENTS

.—A procedure developed under

subparagraph (A) shall—

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139 Sec. 595 PUBLIC HEALTH SERVICE ACT

(i) ensure that a supervisory or senior staff person

with training in restraint and seclusion who is com-

petent to conduct a face-to-face assessment (as defined

in regulations promulgated by the Secretary), will as-

sess 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 re-

straint or seclusion; and

(iii) ensure that the supervisory or senior staff

person continues to monitor the situation for the dura-

tion of the restraint and seclusion.

(3) L

IMITATIONS

.—

(A) I

N GENERAL

.—The use of a drug or medication that

is used as a restraint to control behavior or restrict the

resident’s freedom of movement that is not a standard

treatment for the resident’s medical or psychiatric condi-

tion in nonmedical community-based facilities for children

and youth described in subsection (a)(1) is prohibited.

(B) P

ROHIBITION

.—The use of mechanical restraints in

non-medical, community-based facilities for children and

youth described in subsection (a)(1) is prohibited.

IMITATION

.—A non-medical, community-based fa-

cility for children and youth described in subsection (a)(1)

may only use seclusion when a staff member is continu-

ously face-to-face monitoring the resident and when strong

licensing or accreditation and internal controls are in

place.

ULE OF

ONSTRUCTION

.—

(1) I

N GENERAL

.—Nothing in this section shall be con-

strued as prohibiting the use of restraints for medical immo-

bilization, adaptive support, or medical protection.

(2) C

URRENT LAW

.—This part shall not be construed to af-

fect or impede any Federal or State law or regulations that

provide greater protections than this part regarding seclusion

and restraint.

(d) D

EFINITIONS

.—In this section:

(1) M

ECHANICAL RESTRAINT

.—The term ‘‘mechanical re-

straint’’ means the use of devices as a means of restricting a

resident’s freedom of movement.

(2) P

HYSICAL ESCORT

.—The term ‘‘physical escort’’ means

the temporary touching or holding of the hand, wrist, arm,

shoulder or back for the purpose of inducing a resident who is

acting out to walk to a safe location.

(3) P

HYSICAL 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) S

ECLUSION

.—The term ‘‘seclusion’’ means a behavior

control technique involving locked isolation. Such term does

not include a time out.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

140 Sec. 595A PUBLIC HEALTH SERVICE ACT

(5) T

IME OUT

.—The term ‘‘time out’’ means a behavior

management technique that is part of an approved treatment

program and may involve the separation of the resident from

the group, in a non-locked setting, for the purpose of calming.

Time out is not seclusion.

SEC. 595A. ø290jj–1¿ REPORTING REQUIREMENT.

Each facility to which this part applies shall notify the appro-

priate State licensing or regulatory agency, as determined by the

Secretary—

(1) of each death that occurs at each such facility. A notifi-

cation under this section shall include the name of the resident

and shall be provided not later than 24 hours after the time

of the individuals death; and

(2) of the use of seclusion or restraints in accordance with

regulations promulgated by the Secretary, in consultation with

the States.

SEC. 595B. ø290jj–2¿ REGULATIONS AND ENFORCEMENT.

(a) T

RAINING

.—Not later than 6 months after the date of the

enactment of this part, the Secretary, after consultation with ap-

propriate State, local, public and private protection and advocacy

organizations, health care professionals, social workers, facilities,

and patients, shall promulgate regulations that—

(1) require States that license non-medical, community-

based residential facilities for children and youth to develop li-

censing rules and monitoring requirements concerning behav-

ior management practice that will ensure compliance with Fed-

eral regulations and to meet the requirements of subsection

(b);

(2) require States to develop and implement such licensing

rules and monitoring requirements within 1 year after the pro-

mulgation of the regulations referred to in the matter pre-

ceding paragraph (1); and

(3) support the development of national guidelines and

standards on the quality, quantity, orientation and training,

required under this part, as well as the certification or licen-

sure of those staff responsible for the implementation of behav-

ioral intervention concepts and techniques.

(b) R

EQUIREMENTS

.—The regulations promulgated under sub-

section (a) shall require—

(1) that facilities described in subsection (a) ensure that

there is an adequate number of qualified professional and sup-

portive staff to evaluate residents, formulate written individ-

ualized, 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 re-

straint, de-escalation methods, avoiding power struggles,

thresholds for restraints, the physiological impact of restraint

and seclusion, monitoring physical signs of distress and obtain-

ing medical assistance, legal issues, position asphyxia, escape

and evasion techniques, time limits for the use of restraint and

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As Amended Through P.L. 117-328, Enacted December 29, 2022

141 Sec. 581 PUBLIC HEALTH SERVICE ACT

There are two parts G in this title. The first was added by section 3101 of Public Law 106–

310 (114 Stat. 1168) and relates to projects for children and violence; that part also begins with

section 581. See page 669. Sections 3207 and 3208 of such Public Law (114 Stat. 1195, 1197)

added parts H and I, respectively.

Subsequently, part G above was 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), which provides that title V of this Act ‘‘is amended by adding at the end the following

part:’’, thereby placing that part G after the part I added by Public Law 106–310.

