[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[S. 2680 Introduced in Senate (IS)]
<DOC>
114th CONGRESS
2d Session
S. 2680
To amend the Public Health Service Act to provide comprehensive mental
health reform, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 15, 2016
Mr. Alexander (for himself, Mrs. Murray, Mr. Cassidy, and Mr. Murphy)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to provide comprehensive mental
health reform, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Mental Health
Reform Act of 2016''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
TITLE I--STRENGTHENING LEADERSHIP AND ACCOUNTABILITY
Sec. 101. Improving oversight of mental and substance use disorder
programs.
Sec. 102. Strengthening leadership of the Substance Abuse and Mental
Health Services Administration.
Sec. 103. Chief Medical Officer.
Sec. 104. Strategic plan.
Sec. 105. Biennial report concerning activities and progress.
Sec. 106. Authorities of centers for mental health services.
Sec. 107. Advisory councils.
Sec. 108. Peer review.
Sec. 109. Inter-Departmental Serious Mental Illness Coordinating
Committee.
TITLE II--ENSURING MENTAL AND SUBSTANCE USE DISORDER PREVENTION,
TREATMENT, AND RECOVERY PROGRAMS KEEP PACE WITH SCIENCE
Sec. 201. Encouraging innovation and evidence-based programs.
Sec. 202. Promoting access to information on evidence-based programs
and practices.
Sec. 203. Priority mental health needs of regional and national
significance.
TITLE III--SUPPORTING STATE RESPONSES TO MENTAL HEALTH AND SUBSTANCE
USE DISORDER NEEDS
Sec. 301. Community Mental Health Services Block Grant.
Sec. 302. Additional provisions related to the block grants.
Sec. 303. Study of distribution of funds under the Substance Abuse
Prevention and Treatment Block Grant and
the Community Mental Health Services Block
Grant.
TITLE IV--PROMOTING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER
CARE
Sec. 401. Grants for treatment and recovery for homeless individuals.
Sec. 402. Grants for jail diversion programs.
Sec. 403. Promoting integration of primary and behavioral health care.
Sec. 404. Projects for assistance in transition from homelessness.
Sec. 405. National Suicide Prevention Lifeline program.
Sec. 406. Connecting individuals and families with care.
Sec. 407. Streamlining mental and behavioral health workforce programs.
Sec. 408. Reports.
Sec. 409. Centers and program repeals.
TITLE V--STRENGTHENING MENTAL AND SUBSTANCE USE DISORDER CARE FOR
CHILDREN AND ADOLESCENTS
Sec. 501. Programs for children with serious emotional disturbances.
Sec. 502. Telehealth child psychiatry access grants.
Sec. 503. Substance use disorder treatment and early intervention
services for children and adolescents.
Sec. 504. Residential treatment programs for pregnant and parenting
women.
TITLE VI--IMPROVING PATIENT CARE AND ACCESS TO MENTAL AND SUBSTANCE USE
DISORDER BENEFITS
Sec. 601. HIPAA clarification.
Sec. 602. Identification of model training programs.
Sec. 603. Confidentiality of records.
Sec. 604. Enhanced compliance with mental health and substance use
disorder coverage requirements.
Sec. 605. Action plan for enhanced enforcement of mental health and
substance use disorder coverage.
Sec. 606. Report on investigations regarding parity in mental health
and substance use disorder benefits.
Sec. 607. GAO study on coverage limitations for individuals with
serious mental illness and substance use
disorders.
Sec. 608. Clarification of existing parity rules.
TITLE I--STRENGTHENING LEADERSHIP AND ACCOUNTABILITY
SEC. 101. IMPROVING OVERSIGHT OF MENTAL AND SUBSTANCE USE DISORDER
PROGRAMS.
(a) In General.--The Secretary of Health and Human Services, acting
through the Assistant Secretary for Planning and Evaluation (referred
to in this section as the ``Assistant Secretary''), shall ensure
efficient and effective planning and evaluation of mental and substance
use disorder programs and related activities.
(b) Activities.--In carrying out subsection (a), the Assistant
Secretary shall--
(1) evaluate programs related to mental and substance use
disorders, including co-occurring disorders, across agencies
and other organizations, as appropriate, including programs
related to--
(A) prevention, intervention, treatment, and
recovery support services, including such services for
individuals with a serious mental illness or serious
emotional disturbance;
(B) the reduction of homelessness and incarceration
among individuals with a mental or substance use
disorder; and
(C) public health and health services; and
(2) consult, as appropriate, with the Administrator of the
Substance Abuse and Mental Health Services Administration, the
Chief Medical Officer of the Substance Abuse and Mental Health
Services Administration, established under section 501(g) of
the Public Health Service Act (42 U.S.C. 290aa(g)) as amended
by section 103, other agencies within the Department of Health
and Human Services, and other relevant Federal departments.
(c) Recommendations.--The Assistant Secretary shall evaluate and
provide recommendations to the Substance Abuse and Mental Health
Services Administration and other relevant agencies within the
Department of Health and Human Services on improving programs and
activities based on the evaluation described in subsection (b)(1).
SEC. 102. STRENGTHENING LEADERSHIP OF THE SUBSTANCE ABUSE AND MENTAL
HEALTH SERVICES ADMINISTRATION.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa) is
amended--
(1) in subsection (b)--
(A) by striking the heading and inserting
``Centers''; and
(B) in the matter preceding paragraph (1), by
striking ``entities'' and inserting ``Centers''; and
(2) in subsection (d)--
(A) in paragraph (1)--
(i) by striking ``agencies'' each place the
term appears and inserting ``Centers''; and
(ii) by striking ``such agency'' and
inserting ``such Center'';
(B) in paragraph (2)--
(i) by striking ``agencies'' and inserting
``Centers'';
(ii) by striking ``with respect to
substance abuse'' and inserting ``with respect
to substance use disorders''; and
(iii) by striking ``and individuals who are
substance abusers'' and inserting ``and
individuals with substance use disorders'';
(C) in paragraph (5), by striking ``substance
abuse'' and inserting ``substance use disorder'';
(D) in paragraph (6)--
(i) by striking ``the Centers for Disease
Control'' and inserting ``the Centers for
Disease Control and Prevention,'';
(ii) by striking ``HIV or tuberculosis
among substance abusers and individuals with
mental illness'' and inserting ``HIV, hepatitis
C, tuberculosis, and other communicable
diseases among individuals with mental illness
or substance use disorders,''; and
(iii) by inserting ``or disorders'' before
the semicolon;
(E) in paragraph (7), by striking ``abuse utilizing
anti-addiction medications, including methadone'' and
inserting ``use disorders, including services that
utilize drugs or devices approved by the Food and Drug
Administration for substance use disorders'';
(F) in paragraph (8)--
(i) by striking ``Agency for Health Care
Policy Research'' and inserting ``Agency for
Healthcare Research and Quality''; and
(ii) by striking ``treatment and
prevention'' and inserting ``prevention and
treatment'';
(G) in paragraph (9)--
(i) by inserting ``and maintenance'' after
``development'';
(ii) by striking ``Agency for Health Care
Policy Research'' and inserting ``Agency for
Healthcare Research and Quality''; and
(iii) by striking ``treatment and
prevention'' and inserting ``prevention and
treatment and appropriately incorporated into
programs carried out by the Administration'';
(H) in paragraph (10), by striking ``abuse'' and
inserting ``use disorder'';
(I) by striking paragraph (11) and inserting the
following:
``(11) work with relevant agencies of the Department of
Health and Human Services on integrating mental health
promotion and substance use disorder prevention with general
health promotion and disease prevention and integrating mental
and substance use disorder treatment services with physical
health treatment services;'';
(J) in paragraph (13)--
(i) in the matter preceding subparagraph
(A), by striking ``this title, assure that''
and inserting ``this title, or part B of title
XIX, or grant programs otherwise funded by the
Administration'';
(ii) in subparagraph (A)--
(I) by inserting ``require that''
before ``all grants''; and
(II) by striking ``and'' at the
end;
(iii) by redesignating subparagraph (B) as
subparagraph (C);
(iv) by inserting after subparagraph (A)
the following:
``(B) ensure that the director of each Center of
the Administration consistently documents the
application of criteria when awarding grants and the
ongoing oversight of grantees after such grants are
awarded;'';
(v) in subparagraph (C), as so
redesignated--
(I) by inserting ``require that''
before ``all grants''; and
(II) by inserting ``and'' after the
semicolon at the end; and
(vi) by adding at the end the following:
``(D) inform a State when any funds are awarded
through such a grant to any entity within such
State;'';
(K) in paragraph (16)--
(i) by striking ``abuse and mental health
information'' and inserting ``use disorder,
including evidence-based and promising best
practices for prevention, treatment, and
recovery support services for individuals with
mental and substance use disorders,'';
(L) in paragraph (17)--
(i) by striking ``substance abuse'' and
inserting ``mental and substance use
disorder''; and
(ii) by striking ``and'' at the end;
(M) in paragraph (18), by striking the period and
inserting a semicolon; and
(N) by adding at the end the following:
``(19) consult with State, local, and tribal governments,
nongovernmental entities, and individuals with mental illness,
particularly individuals with a serious mental illness and
children and adolescents with a serious emotional disturbance,
and their family members, with respect to improving community-
based and other mental health services;
``(20) collaborate with the Secretary of Defense and the
Secretary of Veterans Affairs to improve the provision of
mental and substance use disorder services provided by the
Department of Defense and the Department of Veterans Affairs to
veterans, including through the provision of services using the
telehealth capabilities of the Department of Veterans Affairs;
``(21) collaborate with the heads of Federal departments
and programs that are members of the United States Interagency
Council on Homelessness, particularly the Secretary of Housing
and Urban Development, the Secretary of Labor, and the
Secretary of Veterans Affairs, and with the heads of other
agencies within the Department of Health and Human Services,
particularly the Administrator of the Health Resources and
Services Administration, the Assistant Secretary for the
Administration for Children and Families, and the Administrator
of the Centers for Medicare & Medicaid Services, to design
national strategies for providing services in supportive
housing to assist in ending chronic homelessness and to
implement programs that address chronic homelessness; and
``(22) work with States and other stakeholders to develop
and support activities to recruit and retain a workforce
addressing mental and substance use disorders.''.
SEC. 103. CHIEF MEDICAL OFFICER.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa), as
amended by section 102, is further amended--
(1) by redesignating subsections (g) through (j) and
subsections (k) through (o) as subsections (h) through (k) and
subsections (m) through (q), respectively;
(2) in subsection (e)(3)(C), by striking ``subsection (k)''
and inserting ``subsection (m)'';
(3) in subsection (f)(2)(C)(iii), by striking ``subsection
(k)'' and inserting ``subsection (m)''; and
(4) by inserting after subsection (f) the following:
``(g) Chief Medical Officer.--
``(1) In general.--The Administrator, with the approval of
the Secretary, shall appoint a Chief Medical Officer within the
Administration.
``(2) Eligible candidates.--The Administrator 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
substance use disorder services;
``(C) have experience working with mental or
substance use disorder programs; and
``(D) have an understanding of biological,
psychosocial, and pharmaceutical treatments of mental
or substance use disorders.
``(3) Duties.--The Chief Medical Officer shall--
``(A) serve as a liaison between the Administration
and providers of mental and substance use disorder
prevention, treatment, and recovery services;
``(B) assist the Administrator in the evaluation,
organization, integration, and coordination of programs
operated by the Administration;
``(C) promote evidence-based and promising best
practices, including culturally and linguistically
appropriate practices, as appropriate, for the
prevention, treatment, and recovery of substance use
disorders and mental illness, including serious mental
illness and serious emotional disturbance; and
``(D) participate in regular strategic planning for
the Administration.''.
SEC. 104. STRATEGIC PLAN.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa), as
amended by section 103, is further amended by inserting after
subsection (k), as redesignated in section 103, the following:
``(l) Strategic Plan.--
``(1) In general.--Not later than December 1, 2017, and
every 4 years thereafter, the Administrator shall develop and
carry out a strategic plan in accordance with this subsection
for the planning and operation of programs and grants carried
out by the Administration.
