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H.R. 5466 (111th): SAMHSA Modernization Act of 2010


The text of the bill below is as of May 28, 2010 (Introduced). The bill was not enacted into law.


I

111th CONGRESS

2d Session

H. R. 5466

IN THE HOUSE OF REPRESENTATIVES

May 28, 2010

(for himself and Mr. Gene Green of Texas) introduced the following bill; which was referred to the Committee on Energy and Commerce

A BILL

To amend titles V and XIX of the Public Health Service Act to revise and extend substance use disorder and mental health programs, and for other purposes.

1.

Short title; table of contents

(a)

Short title

This Act may be cited as the SAMHSA Modernization Act of 2010 .

(b)

Table of contents

The table of contents of this Act is as follows:

Sec. 1. Short title; table of contents.

Sec. 2. Amendments to title V of the Public Health Service Act.

Sec. 3. Amendments to title XIX of the Public Health Service Act.

Sec. 4. Repeal.

Sec. 5. Amendments to the Protection and Advocacy for Individuals with Mental Illness Act.

Sec. 6. Study of the distribution of funds under the Substance Abuse Prevention and treatment block grant and the community Mental Health Services block grant.

Sec. 7. Task force on behavioral and mental health in medical education.

Sec. 8. Council on Integration of Health Care Education.

2.

Amendments to title V of the Public Health Service Act

(a)

In General

Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.), except for the second part G (41 U.S.C. 290kk et seq.), is amended to read as follows:

V

SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

A

ORGANIZATION AND GENERAL AUTHORITIES

501.

Substance Abuse and Mental Health Services Administration

(a)

Establishment

The Substance Abuse and Mental Health Services Administration (hereafter referred to in this title as the Administration) is an agency of the Service.

(b)

Agencies

The following entities are agencies of the Administration:

(1)

The Center for Substance Abuse Treatment.

(2)

The Center for Substance Abuse Prevention.

(3)

The Center for Mental Health Services.

(c)

Administrator and Deputy Administrator

(1)

Administrator

The Administration shall be headed by an Administrator (hereinafter in this title referred to as the Administrator) who shall be appointed by the President, by and with the advice and consent of the Senate.

(2)

Deputy administrator

The Administrator, with the approval of the Secretary, may appoint a Deputy Administrator and may employ and prescribe the functions of such officers and employees, including attorneys, as are necessary to administer the activities to be carried out through the Administration.

(d)

Authorities

The Secretary, acting through the Administrator, shall—

(1)

supervise the functions of the centers of the Administration in order to assure that the programs carried out through each such center receive appropriate and equitable support and that there is cooperation among the centers in the implementation of such programs;

(2)

establish and implement, through the respective centers, a comprehensive program to improve the provision of treatment and related services to individuals with respect to substance use disorders and mental illness and to improve substance use disorder prevention services, promote mental health and protect the legal rights of individuals with mental illness or substance use disorders;

(3)

carry out the administrative and financial management, policy development and planning, evaluation, knowledge dissemination, and public information functions that are required for the implementation of this title;

(4)

assure that the Administration conduct and coordinate demonstration projects, evaluations, and service system assessments and other activities necessary to improve the availability and quality of prevention, treatment, and related services that reflect the needs and preferences of individuals with mental illness or substance use disorders and their families;

(5)

support activities that will improve the provision of treatment, prevention and related services, including the development of national mental health and substance use disorder goals and model programs;

(6)

in cooperation with the National Institutes of Health, the Centers for Disease Control and Prevention, and the Health Resources and Services Administration develop educational materials and intervention strategies to reduce the risks of HIV, hepatitis C, sexually transmitted diseases, tuberculosis, and other communicable diseases among individuals with mental illness or substance use disorders and to develop appropriate mental health and substance use disorder services for individuals with such illnesses;

(7)

coordinate Federal policy with respect to the provision of treatment services for substance use disorders utilizing anti-addiction medications, including the certification of opioid treatment programs and monitoring compliance with requirements established in regulations, including the authority to monitor and inspect programs to ensure quality service and to suspend and revoke such certifications;

(8)

conduct programs, and assure the coordination of such programs with activities of the National Institutes of Health and the Agency for Healthcare Research and Quality, as appropriate, to evaluate the process, outcomes and community impact of prevention and treatment services and systems of care in order to identify the manner in which such services can most effectively be provided;

(9)

collaborate with the Director of the National Institutes of Health in the development of a system by which the relevant research findings of the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health, and, as appropriate, the Agency for Healthcare Research and Quality are disseminated to service providers in a manner designed to improve the delivery and effectiveness of treatment and prevention services;

(10)

encourage public and private entities that provide health insurance to provide benefits for substance use disorder and mental health services;

(11)

promote the integration of substance use disorder and mental health services into the mainstream of the health care delivery system of the United States;

(12)

monitor compliance by hospitals and other facilities with the requirements of sections 562 and 563;

(13)

with respect to grant programs authorized under this title and part B of title XIX—

(A)

require that all grants that are awarded for the provision of services are subject to performance and outcome evaluations using the performance measures developed in accordance with section 504(b);

(B)

require that all grants that are awarded to entities other than States are awarded only after the State in which the entity intends to provide services—

(i)

is notified of the pendency of the grant application; and

(ii)

is afforded an opportunity to comment on the merits of the application; and

(C)

inform the State when funds are awarded to entities within the State;

(14)

assure that services provided with amounts appropriated under this title are culturally and linguistically appropriate;

(15)

improve coordination among prevention programs, treatment facilities and nonhealth care systems such as employers, labor unions, and schools, and encourage the adoption of employee assistance programs and student assistance programs;

(16)

maintain a clearinghouse for substance use disorder and mental health information to assure the widespread dissemination of such information to States, political subdivisions, educational agencies and institutions, treatment providers, and the general public;

(17)

in collaboration with the National Institute on Aging, and in consultation with the National Institute on Drug Abuse, the National Institute on Alcohol Abuse and Alcoholism and the National Institute of Mental Health, as appropriate, promote and evaluate mental health and substance use disorder services for older Americans in need of such services;

(18)

promote the coordination of service programs conducted by other departments, agencies, organizations and individuals that are or may be related to the problems of individuals suffering from mental illness or substance use disorders, including liaisons with the Social Security Administration, Centers for Medicare & Medicaid Services, and other programs of the Department, as well as liaisons with the Department of Education, Department of Justice, and other Federal Departments and offices, as appropriate;

(19)

collaborate with the Secretary of Defense and the Secretary of Veterans Affairs to improve the provision of mental health and substance use disorder services provided by the Department of Defense and the Department of Veterans Affairs to veterans and their families (including members of the national guard and military reserve components who have served in active duty and their families), including through the provision of services using the telehealth capabilities of the Department of Veterans Affairs;

(20)

in coordination with the Assistant Secretary for Preparedness and Response of the Department of Health and Human Services, the Administrator of the Federal Emergency Management Agency, and the Director of the Centers for Disease Control and Prevention, work with States to establish mental health and substance use disorder emergency response plans and assist in incorporating such plans into State emergency response plans in preparation for possible emergencies or major disasters;

(21)

in coordination with the Secretary of Education and the Secretary of Homeland Security, work with universities and colleges to establish mental health and substance use disorder emergency response plans and incorporate such plans into overall institutional emergency response plans;

(22)

work with the Health Resources and Services Administration and the Centers for Disease Control and Prevention on integrating mental health and substance use disorder promotion with general health promotion and disease prevention;

(23)

collaborate with Federal departments and programs that are part of the President’s Interagency Council on Homelessness, particularly the Department of Housing and Urban Development, the Department of Labor, and the Department of Veterans Affairs, and with other agencies within the Department of Health and Human Services, particularly the Health Resources and Services Administration, the Administration on Children and Families, and the Centers for Medicare & Medicaid Services, to design national strategies for providing services in supportive housing that will assist in ending chronic homelessness and to implement programs that address chronic homelessness;

(24)

work with States and other stakeholders to develop and support activities to recruit and retain a mental health and substance use disorders workforce that is qualified to provide mental health or substance use disorder prevention and treatment services in the public sector, which may include fellowships, internships, and encouraging efforts to identify essential skills and abilities for non-degreed and bachelor degreed direct care staff, community leaders, and individuals in recovery and their families; and

(25)

ensure that parents receiving services from a program authorized under this title or under part B of title XIX, receive referral for evaluation for early intervention under part C of the Individuals with Disabilities Education Improvement Act.

(e)

Associate Administrator for Alcohol Prevention and Treatment Policy

(1)

In general

There may be in the Administration an Associate Administrator for Alcohol Prevention and Treatment Policy to whom the Administrator may delegate the function of promoting and coordinating activities related to the prevention and reduction of underage drinking, as well as promoting, monitoring, and evaluating service programs for the prevention and treatment of alcoholism and alcohol abuse within the Center for Substance Abuse Prevention, the Center for Substance Abuse Treatment and the Center for Mental Health Services, and coordinating such programs among the Centers, and among the Centers and other public and private entities. The Associate Administrator also may ensure that alcohol prevention, education, and policy strategies are integrated into all programs of the Centers that address substance use disorder prevention, education, and policy, and that the Center for Substance Abuse Prevention addresses the Healthy People 2010 goals and the National Dietary Guidelines of the Department of Health and Human Services and the Department of Agriculture related to alcohol consumption.

(2)

Plan

The Administrator, acting through the Associate Administrator for Alcohol Prevention and Treatment Policy, shall develop, and periodically review and as appropriate revise, a plan for programs and policies to treat and prevent alcoholism and alcohol abuse. The plan shall be developed (and reviewed and revised) in collaboration with the Directors of the Centers of the Administration and in consultation with members of other Federal agencies and public and private entities.

(3)

Report

(A)

In general

Not less than once during each 2-year period, the Administrator, acting through the Associate Administrator for Alcohol Prevention and Treatment Policy, shall prepare a report describing the alcoholism and alcohol abuse prevention and treatment programs undertaken by the Administration and its agencies particularly those focusing on underage drinking, and the report shall include a detailed statement of the expenditures made for the activities reported on and the personnel used in connection with such activities.

(B)

Revisions

Each report under subparagraph (A) shall include a description of any revisions in the plan under paragraph (2) made during the preceding 2 years.

(f)

Associate Administrator for Women’s Services

(1)

Appointment

The Administrator, with the approval of the Secretary, shall appoint an Associate Administrator for Women’s Services.

(2)

Duties

The Associate Administrator appointed under paragraph (1) shall—

(A)

establish a committee to be known as the Coordinating Committee for Women’s Services (hereafter in this subparagraph referred to as the Coordinating Committee), which shall be composed of the Directors of the agencies of the Administration (or the designees of the Directors);

(B)

acting through the Coordinating Committee, with respect to women’s substance use disorders and mental health services—

(i)

identify the need for such services, and make an estimate each fiscal year of the funds needed to adequately support the services;

(ii)

identify needs regarding the coordination of services;

(iii)

encourage the agencies of the Administration to support such services;

(iv)

assure that the unique needs of minority women, including Native American, Alaskan Native, Hispanic, African-American and Asian women, are recognized and addressed within the activities of the Administration;

(v)

recognize the distinct condition of maternal addiction and the specific needs that pregnant and parenting women and their children present to treatment approaches and interventions; and

(vi)

explore the relationship between sexual violence, trauma, and maternal addiction in order to effectively respond to the distinct pathways to addiction for pregnant and parenting women;

(C)

establish an advisory committee to be known as the Advisory Committee for Women’s Services, which shall be composed of not more than 10 individuals, a majority of whom shall be women, who are not officers or employees of the Federal Government, to be appointed by the Administrator from among physicians, practitioners, treatment providers, prevention specialists, and other health professionals, whose clinical practice, specialization, or professional expertise includes a significant focus on women’s substance use disorders and mental health conditions, that shall—

(i)

advise the Associate Administrator on appropriate activities to be undertaken by the agencies of the Administration with respect to women’s substance use disorder and mental health services, including services which require a multidisciplinary approach;

(ii)

collect and review data, including information provided by the Secretary, and report biannually to the Administrator regarding the extent to which women are represented among senior personnel, and make recommendations regarding improvement in the participation of women in the workforce of the Administration; and

(iii)

prepare a description of activities of the Committee, including findings made by the Committee regarding—

(I)

the extent of expenditures made for substance use disorder and mental health services for women and pregnant and parenting women by the Administration; and

(II)

the estimated level of funding needed for substance use disorder and mental health services to meet the needs of women and pregnant and parenting women;

(D)

improve the collection of data on women’s health by—

(i)

reviewing the current data at the Administration to determine its uniformity and applicability;

(ii)

developing standards for all programs funded by the Administration so that data are, to the extent practicable, collected and reported using common reporting formats, linkages and definitions; and

(iii)

reporting to the Administrator a plan for incorporating the standards developed under clause (ii) in all Administration programs and a plan to assure that the data so collected are accessible to health professionals, providers, researchers, and members of the public; and

(E)

shall establish, maintain, and operate a program to provide information on women’s substance use disorder and mental health services.

(3)

Definition

For purposes of this subsection, the term women’s substance use disorder and mental health conditions, with respect to women of all age, ethnic, and racial groups, means all aspects of substance use disorders and mental illness—

(A)

unique to or that directly affects women; or

(B)

with respect to which there have been insufficient services involving women or insufficient data.

(g)

Associate Administrator for Older Adult Services

(1)

Appointment

The Administrator, with the consent of the Secretary, shall appoint an individual to serve as the Associate Administrator of Older Adult Services.

(2)

Duties

The Associate Administrator appointed under paragraph (1) shall act as the lead staff for the coordination, promotion, and monitoring of—

(A)

services research on the prevention and identification of mental health and substance use disorders in the older adult population, including the risk of suicide;

(B)

innovative projects for the delivery of community-based mental health and substance use disorder services for older adults, including senior suicide prevention and the integration of mental health services in primary care settings;

(C)

support for the development and dissemination of evidence-based practice models, including models to address mental health and substance-related disorders in older adults, including the risk of suicide;

(D)

the development of model training programs for mental health and substance use disorder professionals and caregivers serving older adults; and

(E)

other activities, as designated by the Administrator, to improve the mental health and substance use disorders of older adults.

(h)

Services of Experts

(1)

In general

The Administrator may obtain (in accordance with section 3109 of title 5, United States Code, but without regard to the limitation in such section on the number of days or the period of service) the services of not more than 20 experts or consultants who have professional qualifications. Such experts and consultants shall be obtained for the Administration and for each of its centers.