Section 1955 of this Act also relates to religious organizations as providers of substance

abuse services. That section was added by section 3305 of Public Law 106–310 (114 Stat. 1212).

seclusion, the process for obtaining approval for continued re-

straints and seclusion, procedures to address problematic re-

straints, documentation, processing with children, and follow-

up with staff, and investigation of injuries and complaints; and

(3) that such facilities provide complete and accurate noti-

fication of deaths, as required under section 595A(1).

NFORCEMENT

.—A State to which this part applies that

fails to comply with any requirement of this part, including a fail-

ure to provide appropriate training and certification, shall not be

eligible for participation in any program supported in whole or in

part by funds appropriated under this Act.

ART

—S

ERVICES

ROVIDED

HROUGH

ELIGIOUS

RGANIZATIONS

SEC. 581. ø290kk¿ APPLICABILITY TO DESIGNATED PROGRAMS.

(a) D

ESIGNATED

ROGRAMS

.—Subject to subsection (b), this

part applies to discretionary and formula grant programs adminis-

tered by the Substance Abuse and Mental Health Services Admin-

istration that make awards of financial assistance to public or pri-

vate entities for the purpose of carrying out activities to prevent or

treat substance abuse (in this part referred to as a ‘‘designated pro-

gram’’). Designated programs include the program under subpart II

of part B of title XIX (relating to formula grants to the States).

(b) L

IMITATION

.—This part does not apply to any award of fi-

nancial assistance under a designated program for a purpose other

than the purpose specified in subsection (a).

EFINITIONS

.—For purposes of this part (and subject to sub-

section (b)):

(1) The term ‘‘designated program’’ has the meaning given

such term in subsection (a).

(2) The term ‘‘financial assistance’’ means a grant, coopera-

tive agreement, or contract.

(3) The term ‘‘program beneficiary’’ means an individual

who receives program services.

(4) The term ‘‘program participant’’ means a public or pri-

vate entity that has received financial assistance under a des-

ignated program.

(5) The term ‘‘program services’’ means treatment for sub-

stance abuse, or preventive services regarding such abuse, pro-

vided pursuant to an award of financial assistance under a

designated program.

(6) The term ‘‘religious organization’’ means a nonprofit re-

ligious organization.

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142 Sec. 582 PUBLIC HEALTH SERVICE ACT

SEC. 582. ø290kk–1¿ RELIGIOUS ORGANIZATIONS AS PROGRAM PAR-

TICIPANTS.

(a) I

ENERAL

.—Notwithstanding any other provision of law,

a religious organization, on the same basis as any other nonprofit

private provider—

(1) may receive financial assistance under a designated

program; and

(2) may be a provider of services under a designated pro-

gram.

(b) R

ELIGIOUS

RGANIZATIONS

.—The purpose of this section is

to allow religious organizations to be program participants on the

same basis as any other nonprofit private provider without impair-

ing the religious character of such organizations, and without di-

minishing the religious freedom of program beneficiaries.

ONDISCRIMINATION

GAINST

ELIGIOUS

RGANIZATIONS

.—

(1) E

LIGIBILITY AS PROGRAM PARTICIPANTS

.—Religious orga-

nizations are eligible to be program participants on the same

basis as any other nonprofit private organization as long as the

programs are implemented consistent with the Establishment

Clause and Free Exercise Clause of the First Amendment to

the United States Constitution. Nothing in this Act shall be

construed to restrict the ability of the Federal Government, or

a State or local government receiving funds under such pro-

grams, to apply to religious organizations the same eligibility

conditions in designated programs as are applied to any other

nonprofit private organization.

(2) N

ONDISCRIMINATION

.—Neither the Federal Government

nor a State or local government receiving funds under des-

ignated programs shall discriminate against an organization

that is or applies to be a program participant on the basis that

the organization has a religious character.

(d) R

ELIGIOUS

HARACTER AND

REEDOM

.—

(1) R

ELIGIOUS ORGANIZATIONS

.—Except as provided in this

section, any religious organization that is a program partici-

pant shall retain its independence from Federal, State, and

local government, including such organization’s control over

the definition, development, practice, and expression of its reli-

gious beliefs.

(2) A

DDITIONAL SAFEGUARDS

.—Neither the Federal Govern-

ment nor a State shall require a religious organization to—

(A) alter its form of internal governance; or

(B) remove religious art, icons, scripture, or other sym-

bols,

in order to be a program participant.

(e) E

MPLOYMENT

RACTICES

.—Nothing in this section shall be

construed to modify or affect the provisions of any other Federal or

State law or regulation that relates to discrimination in employ-

ment. A religious organization’s exemption provided under section

702 of the Civil Rights Act of 1964 regarding employment practices

shall not be affected by its participation in, or receipt of funds

from, a designated program.