``(2) Coordination.--In developing and carrying out the
strategic plan under this section, the Administrator shall take
into consideration the findings and recommendations of the
Assistant Secretary for Planning and Evaluation under section
101 of the Mental Health Reform Act of 2016 and the report of
the Inter-Departmental Serious Mental Illness Coordinating
Committee under section 109 of such Act.
``(3) Publication of plan.--Not later than December 1,
2017, and every 4 years thereafter, the Administrator shall--
``(A) submit the strategic plan developed under
paragraph (1) to the appropriate committees of
Congress; and
``(B) post such plan on the Internet website of the
Administration.
``(4) Contents.--The strategic plan developed under
paragraph (1) shall--
``(A) identify strategic priorities, goals, and
measurable objectives for mental and substance use
disorder activities and programs operated and supported
by the Administration;
``(B) identify ways to improve services for
individuals with a mental or substance use disorder,
including services related to the prevention of,
diagnosis of, intervention in, treatment of, and
recovery from, mental or substance use disorders,
including serious mental illness or serious emotional
disturbance, and access to services and supports for
individuals with a serious mental illness or serious
emotional disturbance;
``(C) ensure that programs provide, as appropriate,
access to effective and evidence-based diagnosis,
prevention, intervention, treatment, and recovery
services, including culturally and linguistically
appropriate services, as appropriate, for individuals
with a mental or substance use disorder;
``(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 populations) as
psychiatrists, psychologists, psychiatric nurse
practitioners, physician assistants, clinical
social workers, certified peer support
specialists, or other licensed or certified
mental health professionals, including such
professionals specializing in the diagnosis,
evaluation, or treatment of individuals with a
serious mental illness or serious emotional
disturbance; and
``(ii) a strategy to improve the
recruitment, training, and retention of a
workforce for the treatment of individuals with
mental or substance use disorders, or co-
occurring disorders; and
``(E) disseminate evidenced-based and promising
best practices related to prevention, early
intervention, treatment, and recovery services related
to mental illness, particularly for individuals with a
serious mental illness and children and adolescents
with a serious emotional disturbance, and substance use
disorders.''.
SEC. 105. BIENNIAL REPORT CONCERNING ACTIVITIES AND PROGRESS.
(a) In General.--Section 501 of the Public Health Service Act (42
U.S.C. 290aa), as amended by section 104, is further amended by
amending subsection (m), as redesignated by section 103, to read as
follows:
``(m) Biennial Report Concerning Activities and Progress.--Not
later than December of 2019, and every 2 years thereafter, the
Administrator shall prepare and submit to the Committee on Energy and
Commerce and the Committee on Appropriations of the House of
Representatives and the Committee on Health, Education, Labor, and
Pensions and the Committee on Appropriations 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
Administration, 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 Administrator, including the extent to which programs
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 disorder prevention, treatment, and
recovery services and improving outcomes by the Administration,
including with respect to co-occurring disorders;
``(4) a description of the manner in which the
Administration coordinates and partners with other Federal
agencies and departments related to mental and substance use
disorders, including activities related to--
``(A) the translation of research findings into
improved programs, including with respect to how
advances in serious mental illness and serious
emotional disturbance research have been incorporated
into programs;
``(B) the recruitment, training, and retention of a
mental and substance use disorder workforce;
``(C) the integration of mental or substance use
disorder services and physical health services;
``(D) homelessness; and
``(E) veterans;
``(5) a description of the manner in which the
Administration promotes coordination by grantees under this
title, and part B of title XIX, with State or local agencies;
and
``(6) a description of the activities carried out by the
Office of Policy, Planning, and Innovation under section 501A
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;
``(C) a description of the activities supported
through such grants, including outcomes of programs
supported; and
``(D) information on how the Office of Policy,
Planning, and Innovation is consulting with the
Assistant Secretary for Planning and Evaluation, and
collaborating with the Center of Substance Abuse
Treatment, the Center of Substance Abuse Prevention,
and the Center for Mental Health Services to carry out
such activities; and
``(7) recommendations made by the Assistant Secretary for
Planning and Evaluation to improve programs within the
Administration.''.
(b) Conforming Amendment.--Section 508(p) of the Public Health
Service Act (42 U.S.C. 290bb-1) is amended by striking ``section
501(k)'' and inserting ``section 501(m)''.
SEC. 106. AUTHORITIES OF CENTERS FOR MENTAL HEALTH SERVICES.
Section 520(b) of the Public Health Service Act (42 U.S.C. 290bb-
31(b)) is amended--
(1) by redesignating paragraphs (3) through (15) as
paragraphs (4) through (16), respectively;
(2) by inserting after paragraph (2) the following:
``(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 of mental illness and the
promotion of mental health are carried out in a manner that
reflects the best available science and evidence-based
practices, including culturally and linguistically appropriate
services, as appropriate;'';
(3) in paragraph (5), as so redesignated, by inserting
``through programs that reduce risk and promote resiliency''
before the semicolon;
(4) in paragraph (6), as so redesignated, by inserting ``in
collaboration with the Director of the National Institute of
Mental Health,'' before ``develop'';
(5) in paragraph (8), as so redesignated, by inserting ``,
increase meaningful participation of individuals with mental
illness,'' before ``and protect the legal'';
(6) in paragraph (10), as so redesignated, by striking
``professional and paraprofessional personnel pursuant to
section 303'' and inserting ``paraprofessional personnel and
health professionals'';
(7) in paragraph (11), as so redesignated, by inserting
``and tele-mental health,'' after ``rural mental health,'';
(8) in paragraph (12), as so redesignated, by striking
``establish a clearinghouse for mental health information to
assure the widespread dissemination of such information'' and
inserting ``disseminate mental health information, including
evidenced-based practices,'';
(9) in paragraph (15), as so redesignated, by striking
``and'' at the end;
(10) in paragraph (16), as so redesignated, by striking the
period and inserting ``; and''; and
(11) by adding at the end the following:
``(17) ensure the consistent documentation of the
application of criteria when awarding grants and the ongoing
oversight of grantees after such grants are awarded.''.
SEC. 107. ADVISORY COUNCILS.
Section 502 of the Public Health Service Act (42 U.S.C. 290aa-1) is
amended--
(1) in subsection (a)(1), in the matter following
subparagraph (D), by adding at the end the following: ``Each
such advisory council may also recommend subjects for
evaluation under section 101 of the Mental Health Reform Act of
2016 to the Assistant Secretary for Planning and Evaluation'';
and
(2) in subsection (b)--
(A) in paragraph (2)--
(i) in subparagraph (E), by striking
``and'' after the semicolon;
(ii) by redesignating subparagraph (F) as
subparagraph (J); and
(iii) by inserting after subparagraph (E),
the following:
``(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
subsections (a)(1)(A) and (a)(1)(D);
``(H) the Director of the National Institute on
Drug Abuse for the advisory councils appointed under
subsections (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''; and
(B) in paragraph (3), by adding at the end the
following:
``(C) Not less than half of the members of the
advisory council appointed under subsection (a)(1)(D)--
``(i) shall have--
``(I) a medical degree;
``(II) a doctoral degree in
psychology; or
``(III) 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.''.
SEC. 108. PEER REVIEW.
Section 504(b) of the Public Health Service Act (42 U.S.C. 290aa-
3(b)) is amended by adding at the end the following: ``In the case of
any such peer review group that is reviewing a grant, cooperative
agreement, or contract related to mental illness, not less than half of
the members of such peer review group shall be licensed and experienced
professionals in the prevention, diagnosis, treatment, and recovery of
mental illness or substance 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.''.
SEC. 109. INTER-DEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING
COMMITTEE.
(a) Establishment.--
(1) In general.--Not later than 3 months after the date of
enactment of this Act, the Secretary of Health and Human
Services, or the designee of the Secretary, shall establish a
committee to be known as the ``Inter-Departmental Serious
Mental Illness Coordinating Committee'' (in this section
referred to as the ``Committee'').
(2) Federal advisory committee act.--Except as provided in
this section, the provisions of the Federal Advisory Committee
Act (5 U.S.C. App.) shall apply to the Committee.
(b) Meetings.--The Committee shall meet not fewer than 2 times each
year.
(c) Responsibilities.--Not later than 1 year after the date of
enactment of this Act, and 5 years after such date of enactment, the
Committee shall submit to Congress a report including--
(1) a summary of advances in serious mental illness
research related to the prevention of, diagnosis of,
intervention in, and treatment and recovery of, serious mental
illnesses, and advances in access to services and support for
individuals with a serious mental illness;
(2) an evaluation of the impact on public health of Federal
programs related to serious mental illness, including
measurements of public health outcomes including--
(A) rates of suicide, suicide attempts, prevalence
of serious mental illness and substance use disorders,
overdose, overdose deaths, emergency hospitalizations,
emergency room boarding, preventable emergency room
visits, incarceration, crime, arrest, homelessness, and
unemployment;
(B) increased rates of employment and enrollment in
educational and vocational programs;
(C) quality of mental and substance use disorder
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 people with serious mental illness.
(d) Committee Extension.--Upon the submission of the second report
under subsection (c), the Secretary shall submit a recommendation to
Congress on whether to extend the operation of the Committee.
(e) Membership.--
(1) Federal members.--The Committee shall be composed of
the following Federal representatives, or their designee--
(A) the Secretary of Health and Human Services, who
shall serve as the Chair of the Committee;
(B) the Administrator of the Substance Abuse and
Mental Health Services Administration;
(C) the Attorney General of the United States;
(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; and
(I) the Commissioner of Social Security.
(2) Non-federal members.--The Committee shall also include
not less than 14 non-Federal public members appointed by the
Secretary of Health and Human Services, of which--
(A) at least 1 member shall be an individual who
has received treatment for a diagnosis of a serious
mental illness;
(B) at least 1 member shall be a parent or legal
guardian of an individual with a history of serious
mental illness;
(C) at least 1 member shall be a representative of
a leading research, advocacy, or service organization
for individuals with serious mental illnesses;
(D) at least 2 members shall be--
(i) a licensed psychiatrist with experience
treating serious mental illness;
(ii) a licensed psychologist with
experience treating serious mental illness;
(iii) a licensed clinical social worker; or
(iv) a licensed psychiatric nurse, nurse
practitioner, or physician assistant with
experience treating serious mental illness;
(E) at least 1 member shall be a licensed mental
health professional with a specialty in treating
children and adolescents;
(F) at least 1 member shall be a mental health
professional who has research or clinical mental health
experience working with minorities;
(G) at least 1 member shall be a mental health
professional who has research or clinical mental health
experience working with medically underserved
populations;
(H) at least 1 member shall be a State certified
mental health peer specialist;
(I) at least 1 member shall be a judge with
experience adjudicating cases related to criminal
justice or serious mental illness; and
(J) at least 1 member shall be a law enforcement
officer or corrections officer with extensive
experience in interfacing with individuals with serious
mental illness or in mental health crisis.
(3) Terms.--A member of the Committee appointed under
subsection (e)(2) shall serve for a term of 3 years, and may be
reappointed for one or more additional 3-year terms. Any member
appointed to fill a vacancy for an unexpired term shall be
appointed for the remainder of such term. A member may serve
after the expiration of the member's term until a successor has
been appointed.
(f) Working Groups.--In carrying out its functions, the Committee
may establish working groups. Such working groups shall be composed of
Committee members, or their designees, and may hold such meetings as
are necessary.
(g) Sunset.--The Committee shall terminate on the date that is 6
years after the date on which the Committee is established under
subsection (a)(1).
TITLE II--ENSURING MENTAL AND SUBSTANCE USE DISORDER PREVENTION,
TREATMENT, AND RECOVERY PROGRAMS KEEP PACE WITH SCIENCE
SEC. 201. ENCOURAGING INNOVATION AND EVIDENCE-BASED PROGRAMS.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.),
as amended by title I, is further amended by inserting after section
501 (42 U.S.C. 290aa) the following:
``SEC. 501A. OFFICE OF POLICY, PLANNING, AND INNOVATION.