(2)

Compensation and expenses

(A)

In general

Experts and consultants whose services are obtained under paragraph (1) shall be paid or reimbursed for their expenses associated with traveling to and from their assignment location in accordance with sections 5724, 5724a(a), 5724a(c), and 5726(c) of title 5, United States Code.

(B)

Limitations

Expenses specified in subparagraph (A) may not be allowed in connection with the assignment of an expert or consultant whose services are obtained under paragraph (1), unless and until the expert or consultant agrees in writing to complete the entire period of assignment or one year, whichever is shorter, unless separated or reassigned for reasons beyond the control of the expert or consultant that are acceptable to the Secretary. If the expert or consultant violates the agreement, the money spent by the United States for the expenses specified in subparagraph (A) is recoverable from the expert or consultant as a debt of the United States. The Secretary may waive in whole or in part a right of recovery under this subparagraph.

(i)

Peer Review Groups

The Administrator shall, without regard to the provisions of title 5, United States Code, governing appointments in the competitive service, and without regard to the provisions of chapter 51 and subchapter III of chapter 53 of such title, relating to classification and General Schedule pay rates, establish such peer review groups and program advisory committees as are needed to carry out the requirements of this title and appoint and pay members of such groups, except that officers and employees of the United States shall not receive additional compensation for services as members of such groups. The Federal Advisory Committee Act shall not apply to the duration of a peer review group appointed under this subsection.

(j)

Voluntary Services

The Administrator may accept voluntary and uncompensated services.

(k)

Administration

The Administrator shall ensure that programs and activities assigned under this title to the Administration are fully administered by the respective Centers to which such programs and activities are assigned.

(l)

Report Concerning Activities and Progress

Not later than 2 years after the date of enactment of the SAMHSA Modernization Act of 2010, and once every 2 years thereafter, the Administrator shall prepare and submit to the Committee on Energy and Commerce and the Committee on Appropriations of the House of Representatives, and to the Committee on Health, Education, Labor, and Pensions and the Committee on Appropriations of the Senate, the report containing, at a minimum—

(1)

the development and assessment of population-based indicators of mental health and substance use disorders for the United States and the progress made in addressing gaps in services and improving outcomes by the Administration and by other public health agencies;

(2)

a description of the activities carried out by the Administration to improve the availability and quality of the mental health and substance use disorder prevention and treatment services;

(3)

an assessment of the success of programs funded under this title and part B of title XIX in meeting the goals of the program using the measures of performance developed in accordance with section 504(b); and

(4)

a description of the manner in which the Administration engages in partnerships with other Federal agencies and promotes coordination by grantees under this title and part B of title XIX with other State or local agencies.

(m)

Applications for Grants and Contracts

(1)

In general

With respect to awards of grants, cooperative agreements, and contracts under this title or other statutory authority of the Administration, the Administrator, or the Director of the Center involved, as the case may be, may not make such an award unless—

(A)

an application for the award is submitted to the official involved;

(B)

with respect to carrying out the purpose for which the award is to be provided, the application provides assurances of compliance with the requirements of the grant, cooperative agreement, or contract satisfactory to such official; and

(C)

the application is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the official determines to be necessary to carry out the purpose for which the award is to be provided.

(2)

Consideration of religion in employment decisions

With respect to any activity to be funded (in whole or in part) through an award of a grant, cooperative agreement, or contract under this title or any other statutory authority of the Administration, the Administrator, or the Director of the Center involved, as the case may be, may not make such an award unless the applicant agrees to refrain from considering religion or any profession of faith when making any employment decision regarding an individual who is or will be assigned to carry out any portion of the activity. This paragraph applies notwithstanding any other provision of Federal law, including any exemption otherwise applicable to a religious corporation, association, educational institution, or society.

(n)

Emergency Response

(1)

In general

Notwithstanding section 504 and except as provided in paragraph (2), the Secretary may use not to exceed 2.5 percent of all amounts appropriated under this title for a fiscal year to make noncompetitive grants, contracts or cooperative agreements to public entities to enable such entities to address emergency substance use disorder or mental health needs in local communities.

(2)

Exceptions

Amounts appropriated under part C shall not be subject to paragraph (1).

(3)

Emergencies

The Secretary shall establish criteria for determining that a substance use disorder or mental health emergency exists and publish such criteria in the Federal Register prior to providing funds under this subsection.

(o)

Limitation on the Use of Certain Information

No information, if an establishment or person supplying the information or described in it is identifiable, obtained in the course of activities undertaken or supported under section 504 may be used for any purpose other than the purpose for which it was supplied unless such establishment or person has consented (as determined under regulations of the Secretary) to its use for such other purpose. Such information may not be published or released in other form if the person who supplied the information or who is described in it is identifiable unless such person has consented (as determined under regulations of the Secretary) to its publication or release in other form.

(p)

Joint Funding of Projects

(1)

In general

(A)

Authority

The Administrator is authorized to enter into arrangements with other Federal agencies to jointly carry out projects of common interest, to transfer to such agencies funds appropriated under any applicable program under this title, and to receive and use funds from such, for projects of common interest.

(B)

Use

Funds transferred or received pursuant to subparagraph (A) shall be used only for purposes for which such funds were appropriated and shall be made available by contract or grant only to recipients eligible to receive such funds under such laws.

(C)

Application of procedures

If the Administrator enters into an arrangement under this subsection for the administration of a project, the Federal agency administering the project shall use such agency’s procedures to award contracts or grants and to administer such awards, unless the parties to the arrangement specify the use of procedures of another agency that is a party to the arrangement.

(D)

Criteria

If the Administrator has entered into an arrangement authorized under this paragraph and the Secretary and the heads of the other Federal agencies participating in the arrangement determine that joint funding is necessary to address a special need consistent with the purposes and authorized activities of each program that provides funding under the joint project, the Administrator and the heads of the other participating agencies may develop a single set of criteria for the jointly funded project and require each applicant for such project to submit a single application for review by the participating agencies.

(2)

Joint applications

The Administrator may develop the criteria for, and require the submission of, joint applications under 2 or more applicable programs under which funds are awarded on a competitive basis, and may jointly review and approve such applications separately from other applications under such programs, where the Secretary determines that such joint awards are necessary to address a special need consistent with the purposes and authorized activities of each such program. Any applicant for such a joint award shall meet the eligibility requirements of each such program.

(3)

Limitations on joint funding

The Secretary may not construe the provisions of this subsection to take precedence over a limitation on joint funding contained in an applicable law.

(4)

Congressional notice

(A)

In general

The Administrator shall provide notice to the Committee on Energy and Commerce of the House of Representatives and Committee on Health, Education, Labor, and Pensions of the Senate and the Subcommittee on Labor, Health and Human Services and Education of the Committee on Appropriations of the House of Representatives and the Subcommittee on Labor, Health and Human Services and Education of the Committee on Appropriations of the Senate of each joint funding agreement made with other Federal agencies under this subsection not later than 60 days after the making of such agreements.

(B)

Requirements

A notice under subparagraph (A) shall include—

(i)

a description of the purpose and objectives of the joint funding arrangement;

(ii)

the amounts and sources, by program, of the funds dedicated to such arrangement; and

(iii)

the criteria developed to govern the award of contracts and grants.

(q)

Publications

The Secretary, without regard to section 501 of title 44, United States Code, shall promptly publish, make available in accessible formats, and disseminate widely, the results of research, demonstration projects, and evaluations conducted or supported under this title.

(r)

International

For the purpose of advancing the status of the health sciences in the United States (and thereby the health of the American people), the Administrator may provide training and technical assistance to foreign countries or international organizations, and participate with foreign countries or international organizations in cooperative endeavors in health care technology, health services research, and statistical activities related to substance use disorders and mental health, including participating and otherwise cooperating in any international meetings, conferences, or other activities concerning with substance use disorders or mental health.

(s)

Definition

In this title, the terms emergency and major disaster have the meanings given such terms in section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act.

(t)

Authorization of Appropriations

For the purpose of providing grants, cooperative agreements, and contracts under this section, there are authorized to be appropriated $50,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

502.

Advisory councils

(a)

Appointment

(1)

In general

The Secretary shall appoint an advisory council for—

(A)

the Substance Abuse and Mental Health Services Administration;

(B)

the Center for Substance Abuse Treatment;

(C)

the Center for Substance Abuse Prevention; and

(D)

the Center for Mental Health Services.

Each such advisory council shall advise, consult with, and make recommendations to the Secretary and the Administrator or Director of the Administration or Center for which the advisory council is established concerning matters relating to the activities carried out by and through the Administration or Center and the policies respecting such activities.
(2)

Function and activities

An advisory council—

(A)

may on the basis of the materials provided by the organization respecting activities conducted at the organization, make recommendations to the Administrator or Director of the Administration or Center for which it was established respecting such activities;

(B)

may collect, by correspondence or by personal investigation, information as to studies and services that are being carried on in the United States or any other country as to the diseases, disorders, or other aspects of human health with respect to which the organization was established and with the approval of the Administrator or Director, whichever is appropriate, make such information available through appropriate publications for the benefit of public and private health entities and health professions personnel and for the information of the general public; and

(C)

may appoint subcommittees and convene workshops and conferences.

(b)

Membership

(1)

In general

Each advisory council shall consist of nonvoting ex officio members and not more than 12 members to be appointed by the Secretary under paragraph (3).

(2)

Ex officio members

The ex officio members of an advisory council shall consist of—

(A)

the Secretary;

(B)

the Administrator;

(C)

the Director of the Center for which the council is established;

(D)

the Under Secretary for Health of the Department of Veterans Affairs;

(E)

the Assistant Secretary for Defense for Health Affairs (or the designates of such officers); and

(F)

such additional officers or employees of the United States as the Secretary determines necessary for the advisory council to effectively carry out its functions.

(3)

Appointed members

Individuals shall be appointed to an advisory council under paragraph (1) as follows:

(A)

Nine of the members shall be appointed by the Secretary from among the leading representatives of the health disciplines (including public health and behavioral and social sciences and, as practicable, age-appropriate health experts) relevant to the activities of the Administration or Center for which the advisory council is established.

(B)

Three of the members shall be appointed by the Secretary from the general public (including an older adult or a member of their family), and shall include consumers and leaders in fields of public policy, public relations, law, health policy economics, or management.

(C)

The Secretary shall appoint a member of the Women’s Advisory Council established under section 501(f)(2)(C) to each of the advisory councils as a liaison between such councils and the Women’s Advisory Council.

(4)

Compensation

Members of an advisory council who are officers or employees of the United States shall not receive any compensation for service on the advisory council. The remaining members of an advisory council shall receive, for each day (including travel time) they are engaged in the performance of the functions of the advisory council, compensation at rates not to exceed the daily equivalent to the annual rate in effect for Executive Level II.

(c)

Terms of Office

(1)

In general

The term of office of a member of an advisory council appointed under subsection (b) shall be 4 years, except that any member appointed to fill a vacancy for an unexpired term shall serve for the remainder of such term. The Secretary shall make appointments to an advisory council in such a manner as to ensure that the terms of the members not all expire in the same year. A member of an advisory council may serve after the expiration of such member’s term until a successor has been appointed and taken office.

(2)

Reappointments

A member who has been appointed to an advisory council for a term of 4 years may not be reappointed to an advisory council during the 2-year period beginning on the date on which such 4-year term expired.

(3)

Time for appointment

If a vacancy occurs in an advisory council among the members under subsection (b), the Secretary shall make an appointment to fill such vacancy within 90 days from the date the vacancy occurs.

(d)

Chair

The Secretary shall select a member of an advisory council to serve as the chair of the council. The Secretary may so select an individual from among the appointed members, or may select the Administrator or the Director of the Center involved. The term of office of the chair shall be 2 years unless the Secretary appoints the Administrator to serve as the chair.

(e)

Meetings

An advisory council shall meet at the call of the chairperson or upon the request of the Administrator or Director of the Administration or Center for which the advisory council is established, but in no event less than 2 times during each fiscal year. The location of the meetings of each advisory council shall be subject to the approval of the Administrator or Director of Administration or Center for which the council was established.

(f)

Executive Secretary and Staff

The Administrator or Director of the Administration or Center for which the advisory council is established shall designate a member of the staff of the Administration or Center for which the advisory council is established to serve as the Executive Secretary of the advisory council. The Administrator or Director shall make available to the advisory council such staff, information, and other assistance as it may require to carry out its functions. The Administrator or Director shall provide orientation and training for new members of the advisory council to provide for their effective participation in the functions of the advisory council.

503.

Peer review

(a)

In General

The Secretary, after consultation with the Administrator, shall require appropriate peer review of grants, cooperative agreements, and contracts to be administered through the agency which exceed the simple acquisition threshold as defined in section 4(11) of the Office of Federal Procurement Policy Act.

(b)

Members

The members of any peer review group established under subsection (a) shall be individuals who by virtue of their training or experience are eminently qualified to perform the review functions of the group. Not more than one-fourth of the members of any such peer review group shall be officers or employees of the United States.

(c)

Conditions

The Secretary may establish limited exceptions to the limitations contained in this section regarding participation of Federal employees. The circumstances under which the Secretary may make such an exception shall be made public.

504.

Data collection

(a)

Data

(1)

In general

The Secretary, acting through the Administrator, shall, at a minimum, collect data each year—

(A)

with respect to mental health, concerning—

(i)

the national incidence and prevalence of the various forms of mental illness and, in particular, the national incidence and prevalence of adults with serious mental illness and children with serious emotional disturbance (as such terms are defined for purposes of section 1912);

(ii)

the number and variety of public and nonprofit private treatment programs;

(iii)

the number and demographic characteristics of individuals receiving treatment through such programs;

(iv)

the type of care received by such individuals;

(v)

the relationship between mental illness and physical diseases; and

(vi)

such other issues as may be appropriate; and

(B)

with respect to substance use, concerning—

(i)

the national incidence and prevalence of the various forms of substance use;

(ii)

the incidence and prevalence of such various forms of substance use in major metropolitan areas selected by the Secretary;

(iii)

the number of individuals admitted to the emergency rooms of hospitals as a result of the abuse of alcohol or other drugs;

(iv)

the number of deaths occurring as a result of substance use disorders, as indicated in reports by coroners;

(v)

the number and variety of public and private nonprofit treatment programs, including their capacity and type of patient services available;

(vi)

the number of individuals seeking treatment through such programs, the number and demographic characteristics of individuals receiving such treatment, the percentage of individuals who complete such programs, and, with respect to individuals receiving such treatment, the length of time between an individual’s request for treatment and the commencement of treatment;

(vii)

the number of such individuals who return for treatment after the completion of a prior treatment in such programs and the method of treatment utilized during the prior treatment;

(viii)

the number of individuals receiving public assistance for such treatment programs;

(ix)

the costs and effectiveness of the different types of treatment modalities for drug and alcohol abuse and the aggregate relative costs of each such treatment modality provided within a State in each fiscal year;

(x)

to the extent information is available, the number of individuals receiving treatment for alcohol or drug abuse who have private insurance coverage for the costs of such treatment;

(xi)

the extent of alcohol and drug abuse among high school students and among the general population; and

(xii)

the number of alcohol and drug abuse counselors and other substance use disorder treatment personnel employed in public and private treatment facilities.