(f) R

IGHTS OF

ROGRAM

ENEFICIARIES

.—

(1) I

N GENERAL

.—If an individual who is a program bene-

ficiary or a prospective program beneficiary objects to the reli-

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143 Sec. 582 PUBLIC HEALTH SERVICE ACT

gious character of a program participant, within a reasonable

period of time after the date of such objection such program

participant shall refer such individual to, and the appropriate

Federal, State, or local government that administers a des-

ignated program or is a program participant shall provide to

such individual (if otherwise eligible for such services), pro-

gram services that—

(A) are from an alternative provider that is accessible

to, and has the capacity to provide such services to, such

individual; and

(B) have a value that is not less than the value of the

services that the individual would have received from the

program participant to which the individual had such ob-

jection.

Upon referring a program beneficiary to an alternative pro-

vider, the program participant shall notify the appropriate

Federal, State, or local government agency that administers

the program of such referral.

(2) N

OTICES

.—Program participants, public agencies that

refer individuals to designated programs, and the appropriate

Federal, State, or local governments that administer des-

ignated programs or are program participants shall ensure

that notice is provided to program beneficiaries or prospective

program beneficiaries of their rights under this section.

(3) A

DDITIONAL REQUIREMENTS

.—A program participant

making a referral pursuant to paragraph (1) shall—

(A) prior to making such referral, consider any list

that the State or local government makes available of enti-

ties in the geographic area that provide program services;

and

(B) ensure that the individual makes contact with the

alternative provider to which the individual is referred.

(4) N

ONDISCRIMINATION

.—A religious organization that is a

program participant shall not in providing program services or

engaging in outreach activities under designated programs dis-

criminate against a program beneficiary or prospective pro-

gram beneficiary on the basis of religion or religious belief.

(g) F

ISCAL

CCOUNTABILITY

.—

(1) I

N GENERAL

.—Except as provided in paragraph (2), any

religious organization that is a program participant shall be

subject to the same regulations as other recipients of awards

of Federal financial assistance to account, in accordance with

generally accepted auditing principles, for the use of the funds

provided under such awards.

(2) L

IMITED AUDIT

.—With respect to the award involved, a

religious organization that is a program participant shall seg-

regate Federal amounts provided under award into a separate

account from non-Federal funds. Only the award funds shall be

subject to audit by the government.

(h) C

OMPLIANCE

.—With respect to compliance with this section

by an agency, a religious organization may obtain judicial review

of agency action in accordance with chapter 7 of title 5, United

States Code.

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144 Sec. 583 PUBLIC HEALTH SERVICE ACT

SEC. 583. ø290kk–2¿ LIMITATIONS ON USE OF FUNDS FOR CERTAIN

PURPOSES.

No funds provided under a designated program shall be ex-

pended for sectarian worship, instruction, or proselytization.

SEC. 584. ø290kk–3¿ EDUCATIONAL REQUIREMENTS FOR PERSONNEL

IN DRUG TREATMENT PROGRAMS.

(a) F

INDINGS

.—The Congress finds that—

(1) establishing unduly rigid or uniform educational quali-

fication for counselors and other personnel in drug treatment

programs may undermine the effectiveness of such programs;

and

(2) such educational requirements for counselors and other

personnel may hinder or prevent the provision of needed drug

treatment services.

(b) N

ONDISCRIMINATION

.—In determining whether personnel of

a program participant that has a record of successful drug treat-

ment for the preceding three years have satisfied State or local re-

quirements for education and training, a State or local government

shall not discriminate against education and training provided to

such personnel by a religious organization, so long as such edu-

cation and training includes basic content substantially equivalent

to the content provided by nonreligious organizations that the

State or local government would credit for purposes of determining

whether the relevant requirements have been satisfied.

PART K—MINORITY FELLOWSHIP PROGRAM

SEC. 597. ø290ll¿ FELLOWSHIPS.

(a) I

ENERAL

.—The Secretary shall maintain a program, to

be known as the Minority Fellowship Program, under which the

Secretary shall award fellowships, which may include stipends, for

the purposes of—

(1) increasing the knowledge of mental and substance use

disorders practitioners on issues related to prevention, treat-

ment, and recovery support for individuals who are from racial

and ethnic minority populations and who have a mental or

substance use disorder;

(2) improving the quality of mental and substance use dis-

order prevention and treatment services delivered to racial and

ethnic minority populations; and

(3) increasing the number of culturally competent mental

and substance use disorders professionals who teach, admin-

ister services, conduct research, and provide direct mental or

substance use disorder services to racial and ethnic minority

populations.

(b) T

RAINING

OVERED

.—The fellowships awarded under sub-

section (a) shall be for postbaccalaureate training (including for

master’s and doctoral degrees) for mental and substance use dis-

order treatment professionals, including in the fields of psychiatry,

nursing, social work, psychology, marriage and family therapy,

mental health counseling, and substance use disorder and addic-

tion counseling.

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As Amended Through P.L. 117-328, Enacted December 29, 2022

145 Sec. 597 PUBLIC HEALTH SERVICE ACT

UTHORIZATION OF

PPROPRIATIONS

.—To carry out this sec-

tion, there are authorized to be appropriated $25,000,000 for each

of fiscal years 2023 through 2027.

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As Amended Through P.L. 117-328, Enacted December 29, 2022