``(a) In General.--There shall be established within the
Administration an Office of Policy, Planning, and Innovation (referred
to in this section as the `Office').
``(b) Responsibilities.--The Office shall--
``(1) continue to carry out the authorities that were in
effect for the Office of Policy, Planning, and Innovation as
such Office existed prior to the date of enactment of the
Mental Health Reform Act of 2016;
``(2) identify, coordinate, and facilitate the
implementation of policy changes likely to have a significant
impact on mental and substance use disorder services;
``(3) collect, as appropriate, information from grantees
under programs operated by the Administration in order to
evaluate and disseminate information on evidence-based
practices and service delivery models;
``(4) provide leadership in identifying and coordinating
policies and programs related to mental health and substance
use disorders;
``(5) in consultation with the Assistant Secretary for
Planning and Evaluation, as appropriate, periodically review
programs and activities relating to the diagnosis or prevention
of, or treatment or rehabilitation for, mental illness and
substance use disorders, including by--
``(A) identifying any such programs or activities
that are duplicative;
``(B) identifying any such programs or activities
that are not evidence-based, effective, or efficient;
``(C) identifying any such programs or activities
that have proven to be effective or efficient in
improving outcomes or increasing access to evidence-
based programs; and
``(D) formulating recommendations for coordinating,
eliminating, or improving programs or activities
identified under subparagraph (A), (B), or (C), and
merging such programs or activities into other
successful programs or activities; and
``(6) carry out other activities as deemed necessary to
continue to encourage innovation and disseminate evidence-based
programs and practices.
``(c) Promoting Innovation.--
``(1) In general.--The Administrator, in coordination with
the Office, may award grants to States, local governments,
Indian tribes or tribal organizations (as such terms are
defined in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b)), educational
institutions, and nonprofit 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 further applied development, for--
``(i) enhancing the prevention, diagnosis,
intervention, treatment, and recovery of mental
illness, serious emotional disturbance,
substance use disorders, and co-occurring
disorders; or
``(ii) integrating or coordinating physical
health services and mental and substance use
disorder services; and
``(B) expanding, replicating, or scaling evidence-
based programs across a wider area to enhance effective
screening, early diagnosis, intervention, and treatment
with respect to mental illness, serious mental illness,
and serious emotional disturbance, primarily by--
``(i) applying delivery of care, including
training staff in effective evidence-based
treatment; or
``(ii) integrating models of care across
specialties and jurisdictions.
``(2) Consultation.--In awarding grants under this
paragraph, the Administrator shall, as appropriate, consult
with the Chief Medical Officer, the advisory councils described
in section 502, the National Institute of Mental Health, the
National Institute on Drug Abuse, and the National Institute on
Alcohol Abuse and Alcoholism.
``(d) Authorization of Appropriations.--To carry out the activities
under subsection (c), there are authorized to be appropriated such sums
as may be necessary for each of fiscal years 2017 through 2021.''.
SEC. 202. PROMOTING ACCESS TO INFORMATION ON EVIDENCE-BASED PROGRAMS
AND PRACTICES.
(a) In General.--The Administrator of the Substance Abuse and
Mental Health Services Administration (referred to in this section as
the ``Administrator'') may improve access to reliable and valid
information on evidence-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 communities, nonprofit entities, and other stakeholders
by posting on the website of the Administration information on
evidence-based programs and practices that have been reviewed by the
Administrator pursuant to the requirements of this section.
(b) Notice.--In carrying out subsection (a), the Administrator may
establish a period for the submission of applications for evidence-
based programs and practices to be posted publicly in accordance with
subsection (a). In establishing such application period, the
Administrator shall provide for the public notice of such application
period in the Federal Register. Such notice may solicit applications
for evidence-based practices and programs to address gaps identified by
the Assistant Secretary for Planning and Evaluation of the Department
of Health and Human Services in the evaluation and recommendations
under section 101 or priorities identified in the strategic plan
established under section 501(l) of the Public Health Service Act (42
U.S.C. 290aa).
(c) Requirements.--The Administrator may establish minimum
requirements for applications referred to under this section, including
applications related to the submission of research and evaluation.
(d) Review and Rating.--The Administrator shall review applications
prior to public posting, and may prioritize the review of applications
for evidenced-based practices and programs that are related to topics
included in the notice established under subsection (b). The
Administrator may utilize a rating and review system, which may include
information on the strength of evidence associated with such programs
and practices and a rating of the methodological rigor of the research
supporting the application.
SEC. 203. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
Section 520A of the Public Health Service Act (42 U.S.C. 290bb-32)
is amended--
(1) in subsection (a)--
(A) in paragraph (4), by inserting before the
period ``, that may include technical assistance
centers''; and
(B) in the flush sentence following paragraph (4)--
(i) by inserting ``, contracts,'' before
``or cooperative agreements''; and
(ii) by striking ``Indian tribes and tribal
organizations'' and inserting ``territories,
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 pursuant to a contract or grant with the
Indian Health Service, or''; and
(2) in subsection (f)--
(A) in paragraph (1) by striking the paragraph
heading;
(B) by striking ``$300,000,000'' and all that
follows through ``2003'' and inserting ``such sums as
may be necessary for each of fiscal years 2017 through
2021''; and
(C) by striking paragraph (2).
TITLE III--SUPPORTING STATE RESPONSES TO MENTAL HEALTH AND SUBSTANCE
USE DISORDER NEEDS
SEC. 301. COMMUNITY MENTAL HEALTH SERVICES BLOCK GRANT.
(a) Formula Grants.--Section 1911(b) of the Public Health Service
Act (42 U.S.C. 300x(b)) is amended--
(1) by redesignating paragraphs (1) through (3) as
paragraphs (2) through (4), respectively; and
(2) by inserting before paragraph (2) (as so redesignated),
the following:
``(1) providing community mental health services for adults
with serious mental illness and children with serious emotional
disturbances as defined in accordance with section 1912(c);''.
(b) State Plan.--Section 1912(b) of the Public Health Service Act
(42 U.S.C. 300x-1(b)) is amended--
(1) in paragraph (3), by redesignating subparagraphs (A)
through (C) as clauses (i) through (iii), respectively, and
realigning the margins accordingly;
(2) by redesignating paragraphs (1) through (5) as
subparagraphs (A) through (E), respectively, and realigning the
margins accordingly;
(3) by striking the matter preceding subparagraph (A) (as
so redesignated), and inserting the following:
``(b) Criteria for Plan.--In accordance with subsection (a), a
State shall submit to the Secretary a plan that, at a minimum, includes
the following:
``(1) System of care.--A description of the State's system
of care that contains the following:'';
(4) by striking subparagraph (A) (as so redesignated), and
inserting the following:
``(A) Comprehensive community-based health
systems.--The plan shall--
``(i) identify the single State agency to
be responsible for the administration of the
program under the grant, including any third
party who administers mental health services
and is responsible for complying with the
requirements of this part with respect to the
grant;
``(ii) provide for an organized community-
based system of care for individuals with
mental illness and describe available services
and resources in a comprehensive system of
care, including services for individuals with
co-occurring disorders;
``(iii) include a description of the manner
in which the State and local entities will
coordinate services to maximize the efficiency,
effectiveness, quality, and cost effectiveness
of services and programs to produce the best
possible outcomes (including health services,
rehabilitation services, employment services,
housing services, educational services,
substance use disorder services, legal
services, law enforcement services, social
services, child welfare services, medical and
dental care services, and other support
services to be provided with Federal, State,
and local public and private resources) with
other agencies to enable individuals receiving
services to function outside of inpatient or
residential institutions, to the maximum extent
of their capabilities, including services to be
provided by local school systems under the
Individuals with Disabilities Education Act;
``(iv) include a description of how the
State promotes evidence-based practices,
including those evidence-based programs that
address the needs of individuals with early
serious mental illness regardless of the age of
the individual at onset;
``(v) include a description of case
management services;
``(vi) include a description of activities
leading to reduction of hospitalization,
arrest, incarceration, or suicide, including
through promoting comprehensive, individualized
treatment;
``(vii) include a description of activities
that seek to engage individuals with serious
mental illness in making health care decisions,
including activities that enhance communication
between individuals, families, and treatment
providers;
``(viii) include a description of how the
State integrates mental health and primary
health care, which may include providing, in
the case of individuals with co-occurring
mental and substance use disorders, both mental
and substance use disorder services in primary
care settings or arrangements to provide
primary and specialty care services in
community-based mental and substance use
disorder service settings; and
``(ix) include a description of how the
State ensures a smooth transition for children
with serious emotion disturbances from the
children's service system to the adult service
system.'';
(5) in subparagraph (B) (as so redesignated), by striking
``to be achieved in the implementation of the system described
in paragraph (1)'' and inserting ``and outcome measures for
programs and services provided under this subpart'';
(6) in subparagraph (C) (as so redesignated)--
(A) by striking ``disturbance'' in the matter
preceding clause (i) (as so redesignated) and all that
follows through ``substance abuse services'' in clause
(i) (as so redesignated) and inserting the following:
``disturbance (as defined pursuant to subsection (c)),
the plan shall provide for a system of integrated
social services, educational services, child welfare
services, juvenile justice services, law enforcement
services, and substance use disorder services'';
(B) by striking ``Education Act;'' and inserting
``Education Act.''; and
(C) by striking clauses (ii) and (iii) (as so
redesignated);
(7) in subparagraph (D) (as so redesignated), by striking
``plan described'' and inserting ``plan shall describe'';
(8) in subparagraph (E) (as so redesignated)--
(A) in the subparagraph heading by striking
``systems'' and inserting ``services'';
(B) by striking ``plan describes'' and all that
follows through ``and provides for'' and inserting
``plan shall describe the financial resources
available, the existing mental health workforce, and
workforce trained in treating individuals with co-
occurring mental and substance use disorders, and
provides for''; and
(C) by inserting before the period the following:
``, and the manner in which the State intends to comply
with each of the funding agreements in this subpart and
subpart III'';
(9) by striking the flush matter at the end; and
(10) by adding at the end the following:
``(2) Goals and objectives.--The establishment of goals and
objectives for the period of the plan, including targets and
milestones that are intended to be met, and the activities that
will be undertaken to achieve those targets.''.
(c) Best Practices in Clinical Care Models.--Section 1920 of the
Public Health Service Act (42 U.S.C. 300x-9) is amended by adding at
the end the following:
``(c) Best Practices in Clinical Care Models.--
``(1) In general.--Except as provided in paragraph (2), a
State shall expend not less than 5 percent of the amount the
State receives for carrying out this section in each fiscal
year to support evidence-based programs that address the needs
of individuals with early serious mental illness, including
psychotic disorders, regardless of the age of the individual at
onset.
``(2) State flexibility.--In lieu of expending 5 percent of
the amount the State receives under this section in a fiscal
year as required under paragraph (1), a State may elect to
expend not less than 10 percent of such amount in the
succeeding fiscal year.''.