(2)

Annual surveys

The Secretary shall carry out annual surveys with respect to the collection of data under this subsection. Summaries and analyses of such data shall be made available to the public.

(b)

National Outcome Measures

(1)

In general

The Secretary, in consultation with States and other stakeholders, shall establish national outcome measures (including client and community measures) for substance abuse and mental health programs to be used by recipients of assistance through programs authorized under this title and part B of title XIX, as appropriate.

(2)

Evaluation

The Secretary shall be responsible for evaluating the effect of the implementation of the outcome measures developed under paragraph (1) and whether such outcome measures continue to be important for measuring program success and for recommending additional measures or modification to current measures.

(3)

Modifications

Any modifications made as a result of an evaluation under paragraph (2) shall be made only after the Secretary has consulted with States and other stakeholders and after such modification are published in the Federal Register.

(4)

Deemed publication

National outcome measures agreed to by the States and other stakeholders prior to the date of enactment of the SAMHSA Modernization Act of 2010 are deemed to have been published in the Federal Register for the purposes of paragraph (3).

(c)

State Infrastructure Grants

(1)

In general

The Secretary may award grants to, and enter into contracts or cooperative agreements with, States for the purpose of developing and operating mental health or substance use disorder data collection, analysis, and reporting systems in accordance with the outcome measures developed under subsection (b).

(2)

Matching requirement

(A)

In general

With respect to the costs of the program to be carried out under a grant under paragraph (1) by a State, the Secretary may make an award under such paragraph only if the applicant agrees to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than 50 percent of such costs.

(B)

Determination of amount contributed

Non-Federal contributions under subparagraph (A) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such contributions.

(3)

Duration of support

The period during which payments may be made for a program under paragraph (1) may be not less than 3 years nor more than 5 years.

(d)

Uniform Criteria

After consultation with the States and with appropriate national organizations, the Administrator shall develop uniform criteria for the collection of data, using the best available technology, pursuant to this section.

(e)

Authorization of Appropriations

For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2011 through 2015.

505.

Supportive services for homeless Individuals

(a)

Grants for Treatment and Recovery for Homeless Individuals

(1)

In general

The Secretary shall award grants, contracts and cooperative agreements to community-based public and private nonprofit entities for the purposes of providing mental health and substance use disorder services for homeless individuals. In carrying out this section, the Secretary shall consult with the Interagency Council on the Homeless, established under section 201 of the Stewart B. McKinney Homeless Assistance Act (42 U.S.C. 11311).

(2)

Preferences

In awarding grants, contracts, and cooperative agreements under paragraph (1), the Secretary shall give a preference to—

(A)

entities that provide integrated primary health, substance use disorder, and mental health services to homeless individuals;

(B)

entities that demonstrate effectiveness in serving runaway, homeless, and street youth;

(C)

entities that have experience in providing substance use disorder and mental health services to homeless individuals;

(D)

entities that demonstrate experience in providing housing for individuals in treatment for or in recovery from mental illness or substance use disorders; and

(E)

entities that demonstrate effectiveness in serving homeless veterans.

(3)

Services for certain individuals

In awarding grants, contracts, and cooperative agreements under paragraph (1), the Secretary shall not—

(A)

prohibit the provision of services under such subsection to homeless individuals who are suffering from a substance use disorder and are not suffering from a mental health disorder; and

(B)

make payments under such paragraph to any entity that has a policy of—

(i)

excluding individuals from mental health services due to the existence or suspicion of substance use disorder; or

(ii)

has a policy of excluding individuals from substance use disorder services due to the existence or suspicion of mental illness.

(b)

Grants for Services To End Long-Term Homelessness

(1)

In general

(A)

Grants

The Secretary shall make grants to entities described in subparagraph (B) for the purpose of carrying out projects to provide the services described in paragraph (4) to chronically homeless individuals in permanent supportive housing.

(B)

Eligible entities

For purposes of subparagraph (A), an entity described in this subparagraph is—

(i)

a State or political subdivision of a State, an American Indian and Alaska Native tribe, tribal organization, a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, or a public or nonprofit private entity, including a community-based provider of homelessness services, health care, housing, or other services important to individuals experiencing chronic homelessness; or

(ii)

a consortium composed of entities described in clause (i), which consortium includes a public or nonprofit private entity that serves as the lead applicant and has responsibility for fiscal management, program management, and coordinating the activities of the consortium.

(2)

Priorities

In making grants under paragraph (1), the Secretary shall give priority to applicants demonstrating that the applicants—

(A)

target the services described in paragraph (4) to individuals or families who—

(i)

have been homeless for longer periods of time or have experienced more episodes of homelessness than are required to meet the definition of chronic homelessness under this section;

(ii)

have high rates of utilization of emergency public systems of care; or

(iii)

have a history of interactions with law enforcement and the criminal justice system;

(B)

have greater funding commitments from State or local government agencies responsible for overseeing mental health treatment, substance use disorder treatment, medical care, and employment (including commitments to provide Federal funds in accordance with paragraph (5)(B)(ii)(II));

(C)

will provide for an increase in the number of units of permanent supportive housing that would serve chronically homeless individuals in the community as a result of an award of a grant under paragraph (1); and

(D)

have demonstrated experience providing services to address the mental health and substance use disorder problems of chronically homeless individuals living in permanent supportive housing settings.

(3)

Geographic distribution

The Secretary shall ensure that consideration is given to geographic distribution (such as urban and rural areas) in the awarding of grants under paragraph (1).

(4)

Services

The services referred to in paragraph (1) are the following:

(A)

Services provided by the grantee or by qualified subcontractors that promote recovery, resiliency, and self-sufficiency and address barriers to housing stability, including the following:

(i)

Mental health services, including treatment services and recovery support services and services that promote resiliency.

(ii)

Substance use disorder treatment and recovery support services, including counseling, treatment planning, recovery coaching, and relapse prevention.

(iii)

Integrated, coordinated treatment and recovery support services for co-occurring disorders.

(iv)

Health education, including referrals for medical and dental care.

(v)

Services designed to help individuals make progress toward self-sufficiency and recovery, including benefits advocacy, money management, life-skills training, self-help programs, and engagement and motivational interventions.

(vi)

Parental skills and family support.

(vii)

Case management.

(viii)

Other supportive services that promote an end to chronic homelessness.

(ix)

Coordination or partnership with other agencies, programs, or mainstream benefits to maximize the availability of services and resources to meet the needs of chronically homeless persons living in supportive housing using cost-effective approaches that avoid duplication.

(x)

Data collection and measuring performance outcomes as specified in paragraph (11).

(B)

Services, as described in subparagraph (A), that are delivered to individuals and families who are chronically homeless and who are scheduled to become residents of permanent supportive housing within 90 days pending the location or development of an appropriate unit of housing.

(C)

For individuals and families who are otherwise eligible, and who have voluntarily chosen to seek other housing opportunities after a period of tenancy in supportive housing, services, as described in subparagraph (A), that are delivered, for a period of 90 days after exiting permanent supportive housing or until the individuals have transitioned to comprehensive services adequate to meet their current needs, provided that the purpose of the services is to support the individuals in their choice to transition into housing that is responsive to their individual needs and preferences.

(5)

Matching funds

(A)

In general

A condition for the receipt of a grant under paragraph (1) is that, with respect to the cost of the project to be carried out by an applicant pursuant to such subsection, the applicant agrees as follows:

(i)

In the case of the initial grant pursuant to paragraph (10)(A)(i), the applicant will, in accordance with subparagraphs (B) and (C), make available contributions toward such costs in an amount that is not less than $1 for each $3 of Federal funds provided in the grant.

(ii)

In the case of a renewal grant pursuant to paragraph (10)(A)(ii), the applicant will, in accordance with subparagraphs (B) and (C), make available contributions toward such costs in an amount that is not less than $1 for each $1 of Federal funds provided in the grant.

(B)

Source of contribution

For purposes of subparagraph (A), contributions made by an applicant are in accordance with this paragraph if made as follows:

(i)

The contribution is made from funds of the applicant or from donations from public or private entities.

(ii)

Of the contribution—

(I)

not less than 80 percent is from non-Federal funds; and

(II)

not more than 20 percent is from Federal funds provided under programs that—

(aa)

are not expressly directed at services for homeless individuals, but whose purposes are broad enough to include the provision of a service or services described in paragraph (4) as authorized expenditures under such program; and

(bb)

do not prohibit Federal funds under the program from being used to provide a contribution that is required as a condition for obtaining Federal funds.

(C)

Determination of amount contributed

Contributions required in subparagraph (A) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of non-Federal contributions required in subparagraph (B)(ii)(I).

(6)

Administrative expenses

A condition for the receipt of a grant under paragraph (1) is that the applicant involved agree that not more than 10 percent of the grant will be expended for administrative expenses with respect to the grant. Expenses for data collection and measuring performance outcomes as specified in paragraph (11) shall not be considered as administrative expenses subject to the limitation in this paragraph.

(7)

Certain uses of funds

Notwithstanding other provisions of this section, not more than 20 percent of the individuals served by a grantee under paragraph (1) may be homeless individuals who are not chronically homeless.

(8)

Application for grant

A grant may be made under paragraph (1) only if an application for the grant is submitted to the Secretary and the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this subsection.

(9)

Certain requirements

A condition for the receipt of a grant under paragraph (1) is that the applicant involved demonstrate the following:

(A)

The applicant and all direct providers of services have the experience, infrastructure, and expertise needed to ensure the quality and effectiveness of services, which may be demonstrated by any of the following:

(i)

Compliance with all local, city, county, or State requirements for licensing, accreditation, or certification (if any) which are applicable to the proposed project.

(ii)

A minimum of 2 years experience providing comparable services that do not require licensing, accreditation, or certification.

(iii)

Certification as a Medicaid service provider, including health care for the homeless programs and community health centers.

(iv)

An executed agreement with a relevant State or local government agency that will provide oversight over the mental health, substance use disorder, or other services that will be delivered by the project.

(B)

There is a mechanism for determining whether residents are chronically homeless. Such a mechanism may rely on local data systems or records of shelter admission. If there are no sources of data regarding the duration or number of homeless episodes, or if such data are unreliable for the purposes of this paragraph, an applicant must demonstrate that the project will implement appropriate procedures, taking into consideration the capacity of local homeless service providers to document episodes of homelessness and the challenges of engaging persons who have been chronically homeless, to verify that an individual or family meets the definition for being chronically homeless under this subsection.

(C)

The applicant participates in a local, regional, or statewide homeless management information system.

(10)

Duration of initial and renewal grants; additional provisions regarding renewal grants

(A)

In general

Subject to subparagraphs (B) and (C), the period during which payments are made to a grantee under paragraph (1) shall be in accordance with the following:

(i)

In the case of the initial grant, the period of payments shall be not less than 3 years and not more than 5 years.

(ii)

In the case of a subsequent grant (referred to in this subsection as a renewal grant), the period of payments shall be not more than 5 years.

(B)

Annual approval; availability of appropriations; number of grants

The provision of payments under an initial or renewal grant is subject to annual approval by the Secretary of the payments and to the availability of appropriations for the fiscal year involved to make the payments. This paragraph may not be construed as establishing a limitation on the number of grants under paragraph (1) that may be made to an entity.

(C)

Additional provisions regarding renewal grants

(i)

Compliance with minimum standards

A renewal grant may be made by the Secretary only if the Secretary determines that the applicant involved has, in the project carried out with the grant, maintained compliance with minimum standards for quality and successful outcomes for housing retention, as determined by the Secretary.

(ii)

Amount

The maximum amount of a renewal grant under this paragraph shall not exceed an amount equal to 75 percent of the amount of the grant awarded in the final year of the initial grant period.

(11)

Strategic performance outcomes and reports

(A)

In general

The Secretary shall, as a condition of the receipt of grants under paragraph (1), require grantees to provide data regarding the performance outcomes of the projects carried out under the grants. Consistent with the requirements and procedures established by the Secretary, each grantee shall measure and report specific performance outcomes related to the long-term goals of increasing stability within the community for people who have been chronically homeless, and decreasing the recurrence of periods of homelessness.

(B)

Performance outcomes

The performance outcomes described under subparagraph (A) shall include, with respect to individuals who have been chronically homeless—

(i)

improvements in housing stability;

(ii)

improvements in employment and education;

(iii)

reductions in problems related to substance use disorders;

(iv)

reductions in problems related to mental health disorders; and

(v)

other areas as the Secretary determines appropriate.

(C)

Coordination and consistency with other homeless assistance programs

(i)

Procedures

In establishing strategic performance outcomes and reporting requirements under subparagraph (A), the Secretary shall develop and implement procedures that minimize the costs and burdens to grantees and program participants, and that are practical, streamlined, and designed for consistency with the requirements of the homeless assistance programs administered by the Secretary of Housing and Urban Development.

(ii)

Applicant coordination

Applicants under this subsection shall coordinate with community stakeholders, including participants in the local homeless management information system, concerning the development of systems to measure performance outcomes and with the Secretary for assistance with data collection and measurements activities.

(D)

Report

A grantee shall submit an annual report to the Secretary that—

(i)

identifies the grantee’s progress toward achieving its strategic performance outcomes; and

(ii)

describes other activities conducted by the grantee to increase the participation, housing stability, and other improvements in outcomes for individuals who have been chronically homeless.

(12)

Training and technical assistance

The Secretary, directly or through awards of grants or contracts to public or nonprofit private entities, shall provide training and technical assistance regarding the planning, development, and provision of services in projects under paragraph (1).