(d) Additional Provisions.--Section 1915(b) of the Public Health
Service Act (42 U.S.C. 300x-4(b)) is amended--
(1) by redesignating paragraph (1) as subparagraph (A), and
realigning the margin accordingly;
(2) by inserting after the subsection heading the
following:
``(1) Requirement.--'';
(3) by inserting after subparagraph (A) (as so
redesignated), the following:
``(B) Condition.--A State shall be deemed to be in
compliance with subparagraph (A) for a fiscal year if
State expenditures of the type described in such
subparagraph for such fiscal year are at least 97
percent of the average of such State expenditures for
the preceding 2-fiscal-year period.'';
(4) by redesignating paragraphs (2) through (4) as
paragraphs (3) through (5), respectively;
(5) by inserting after paragraph (1), the following:
``(2) Future fiscal years.--Determinations of whether a
State has complied with paragraph (1) for each fiscal year
shall be based on the State funding level for the preceding 2-
fiscal-year period, as required under paragraph (1)(A), without
regard to reductions in the actual amount of State expenditures
as permitted under paragraph (1)(B) or under a waiver under
paragraph (4).'';
(6) in paragraph (3) (as so redesignated), by striking
``subsection (a)'' and inserting ``paragraph (1)'';
(7) in paragraph (4) (as so redesignated)--
(A) by striking ``The Secretary'' and inserting the
following:
``(A) In general.--The Secretary'';
(B) by striking ``paragraph (1) if the Secretary''
and inserting the following: ``paragraph (1) in whole
or in part, if--
``(i) the Secretary'';
(C) by striking ``State justify the waiver.'' and
inserting ``State in the fiscal year involved or in the
previous fiscal year justify the waiver; or''; and
(D) by adding at the end the following:
``(ii) the State, or any part of the State,
has experienced a natural disaster that has
received a Presidential Disaster Declaration
under section 102 of the Robert T. Stafford
Disaster Relief Emergency Assistance Act.
``(B) Date certain for action upon request.--The
Secretary shall approve or deny a request for a waiver
under subparagraph (A) not later than 120 days after
the date on which the request is made.
``(C) Applicability of waiver.--A waiver provided
by the Secretary under subparagraph (A) shall be
applicable only to the fiscal year involved.''; and
(8) in paragraph (5) (as so redesignated)--
(A) in subparagraph (A)--
(i) by inserting after the subparagraph
designation the following: ``In general''; and
(ii) by striking ``maintained material
compliance'' and insert ``complied''; and
(B) in subparagraph (B), by inserting after the
subparagraph designation the following: ``Submission of
information to the secretary''.
(e) Application for Grant.--Section 1917(a) of the Public Health
Service Act (42 U.S.C. 300x-6(a)) is amended--
(1) in paragraph (1), by striking ``1941'' and inserting
``1942(a)''; and
(2) in paragraph (5), by striking ``1915(b)(3)(B)'' and
inserting ``1915(b)''.
(f) Funding.--Section 1920(a) of the Public Health Service Act (42
U.S.C. 300x-9(a)) is amended by striking ``$450,000,000'' and all that
follows and inserting ``such sums as may be necessary for each of
fiscal years 2017 through 2021.''.
SEC. 302. ADDITIONAL PROVISIONS RELATED TO THE BLOCK GRANTS.
Subpart III of part B of title XIX of the Public Health Service Act
(42 U.S.C. 300x-51 et seq.) is amended--
(1) in section 1953(b) (42 U.S.C. 300x-63(b)), by striking
``substance abuse'' and inserting ``substance use disorder'';
and
(2) by adding at the end the following:
``SEC. 1957. PUBLIC HEALTH EMERGENCIES.
``In the case of a public health emergency (as defined in section
319), the Administrator, on a State-by-State basis, may grant an
extension or waive application deadlines and compliance with any other
requirements of sections 521, 1911, and 1921, and Public Law 99-319 (42
U.S.C. 10801 et seq.) as the circumstances of such emergency reasonably
require and for the period of such public health emergency.
``SEC. 1958. JOINT APPLICATIONS.
``The Secretary, acting through the Administrator, shall permit a
joint application to be submitted for grants under subpart I and
subpart II upon the request of a State. Such application may be jointly
reviewed and approved by the Secretary with respect to such subparts,
consistent with the purposes and authorized activities of each such
grant program. A State submitting such a joint application shall
otherwise meet the requirements with respect to each such subpart.''.
SEC. 303. STUDY OF DISTRIBUTION OF FUNDS UNDER THE SUBSTANCE ABUSE
PREVENTION AND TREATMENT BLOCK GRANT AND THE COMMUNITY
MENTAL HEALTH SERVICES BLOCK GRANT.
(a) In General.--The Secretary of Health and Human Services, acting
through the Administrator of the Substance Abuse and Mental Health
Services Administration, shall, directly or through a grant or
contract, conduct a study to examine whether the funds under the
substance abuse prevention and treatment block grant and the community
mental health services block grant under title XIX of the Public Health
Service Act (42 U.S.C. 300w et seq.) are being distributed to States
and territories according to need, and to recommend changes in such
distribution if necessary. Such study shall include--
(1) an analysis of whether the distributions under such
block grants accurately reflect the need for the services under
the grants in such States and territories;
(2) an examination of whether the indices used under the
formulas for distribution of funds under such block grants are
appropriate, and if not, alternatives recommended by the
Secretary;
(3) where recommendations are included under paragraph (2)
for the use of different indices, a description of the
variables and data sources that should be used to determine the
indices;
(4) an evaluation of the variables and data sources that
are being used for each of the indices involved, and whether
such variables and data sources accurately represent the need
for services, the cost of providing services, and the ability
of the States to pay for such services;
(5) the impact that the minimum allotment provisions under
each such block grant have on each State's final allotment and
its effect, if any, on each State's formula-based allotment;
(6) recommendations for modifications to the minimum
allotment provisions to ensure an appropriate distribution of
funds; and
(7) any other information that the Secretary determines
appropriate.
(b) Report.--Not later than 24 months after the date of enactment
of this Act, the Secretary of Health and Human Services shall submit to
the Committee on Health, Education, Labor, and Pensions of the Senate
and the Committee on Energy and Commerce of the House of
Representatives, a report containing the findings and recommendations
of the study conducted under subsection (a).
TITLE IV--PROMOTING ACCESS TO MENTAL HEALTH AND SUBSTANCE USE DISORDER
CARE
SEC. 401. GRANTS FOR TREATMENT AND RECOVERY FOR HOMELESS INDIVIDUALS.
Section 506 of the Public Health Service Act (42 U.S.C. 290aa-5) is
amended--
(1) in subsections (a), by striking ``substance abuse'' and
inserting ``substance use disorder'';
(2) in subsection (b)--
(A) in paragraphs (1) and (3), by striking
``substance abuse'' each place the term appears and
inserting ``substance use disorder''; and
(B) in paragraph (4), by striking ``substance
abuse'' and inserting ``a substance use disorder'';
(3) in subsection (c)--
(A) in paragraph (1), by striking ``substance abuse
disorder'' and inserting ``substance use disorder'';
and
(B) in paragraph (2)--
(i) in subparagraph (A), by striking
``substance abuse'' and inserting ``a substance
use disorder''; and
(ii) in subparagraph (B), by striking
``substance abuse'' and inserting ``substance
use disorder''; and
(4) in subsection (e), by striking ``, $50,000,000 for
fiscal year 2001, and such sums as may be necessary for each of
the fiscal years 2002 and 2003'' and inserting ``such sums as
may be necessary for each of fiscal years 2017 through 2021''.
SEC. 402. GRANTS FOR JAIL DIVERSION PROGRAMS.
Section 520G of the Public Health Service Act (42 U.S.C. 290bb-38)
is amended--
(1) by striking ``substance abuse'' each place such term
appears and inserting ``substance use disorder'';
(2) in subsection (a)--
(A) by striking ``Indian tribes, and tribal
organizations'' and inserting ``and Indian tribes and
tribal organizations (as such terms are defined in
section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b))''; and
(B) by inserting ``or a health facility or program
operated by or pursuant to a contract or grant with the
Indian Health Service,'' after ``entities,'';
(3) in subsection (c)(2)(A)(i), by striking ``the best
known'' and inserting ``evidence-based''; and
(4) in subsection (i), by striking ``$10,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 through 2003'' and inserting ``such sums as may be
necessary for each of fiscal years 2017 through 2021''.
SEC. 403. PROMOTING INTEGRATION OF PRIMARY AND BEHAVIORAL HEALTH CARE.
Section 520K of the Public Health Service Act (42 U.S.C. 290bb-42)
is amended to read as follows:
``SEC. 520K. INTEGRATION INCENTIVE GRANTS.
``(a) Definitions.--In this section:
``(1) Eligible entity.--The term `eligible entity' means a
State, or other appropriate State agency, in collaboration with
one or more qualified community programs as described in
section 1913(b)(1).
``(2) Integrated care.--The term `integrated care' means
collaboration in merged or transformed practices offering
mental and physical health services within the same shared
practice space in the same facility.
``(3) Special population.--The term `special population'
means--
``(A) adults with mental illnesses who have co-
occurring primary care conditions or chronic diseases;
``(B) adults with serious mental illnesses who have
co-occurring primary care conditions or chronic
diseases;
``(C) children and adolescents with serious
emotional disturbance with co-occurring primary care
conditions or chronic diseases; or
``(D) individuals with substance use disorders.
``(b) Grants.--
``(1) In general.--The Secretary may award grants and
cooperative agreements to eligible entities to support the
improvement of integrated care for primary care and behavioral
health care in accordance with paragraph (2).
``(2) Purposes.--Grants and cooperative agreements awarded
under this section shall be designed to--
``(A) promote full collaboration in clinical
practices between primary and behavioral health care;
``(B) support the improvement of integrated care
models for primary care and behavioral health care to
improve the overall wellness and physical health status
of individuals with serious mental illness or serious
emotional disturbance; and
``(C) promote integrated care services related to
screening, diagnosis, and treatment of mental illness
and co-occurring primary care conditions and chronic
diseases.
``(c) Applications.--
``(1) In general.--An eligible entity desiring 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 require,
including the contents described in paragraph (2).
``(2) Contents.--The contents described in this paragraph
are--
``(A) a description of a plan to achieve fully
collaborative agreements to provide services to special
populations;
``(B) a document that summarizes the policies, if
any, that serve as barriers to the provision of
integrated care, and the specific steps, if applicable,
that will be taken to address such barriers;
``(C) a description of partnerships or other
arrangements with local health care providers to
provide services to special populations;
``(D) an agreement and plan to report performance
measures necessary to evaluate patient outcomes and to
facilitate evaluations across participating projects to
the Secretary; and
``(E) a plan for sustainability beyond the grant or
cooperative agreement period under subsection (e).
``(d) Grant Amounts.--The maximum amount that an eligible entity
may receive for a year through a grant or cooperative agreement under
this section shall be $2,000,000. In the case of a recipient of funding
under this section that is a State, not more than 10 percent of funds
awarded under this section may be allocated to State administrative
functions, and the remaining amounts shall be allocated to health
facilities that provide integrated care.
``(e) Duration.--A grant or cooperative agreement under this
section shall be for a period not to exceed 5 years.
``(f) Report on Program Outcomes.--An eligible entity receiving a
grant or cooperative agreement under this section shall submit an
annual report to the Secretary that includes--
``(1) the progress to reduce barriers to integrated care as
described in the entity's application under subsection (c); and
``(2) a description of functional outcomes of special
populations, including--
``(A) with respect to individuals with serious
mental illness, participation in supportive housing or
independent living programs, attendance in social and
rehabilitative programs, participation in job training
opportunities, satisfactory performance in work
settings, attendance at scheduled medical and mental
health appointments, and compliance with prescribed
medication regimes;
``(B) with respect to individuals with co-occurring
mental illness and primary care conditions and chronic
diseases, attendance at scheduled medical and mental
health appointments, compliance with prescribed
medication regimes, and participation in learning
opportunities related to improved health and lifestyle
practices; and
``(C) with respect to children and adolescents with
serious emotional disorders who have co-occurring
primary care conditions and chronic diseases,
attendance at scheduled medical and mental health
appointments, compliance with prescribed medication
regimes, and participation in learning opportunities at
school and extracurricular activities.
``(g) Technical Assistance for Primary-Behavioral Health Care
Integration.--
``(1) In general.--The Secretary may provide appropriate
information, training, and technical assistance to eligible
entities that receive a grant or cooperative agreement under
this section, in order to help such entities meet the
requirements of this section, including assistance with--
``(A) development and selection of integrated care
models;
``(B) dissemination of evidence-based interventions
in integrated care;
``(C) establishment of organizational practices to
support operational and administrative success; and
``(D) other activities, as the Secretary determines
appropriate.