(c)

Definitions

For purposes of this section:

(1)

Chronically homeless

(A)

In general

The term chronically homeless, used with respect to an individual or family, means an individual or family who—

(i)

is homeless and lives or resides in a place not meant for human habitation, a safe haven, or in an emergency shelter;

(ii)

has been homeless and living or residing in a place not meant for human habitation, a safe haven, or in an emergency shelter continuously for at least 1 year or on at least 4 separate occasions in the last 3 years; and

(iii)

has an adult head of household (or a minor head of household if no adult is present in the household) with a diagnosable substance use disorder, serious mental illness, developmental disability (as defined in section 102 of the Developmental Disabilities Assistance and Bill of Rights Act of 2000 (42 U.S.C. 15002)), post traumatic stress disorder, cognitive impairments resulting from a brain injury, or chronic physical illness or disability, including the co-occurrence of 2 or more of those conditions.

(B)

Rule of construction

A person who currently lives or resides in an institutional care facility, including a jail, substance use disorder or mental health treatment facility, hospital or other similar facility, and has resided there for fewer than 90 days shall be considered chronically homeless if such person met all of the requirements described in subparagraph (A) prior to entering that facility.

(2)

Homeless

The term homeless means sleeping in a place not meant for human habitation or in an emergency homeless shelter.

(3)

Homeless individual

The term homeless individual has the meaning given such term in section 330(h)(5)(A).

(4)

Permanent supportive housing

(A)

In general

The term permanent supportive housing means permanent, affordable housing with flexible support services that are available and designed to help the tenants stay housed and build the necessary skills to live as independently as possible. Such term does not include housing that is time-limited. Supportive housing offers residents assistance in reaching their full potential, which may include opportunities to secure other housing that meets their needs and preferences, based on individual choice instead of the requirements of time-limited transitional programs. Under this section, permanent affordable housing includes permanent housing funded or assisted through title IV of the McKinney-Vento Homeless Assistance Act and section (8) of the United States Housing Act of 1937.

(B)

Affordable

For purposes of subparagraph (A), the term affordable means within the financial means of individuals who are extremely low income, as defined by the Secretary of Housing and Urban Development.

(5)

Substance use disorder services

The term substance use disorder services has the meaning given the term substance abuse services in section 330(h)(5)(C).

(d)

Term of the Awards

No entity may receive a grant, contract, or cooperative agreement under this section for more than 5 years.

(e)

Report

Not later than 2 years after the date of enactment of the SAMHSA Modernization Act of 2010, and once every 2 years thereafter, the Secretary shall submit to the appropriate committees of Congress a report concerning the programs and services provided under this section. Such report shall include—

(1)

a summary of the information received by the Secretary under paragraph (11) of subsection (b);

(2)

a description of how the services provided under each such program are coordinated with State and local social service programs and homelessness assistance programs and Department of Veterans Affairs services programs; and

(3)

an evaluation of the manner in which funds are used under such programs and the effectiveness of such programs in ending chronic homelessness and improving outcomes for individuals with mental illness and substance use disorder problems.

(f)

Authorization of Appropriations

(1)

In general

There is authorized to be appropriated to carry out this section, $100,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

(2)

Continuing grants

Of the total amount appropriated to carry out this section, amounts shall first be allocated for continuing grants awarded under section 505(a) (as such section existed on the day before the date of enactment of the SAMHSA Modernization Act of 2010.

(3)

Remaining funds

Upon complying with paragraph (2), any remaining funds shall be allocated equally between subsections (a) and (b).

506.

American Indians and Alaska Natives

(a)

Technical Assistance

The Secretary shall provide technical assistance to American Indian and Alaska Native tribes and tribal organizations in submitting applications for any program of grants under this title.

(b)

SAMHSA Tribal Technical Advisory Group

(1)

In general

The Secretary shall establish and maintain a Tribal Technical Advisory Group (referred to in this section as the Group) that shall be composed of—

(A)

Indian representation, as selected by the tribes, from each of the 12 administrative units (Area Offices) of the Indian Health Service;

(B)

a representative of the Indian Health Service;

(C)

representatives of National Indian Organizations with general interests in Indian health care;

(D)

a representative of the Administration; and

(E)

a representative of a national organization representing States’ interests in mental health and substance use disorders.

(2)

Purpose

The purpose of the Group is to enhance the tribal government to Federal Government relationship by providing recommendations and advice to tribes, States, and the Administration through—

(A)

identifying the barriers and issues in providing mental health and substance use disorder treatments and services between the Administration, States and tribal health programs, including those programs administered by the Indian Health Service;

(B)

providing expertise on policies, guidelines, and programmatic issues affecting the delivery of mental health and substance use disorder care for American Indians and Alaska Natives;

(C)

facilitating any interaction relating to intergovernmental and intragovernmental responsibilities; and

(D)

providing any other advice or assistance to the Administration to improve the mental health and substance use disorder status levels of American Indians and Alaska Natives.

(3)

Support no supplant

The Group shall support and not supplant the tribal consultation process between the Administration and tribes.

(4)

Report

Not later than 1 year after the date of the enactment of the SAMHSA Modernization Act of 2010, and annually thereafter, the Group shall prepare and submit, to the Secretary, the Committee on Indian Affairs and the Committee on Health, Education, Labor, and Pensions of the Senate, and the Committee on Natural Resources and the Committee on Energy and Commerce of the House of Representatives, a report describing the activities, findings, and recommendations pursuant to this section.

(c)

Duties

The Secretary shall appoint an individual within the Administration to—

(1)

act as a point of contact for tribes and tribal organizations;

(2)

coordinate and provide technical assistance to tribes and tribal organizations;

(3)

act as a knowledgeable source on American Indian and Alaska Native mental health and substance use disorders issues;

(4)

advise grant review panels about the effectiveness of traditional intervention and treatment methods used by American Indians and Alaska Natives;

(5)

coordinates activities between the Administration and the Group; and

(6)

coordinate activities between the Administration and Indian Health Service.

(d)

Special mental health and substance use disorders Programs for American Indians and Alaska Natives

(1)

In general

The Secretary shall award grants, in addition to discretionary grants under this title, to provide services for mental health and substance use disorders in accordance with paragraph (2).

(2)

Service through Indian health facilities

For purposes of paragraph (1), services under such subsection shall be considered to be provided in accordance with this subsection if such services are provided through an American Indian and Alaska Native program operated by an Indian tribe, tribal organization, Indian Health Service, or a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service.

(3)

Data collection

The Secretary shall periodically collect and report on information concerning the numbers of people served through grants pursuant to this subsection and the effectiveness of such grants.

(4)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection, $40,000,000 for fiscal year 2011, and such sums as may be necessary for fiscal years 2012 through and 2015.

507.

Early Detection and Intervention for Mental Illness and Substance Abuse Disorders

(a)

In general

The Administrator may award grants, contracts, or cooperative agreements to eligible entities for mental illness and substance abuse screening, brief intervention, referral, and recovery services for individuals in primary health care settings.

(b)

Eligible entity

In this section, the term eligible entity means a public or private nonprofit entity that—

(1)

provides primary health services;

(2)

seeks to integrate mental illness and substance abuse services into its service system;

(3)

has developed a working relationship with providers of mental health and substance abuse services; and

(4)

demonstrates a need for the inclusion of mental illness and substance abuse services in its service system.

(c)

Priority

In awarding grants, contracts, and cooperative agreements under this section, the Secretary shall give priority to eligible entities that—

(1)

provide services in rural or frontier areas of the Nation;

(2)

provide services to American Indian or Alaska Native populations; or

(3)

provide services on university and college campuses.

(d)

Use of funds

The Secretary may award a grant to an eligible entity under this section only if the entity agrees to use the grant—

(1)

to provide screening, brief interventions, referral, and recovery services for mental health and substance abuse;

(2)

to coordinate these services with primary health care services in the same program;

(3)

to develop a network of facilities to which patients can be referred if needed;

(4)

to purchase needed screening and other tools that are—

(A)

necessary for providing the services; and

(B)

supported by research; and

(5)

to maintain communication with appropriate State mental health and substance abuse agencies.

(d)

Duration

The period of a grant, contract, or cooperative agreement awarded under this section may not exceed 5 years.

(e)

Evaluation

The Secretary may not award a grant, contract, or cooperative agreement to an eligible entity under this section unless the entity agrees—

(1)

to prepare and submit to the Secretary at the end of the grant, contract, or cooperative agreement period an evaluation of all activities funded through the grant, contract, or cooperative agreement; and

(2)

to use such performance measures as may be stipulated by the Secretary for purposes of such evaluation.

(f)

Study

Not later than 4 years after the first appropriation of funds to carry out this section, the Secretary—

(1)

shall conduct a study on the benefits of integrating mental illness and substance abuse care within primary health care, focusing on the performance measures stipulated by the Secretary for purposes of evaluations under subsection (e); and

(2)

shall submit the results of such study to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives.

(g)

Authorization of appropriations

(1)

In general

To carry out this section, there are authorized to be appropriated $60,000,000 for fiscal year 2011 and such sums as may be necessary for fiscal years 2012 through 2015.

(2)

Program management

Of the funds appropriated to carry out this section for a fiscal year, the Secretary may use not more than 5 percent to manage the program under this section.

508.

Report on coordination between the Substance Abuse and Mental Health Services Administration and the Federal emergency management Agency

Not later than 1 year after the date of enactment of the SAMHSA Modernization Act of 2010, the Administrator, in coordination with the Administrator of the Federal Emergency Management Agency, shall submit to the appropriate committees of Congress a report that contains the following:

(1)

A description of the manner in which the Federal Emergency Management Agency and the Administration have coordinated to provide mental health and substance use disorder outreach, counseling, and treatment following Presidentially declared disasters.

(2)

An analysis of the manner in which the services provided (as described in paragraph (1)) have been coordinated with existing State and local mental health and substance use disorder programs, including the manner in which such services assisted the emergency response and post-disaster recovery and how such services are delivered during the transition from an emergency response situation to a post-disaster and recovery situation.

(3)

An analysis of the methods by which the Federal Emergency Management Agency and the Administration coordinated with other appropriate Federal agencies to leverage use of supplemental funds appropriated by Congress to meet the mental health and substance use disorder needs of the affected individuals following Presidentially declared disasters.

(4)

Recommendations of the actions that may be taken by the Federal Emergency Management Agency and the Administration to facilitate the improved provision of mental health and substance use disorder outreach, counseling, and treatment following Presidentially declared disasters, including an analysis of ways in which the Crisis Counseling Program may be used to meet community-identified mental health and substance use disorder needs.

B

CENTERS AND PROGRAMS

1

Center for Substance Abuse Treatment

510.

Center for Substance Abuse Treatment

(a)

In General

There is established in the Administration a Center for Substance Abuse Treatment (hereafter in this section referred to as the Center). The Center shall be headed by a Director (hereafter in this section referred to as the Director) appointed by the Secretary from among individuals with extensive experience or academic qualifications in the treatment of substance use disorders or in the evaluation of substance use disorder treatment systems.

(b)

Duties

The Director of the Center shall—

(1)

administer the substance use disorder treatment block grant program authorized in section 1921;

(2)

ensure that emphasis is placed on children and adolescents in the development of treatment programs;

(3)

collaborate with the Attorney General to develop programs to provide substance use disorder treatment services to individuals who have had contact with the Justice system, especially adolescents;

(4)

collaborate with the Director of the Center for Substance Abuse Prevention in order to provide outreach services to identify individuals in need of treatment services, with emphasis on the provision of such services to pregnant and postpartum women and their infants and to individuals who use drugs intravenously;

(5)

collaborate with the Director of the National Institute on Drug Abuse, with the Director of the National Institute on Alcohol Abuse and Alcoholism, and with the States to promote the study, dissemination, and implementation of research findings that will improve the delivery and effectiveness of treatment services;

(6)

collaborate with the Administrator of the Health Resources and Services Administration and the Administrator of the Centers for Medicare & Medicaid Services to promote the increased integration into the mainstream of the health care system of the United States of programs for providing treatment services;

(7)

evaluate plans submitted by the States pursuant to section 1931(a)(6) in order to determine whether the plans adequately provide for the availability, allocation, and effectiveness of treatment services;

(8)

sponsor regional workshops on improving the quality and availability of treatment services;

(9)

provide technical assistance to public and nonprofit private entities that provide treatment services, including technical assistance with respect to the process of submitting to the Director applications for any program of grants or contracts carried out by the Director;

(10)

carry out activities to educate individuals on the need for establishing treatment facilities within their communities;

(11)

encourage public and private entities that provide health insurance to provide benefits for outpatient treatment services and other nonhospital-based treatment services;

(12)

evaluate treatment programs to determine the quality and appropriateness of various forms of treatment, which shall be carried out through grants, contracts, or cooperative agreements provided to public or nonprofit private entities;

(13)

in carrying out paragraph (12), assess the quality, appropriateness, and costs of various treatment forms from specific patient groups and ensure that the national outcome measures developed under section 504(b) are used with respect to all appropriate grants administered by the Center; and

(14)

work with States, providers, and individuals in recovery and their families to promote the expansion of recovery support services and recovery oriented systems of care.

(c)

Grants and Contracts

In carrying out the duties established in subsection (b), the Director may make grants to and enter into contracts and cooperative agreements with public and nonprofit private entities.

511.

Residential treatment programs for pregnant and parenting women

(a)

In General

The Director of the Center for Substance Abuse Treatment shall provide awards of grants, cooperative agreement, or contracts to public and nonprofit private entities for the purpose of providing to pregnant and parenting women treatment for substance use disorders through programs in which, during the course of receiving treatment—

(1)

the women reside in or receive outpatient treatment services from facilities provided by the programs;

(2)

the minor children of the women reside with the women in such facilities, if the women so request; and

(3)

the services described in subsection (d) are available to or on behalf of the women.

(b)

Availability of Services for Each Participant

A funding agreement for an award under subsection (a) for an applicant is that, in the program operated pursuant to such subsection—

(1)

treatment services and each supplemental service will be available through the applicant, either directly or through agreements with other public or nonprofit private entities; and

(2)

services will be made available to each woman and child admitted to the program.

(c)

Individualized Plan of Services

A funding agreement for an award under subsection (a) for an applicant is that—

(1)

in providing authorized services for an eligible woman pursuant to such subsection, the applicant will, in consultation with the women, prepare an individualized plan for the provision of services for the woman and her child; and

(2)

treatment services under the plan will include—

(A)

individual, group, and family counseling, as appropriate, regarding substance use disorders; and

(B)

follow-up services to assist the woman in preventing a relapse into such abuse.

(d)

Required Supplemental Services

In the case of an eligible woman, the services referred to in subsection (a)(3) are as follows:

(1)

Prenatal and postpartum health care.

(2)

Referrals for necessary hospital services.

(3)

For the infants and children of the woman—

(A)

pediatric health care, including treatment for any perinatal effects of maternal substance use disorders and including screenings regarding the physical and mental development of the infants and children;

(B)

counseling and other mental health services, in the case of children; and

(C)

comprehensive social services.

(4)

Providing therapeutic, comprehensive child care for children during the periods in which the woman is engaged in therapy or in other necessary health and rehabilitative activities.

(5)

Training in parenting.

(6)

Counseling on the human immunodeficiency virus and on acquired immune deficiency syndrome.

(7)

Counseling on domestic violence and sexual abuse.

(8)

Counseling on obtaining employment, including the importance of graduating from a secondary school.

(9)

Reasonable efforts to preserve and support the family unit of the woman, including promoting the appropriate involvement of parents and others, and counseling the children of the woman.

(10)

Planning for and counseling to assist reentry into society, both before and after discharge, including referrals to any public or nonprofit private entities in the community involved that provide services appropriate for the woman and the children of the woman.

(11)

Case management services, including—

(A)

assessing the extent to which authorized services are appropriate for the woman and her children;

(B)

in the case of the services that are appropriate, ensuring that the services are provided in a coordinated manner;

(C)

assistance in establishing eligibility for assistance under Federal, State, and local programs providing health services, mental health services, housing services, employment services, educational services, or social services; and

(D)

family reunification with children in kinship or foster care arrangements, where safe and appropriate.

(e)

Minimum Qualifications for Receipt of Award

(1)

Certification by relevant state agency

With respect to the principal agency of the State involved that administers programs relating to substance use disorders, the Director may make an award under subsection (a) to an applicant only if the agency has certified to the Director that—

(A)

the applicant has the capacity to carry out a program described in subsection (a);

(B)

the plans of the applicant for such a program are consistent with the policies of such agency regarding the treatment of substance use disorders; and

(C)

the applicant, or any entity through which the applicant will provide authorized services, meets all applicable State licensure or certification requirements regarding the provision of the services involved.

(2)

Status as medicaid provider

(A)

In general

Subject to subparagraphs (B) and (C), the Director may make an award under subsection (a) only if, in the case of any authorized service that is available pursuant to the State plan approved under title XIX of the Social Security Act for the State involved—

(i)

the applicant for the award will provide the service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or

(ii)

the applicant will enter into an agreement with a public or nonprofit private entity under which the entity will provide the service, and the entity has entered into such a participation agreement plan and is qualified to receive such payments.

(B)

Waiver of participation agreements

(i)

In general

In the case of an entity making an agreement pursuant to subparagraph (A)(ii) regarding the provision of services, the requirement established in such subparagraph regarding a participation agreement shall be waived by the Director if the entity does not, in providing health care services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits plan.

(ii)

Donations

A determination by the Director of whether an entity referred to in clause (i) meets the criteria for a waiver under such clause shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public.

(C)

Nonapplication of certain requirements

With respect to any authorized service that is available pursuant to the State plan described in subparagraph (A), the requirements established in such subparagraph shall not apply to the provision of any such service by an institution for mental diseases to an individual who has attained 21 years of age and who has not attained 65 years of age. For purposes of the preceding sentence, the term institution for mental diseases has the meaning given such term in section 1905(i) of the Social Security Act.

(f)

Requirement of Matching Funds

(1)

In general

With respect to the costs of the program to be carried out by an applicant pursuant to subsection (a), a funding agreement for an award under such subsection is that the applicant will make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that—

(A)

for the first fiscal year for which the applicant receives payments under an award under such subsection, is not less than $1 for each $9 of Federal funds provided in the award;

(B)

for any second such fiscal year, is not less than $1 for each $9 of Federal funds provided in the award; and

(C)

for any subsequent such fiscal year, is not less than $1 for each $3 of Federal funds provided in the award.

(2)

Determination of amount contributed

Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(g)

Outreach

A funding agreement for an award under subsection (a) for an applicant is that the applicant will provide outreach services in the community involved to identify women who are engaging in substance use disorders and to encourage the women to undergo treatment for such abuse.

(h)

Accessibility of Program; Cultural Context of Services

A funding agreement for an award under subsection (a) for an applicant is that—

(1)

the program operated pursuant to such subsection will be operated at a location that is accessible to low-income pregnant and parenting women; and

(2)

authorized services will be provided in the language and the cultural context that is most appropriate.

(i)

Continuing Education

A funding agreement for an award under subsection (a) is that the applicant involved will provide for continuing education in treatment services for the individuals who will provide treatment in the program to be operated by the applicant pursuant to such subsection.

(j)

Imposition of Charges

A funding agreement for an award under subsection (a) for an applicant is that, if a charge is imposed for the provision of authorized services to on behalf of an eligible woman, such charge—

(1)

will be made according to a schedule of charges that is made available to the public;

(2)

will be adjusted to reflect the income of the woman involved; and

(3)

will not be imposed on any such woman with an income of less than 185 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.

(k)

Reports to Director

A funding agreement for an award under subsection (a) is that the applicant involved will submit to the Director a report—

(1)

describing the utilization and costs of services provided under the award;

(2)

specifying the number of women served, the number of infants served, and the type and costs of services provided; and

(3)

providing such other information as the Director determines to be appropriate.

(l)

Requirement of Application

The Director may make an award under subsection (a) only if an application for the award is submitted to the Director containing such agreements, and the application is in such form, is made in such manner, and contains such other agreements and such assurances and information as the Director determines to be necessary to carry out this section.

(m)

Allocation of Awards

In making awards under subsection (a), the Director shall give priority to any entity that agrees to use the award for a program serving an area that is a rural area, an area designated under section 332 by the Administrator of the Health Resources and Services Administration as a health professional shortage area with a shortage of professionals, or an area determined by the Director to have a shortage of family-based substance use disorder treatment options.

(n)

Duration of Award

The period during which payments are made to an entity from an award under subsection (a) may not exceed 5 years. The provision of such payments shall be subject to annual approval by the Director of the payments and subject to the availability of appropriations for the fiscal year involved to make the payments. This subsection may not be construed to establish a limitation on the number of awards under such subsection that may be made to an entity.

(o)

Evaluations; Dissemination of Findings

The Director shall, directly or through contract, provide for the conduct of evaluations of programs carried out pursuant to subsection (a). The Director shall disseminate to the States the findings made as a result of the evaluations.

(p)

Definitions

For purposes of this section:

(1)

The term authorized services means treatment services and supplemental services.

(2)

The term eligible woman means a woman who has been admitted to a program operated pursuant to subsection (a).

(3)

The term funding agreement, with respect to an award under subsection (a), means that the Director may make the award only if the applicant makes the agreement involved.

(4)

The term treatment services means treatment for substance use disorders, including the counseling and services described in subsection (c)(2).

(5)

The term supplemental services means the services described in subsection (d).

(q)

Authorization of Appropriations

For the purpose of carrying out this section, there are authorized to be appropriated $50,000,000 for each of fiscal years 2011 through 2015.

512.

Priority substance use disorder treatment needs of regional and national significance

(a)

Projects

The Secretary shall address priority substance use disorder treatment needs of regional and national significance (as determined under subsection (b)) through the provision of or through assistance for—

(1)

knowledge development and application projects for treatment and rehabilitation and the conduct or support of evaluations of such projects;

(2)

training and technical assistance; and

(3)

targeted capacity response programs that permit States, local jurisdictions, communities, and American Indian and Alaska Native tribes to focus on emerging trends in substance use and co-occurrence of substance use disorders with mental illness or other disorders.

The Secretary may carry out the activities described in this section directly or through grants, contracts, or cooperative agreements with States, political subdivisions of States, territories, American Indian and Alaska Native tribes, tribal organizations, or a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, and other public or nonprofit private entities.
(b)

Priority Substance Use Disorder Treatment Needs

(1)

In general

Priority substance use disorder treatment needs of regional and national significance shall be determined by the Secretary after consultation with States and other interested groups. The Secretary shall meet with the States and interested groups on an annual basis to discuss program priorities.

(2)

Special consideration

In developing program priorities under paragraph (1), the Secretary shall give special consideration to promoting the integration of substance use disorder treatment services into primary health care systems and to provide treatment for older adults with substance use disorders.

(c)

Requirements

(1)

In general

Recipients of grants, contracts, or cooperative agreements under this section shall comply with information and application requirements determined appropriate by the Secretary.

(2)

Duration of award

With respect to a grant, contract, or cooperative agreement awarded under this section, the period during which payments under such award are made to the recipient may not exceed 5 years.

(3)

Matching funds

The Secretary may, for projects carried out under subsection (a), require that entities that apply for grants, contracts, or cooperative agreements under that project provide non-Federal matching funds, as determined appropriate by the Secretary, to ensure the institutional commitment of the entity to the projects funded under the grant, contract, or cooperative agreement. Such non-Federal matching funds may be provided directly or through donations from public or private entities and may be in cash or in kind, fairly evaluated, including plant, equipment, or services.

(4)

Maintenance of effort

With respect to activities for which a grant, contract, or cooperative agreement is awarded under this section, the Secretary may require that recipients for specific projects under subsection (a) agree to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives such a grant, contract, or cooperative agreement.

(d)

Evaluation

The Secretary shall evaluate each project carried out under subsection (a)(1) and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities.

(e)

Information and Education

The Secretary shall establish comprehensive information and education programs to disseminate and apply the findings of the knowledge development and application, training and technical assistance programs, and targeted capacity response programs under this section to the general public, to health professionals and other interested groups. The Secretary shall make every effort to provide linkages between the findings of supported projects and State agencies responsible for carrying out substance use disorder prevention and treatment programs.

(f)

Authorization of Appropriation

There are authorized to be appropriated to carry out this section, $500,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

513.

Services to assist local communities in addressing emerging drugs

(a)

Grants

(1)

In general

The Secretary shall award grants to eligible entities to assist local communities in addressing emerging drug issues.

(2)

Definition

In this section, the term emerging drug issue means, with respect to an area—

(A)

a drug treatment problem that has occurred because of—

(i)

a sudden increase in the demand for drug treatment in the area; or

(ii)

the necessity of drug treatment protocols that the area is not equipped to provide; and

(B)

the lack of resources within the area to address the problem.

(b)

Eligibility

To be eligible to receive a grant under this section, an entity shall—

(1)

be a public or nonprofit private entity, including American Indian and Alaska Native tribes, tribal organizations, or a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service;

(2)

submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require, including—

(A)

information that demonstrates an emerging drug issue in the area to be served under the grant and the lack of available resources to address such issue;

(B)

a description of the area to be served under the grant and the target population, if relevant, and the need of such population for services;

(C)

data on the prevalence of the emerging drug involved using whatever data may be available from the appropriate State or local agencies, including admissions data, waiting lists, data from law enforcement, and other data to establish that there is an emerging drug problem;

(D)

a summary of the need involved that is based not only on prevalence but the fact that the emerging drug requires skills that the area does not have;

(E)

a statement on the attempts by the local areas to find funding from other sources including the State;

(F)

information to demonstrate that the identified need is consistent with the State priorities (as evidenced by a letter from the governor of the State);

(G)

a list of goals and objectives with respect to activities under the grant;

(H)

an assurance that the entity will use evidence-based practices, when available, in providing services under the grant; and

(I)

an assurance that treatment activities will be coordinated with prevention efforts.

(c)

Use of Funds

An entity shall use amounts received under a grant to—

(1)

carry out outreach and other strategies to increase participation in, and access to, drug treatment services;

(2)

provide outpatient or residential drug treatment services, including screening, assessment, and care management services;

(3)

provide for the involvement of friends and families in drug treatment; and

(4)

provide recovery support services that help prevent relapse and promote sustained recovery, including assistance with employment, housing, and establishing community connections.

(d)

Coordination of Services

An entity that receives a grant under this section shall ensure that—

(1)

services provided under the grant are coordinated with other community, social, and health agency service provider programs, including programs conducted by mental health departments, social services departments, health departments, education agencies, juvenile and adult justice systems, and child welfare agencies; and

(2)

drug treatment service systems are partnered with prevention systems.

(e)

Priority

In awarding grants under this section, the Secretary shall give priority to entities that use a portion of grant funds to serve rural areas.

(f)

Data Collection

A grantee shall collect data on the national outcome measures established under section 504(b) and any other data needed to demonstrate the success of the grantee in achieving the goals and objectives described in its application under subsection (b)(2)(F).

(g)

Evaluation

A grantee shall conduct and evaluation of the activities carried out under the grant and provide the results of such evaluation to the Secretary.

(h)

Grant Period

The period of a grant under this section shall be 3 years.

(i)

Authorization of Appropriations

There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2011 through 2015.

514.

Action by the Center for Substance Abuse Treatment and States concerning military facilities

(a)

Center for Substance Abuse Treatment

The Director of the Center for Substance Abuse Treatment shall—

(1)

coordinate with the agencies represented on the Commission on Alternative Utilization of Military Facilities the utilization of military facilities or parts thereof, as identified by such Commission, established under the National Defense Authorization Act of 1989, that could be utilized or renovated to house nonviolent persons for drug treatment purposes;

(2)

notify State agencies responsible for the oversight of drug abuse treatment entities and programs of the availability of space at the installations identified in paragraph (1); and

(3)

assist State agencies responsible for the oversight of drug abuse treatment entities and programs in developing methods for adapting the installations described in paragraph (1) into residential treatment centers.

(b)

States

With regard to military facilities or parts thereof, as identified by the Commission on Alternative Utilization of Military Facilities established under section 3042 of the Comprehensive Alcohol Abuse, Drug Abuse, and Mental Health Amendments Act of 1988, that could be utilized or renovated to house nonviolent persons for drug treatment purposes, State agencies responsible for the oversight of drug abuse treatment entities and programs shall—

(1)

establish eligibility criteria for the treatment of individuals at such facilities;

(2)

select treatment providers to provide drug abuse treatment at such facilities;

(3)

provide assistance to treatment providers selected under paragraph (2) to assist such providers in securing financing to fund the cost of the programs at such facilities; and

(4)

establish, regulate, and coordinate with the military official in charge of the facility, work programs for individuals receiving treatment at such facilities.

(c)

Reservation of Space

Prior to notifying States of the availability of space at military facilities under subsection (a)(2), the Director may reserve space at such facilities to conduct research or demonstration projects.

515.

Substance use disorder treatment and early intervention services for children and adolescents

(a)

In General

The Secretary shall award grants, contracts, or cooperative agreements to public and private nonprofit entities, including American Indian and Alaska Native tribes, tribal organizations, or a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, for the purpose of—

(1)

providing early identification and services to meet the needs of children and adolescents who are at risk of substance use disorders; and

(2)

providing substance use disorder treatment services for children, including children and adolescents with co-occurring mental illness and substance use disorders.