``(2) Additional dissemination of technical information.--
The information and resources provided by the Secretary under
paragraph (1) shall, as appropriate, be made available to
States, political subdivisions of States, Indian tribes or
tribal organizations (as defined in section 4 of the Indian
Self-Determination and Education Assistance Act), outpatient
mental health and addiction treatment centers, community mental
health centers that meet the criteria under section 1913(c),
certified community behavioral health clinics described in
section 223 of the Protecting Access to Medicare Act of 2014
(42 U.S.C. 1396a note), primary care organizations such as
Federally qualified health centers or rural health clinics as
defined in section 1861(aa) of the Social Security Act (42
U.S.C. 1395x(aa)), other community-based organizations, or
other entities engaging in integrated care activities, as the
Secretary determines appropriate.
``(h) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2017 through 2021.''.
SEC. 404. PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS.
(a) Formula Grants to States.--Section 521 of the Public Health
Service Act (42 U.S.C. 290cc-21) is amended by striking ``each of the
fiscal years 1991 through 1994'' and inserting ``fiscal year 2017 and
each subsequent fiscal year''.
(b) Purpose of Grants.--Section 522 of the Public Health Service
Act (42 U.S.C. 290cc-22) is amended--
(1) in subsection (a)(1)(B), by striking ``substance
abuse'' and inserting ``a substance use disorder'';
(2) in subsection (b)(6), by striking ``substance abuse''
and inserting ``substance use disorder'';
(3) in subsection (c), by striking ``substance abuse'' and
inserting ``a substance use disorder'';
(4) in subsection (e)--
(A) in paragraph (1), by striking ``substance
abuse'' and inserting ``a substance use disorder''; and
(B) in paragraph (2), by striking ``substance
abuse'' and inserting ``substance use disorder''; and
(5) in subsection (h), by striking ``substance abuse'' each
place such term appears and inserting ``substance use
disorder''.
(c) Description of Intended Expenditures of Grant.--Section 527 of
the Public Health Service Act (42 U.S.C. 290cc-27) is amended by
striking ``substance abuse'' each place such term appears and inserting
``substance use disorder''.
(d) Technical Assistance.--Section 530 of the Public Health Service
Act (42 U.S.C. 290cc-30) is amended by striking ``through the National
Institute of Mental Health, the National Institute of Alcohol Abuse and
Alcoholism, and the National Institute on Drug Abuse'' and inserting
``acting through the Administrator''.
(e) Definitions.--Section 534(4) of the Public Health Service Act
(42 U.S.C. 290cc-34(4)) is amended to read as follows:
``(4) Substance use disorder services.--The term `substance
use disorder services' has the meaning given the term
`substance abuse services' in section 330(h)(5)(C).''.
(f) Funding.--Section 535(a) of the Public Health Service Act (42
U.S.C. 290cc-35(a)) is amended by striking ``$75,000,000 for each of
the fiscal years 2001 through 2003'' and inserting ``such sums as may
be necessary for each of fiscal years 2017 through 2021''.
(g) Study Concerning Formula.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, the Administrator of the Substance Abuse
and Mental Health Services Administration (referred to in this
section as the ``Administrator'') shall conduct a study
concerning the formula used under section 524(a) of the Public
Health Service Act (42 U.S.C. 290cc-24(a)) for making
allotments to States under section 521 of such Act (42 U.S.C.
290cc-21). Such study shall include an evaluation of quality
indicators of need for purposes of revising the formula for
determining the amount of each allotment for the fiscal years
following the submission of the study.
(2) Report.--The Administrator shall submit to the
appropriate committees of Congress a report concerning the
results of the study conducted under paragraph (1).
SEC. 405. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.) is amended by inserting after section 520E-2
(42 U.S.C. 290bb-36) the following:
``SEC. 520E-3. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
``(a) In General.--The Secretary, acting through the Administrator,
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 Mental
Health Reform Act of 2016.
``(b) Activities.--In maintaining the program, the activities of
the Secretary shall include--
``(1) coordinating a network of crisis centers across the
United States for providing suicide prevention and crisis
intervention 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
resources; and
``(3) consulting with the Secretary of Veterans Affairs to
ensure that veterans calling the suicide prevention hotline
have access to a specialized veterans' suicide prevention
hotline.
``(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated such sums as may be necessary
for each of fiscal years 2017 through 2021.''.
SEC. 406. CONNECTING INDIVIDUALS AND FAMILIES WITH CARE.
Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.), as amended by section 405, is further amended
by inserting after section 520E-3, the following:
``SEC. 520E-4. TREATMENT REFERRAL ROUTING SERVICE.
``(a) In General.--The Secretary, acting through the Administrator,
shall maintain the National Treatment Referral Routing Service
(referred to in this section as the `Routing Service') to assist
individuals and families in locating mental and substance use disorder
treatment providers.
``(b) Activities of the Secretary.--To maintain the Routing
Service, the activities of the Secretary shall include administering--
``(1) a nationwide, telephone number providing year-round
access to information that is updated on a regular basis
regarding 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 that includes information on the
name, location, contact information, and basic services
provided for behavioral health treatment providers and
community-based organizations.
``(c) Rule of Construction.--Nothing in this section shall be
construed to prevent the Administrator from using any unobligated
amounts otherwise made available to the Substance Abuse and Mental
Health Services Administration to maintain the Routing Service.''.
SEC. 407. STREAMLINING MENTAL AND BEHAVIORAL HEALTH WORKFORCE PROGRAMS.
(a) In General.--Part D of title VII of the Public Health Service
Act (42 U.S.C. 294 et seq.) is amended--
(1) by striking sections 755 (42 U.S.C. 294e) and 756 (42
U.S.C. 294e-1);
(2) by redesignating sections 757 and 759 as sections 756
and 757, respectively; and
(3) by inserting after section 754 the following:
``SEC. 755. MENTAL AND BEHAVIORAL HEALTH EDUCATION AND TRAINING GRANTS.
``(a) Grants Authorized.--The Secretary may award grants to
eligible institutions of higher education to support the recruitment of
students for, and education and clinical experience of the students
in--
``(1) accredited institutions of higher education or
accredited professional training programs that are establishing
or expanding internships or other field placement programs in
mental health in psychiatry, psychology, school psychology,
behavioral pediatrics, psychiatric nursing, social work, school
social work, substance use disorder prevention and treatment,
marriage and family therapy, occupational therapy, school
counseling, or professional counseling, including such
internships or programs with a focus on child and adolescent
mental health and transitional-age youth;
``(2) accredited doctoral, internship, and post-doctoral
residency programs of health service psychology, including
clinical psychology, counseling, and school psychology, for the
development and implementation of interdisciplinary training of
psychology graduate students for providing behavioral and
mental health services, including substance use disorder
prevention and treatment services, and the development of
faculty in health service psychology;
``(3) accredited master's and doctoral degree programs of
social work for the development and implementation of
interdisciplinary training of social work graduate students for
providing behavioral and mental health services, including
substance use disorder prevention and treatment services, and
the development of faculty in social work; or
``(4) State-licensed mental health nonprofit and for-profit
organizations to enable such organizations to pay for programs
for preservice or in-service training in a behavioral health-
related paraprofessional field with preference for preservice
or in-service training of paraprofessional child and adolescent
mental health workers.
``(b) Eligibility Requirements.--To be eligible for a grant under
this section, an institution of higher education shall demonstrate--
``(1) an ability to recruit and place the students
described in subsection (a) in areas with a high need and high
demand population;
``(2) that individuals and groups from different racial,
ethnic, cultural, geographic, religious, linguistic, and class
backgrounds, and different genders and sexual orientations,
participate in the programs of the institution;
``(3) knowledge and understanding of the concerns of the
individuals and groups described in paragraph (2), especially
individuals with mental health symptoms or diagnoses,
particularly children and adolescents, and transitional-age
youth;
``(4) that any internship or other field placement program
assisted through the grant will prioritize cultural and
linguistic competency; and
``(5) that the institution of higher education will provide
to the Secretary such data, assurances, and information as the
Secretary may require.
``(c) Institutional Requirement.--For grants awarded under
paragraphs (2) and (3) of subsection (a), at least 4 of the grant
recipients shall be historically black colleges or universities or
other minority-serving institutions.
``(d) Priority.--In selecting grant recipients, the Secretary shall
give priority to--
``(1) for grants awarded under paragraphs (1), (2), and (3)
of subsection (a), programs that have demonstrated the ability
to train psychology and social work professionals to work in
integrated care settings; and
``(2) for a grant under subsection (a)(4), programs for
paraprofessionals that emphasize the role of the family and the
lived experience of the consumer and family-paraprofessional
partnerships.
``(e) Report to Congress.--Not later than 2 years after the date of
enactment of the Mental Health Reform Act of 2016, and annually
thereafter, the Secretary shall submit to Congress a report on the
effectiveness of the grants under this section in--
``(1) providing graduate students support for experiential
training (internship or field placement);
``(2) recruiting of students interested in behavioral
health practice;
``(3) developing and implementing interprofessional
training and integration within primary care;
``(4) developing and implementing accredited field
placements and internships; and
``(5) collecting data on the number of students trained in
mental health and the number of available accredited
internships and field placements.
``(f) Authorization of Appropriation.--There are authorized to be
appropriated to carry out this section such sums as may be necessary
for each of fiscal years 2017 through 2021.''.
(b) Conforming Amendments.--The Public Health Service Act (42
U.S.C. 201 et seq.), as amended by subsection (a), is further amended--
(1) in section 338A(d)(2)(A) (42 U.S.C. 254l(d)(2)(A)), by
striking ``or under section 758'';
(2) in section 756(b)(2) (42 U.S.C. 794f(b)(2)), as
redesignated by subsection (a), by striking ``753(b), and
755(b)'' and inserting ``and 753(b)''; and
(3) in section 761 (42 U.S.C. 294n)--
(A) in subsection (b)(2)(E), by striking
``757(d)(3)'' and inserting ``756(d)(3)'';
(B) in subsection (d)(2)(B), by striking
``757(d)(3)'' and inserting ``756(d)(3)''; and
(C) in subsection (d)(3), by striking ``757(d)(4)''
and inserting ``756(d)(4)''.
SEC. 408. REPORTS.
(a) Report on Mental Health and Substance Use Treatment in
States.--
(1) In general.--Not later than 18 months after the date of
enactment of this Act, and not less than every 2 years
thereafter, the Assistant Secretary for Planning and Evaluation
of the Department of Health and Human Services, in
collaboration with the Administrator of the Substance Abuse and
Mental Health Services Administration, the Director of the
Agency for Healthcare Research and Quality, and the Director of
the National Institutes of Health, shall submit to Congress and
make available on the Internet website of the Department a
report on mental and substance use disorder treatment in the
States, including each of the following:
(A) A detailed description on how Federal mental
and substance use disorder treatment funds are used in
each State, including--
(i) the numbers of individuals with mental
illness, serious mental illness, serious
emotional disturbance, substance use disorders,
or co-occurring disorders who are served using
Federal funds; and
(ii) the types of Federal programs made
available to individuals with mental illness,
serious mental illness, serious emotional
disturbance, substance use disorders, or co-
occurring disorders.
(B) A summary of best practices or evidence-based
models in the States, including programs that are cost-
effective, provide evidence-based care, increase access
to care, integrate physical, psychiatric,
psychological, and behavioral medicine, and improve
outcomes for individuals with serious mental illness,
serious emotional disturbance, or substance use
disorders.
(C) An analysis of outcome measures in each State
for individuals with mental illness, serious mental
illness, serious emotional disturbance, substance use
disorders, or co-occurring disorders, including rates
of suicide, suicide attempts, substance abuse,
overdose, overdose deaths, positive health outcomes,
emergency psychiatric hospitalizations and emergency
room boarding, arrests, incarcerations, homelessness,
joblessness, employment, and enrollment in educational
or vocational programs.
(D) An analysis of outcomes for different models of
outpatient treatment programs for individuals with a
serious mental illness or serious emotional
disturbance, including--
(i) rates of keeping treatment appointments
and adherence to treatment plans;
(ii) participants' perceived effectiveness
of the program;
(iii) alcohol and drug abuse rates;
(iv) incarceration and arrest rates;
(v) violence against persons or property;
(vi) homelessness;
(vii) total treatment costs for compliance
with the program; and
(viii) health outcomes.
(2) Definition.--In this subsection, the term ``emergency
room boarding'' means the practice of admitting patients to an
emergency department and holding such patients in the emergency
department until inpatient psychiatric beds become available.
(b) Reporting Compliance Study for Community Mental Health
Centers.--
(1) In general.--The Comptroller General of the United
States shall conduct a review and submit to the appropriate
committees of Congress a report evaluating the combined
paperwork burden of--
(A) community mental health centers meeting the
criteria specified in section 1913(c) of the Public
Health Service Act (42 U.S.C. 300x-2(c)), including
such centers meeting such criteria as in effect on the
day before the date of enactment of this Act; and
(B) community mental health centers, as defined in
section 1861(ff)(3)(B) of the Social Security Act (42
U.S.C. 1395x(ff)(3)(B)).
(2) Scope.--In preparing the report under paragraph (1),
the Comptroller General of the United States shall examine
requirements for licensing, certification, service definitions,
claims payments, billing codes, and financial auditing that
are--
(A) used by the Office of Management and Budget,
the Centers for Medicare & Medicaid Services, the
Health Resources and Services Administration, the
Substance Abuse and Mental Health Services
Administration, the Office of the Inspector General of
the Department of Health and Human Services, and State
Medicaid agencies; and
(B) required by the Federal Government for State
agencies to utilize in order to make administrative and
statutory recommendations to Congress (which
recommendations may include a uniform methodology) to
reduce the paperwork burden experienced by the centers
described in paragraph (1).
(c) Workforce Development Report.--
(1) Public report.--
(A) In general.--Not later than 2 years after the
date of enactment of this Act, the Administrator of the
Substance Abuse and Mental Health Services
Administration, in consultation with the Administrator
of the Health Resources and Services Administration,
shall conduct a study and publicly post on the
appropriate Internet website of the Department of
Health and Human Services a report on the mental health
and substance use disorder workforce in order to inform
Federal, State, and local efforts related to workforce
enhancement.
(B) Contents.--The report under this paragraph
shall contain--
(i) national and State-level projections of
the supply and demand of mental health and
substance use disorder health workers;
(ii) an assessment of the mental health and
substance use disorder workforce capacity,
strengths, and weaknesses as of the date of the
report;
(iii) information on trends within the
mental health and substance use disorder
provider workforce; and
(iv) any additional information determined
by the Administrator of the Substance Abuse and
Mental Health Services Administration, in
consultation with the Administrator of the
Health Resources and Services Administration,
to be relevant to the mental health and
substance use disorder provider workforce.
(2) Report to congress.--
(A) In general.--Not later than 3 years after the
date of enactment of this Act, the Administrator of the
Substance Abuse and Mental Health Services
Administration, in consultation with the Administrator
of the Health Resources and Services Administration,
shall evaluate and 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 on the programs within such
Administrations to support the development of the
mental health and substance use disorder workforce.
(B) Contents.--The report under this paragraph
shall include--
(i) an evaluation of the outcomes of each
program described in subparagraph (A),
including whether the program met identified
goals and performance measures developed for
the respective program and activities carried
out by the program;
(ii) an evaluation of how each program, and
the programs together, target any workforce
weaknesses identified by the report under
paragraph (1); and
(iii) recommendations for improving
coordination among programs, and addressing
gaps and overlap within programs, including
recommendations for Congress, as appropriate.
(d) Peer-Support Specialist Programs.--
(1) In general.--Not later than 2 years after the date of
enactment of this Act, the Comptroller General of the United
States shall conduct a study on peer-support specialist
programs in selected States that receive funding from the
Substance Abuse and Mental Health Services Administration and
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.
(2) Contents of study.--In conducting the study under
paragraph (1), the Comptroller General of the United States
shall examine and identify best practices in the selected
States related to training and credential requirements for
peer-specialist programs, such as--
(A) hours of formal work or volunteer experience
related to mental and substance use disorders conducted
through such programs;
(B) types of peer support specialist exams required
for such programs in the States;
(C) codes of ethics used by such programs in the
States;
(D) required or recommended skill sets of such
programs in the State; and
(E) requirements for continuing education.
SEC. 409. CENTERS AND PROGRAM REPEALS.
Part B of title V of the Public Health Service Act (42 U.S.C. 290bb
et seq.) is amended by striking the second section 514 (42 U.S.C.
290bb-9), relating to methamphetamine and amphetamine treatment
initiatives, and sections 514A, 517, 519A, 519C, 519E, 520D, and 520H
(42 U.S.C. 290bb-8, 290bb-23, 290bb-25a, 290bb-25c, 290bb-25e, 290bb-
35, and 290bb-39).
TITLE V--STRENGTHENING MENTAL AND SUBSTANCE USE DISORDER CARE FOR
CHILDREN AND ADOLESCENTS
SEC. 501. PROGRAMS FOR CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.
(a) Comprehensive Community Mental Health Services for Children
With Serious Emotional Disturbances.--Section 561(a)(1) of the Public
Health Service Act (42 U.S.C. 290ff(a)(1)) is amended by inserting ``,
which may include efforts to identify and serve children at risk''
before the period.
(b) Requirements With Respect to Carrying Out Purpose of Grants.--
Section 562(b) of the Public Health Service Act (42 U.S.C. 290ff-1(b))
is amended by striking ``will not provide an individual with access to
the system if the individual is more than 21 years of age'' and
inserting ``will provide an individual with access to the system
through the age of 21 years''.
(c) Additional Provisions.--Section 564(f) of the Public Health
Service Act (42 U.S.C. 290ff-3(f)) is amended by inserting ``(and
provide a copy to the State involved)'' after ``to the Secretary''.
(d) General Provisions.--Section 565 of the Public Health Service
Act (42 U.S.C. 290ff-4) is amended--
(1) in subsection (b)(1)--
(A) in the matter preceding subparagraph (A), by
striking ``receiving a grant under section 561(a)'' and
inserting ``, regardless of whether such public entity
is receiving a grant under section 561(a)''; and
(B) in subparagraph (B), by striking ``pursuant
to'' and inserting ``described in'';
(2) in subsection (d)(1), by striking ``not more than 21
years of age'' and inserting ``through the age of 21 years'';
and
(3) in subsection (f)(1), by striking ``$100,000,000 for
fiscal year 2001, and such sums as may be necessary for each of
the fiscal years 2002 and 2003'' and inserting ``such sums as
may be necessary for each of fiscal years 2017 through 2021''.
SEC. 502. TELEHEALTH CHILD PSYCHIATRY ACCESS GRANTS.
(a) Definitions.--In this subsection:
(1) Eligible entity.--The term ``eligible entity'' means a
State, political subdivision of a State, Indian tribe, or
tribal organization.
(2) Indian tribe; tribal organization.--The terms ``Indian
tribe'' and ``tribal organization'' have the meanings given
such terms in section 4 of the Indian Self-Determination and
Education Assistance Act (25 U.S.C. 450b).
(3) Pediatric mental health teams.--The term ``pediatric
mental health team'' means a team of case coordinators, child
and adolescent psychiatrists, and a licensed clinical mental
health professional, such as a psychologist, social worker, or
mental health counselor. Such a team may be regionally based,
provided there is access to a pediatric mental health team
across the State.
(4) Secretary.--The term ``Secretary'' means the Secretary
of Health and Human Services.
(b) Grants.--The Secretary, acting through the Administrator of the
Health Resources and Services Administration, may award grants to
eligible entities that satisfy all requirements under this section to
promote behavioral health integration in pediatric primary care by--
(1) supporting the development of statewide or regional
child psychiatry access programs; and
(2) supporting the improvement of statewide or regional
child psychiatry access programs in existence on the day before
the date of enactment of this Act.
(c) Child Psychiatry Access Program Requirements.--To be eligible
for support under subsection (b), a child psychiatry access program
shall--
(1) be a statewide or regional network of pediatric mental
health teams that provide support to pediatric primary care
sites as an integrated team;
(2) support and further develop organized State networks of
child and adolescent psychiatrists to provide consultative
support to pediatric primary care sites;
(3) conduct an assessment of critical behavioral
consultation needs among pediatric providers and such
providers' preferred mechanisms for receiving consultation,
training, and technical assistance;
(4) develop an online database and communication
mechanisms, including through telehealth services, to
facilitate consultation support to pediatric practices;
(5) provide rapid statewide or regional clinical telephone
consultations when requested between the pediatric mental
health teams and pediatric primary care providers;
(6) conduct training and provide technical assistance to
pediatric primary care providers to support the early
identification, diagnosis, treatment, and referral of children
with behavioral health conditions;
(7) inform and assist pediatric providers in accessing
child psychiatry consultations and in scheduling and conducting
technical assistance;
(8) assist with referrals to specialty care and community
and behavioral health resources; and
(9) establish mechanisms for measuring and monitoring
increased access to child and adolescent psychiatric services
by pediatric primary care providers and expanded capacity of
pediatric primary care providers to identify, treat, and refer
children with mental health problems.
(d) Application.--An eligible entity that desires a grant under
this section shall submit an application to the Secretary at such time,
in such manner, and containing such information as the Secretary may
require, including a plan for the comprehensive evaluation and the
performance and outcome evaluation described in subsection (e).
(e) Evaluation.--An eligible entity that receives a grant under
this section 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 a comprehensive evaluation
of activities carried out with funds received through such grant and a
performance and outcome evaluation of such activities.
(f) Funding.--
(1) Federal funds.--In addition to the funding provided
through contributions under paragraph (2), the Secretary shall
fund the grant program under this section using such sums as
may be necessary out of any unobligated amounts made available
to carry out section 330I, 330K, or 330L of the Public Health
Service Act (42 U.S.C. 254c-14, 254c-16, 254c-18).
(2) Matching requirement.--The Secretary may not award a
grant under this section unless the eligible entity desiring
the grant agrees, with respect to the costs to be incurred by
the eligible entity in carrying out the purpose of the grant
described in subsection (b), to make available non-Federal
contributions (in cash or in kind) toward such costs in an
amount that is not less than 20 percent of Federal funds
provided through the grant.
SEC. 503. SUBSTANCE USE DISORDER TREATMENT AND EARLY INTERVENTION
SERVICES FOR CHILDREN AND ADOLESCENTS.
The first section 514 of the Public Health Service Act (42 U.S.C.
290bb-7), relating to substance abuse treatment services for children
and adolescents, is amended--
(1) in the heading, by striking ``abuse treatment'' and
inserting ``use disorder treatment and early intervention'';
(2) by striking subsection (a) and inserting the following:
``(a) In General.--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 Education
Assistance Act (25 U.S.C. 450b)), or health facilities or programs
operated by or pursuant to a contract or grant with the Indian Health
Service, for the purpose of--
``(1) providing early identification and services to meet
the needs of children and adolescents who are at risk of
substance use disorders; and
``(2) providing substance use disorder treatment services
for children, including children and adolescents with co-
occurring mental illness and substance use disorders.'';
(3) in subsection (b)--
(A) by striking paragraph (1) and inserting the
following:
``(1) apply evidence-based and cost-effective methods'';
(B) in paragraph (2)--
(i) by striking ``treatment''; and
(ii) by inserting ``substance abuse,''
after ``child welfare,'';
(C) in paragraph (3), by striking ``substance abuse
disorders'' and inserting ``substance use disorders,
including children and adolescents with co-occurring
mental illness and substance use disorders,'';
(D) in paragraph (5), by striking ``treatment;''
and inserting ``services; and'';
(E) in paragraph (6), by striking ``substance abuse
treatment; and'' and inserting ``treatment.''; and
(F) by striking paragraph (7); and
(4) in subsection (f), by striking ``$40,000,000'' and all
that follows through the period and inserting ``such sums as
may be necessary for each of fiscal years 2017 through 2021.''.