(b)

Priority

In awarding grants, contracts, or cooperative agreements under subsection (a), the Secretary shall give priority to applicants who propose to—

(1)

apply evidence-based and cost effective methods;

(2)

coordinate the provision of services with other social service agencies in the community, including educational, juvenile justice, child welfare, substance abuse, and mental health agencies;

(3)

provide a continuum of integrated treatment services, including case management, for children and adolescents with substance use disorders, including children and adolescents with co-occurring mental illness and substance use disorders and their families;

(4)

provide services that are gender-specific and culturally appropriate;

(5)

involve and work with families of children and adolescents receiving services; and

(6)

provide aftercare services for children and adolescents and their families after completion of treatment.

(c)

Duration of Grants

The Secretary shall award grants, contracts, or cooperative agreements under subsection (a) for 5 fiscal years.

(d)

Application

An entity desiring a grant, contract, or cooperative agreement under subsection (a) shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may reasonably require.

(e)

Evaluation

An entity that receives a grant, contract, or cooperative agreement under subsection (a) shall submit, in the application for such grant, contract, or cooperative agreement, a plan for the evaluation of any project undertaken with funds provided under this section. Such entity shall provide the Secretary with periodic evaluations of the progress of such project and such evaluation at the completion of such project as the Secretary determines to be appropriate.

(f)

Authorization of Appropriations

There are authorized to be appropriated to carry out this section, $60,000,000 for fiscal year 2011, and such sums as may be necessary for fiscal years 2012 through 2015.

2

Center for Substance Abuse Prevention

520.

Center for Substance Abuse Prevention

(a)

In General

There is established in the Administration a Center for Substance Abuse Prevention (hereafter referred to in this part as the Prevention Center). The Center shall be headed by a Director appointed by the Secretary from individuals with extensive experience or academic qualifications in the prevention of drug or alcohol abuse.

(b)

Duties

The Director of the Prevention Center shall—

(1)

sponsor regional workshops on the prevention of drug and alcohol abuse through the reduction of risk and the promotion of resiliency;

(2)

coordinate the findings of research sponsored by agencies of the Service on the prevention of drug and alcohol abuse;

(3)

develop effective drug and alcohol abuse prevention literature (including literature on the adverse effects of emerging drugs);

(4)

in cooperation with the Secretary of Education, assure the widespread dissemination of prevention materials among States, political subdivisions, and school systems;

(5)

support clinical training programs for substance use disorder prevention practitioners and other health professionals involved in drug abuse education, prevention;

(6)

in cooperation with the Director of the Centers for Disease Control and Prevention, develop educational materials designed to increase awareness of those at greatest risk for substance use disorders thereby preventing new infections and reducing the probability of the transmission of HIV, Hepatitis C, sexually transmitted diseases, tuberculosis, and other communicable diseases;

(7)

conduct training, technical assistance, data collection, and evaluation activities of programs supported under the Drug Free Schools and Communities Act of 1986;

(8)

support the development of model, innovative, community-based programs that reduce the risk of substance use and promote resiliency among young people;

(9)

collaborate with the Attorney General of the Department of Justice to develop programs to prevent drug abuse among high risk youth;

(10)

prepare for distribution documentary films and public service announcements for television and radio to educate the public, especially adolescent audiences, concerning the dangers to health resulting from the consumption of alcohol and drugs and, to the extent feasible, use appropriate private organizations and business concerns in the preparation of such announcements; and

(11)

develop and support innovative demonstration programs designed to identify and deter the improper use or abuse of anabolic steroids by students, especially students in secondary schools.

(c)

Grants, Contracts, Cooperative Agreements

The Director may make grants and enter into contracts and cooperative agreements in carrying out subsection (b).

521.

Priority substance use disorder prevention needs of regional and national significance

(a)

Projects

The Secretary shall address priority substance use disorder prevention needs of regional and national significance (as determined under subsection (b)) through the provision of or through assistance for—

(1)

knowledge development and application projects for prevention and the conduct or support of evaluations of such projects;

(2)

training and technical assistance; and

(3)

targeted capacity response programs, including a focus on emerging drugs.

The Secretary may carry out the activities described in this section directly or through grants, contracts, or cooperative agreements with States, territories, political subdivisions of States, American Indian and Alaska Native tribes, tribal organizations and a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, or other public or nonprofit private entities.
(b)

Priority Substance Use Disorder Prevention Needs

(1)

In general

Priority substance use disorder prevention needs of regional and national significance shall be determined by the Secretary in consultation with the States and other interested groups. The Secretary shall meet with the States and interested groups on an annual basis to discuss program priorities.

(2)

Special priority and consideration

(A)

Priority

In developing priority needs under paragraph (1), the Secretary shall ensure that specific priority is given to high risk youth, including youth who—

(i)

are failing in, or who have dropped out of, school;

(ii)

associate with peers who engage in substance use;

(iii)

live in communities where drugs and alcohol are readily available;

(iv)

are raised in a family with a history of problem behaviors including drug and alcohol abuse;

(v)

are identified as children of a substance abuser;

(vi)

are victims of physical, sexual, or psychological abuse;

(vii)

have committed a violent or delinquent act;

(viii)

have experienced mental health problems;

(ix)

have attempted suicide; or

(x)

have experienced long-term physical pain due to injury.

(B)

Considerations

In developing program priorities under paragraph (1), the Secretary shall give special consideration to—

(i)

applying the most promising strategies and research-based primary prevention approaches;

(ii)

promoting the integration of substance use disorder prevention information and activities into primary health care systems; and

(iii)

supporting education projects that focus on, or include, specific information about the oral health risks and conditions associated with drug use.

(c)

Requirements

(1)

In general

Recipients of grants, contracts, and cooperative agreements under this section shall comply with information and application requirements determined appropriate by the Secretary.

(2)

Duration of award

With respect to a grant, contract, or cooperative agreement awarded under this section, the period during which payments under such award are made to the recipient may not exceed 5 years.

(3)

Matching funds

The Secretary may, for projects carried out under subsection (a), require that entities that apply for grants, contracts, or cooperative agreements under that project provide non-Federal matching funds, as determined appropriate by the Secretary, to ensure the institutional commitment of the entity to the projects funded under the grant, contract, or cooperative agreement. Such non-Federal matching funds may be provided directly or through donations from public or private entities and may be in cash or in kind, fairly evaluated, including plant, equipment, or services.

(4)

Maintenance of effort

With respect to activities for which a grant, contract, or cooperative agreement is awarded under this section, the Secretary may require that recipients for specific projects under subsection (a) agree to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives such a grant, contract, or cooperative agreement.

(d)

Evaluation

The Secretary shall evaluate each project carried out under subsection (a)(1) and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities.

(e)

Information and Education

The Secretary shall establish comprehensive information and education programs to disseminate the findings of the knowledge development and application, training and technical assistance programs, and targeted capacity response programs under this section to the general public and to health professionals. The Secretary shall make every effort to provide linkages between the findings of supported projects and State agencies responsible for carrying out substance use disorder prevention and treatment programs.

(f)

Authorization of Appropriation

There are authorized to be appropriated to carry out this section, $300,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

522.

Programs to reduce underage drinking

(a)

Definitions

For purposes of this section:

(1)

The term alcohol beverage industry means the brewers, vintners, distillers, importers, distributors, and retail or online outlets that sell or serve beer, wine, and distilled spirits.

(2)

The term school-based prevention means programs, which are institutionalized, and run by staff members or school-designated persons or organizations in any grade of school, kindergarten through 12th grade.

(3)

The term youth means persons under the age of 21.

(4)

The term IOM report means the report released in September 2003 by the National Research Council, Institute of Medicine, and entitled Reducing Underage Drinking: A Collective Responsibility.

(b)

Sense of Congress

It is the sense of the Congress that:

(1)

A multi-faceted effort is needed to more successfully address the problem of underage drinking in the United States. A coordinated approach to prevention, intervention, treatment, enforcement, and research is key to making progress. This Act recognizes the need for a focused national effort, and addresses particulars of the Federal portion of that effort, as well as Federal support for State activities.

(2)

The Secretary of Health and Human Services shall continue to conduct research and collect data on the short and long-range impact of alcohol use and abuse upon adolescent brain development and other organ systems.

(3)

States and communities, including colleges and universities, are encouraged to adopt comprehensive prevention approaches, including—

(A)

evidence-based screening, programs and curricula;

(B)

brief intervention strategies;

(C)

consistent policy enforcement; and

(D)

environmental changes that limit underage access to alcohol.

(4)

Public health groups, consumer groups, and the alcohol beverage industry should continue and expand evidence-based efforts to prevent and reduce underage drinking.

(5)

The entertainment industries have a powerful impact on youth, and they should use rating systems and marketing codes to reduce the likelihood that underage audiences will be exposed to movies, recordings, or television programs with unsuitable alcohol content.

(6)

The National Collegiate Athletic Association, its member colleges and universities, and athletic conferences should affirm a commitment to a policy of discouraging alcohol use among underage students and other young fans.

(7)

Alcohol is a unique product and should be regulated differently than other products by the States and Federal Government. States have primary authority to regulate alcohol distribution and sale, and the Federal Government should support and supplement these State efforts. States also have a responsibility to fight youth access to alcohol and reduce underage drinking. Continued State regulation and licensing of the manufacture, importation, sale, distribution, transportation and storage of alcoholic beverages are clearly in the public interest and are critical to promoting responsible consumption, preventing illegal access to alcohol by persons under 21 years of age from commercial and non-commercial sources, maintaining industry integrity and an orderly marketplace, and furthering effective State tax collection.

(c)

Interagency Coordinating Committee; Annual Report on State Underage Drinking Prevention and Enforcement Activities

(1)

Interagency coordinating committee on the prevention of underage drinking

(A)

In general

The Secretary, in collaboration with the Federal officials specified in subparagraph (B), shall formally establish and enhance the efforts of the interagency coordinating committee, that began operating in 2004, focusing on underage drinking (referred to in this subsection as the Committee).

(B)

Other agencies

The officials referred to in paragraph (1) are the Secretary of Education, the Attorney General, the Secretary of Transportation, the Secretary of the Treasury, the Secretary of Defense, the Surgeon General, the Director of the Centers for Disease Control and Prevention, the Director of the National Institute on Alcohol Abuse and Alcoholism, the Administrator of the Substance Abuse and Mental Health Services Administration, the Director of the National Institute on Drug Abuse, the Assistant Secretary for Children and Families, the Director of the Office of National Drug Control Policy, the Administrator of the National Highway Traffic Safety Administration, the Administrator of the Office of Juvenile Justice and Delinquency Prevention, the Chairman of the Federal Trade Commission, and such other Federal officials as the Secretary of Health and Human Services determines to be appropriate.

(C)

Chair

The Secretary of Health and Human Services shall serve as the chair of the Committee.

(D)

Duties

The Committee shall guide policy and program development across the Federal Government with respect to underage drinking, provided, however, that nothing in this section shall be construed as transferring regulatory or program authority from an Agency to the Coordinating Committee.

(E)

Consultations

The Committee shall actively seek the input of and shall consult with all appropriate and interested parties, including States, public health research and interest groups, foundations, and alcohol beverage industry trade associations and companies.

(F)

Annual report

(i)

In general

The Secretary, on behalf of the Committee, shall annually submit to the Congress a report that summarizes—

(I)

all programs and policies of Federal agencies designed to prevent and reduce underage drinking;

(II)

the extent of progress in preventing and reducing underage drinking nationally;

(III)

data that the Secretary shall collect with respect to the information specified in clause (ii); and

(IV)

such other information regarding underage drinking as the Secretary determines to be appropriate.

(ii)

Certain information

The report under clause (i) shall include information on the following:

(I)

Patterns and consequences of underage drinking as reported in research and surveys such as, but not limited to Monitoring the Future, Youth Risk Behavior Surveillance System, the National Survey on Drug Use and Health, and the Fatality Analysis Reporting System.

(II)

Measures of the availability of alcohol from commercial and non-commercial sources to underage populations.

(III)

Measures of the exposure of underage populations to messages regarding alcohol in advertising and the entertainment media as reported by the Federal Trade Commission.

(IV)

Surveillance data, including information on the onset and prevalence of underage drinking, consumption patterns and the means of underage access. The Secretary shall develop a plan to improve the collection, measurement and consistency of reporting Federal underage alcohol data.

(V)

Any additional findings resulting from research conducted or supported under subsection (f).

(VI)

Evidence-based best practices to prevent and reduce underage drinking and provide treatment services to those youth who need them.

(2)

Annual report on state underage drinking prevention and enforcement activities

(A)

In general

The Secretary shall, with input and collaboration from other appropriate Federal agencies, States, Indian tribes, territories, and public health, consumer, and alcohol beverage industry groups, annually issue a report on each State’s performance in enacting, enforcing, and creating laws, regulations, and programs to prevent or reduce underage drinking.

(B)

State performance measures

(i)

In general

The Secretary shall develop, in consultation with the Committee, a set of measures to be used in preparing the report on best practices.

(ii)

Categories

In developing these measures, the Secretary shall consider categories including, but not limited to:

(I)

Whether or not the State has comprehensive anti-underage drinking laws such as for the illegal sale, purchase, attempt to purchase, consumption, or possession of alcohol; illegal use of fraudulent ID; illegal furnishing or obtaining of alcohol for an individual under 21 years; the degree of strictness of the penalties for such offenses; and the prevalence of the enforcement of each of these infractions.

(II)

Whether or not the State has comprehensive liability statutes pertaining to underage access to alcohol such as dram shop, social host, and house party laws, and the prevalence of enforcement of each of these laws.

(III)

Whether or not the State encourages and conducts comprehensive enforcement efforts to prevent underage access to alcohol at retail outlets, such as random compliance checks and shoulder tap programs, and the number of compliance checks within alcohol retail outlets measured against the number of total alcohol retail outlets in each State, and the result of such checks.

(IV)

Whether or not the State encourages training on the proper selling and serving of alcohol for all sellers and servers of alcohol as a condition of employment.

(V)

Whether or not the State has policies and regulations with regard to direct sales to consumers and home delivery of alcoholic beverages.

(VI)

Whether or not the State has programs or laws to deter adults from purchasing alcohol for minors; and the number of adults targeted by these programs.

(VII)

Whether or not the State has programs targeted to youths, parents, and caregivers to deter underage drinking; and the number of individuals served by these programs.