SEC. 504. RESIDENTIAL TREATMENT PROGRAMS FOR PREGNANT AND PARENTING
WOMEN.
Section 508 of the Public Health Service Act (42 U.S.C. 290bb-1) is
amended--
(1) in the section heading, by striking ``postpartum'' and
inserting ``parenting'';
(2) in subsection (a)--
(A) in the matter preceding paragraph (1)--
(i) by inserting ``(referred to in this
section as the `Director')'' after
``Treatment'';
(ii) by striking ``grants,'' and inserting
``grants, including the grants under subsection
(r),'';
(iii) by striking ``postpartum'' and
inserting ``parenting''; and
(iv) by striking ``for substance abuse''
and inserting ``for substance use disorders'';
and
(B) in paragraph (1), by inserting ``or receive
outpatient treatment services from'' after ``reside
in'';
(3) in subsection (b)(2), by striking ``the services will
be made available to each woman'' and inserting ``services will
be made available to each woman and child'';
(4) in subsection (c)--
(A) in paragraph (1), by striking ``to the woman of
the services'' and inserting ``of services for the
woman and her child''; and
(B) in paragraph (2)--
(i) in subparagraph (A), by striking
``substance abuse'' and inserting ``substance
use disorders''; and
(ii) in subparagraph (B), by striking
``such abuse'' and inserting ``such a
disorder'';
(5) in subsection (d)--
(A) in paragraph (3)(A), by striking ``maternal
substance abuse'' and inserting ``a maternal substance
use disorder'';
(B) by amending paragraph (4) to read as follows:
``(4) Providing therapeutic, comprehensive child care for
children during the periods in which the woman is engaged in
therapy or in other necessary health and rehabilitative
activities.'';
(C) in paragraphs (9), (10), and (11), by striking
``women'' each place such term appears and inserting
``woman'';
(D) in paragraph (9), by striking ``units'' and
inserting ``unit''; and
(E) in paragraph (11)--
(i) in subparagraph (A), by striking
``their children'' and inserting ``any child of
such woman'';
(ii) in subparagraph (B), by striking ``;
and'' and inserting a semicolon;
(iii) in subparagraph (C), by striking the
period and inserting ``; and''; and
(iv) by adding at the end the following:
``(D) family reunification with children in kinship
or foster care arrangements, where safe and
appropriate.'';
(6) in subsection (e)--
(A) in paragraph (1)--
(i) in the matter preceding subparagraph
(A), by striking ``substance abuse'' and
inserting ``substance use disorders''; and
(ii) in subparagraph (B), by striking
``substance abuse'' and inserting ``substance
abuse disorders''; and
(B) in paragraph (2)--
(i) by striking ``(A) Subject'' and
inserting the following:
``(A) In general.--Subject'';
(ii) in subparagraph (B)--
(I) by striking ``(B)(i) In the
case'' and inserting the following:
``(B) Waiver of participation agreements.--
``(i) In general.--In the case''; and
(II) by striking ``(ii) A
determination'' and inserting the
following:
``(ii) Donations.--A determination''; and
(iii) by striking ``(C) With respect'' and
inserting the following:
``(C) Nonapplication of certain requirements.--With
respect'';
(7) in subsection (g)--
(A) by striking ``who are engaging in substance
abuse'' and inserting ``who have a substance use
disorder''; and
(B) by striking ``such abuse'' and inserting ``such
disorder'';
(8) in subsection (h)(1), by striking ``postpartum'' and
inserting ``parenting'';
(9) in subsection (j)--
(A) in the matter preceding paragraph (1), by
striking ``to on'' and inserting ``to or on''; and
(B) in paragraph (3), by striking ``Office for''
and inserting ``Office of'';
(10) by amending subsection (m) to read as follows:
``(m) Allocation of Awards.--In making awards under subsection (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 disorder treatment options.'';
(11) in subsection (q)--
(A) in paragraph (3), by striking ``funding
agreement under subsection (a)'' and inserting
``funding agreement''; and
(B) in paragraph (4), by striking ``substance
abuse'' and inserting ``a substance use disorder'';
(12) by redesignating subsection (r) as subsection (s);
(13) by inserting after subsection (q) the following:
``(r) Pilot Program for State Substance Abuse Agencies.--
``(1) In general.--From amounts made available under
subsection (s), the Director may carry out a pilot program
under which the Director makes competitive grants to State
substance abuse agencies to--
``(A) enhance flexibility in the use of funds
designed to support family-based services for pregnant
and parenting women with a primary diagnosis of a
substance use disorder, including an opioid use
disorder;
``(B) help State substance abuse agencies address
identified gaps in services provided to such women
along the continuum of care, including services
provided to women in nonresidential based settings; and
``(C) promote a coordinated, effective, and
efficient State system managed by State substance abuse
agencies by encouraging new approaches and models of
service delivery that are evidence-based.
``(2) Requirements.--Notwithstanding any other provisions
of this section, in carrying out the pilot program under this
subsection, the Director--
``(A) shall require a State substance abuse agency
to submit to the Director an application, 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) shall identify, based on applications
submitted under subparagraph (A), State substance abuse
agencies that are eligible for such grants;
``(C) shall require services proposed to be
furnished through such a grant to support family-based
treatment and other services for pregnant and parenting
women with a primary diagnosis of a substance use
disorder, including an opioid use disorder;
``(D) shall not require that services furnished
through such a grant be provided solely to women that
reside in facilities;
``(E) shall not require that grant recipients under
the program make available all services described in
subsection (d); and
``(F) may waive the requirements of subsection (f),
depending on the circumstances of the grantee.
``(3) Required services.--
``(A) In general.--The Director shall specify
minimum services required to be made available to
eligible women through a grant awarded under the pilot
program under this subsection. Notwithstanding any
other provision of this section, such minimum
services--
``(i) shall include the requirements
described in subsection (c);
``(ii) may include any of the services
described in subsection (d);
``(iii) may include other services, as
appropriate; and
``(iv) shall be based on the
recommendations submitted under subparagraph
(B).
``(B) Stakeholder input.--The Director shall
consider recommendations from stakeholders, including
State substance abuse agencies, health care providers,
persons in recovery from substance a substance use
disorder, and other appropriate individuals, for the
minimum services described in subparagraph (A).
``(4) Evaluation and report to congress.--
``(A) Evaluations.--Out of amounts made available
to the Center for Behavioral Health Statistics and
Quality, the Director of the Center for Behavioral
Health Statistics and Quality, in cooperation with the
Director of the Center for Substance Abuse Treatment
and the recipients of grants under this subsection,
shall conduct an evaluation of the pilot program,
beginning one year after the date on which a grant is
first awarded under this subsection.
``(B) Reports.--
``(i) In general.--Not later than 120 days
after the completion of the evaluation under
subparagraph (A), 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 relevant Committees of the Senate and the
House of Representatives a report on such
evaluation.
``(ii) Contents.--The report to Congress
under clause (i) shall include, at a minimum,
outcomes information from the pilot program
under this section, including any resulting
reductions in the use of alcohol and other
drugs, engagement in treatment services,
retention in the appropriate level and duration
of services, increased access to the use of
drugs approved by the Food and Drug
Administration for the treatment of substance
use disorders in combination with counseling,
and other appropriate measures.
``(5) State substance abuse agencies defined.--For purposes
of this subsection, the term `State substance abuse agency'
means, with respect to a State, the agency in such State that
manages the block grant for prevention and treatment of
substance use disorders under subpart II of part B of title XIX
with respect to the State.''; and
(14) in subsection (s), as so redesignated, by striking
``such sums as may be necessary to fiscal years 2001 through
2003.'' and inserting ``such sums as may be necessary for each
of fiscal years 2017 through 2021. Of the amounts made
available for a fiscal year pursuant to the previous sentence,
not more than 25 percent of such amounts shall be made
available for such fiscal year to carry out subsection (r).''.
TITLE VI--IMPROVING PATIENT CARE AND ACCESS TO MENTAL AND SUBSTANCE USE
DISORDER BENEFITS
SEC. 601. HIPAA CLARIFICATION.
(a) In General.--The Secretary of Health and Human Services, acting
through the Director of the Office for Civil Rights, shall ensure that
providers, professionals, patients and their families, and others
involved in mental or substance use disorder treatment or care have
adequate, accessible, and easily comprehensible resources relating to
appropriate uses and disclosures of protected health information under
the regulations promulgated under section 264(c) of the Health
Insurance Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2
note), including resources to clarify permitted uses and disclosures of
such information that--
(1) require the patient's consent;
(2) require providing the patient with an opportunity to
object;
(3) are based on the exercise of professional judgment
regarding whether the patient would object when the opportunity
to object cannot practicably be provided because of the
patient's incapacity or an emergency treatment circumstance;
and
(4) are determined, based on the exercise of professional
judgment, to be in the best interest of the patient when the
patient is not present or otherwise incapacitated.
(b) Considerations.--In carrying out subsection (a), the Secretary
of Health and Human Services shall consider actual and perceived
barriers to the ability of family members to assist in the treatment of
patients with a serious mental illness.
SEC. 602. IDENTIFICATION OF MODEL TRAINING PROGRAMS.
(a) Programs and Materials.--Not later than 1 year after the date
of enactment of this Act, the Secretary of Health and Human Services
(in this section referred to as the ``Secretary''), in consultation
with appropriate experts, shall identify or, in the case that none
exist, recognize private or public entities to develop--
(1) model programs and materials for training health care
providers (including physicians, emergency medical personnel,
psychiatrists, psychologists, counselors, therapists,
behavioral health facilities and clinics, care managers, and
hospitals, including individuals such as a general counsel or
regulatory compliance staff who are responsible for
establishing provider privacy policies) regarding the permitted
uses and disclosures, consistent with the standards governing
the privacy and security of individually identifiable health
information pursuant to regulations promulgated by the
Secretary under section 264(c) of the Health Insurance
Portability and Accountability Act of 1996 (42 U.S.C. 1320d-2
note) and part C of title XI of the Social Security Act (42
U.S.C. 1320d et seq.), of the protected health information of
patients seeking or undergoing mental health or substance use
disorder treatment or care; and
(2) model programs and materials for training patients and
their families regarding their rights to protect and obtain
information under the standards described in paragraph (1).
(b) Periodic Updates.--The Secretary shall--
(1) periodically review, evaluate, and update the model
programs and materials identified under subsection (a); and
(2) disseminate the updated model programs and materials.
(c) Coordination.--The Secretary shall carry out this section in
coordination with the Director of the Office for Civil Rights, the
Assistant Secretary for Planning and Evaluation, the Administrator of
the Substance Abuse and Mental Health Services Administration, the
Administrator of the Health Resources and Services Administration, and
the heads of other relevant agencies within the Department of Health
and Human Services.
(d) Input of Certain Entities.--In identifying the model programs
and materials under subsections (a) and (b), the Secretary shall
solicit input from key stakeholders, including relevant national,
State, and local associations, medical societies licensing boards,
providers of mental and substance use disorder treatment and care, and
organizations representing patients and consumers.
SEC. 603. CONFIDENTIALITY OF RECORDS.
Not later than 1 year after the date on which the Secretary of
Health and Human Services first finalizes the regulations updating part
2 of title 42, Code of Federal Regulations (relating to confidentiality
of alcohol and drug abuse patient records), after the date of enactment
of this Act, the Secretary shall convene relevant stakeholders to
determine the impact of such regulations on patient care, health
outcomes, and patient privacy.
SEC. 604. ENHANCED COMPLIANCE WITH MENTAL HEALTH AND SUBSTANCE USE
DISORDER COVERAGE REQUIREMENTS.