(VIII)

Whether or not the State has enacted graduated drivers licenses and the extent of those provisions.

(IX)

The amount that the State invests, per youth capita, on the prevention of underage drinking, further broken down by the amount spent on—

(aa)

compliance check programs in retail outlets, including providing technology to prevent and detect the use of false identification by minors to make alcohol purchases;

(bb)

checkpoints and saturation patrols that include the goal of reducing and deterring underage drinking;

(cc)

community-based, school-based, and higher-education-based programs to prevent underage drinking;

(dd)

underage drinking prevention programs that target youth within the juvenile justice and child welfare systems; and

(ee)

other State efforts or programs as deemed appropriate.

(3)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection $1,000,000 for fiscal year 2011, and $1,000,000 for each of the fiscal years 2012 through 2015.

(d)

National Media Campaign To Prevent Underage Drinking

(1)

Scope of the campaign

The Secretary shall continue to fund and oversee the production, broadcasting, and evaluation of the national adult-oriented media public service campaign if the Secretary determines that such campaign is effective in achieving the media campaign’s measurable objectives.

(2)

Report

The Secretary shall provide a report to the Congress annually detailing the production, broadcasting, and evaluation of the campaign referred to in paragraph (1), and to detail in the report the effectiveness of the campaign in reducing underage drinking, the need for and likely effectiveness of an expanded adult-oriented media campaign, and the feasibility and the likely effectiveness of a national youth-focused media campaign to combat underage drinking.

(3)

Consultation requirement

In carrying out the media campaign, the Secretary shall direct the entity carrying out the national adult-oriented media public service campaign to consult with interested parties including both the alcohol beverage industry and public health and consumer groups. The progress of this consultative process is to be covered in the report under paragraph (2).

(4)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection, $1,000,000 for fiscal year 2011 and $1,000,000 for each of the fiscal years 2012 through 2015.

(e)

Interventions

(1)

Community-based coalition enhancement grants to prevent underage drinking

(A)

Authorization of program

The Administrator of the Substance Abuse and Mental Health Services Administration, in consultation with the Director of the Office of National Drug Control Policy, shall award, if the Administrator determines that the Department of Health and Human Services is not currently conducting activities that duplicate activities of the type described in this subsection, enhancement grants to eligible entities to design, test, evaluate and disseminate effective strategies to maximize the effectiveness of community-wide approaches to preventing and reducing underage drinking. This subsection is subject to the availability of appropriations.

(B)

Purposes

The purposes of this paragraph are to—

(i)

prevent and reduce alcohol use among youth in communities throughout the United States;

(ii)

strengthen collaboration among communities, the Federal Government, and State, local, and tribal governments;

(iii)

enhance intergovernmental cooperation and coordination on the issue of alcohol use among youth;

(iv)

serve as a catalyst for increased citizen participation and greater collaboration among all sectors and organizations of a community that first demonstrates a long-term commitment to reducing alcohol use among youth;

(v)

disseminate to communities timely information regarding state-of-the-art practices and initiatives that have proven to be effective in preventing and reducing alcohol use among youth; and

(vi)

enhance, not supplant, effective local community initiatives for preventing and reducing alcohol use among youth.

(C)

Application

An eligible entity desiring an enhancement grant under this paragraph shall submit an application to the Administrator at such time, and in such manner, and accompanied by such information as the Administrator may require. Each application shall include—

(i)

a complete description of the entity’s current underage alcohol use prevention initiatives and how the grant will appropriately enhance the focus on underage drinking issues; or

(ii)

a complete description of the entity’s current initiatives, and how it will use this grant to enhance those initiatives by adding a focus on underage drinking prevention.

(D)

Uses of funds

Each eligible entity that receives a grant under this paragraph shall use the grant funds to carry out the activities described in such entity’s application submitted pursuant to subparagraph (C). Grants under this paragraph shall not exceed $50,000 per year and may not exceed four years.

(E)

Supplement not supplant

Grant funds provided under this paragraph shall be used to supplement, not supplant, Federal and non-Federal funds available for carrying out the activities described in this paragraph.

(F)

Evaluation

Grants under this paragraph shall be subject to the same evaluation requirements and procedures as the evaluation requirements and procedures imposed on recipients of drug free community grants.

(G)

Definitions

For purposes of this paragraph, the term eligible entity means an organization that is currently receiving or has received grant funds under the Drug-Free Communities Act of 1997 (21 U.S.C. 1521 et seq.).

(H)

Administrative expenses

Not more than 6 percent of a grant under this paragraph may be expended for administrative expenses.

(I)

Authorization of appropriations

There are authorized to be appropriated to carry out this paragraph $5,000,000 for fiscal year 2011, and $5,000,000 for each of the fiscal years 2012 through 2015.

(2)

Grants directed at preventing and reducing alcohol abuse at institutions of higher education

(A)

Authorization of program

The Secretary shall award grants to eligible entities to enable the entities to prevent and reduce the rate of underage alcohol consumption including binge drinking among students at institutions of higher education.

(B)

Applications

An eligible entity that desires to receive a grant under this paragraph shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require. Each application shall include—

(i)

a description of how the eligible entity will work to enhance an existing, or where none exists to build a, statewide coalition;

(ii)

a description of how the eligible entity will target underage students in the State;

(iii)

a description of how the eligible entity intends to ensure that the statewide coalition is actually implementing the purpose of this section and moving toward indicators described in subparagraph (D);

(iv)

a list of the members of the statewide coalition or interested parties involved in the work of the eligible entity;

(v)

a description of how the eligible entity intends to work with State agencies on substance use disorder prevention and education;

(vi)

the anticipated impact of funds provided under this paragraph in preventing and reducing the rates of underage alcohol use;

(vii)

outreach strategies, including ways in which the eligible entity proposes to—

(I)

reach out to students and community stakeholders;

(II)

promote the purpose of this paragraph;

(III)

address the range of needs of the students and the surrounding communities; and

(IV)

address community norms for underage students regarding alcohol use; and

(viii)

such additional information as required by the Secretary.

(C)

Uses of funds

Each eligible entity that receives a grant under this paragraph shall use the grant funds to carry out the activities described in such entity’s application submitted pursuant to subparagraph (B).

(D)

Accountability

On the date on which the Secretary first publishes a notice in the Federal Register soliciting applications for grants under this paragraph, the Secretary shall include in the notice achievement indicators for the program authorized under this paragraph. The achievement indicators shall be designed—

(i)

to measure the impact that the statewide coalitions assisted under this paragraph are having on the institutions of higher education and the surrounding communities, including changes in the number of incidents of any kind in which students have abused alcohol or consumed alcohol while under the age of 21 (including violations, physical assaults, sexual assaults, reports of intimidation, disruptions of school functions, disruptions of student studies, mental health referrals, illnesses, or deaths);

(ii)

to measure the quality and accessibility of the programs or information offered by the eligible entity; and

(iii)

to provide such other measures of program impact as the Secretary determines appropriate.

(E)

Supplement not supplant

Grant funds provided under this paragraph shall be used to supplement, and not supplant, Federal and non-Federal funds available for carrying out the activities described in this paragraph.

(F)

Definitions

For purposes of this paragraph:

(i)

Eligible entity

The term eligible entity means a State, institution of higher education, or nonprofit entity.

(ii)

Institution of higher education

The term institution of higher education has the meaning given the term in section 101(a) of the Higher Education Act of 1965.

(iii)

Secretary

The term Secretary means the Secretary of Education.

(iv)

State

The term State means each of the 50 States, the District of Columbia, and the Commonwealth of Puerto Rico.

(v)

Statewide coalition

The term statewide coalition means a coalition that—

(I)

includes, but is not limited to—

(aa)

institutions of higher education within a State; and

(bb)

a nonprofit group, a community underage drinking prevention coalition, or another substance use disorder prevention group within a State; and

(II)

works toward lowering the alcohol abuse rate by targeting underage students at institutions of higher education throughout the State and in the surrounding communities.

(vi)

Surrounding community

The term surrounding community means the community—

(I)

that surrounds an institution of higher education participating in a statewide coalition;

(II)

where the students from the institution of higher education take part in the community; and

(III)

where students from the institution of higher education live in off-campus housing.

(G)

Administrative expenses

Not more than 5 percent of a grant under this paragraph may be expended for administrative expenses.

(H)

Authorization of appropriations

There are authorized to be appropriated to carry out this paragraph $6,000,000 for fiscal year 2011, and $6,000,000 for each of the fiscal years 2012 through 2015.

(f)

Additional Research

(1)

Additional research on underage drinking

(A)

In general

The Secretary shall, subject to the availability of appropriations, collect data, and conduct or support research that is not duplicative of research currently being conducted or supported by the Department of Health and Human Services, on underage drinking, with respect to the following:

(i)

Comprehensive community-based programs or strategies and statewide systems to prevent and reduce underage drinking, across the underage years from early childhood to age 21, including programs funded and implemented by government entities, public health interest groups and foundations, and alcohol beverage companies and trade associations.

(ii)

Annually obtain and report more precise information than is currently collected on the scope of the underage drinking problem and patterns of underage alcohol consumption, including improved knowledge about the problem and progress in preventing, reducing and treating underage drinking; as well as information on the rate of exposure of youth to advertising and other media messages encouraging and discouraging alcohol consumption.

(iii)

Compiling information on the involvement of alcohol in unnatural deaths of persons ages 12 to 20 in the United States, including suicides, homicides, and unintentional injuries such as falls, drownings, burns, poisonings, and motor vehicle crash deaths.

(B)

Certain matters

The Secretary shall carry out activities toward the following objectives with respect to underage drinking:

(i)

Obtaining new epidemiological data within the national or targeted surveys that identify alcohol use and attitudes about alcohol use during pre- and early adolescence, including harm caused to self or others as a result of adolescent alcohol use such as violence, date rape, risky sexual behavior, and prenatal alcohol exposure.

(ii)

Developing or identifying successful clinical treatments for youth with alcohol problems.

(C)

Peer review

Research under subparagraph (A) shall meet current Federal standards for scientific peer review.

(2)

Authorization of appropriations

There are authorized to be appropriated to carry out this subsection $6,000,000 for fiscal year 2011, and $6,000,000 for each of the fiscal years 2012 through 2015.

523.

Services for Individuals with Fetal Alcohol Syndrome

(a)

In General

The Secretary shall make awards of grants, cooperative agreements, or contracts to public and nonprofit private entities, including American Indian and Alaska Native tribes, tribal organizations, and a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, to provide services to individuals diagnosed with fetal alcohol syndrome or alcohol-related birth defects.

(b)

Use of Funds

An award under subsection (a) may, subject to subsection (d), be used to—

(1)

screen and test individuals to determine the type and level of services needed;

(2)

develop a comprehensive plan for providing services to the individual;

(3)

provide mental health counseling;

(4)

provide substance use disorder prevention services and treatment, if needed;

(5)

coordinate services with other social programs including social services, justice system, educational services, health services, mental health and substance use disorder services, financial assistance programs, vocational services and housing assistance programs;

(6)

provide vocational services;

(7)

provide health counseling;

(8)

provide housing assistance;

(9)

parenting skills training;

(10)

overall case management;

(11)

supportive services for families of individuals with Fetal Alcohol Syndrome;

(12)

provide respite care for caretakers of individuals with Fetal Alcohol Syndrome and other prenatal alcohol-related disorders;

(13)

recruit and train mentors for individuals with Fetal Alcohol Syndrome and other prenatal alcohol-related disorders;

(14)

provide educational and supportive services to families of individuals with Fetal Alcohol Spectrum Disorders; and

(15)

provide other services and programs, to the extent authorized by the Secretary after consideration of recommendations made by the National Task Force on Fetal Alcohol Syndrome.

(c)

Requirements

To be eligible to receive an award under subsection (a), an applicant shall—

(1)

demonstrate that the program will be part of a coordinated, comprehensive system of care for such individuals;

(2)

demonstrate an established communication with other social programs in the community including social services, justice system, financial assistance programs, health services, educational services, mental health and substance use disorder services, vocational services and housing assistance services;

(3)

show a history of working with individuals with fetal alcohol syndrome or alcohol-related birth defects;

(4)

provide assurance that the services will be provided in a culturally and linguistically appropriate manner; and

(5)

provide assurance that at the end of the 5-year award period, other mechanisms will be identified to meet the needs of the individuals and families served under such award.

(d)

Relationship to Payments Under Other Programs

An award may be made under subsection (a) only if the applicant involved agrees that the award will not be expended to pay the expenses of providing any service under this section to an individual to the extent that payment has been made, or can reasonably be expected to be made, with respect to such expenses—

(1)

under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or

(2)

by an entity that provides health services on a prepaid basis.

(e)

Duration of Awards

With respect to an award under subsection (a), the period during which payments under such award are made to the recipient may not exceed 5 years.

(f)

Evaluation

The Secretary shall evaluate each project carried out under subsection (a) and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities.

(g)

Funding

(1)

Authorization of appropriations

For the purpose of carrying out this section, there are authorized to be appropriated $25,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

(2)

Allocation

Of the amounts appropriated under paragraph (1) for a fiscal year, not less than $300,000 shall, for purposes relating to fetal alcohol syndrome and alcohol-related birth defects, be made available for collaborative, coordinated interagency efforts with the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Child Health and Human Development, the Health Resources and Services Administration, the Agency for Healthcare Research and Quality, the Centers for Disease Control and Prevention, the Department of Education, and the Department of Justice.

524.

Centers of excellence on services for Individuals with Fetal Alcohol Syndrome and alcohol-related birth defects and treatment for Individuals with such conditions and their families

(a)

In General

The Secretary shall make awards of grants, cooperative agreements, or contracts to public or nonprofit private entities for the purposes of establishing not more than four centers of excellence to study techniques for the prevention of fetal alcohol syndrome and alcohol-related birth defects and adaptations of innovative clinical interventions and service delivery improvements for the provision of comprehensive services to individuals with fetal alcohol syndrome or alcohol-related birth defects and their families and for providing training on such conditions.

(b)

Use of Funds

An award under subsection (a) may be used to—

(1)

study adaptations of innovative clinical interventions and service delivery improvements strategies for children and adults with fetal alcohol syndrome or alcohol-related birth defects and their families;

(2)

identify communities which have an exemplary comprehensive system of care for such individuals so that they can provide technical assistance to other communities attempting to set up such a system of care;

(3)

provide technical assistance to communities who do not have a comprehensive system of care for such individuals and their families;

(4)

train community leaders, mental health and substance use disorder professionals, families, law enforcement personnel, judges, health professionals, persons working in financial assistance programs, social service personnel, child welfare professionals, and other service providers on the implications of fetal alcohol syndrome and alcohol-related birth defects, the early identification of and referral for such conditions;

(5)

develop innovative techniques for preventing alcohol use by women in child bearing years; or

(6)

perform other functions, to the extent authorized by the Secretary after consideration of recommendations made by the National Task Force on Fetal Alcohol Syndrome.