(a) Guidance.--Section 2726(a) of the Public Health Service Act (42
U.S.C. 300gg-26(a)) is amended by adding at the end the following:
``(6) Additional guidance.--
``(A) In general.--Not later than 1 year after the
date of enactment of the Mental Health Reform Act of
2016, the Secretary, in coordination with the Secretary
of Labor and the Secretary of the Treasury, shall issue
guidance to group health plans and health insurance
issuers offering group or individual health insurance
coverage to assist such plans and issuers in satisfying
the requirements of this section.
``(B) Disclosure.--
``(i) Guidance for plans and issuers.--The
guidance issued under this paragraph shall
include specific examples of methods that group
health plans and health insurance issuers
offering group or individual health insurance
coverage may use for disclosing information to
demonstrate compliance with the requirements
under this section (and any regulations
promulgated pursuant to this section),
including methods for complying with
requirements for nonquantitative treatment
limitations.
``(ii) Documents for participants,
beneficiaries, or contracting providers.--The
guidance issued under this paragraph may
include examples of standardized methods that
group health plans and health insurance issuers
offering group or individual health insurance
coverage may use to provide any participant,
beneficiary, or contracting provider, upon
request, with documents containing coverage
information that the health plans or issuers
are required, by this section or any other
provision of law, to disclose to such
participants, beneficiaries, or contracting
providers, including--
``(I) information, including
information that is comparative in
nature, on nonquantitative treatment
limitations for both medical and
surgical benefits and mental health and
substance use disorder benefits;
``(II) information, including
information that is comparative in
nature, about the processes,
strategies, evidentiary standards, and
other factors used to apply
nonquantitative treatment limitations
for both medical and surgical benefits
and mental health and substance use
disorder benefits, including how such
limitations are applied to mental
health or substance use disorder
benefits; and
``(III) information, including
information that is comparative in
nature, about how nonquantitative
treatment limitations are applied to
medical and surgical benefits relative
to how such limitations are applied to
mental health or substance use disorder
benefits.
``(C) Nonquantitative treatment limitations.--The
guidance issued under this paragraph shall include
information that group health plans and health
insurance issuers offering group or individual health
insurance coverage may use to comply with requirements
for nonquantitative treatment limitations under this
section, including--
``(i) examples of appropriate types of
nonquantitative treatment limitations on mental
health and substance use disorder benefits that
comply or do not comply with this section,
including--
``(I) medical management standards
that limit or exclude benefits based on
medical necessity, medical
appropriateness, or whether a treatment
is experimental or investigative;
``(II) limitations with respect to
prescription drug formulary design; and
``(III) use of fail-first or step
therapy protocols;
``(ii) examples of network admission
standards and individual provider reimbursement
rates, as such standards and rates apply to
network adequacy, that comply or do not comply
with this section;
``(iii) examples of sources of information
that may serve as evidentiary standards for the
purpose of determining compliance or
noncompliance with applicable nonquantitative
treatment limitation requirements;
``(iv) examples of specific factors that
may be used by such plans or issuers in
performing a nonquantitative treatment
limitation analysis;
``(v) examples of specific evidentiary
standards that may be used by such plans or
issuers to evaluate the specific factors
described in clause (iv);
``(vi) examples of how a lack of clinical
evidence may be taken into consideration by
such plans or issuers in the case of
experimental treatment exclusions;
``(vii) examples of how specific
evidentiary standards may be applied to each
service category or classification of benefits;
``(viii) examples of new mental health or
substance use disorder treatments that comply
or do not comply with this section, such as
evidence-based early intervention programs for
individuals with a serious mental illness and
types of medical management techniques that
have been determined to meet or fail to meet
requirements for nonquantitative treatment
limitations;
``(ix) examples of coverage determinations
that comply or do not comply with this section
and for which there is an indirect relationship
between the covered mental health or substance
use disorder benefit and a traditional covered
medical and surgical benefit, such as
residential treatment or hospitalizations
involving involuntary commitment;
``(x) examples of how nonquantitative
treatment limitations and their application,
determinations that treatments are no longer
medically necessary, and efforts to terminate
or reduce care may be resolved in a manner that
is least burdensome to the patient and provides
for continuity of patient care; and
``(xi) additional examples of coverage of
mental health and substance use disorder
benefits that comply or do not comply with this
section, including cases in which restrictions
based on geographic locations, facility type,
provider specialty, or other criteria limit the
scope or duration of benefits.
``(D) Public comment.--Prior to issuing any final
guidance under this section, the Secretary shall
provide a public comment period of not less than 60
days during which any member of the public may provide
comments on a draft of the guidance.''.
(b) Improving Compliance.--
(1) In general.--In the case of a group health plan or
health insurance issuer offering health insurance coverage in
the group or individual market with respect to which there are
at least 5 findings of noncompliance with section 2726 of the
Public Health Service Act (42 U.S.C. 300gg-26), section 712 of
the Employee Retirement Income Security Act of 1974 (29 U.S.C.
1185a), or section 9812 of the Internal Revenue Code, the
appropriate Secretary shall audit plan documents for such
health plan or issuer in the following plan year in order to
help improve compliance with such section.
(2) Rule of construction.--Nothing in this subsection shall
be construed to limit the authority, as in effect on the day
before the date of enactment of this Act, of the Secretary of
Health and Human Services, the Secretary of Labor, or the
Secretary of the Treasury to audit documents of health plans or
health insurance issuers.
SEC. 605. ACTION PLAN FOR ENHANCED ENFORCEMENT OF MENTAL HEALTH AND
SUBSTANCE USE DISORDER COVERAGE.
(a) Public Meeting.--
(1) In general.--Not later than 6 months after the date of
enactment of this Act, the Secretary of Health and Human
Services shall convene a public meeting of stakeholders
described in paragraph (2) to produce an action plan for
improved Federal and State coordination related to the
enforcement of mental health parity and addiction equity
requirements.
(2) Stakeholders.--The stakeholders described in this
paragraph shall include each of the following:
(A) The Federal Government, including
representatives from--
(i) the Department of Health and Human
Services;
(ii) the Department of the Treasury;
(iii) the Department of Labor; and
(iv) the Department of Justice.
(B) State governments, including--
(i) State health insurance commissioners;
(ii) appropriate State agencies, including
agencies on public health or mental health; and
(iii) State attorneys general or other
representatives of State entities involved in
the enforcement of mental health parity laws.
(C) Representatives from key stakeholder groups,
including--
(i) the National Association of Insurance
Commissioners;
(ii) health insurance providers;
(iii) providers of mental health and
substance use disorder treatment;
(iv) employers; and
(v) patients or their advocates.
(b) Action Plan.--Not later than 6 months after the public meeting
under subsection (a), the Secretary of Health and Human Services shall
finalize the action plan described in such subsection and make it
plainly available on the Internet website of the Department of Health
and Human Services.
(c) Content.--The action plan under this section shall--
(1) reflect the input of the stakeholders invited to the
public meeting under subsection (a);
(2) identify specific strategic objectives regarding how
the various Federal and State agencies charged with enforcement
of mental health parity and addiction equity requirements will
collaborate to improve enforcement of such requirements;
(3) provide a timeline for when such objectives shall be
met; and
(4) provide specific examples of how such objectives may be
met, which may include--
(A) providing common educational information and
documents to patients about their rights under Federal
or State mental health parity and addiction equity
requirements;
(B) facilitating the centralized collection of,
monitoring of, and response to patient complaints or
inquiries relating to Federal or State mental health
parity and addiction equity requirements, which may be
through the development and administration of a single,
toll-free telephone number and an Internet website
portal;
(C) Federal and State law enforcement agencies
entering into memoranda of understanding to better
coordinate enforcement responsibilities and information
sharing, including whether such agencies should make
the results of enforcement actions related to mental
health parity and addiction equity requirements
publicly available; and
(D) recommendations to the Secretary and Congress
regarding the need for additional legal authority to
improve enforcement of mental health parity and
addiction equity requirements, including requirements
for nonquantitative treatment limitations and the
extent and frequency of how such limitations are
applied both to medical and surgical benefits and to
mental health and substance use disorder benefits.
SEC. 606. REPORT ON INVESTIGATIONS REGARDING PARITY IN MENTAL HEALTH
AND SUBSTANCE USE DISORDER BENEFITS.
(a) In General.--Not later than 1 year after the date of enactment
of this Act, and annually thereafter for the subsequent 5 years, the
Administrator of the Centers for Medicare & Medicaid Services, in
collaboration with the Assistant Secretary of Labor of the Employee
Benefits Security Administration and the Secretary of the Treasury,
shall submit to the Committee on Health, Education, Labor, and Pensions
of the Senate a report summarizing the results of all closed Federal
investigations completed during the preceding 12-month period with
findings of any serious violation regarding compliance with parity in
mental health and substance use disorder benefits, including benefits
provided to persons with a serious mental illness or a substance use
disorder, under section 2726 of the Public Health Service Act (42
U.S.C. 300gg-26), section 712 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of the
Internal Revenue Code of 1986.
(b) Contents.--Subject to subsection (c), a report under subsection
(a) shall, with respect to investigations described in such subsection,
include each of the following:
(1) The number of open or closed Federal investigations
conducted during the covered reporting period.
(2) Each benefit classification examined by any such
investigation conducted during the covered reporting period.
(3) Each subject matter, including compliance with
requirements for quantitative and nonquantitative treatment
limitations, of any such investigation conducted during the
covered reporting period.
(4) A summary of the basis of the final decision rendered
for each closed investigation conducted during the covered
reporting period that resulted in a finding of a serious
violation.
(c) Limitation.--Any individually identifiable information shall be
excluded from reports under subsection (a) consistent with protections
under the health privacy and security rules promulgated under section
264(c) of the Health Insurance Portability and Accountability Act of
1996 (42 U.S.C. 1320d-2 note).
SEC. 607. GAO STUDY ON COVERAGE LIMITATIONS FOR INDIVIDUALS WITH
SERIOUS MENTAL ILLNESS AND SUBSTANCE USE DISORDERS.
Not later than 3 years after the date of enactment of this Act, the
Comptroller General of the United States, in consultation with the
Secretary of Health and Human Services, the Secretary of Labor, and the
Secretary of the Treasury, shall submit to the Committee on Health,
Education, Labor, and Pensions of the Senate a report detailing the
extent to which group health plans or health insurance issuers offering
group or individual health insurance coverage that provides both
medical and surgical benefits and mental health or substance use
disorder benefits, and medicaid managed care organizations with a
contract under section 1903(m) of the Social Security Act (42 U.S.C.
1396b(m)), comply with section 2726 of the Public Health Service Act
(42 U.S.C. 300gg-26), section 712 of the Employee Retirement Income
Security Act of 1974 (29 U.S.C. 1185a), and section 9812 of the
Internal Revenue Code of 1986, including--
(1) how nonquantitative treatment limitations, including
medical necessity criteria, of such plans or issuers comply
with such sections;
(2) how the responsible Federal departments and agencies
ensure that such plans or issuers comply with such sections,
including an assessment of how the Secretary of Health and
Human Services has used its authority to conduct audits of such
plans to ensure compliance;
(3) a review of how the various Federal and State agencies
responsible for enforcing mental health parity requirements
have improved enforcement of such requirements in accordance
with the objectives and timeline described in the action plan
under section 605; and
(4) recommendations for how additional enforcement,
education, and coordination activities by responsible Federal
and State departments and agencies could better ensure
compliance with such sections, including recommendations
regarding the need for additional legal authority.
SEC. 608. CLARIFICATION OF EXISTING PARITY RULES.
If a group health plan or a health insurance issuer offering group
or individual health insurance coverage provides coverage for eating
disorder benefits including, but not limited to, residential treatment,
such group health plan or health insurance issuer shall provide such
benefits consistent with the requirements of section 2726 of the Public
Health Service Act (42 U.S.C. 300gg-26), section 712 of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1185a), and section
9812 of the Internal Revenue Code of 1986.
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