(c)

Report

(1)

In general

A recipient of an award under subsection (a) shall at the end of the period of funding report to the Secretary on any innovative techniques that have been discovered for preventing alcohol abuse, alcohol use among women of child bearing years, and alcohol use among pregnant women and women considering pregnancy.

(2)

Dissemination of findings

The Secretary shall upon receiving a report under paragraph (1) disseminate the findings to appropriate public and private entities.

(d)

Duration of Awards

With respect to an award under subsection (a), the period during which payments under such award are made to the recipient may not exceed 5 years.

(e)

Evaluation

The Secretary shall evaluate each project carried out under subsection (a) and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities.

(f)

Authorization of Appropriations

For the purpose of carrying out this section, there are authorized to be appropriated $9,200,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

3

Center for Mental Health Services

525.

Center for Mental Health Services

(a)

Establishment

There is established in the Administration a Center for Mental Health Services (hereafter in this section referred to as the Center). The Center shall be headed by a Director (hereafter in this section referred to as the Director) appointed by the Secretary from among individuals with extensive experience or academic qualifications in the provision of mental health services or in the evaluation of mental health service systems.

(b)

Duties

The Director of the Center shall—

(1)

design national goals and establish national priorities for—

(A)

the prevention of mental illness; and

(B)

the promotion of mental health;

(2)

encourage and assist local entities and State agencies to achieve the goals and priorities described in paragraph (1);

(3)

collaborate with the Department of Education and the Department of Justice to develop programs to assist local communities in addressing violence among children and adolescents;

(4)

develop and coordinate Federal prevention policies and programs and to assure increased focus on the prevention of mental illness and the promotion of mental health through programs that reduce risk and promote resiliency;

(5)

develop improved methods of treating individuals with mental health problems and improved methods of assisting the families of such individuals;

(6)

administer the mental health services block grant program authorized in section 1911;

(7)

promote policies and programs at Federal, State, and local levels and in the private sector that foster independence, increase meaningful participation of, and protect the legal rights of persons with mental illness, including carrying out the provisions of the Protection and Advocacy of Individuals with Mental Illness Act;

(8)

carry out the programs under part C;

(9)

carry out responsibilities for the Human Resource Development program, and programs of clinical training for paraprofessional personnel and health professionals;

(10)

conduct services-related assessments, including evaluations of the organization and financing of care, self-help and consumer-run programs, mental health economics, mental health service systems, rural mental health, tele-mental health, and improve the capacity of State to conduct evaluations of publicly funded mental health programs;

(11)

provide technical assistance to public and private entities that are providers of mental health services;

(12)

conduct surveys with respect to mental health, such as the National Reporting Program; and

(13)

assist States in improving their mental health data collection.

(c)

Grants and Contracts

In carrying out the duties established in subsection (b), the Director may makes grants to and enter into contracts and cooperative agreements with public and nonprofit private entities.

526.

Priority mental Health needs of regional and national significance

(a)

Projects

The Secretary shall address priority mental health needs of regional and national significance (as determined under subsection (b)) through the provision of or through assistance for—

(1)

knowledge development and application projects for prevention, treatment, and rehabilitation, and the conduct or support of evaluations of such projects;

(2)

training and technical assistance programs;

(3)

targeted capacity response programs; and

(4)

systems change grants including statewide family network grants and client-oriented and consumer run self-help activities which may include technical assistance centers.

The Secretary may carry out the activities described in this subsection directly or through grants, contracts, or cooperative agreements with States, territories, political subdivisions of States, Indian tribes and tribal organizations, other public or private nonprofit entities.
(b)

Priority Mental Health Needs

(1)

Determination of needs

Priority mental health needs of regional and national significance shall be determined by the Secretary in consultation with States and other interested groups. The Secretary shall meet with the States and interested groups on an annual basis to discuss program priorities.

(2)

Special consideration

In developing program priorities described in paragraph (1), the Secretary shall give special consideration to promoting the integration of mental health services into primary health care systems.

(c)

Requirements

(1)

In general

Recipients of grants, contracts, and cooperative agreements under this section shall comply with information and application requirements determined appropriate by the Secretary.

(2)

Duration of award

With respect to a grant, contract, or cooperative agreement awarded under this section, the period during which payments under such award are made to the recipient may not exceed 5 years.

(3)

Matching funds

The Secretary may, for projects carried out under subsection (a), require that entities that apply for grants, contracts, or cooperative agreements under this section provide non-Federal matching funds, as determined appropriate by the Secretary, to ensure the institutional commitment of the entity to the projects funded under the grant, contract, or cooperative agreement. Such non-Federal matching funds may be provided directly or through donations from public or private entities and may be in cash or in kind, fairly evaluated, including plant, equipment, or services. The requirements of this paragraph shall apply to Statewide consumer family networks.

(4)

Maintenance of effort

With respect to activities for which a grant, contract or cooperative agreement is awarded under this section, the Secretary may require that recipients for specific projects under subsection (a) agree to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives such a grant, contract, or cooperative agreement.

(d)

Evaluation

The Secretary shall evaluate each project carried out under subsection (a)(1) and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities.

(e)

Information and Education

(1)

In general

The Secretary shall establish information and education programs to disseminate and apply the findings of the knowledge development and application, training, and technical assistance programs, and targeted capacity response programs, under this section to the general public, to health care professionals, and to interested groups. The Secretary shall make every effort to provide linkages between the findings of supported projects and State agencies responsible for carrying out mental health services.

(2)

Rural and underserved areas

In disseminating information on evidence-based practices in the provision of children’s mental health services under this subsection, the Secretary shall ensure that such information is distributed to rural and medically underserved areas.

(f)

Authorization of Appropriation

(1)

In general

There are authorized to be appropriated to carry out this section, $300,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

(2)

Data infrastructure

If amounts are not appropriated for a fiscal year to carry out section 1971 with respect to mental health, then the Secretary shall make available, from the amounts appropriated for such fiscal year under paragraph (1), an amount equal to the sum of $6,000,000 and 10 percent of all amounts appropriated for such fiscal year under such paragraph in excess of $100,000,000, to carry out such section 1971.

527.

Suicide prevention technical assistance Center

(a)

Program Authorized

The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian tribes, tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations concerning the prevention of suicide among all ages, particularly among groups that are at high risk for suicide.

(b)

Responsibilities of the Center

The center established under subsection (a) shall—

(1)

assist in the development or continuation of statewide and tribal suicide early intervention and prevention strategies for all ages, particularly among groups that are at high risk for suicide;

(2)

ensure the surveillance of suicide early intervention and prevention strategies for all ages, particularly among groups that are at high risk for suicide;

(3)

study the costs and effectiveness of statewide and tribal suicide early intervention and prevention strategies in order to provide information concerning relevant issues of importance to State, tribal, and national policymakers;

(4)

further identify and understand causes and associated risk factors for suicide for all ages, particularly among groups that are at high risk for suicide;

(5)

analyze the efficacy of new and existing suicide early intervention and prevention techniques and technology for all ages, particularly among groups that are at high risk for suicide;

(6)

ensure the surveillance of suicidal behaviors and nonfatal suicidal attempts;

(7)

study the effectiveness of State-sponsored statewide and tribal suicide early intervention and prevention strategies for all ages particularly among groups that are at high risk for suicide on the overall wellness and health promotion strategies related to suicide attempts;

(8)

promote the sharing of data regarding suicide with Federal agencies involved with suicide early intervention and prevention, and State-sponsored statewide and tribal suicide early intervention and prevention strategies for the purpose of identifying previously unknown mental health causes and associated risk factors for suicide among all ages particularly among groups that are at high risk for suicide;

(9)

evaluate and disseminate outcomes and best practices of mental health and substance use disorder services at institutions of higher education; and

(10)

conduct other activities determined appropriate by the Secretary.

(c)

Authorization of Appropriations

For the purpose of carrying out this section, there are authorized to be appropriated $5,000,000 for fiscal year 2011, and such sums as may be necessary for each of fiscal years 2012 through 2015.

528.

Youth suicide early intervention and prevention strategies

(a)

In General

The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall award grants or cooperative agreements to eligible entities to—

(1)

develop and implement State-sponsored statewide or tribal youth suicide early intervention and prevention strategies in schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations;

(2)

support public organizations and private nonprofit organizations actively involved in State-sponsored statewide or tribal youth suicide early intervention and prevention strategies and in the development and continuation of State-sponsored statewide youth suicide early intervention and prevention strategies;

(3)

provide grants to institutions of higher education to coordinate the implementation of State-sponsored statewide or tribal youth suicide early intervention and prevention strategies;

(4)

collect and analyze data on State-sponsored statewide or tribal youth suicide early intervention and prevention services that can be used to monitor the effectiveness of such services and for research, technical assistance, and policy development; and

(5)

assist eligible entities, through State-sponsored statewide or tribal youth suicide early intervention and prevention strategies, in achieving targets for youth suicide reductions under title V of the Social Security Act.

(b)

Eligible Entity

(1)

Definition

In this section, the term eligible entity means—

(A)

a State;

(B)

a public organization or private nonprofit organization designated by a State to develop or direct the State-sponsored statewide youth suicide early intervention and prevention strategy; or

(C)

a federally recognized Indian tribe or tribal organization (as defined in the Indian Self-Determination and Education Assistance Act) or an urban Indian organization (as defined in the Indian Health Care Improvement Act) that is actively involved in the development and continuation of a tribal youth suicide early intervention and prevention strategy.

(2)

Limitation

In carrying out this section, the Secretary shall ensure that a State does not receive more than one grant or cooperative agreement under this section at any one time. For purposes of the preceding sentence, a State shall be considered to have received a grant or cooperative agreement if the eligible entity involved is the State or an entity designated by the State under paragraph (1)(B). Nothing in this paragraph shall be constructed to apply to entities described in paragraph (1)(C).

(c)

Preference

In providing assistance under a grant or cooperative agreement under this section, an eligible entity shall give preference to public organizations, private nonprofit organizations, political subdivisions, institutions of higher education, and tribal organizations actively involved with the State-sponsored statewide or tribal youth suicide early intervention and prevention strategy that—

(1)

provide early intervention and assessment services, including screening programs, to youth who are at risk for mental or emotional disorders that may lead to a suicide attempt, and that are integrated with school systems, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations;

(2)

demonstrate collaboration among early intervention and prevention services or certify that entities will engage in future collaboration;

(3)

employ or include in their applications a commitment to evaluate youth suicide early intervention and prevention practices and strategies adapted to the local community;

(4)

provide timely referrals for appropriate community-based mental health care and treatment of youth who are at risk for suicide in child-serving settings and agencies;

(5)

provide immediate support and information resources to families of youth who are at risk for suicide;

(6)

offer access to services and care to youth with diverse linguistic and cultural backgrounds;

(7)

offer appropriate postsuicide intervention services, care, and information to families, friends, schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, and other child and youth support organizations of youth who recently completed suicide;

(8)

offer continuous and up-to-date information and awareness campaigns that target parents, family members, child care professionals, community care providers, and the general public and highlight the risk factors associated with youth suicide and the life-saving help and care available from early intervention and prevention services;

(9)

ensure that information and awareness campaigns on youth suicide risk factors, and early intervention and prevention services, use effective communication mechanisms that are targeted to and reach youth, families, schools, educational institutions, and youth organizations;

(10)

provide a timely response system to ensure that child-serving professionals and providers are properly trained in youth suicide early intervention and prevention strategies and that child-serving professionals and providers involved in early intervention and prevention services are properly trained in effectively identifying youth who are at risk for suicide;

(11)

provide continuous training activities for child care professionals and community care providers on the latest youth suicide early intervention and prevention services practices and strategies;

(12)

conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations;

(13)

provide services in areas or regions with rates of youth suicide that exceed the national average as determined by the Centers for Disease Control and Prevention; and

(14)

obtain informed written consent from a parent or legal guardian of an at-risk child before involving the child in a youth suicide early intervention and prevention program.

(d)

Requirement for Direct Services

Not less than 85 percent of grant funds received under this section shall be used to provide direct services, of which not less than 5 percent shall be used for activities authorized under subsection (a)(3).

(e)

Consultation and Policy Development

(1)

In general

In carrying out this section, the Secretary shall collaborate with relevant Federal agencies and suicide working groups responsible for early intervention and prevention services relating to youth suicide.

(2)

Consultation

In carrying out this section, the Secretary shall consult with—

(A)

State and local agencies, including agencies responsible for early intervention and prevention services under title XIX of the Social Security Act, the State Children’s Health Insurance Program under title XXI of the Social Security Act, and programs funded by grants under title V of the Social Security Act;

(B)

local and national organizations that serve youth at risk for suicide and their families;

(C)

relevant national medical and other health and education specialty organizations;

(D)

youth who are at risk for suicide, who have survived suicide attempts, or who are currently receiving care from early intervention services;

(E)

families and friends of youth who are at risk for suicide, who have survived suicide attempts, who are currently receiving care from early intervention and prevention services, or who have completed suicide;

(F)

qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve youth at risk for suicide and their families; and

(G)

third-party payers, managed care organizations, and related commercial industries.

(3)

Policy development

In carrying out this section, the Secretary shall—

(A)

coordinate and collaborate on policy development at the Federal level with the relevant Department of Health and Human Services agencies and suicide working groups; and

(B)

consult on policy development at the Federal level with the private sector, including consumer, medical, suicide prevention advocacy groups, and other health and education professional-based organizations, with respect to State-sponsored statewide or tribal youth suicide early intervention and prevention strategies.

(f)

Rule of Construction; Religious and Moral Accommodation

Nothing in this section shall be construed to require suicide assessment, early intervention, or treatment services for youth whose parents or legal guardians object based on the parents’ or legal guardians’ religious beliefs or moral objections.

(g)

Evaluations and Report

(1)

Evaluations by eligible entities

Not later than 18 months after receiving a grant or cooperative agreement under this section, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement.

(2)

Report

Not later than 2 years after the date of enactment of this section, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of—

(A)

the evaluations conducted under paragraph (1); and

(B)

an evaluation conducted by the Secretary to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this section.

(h)

Rule of Construction; Student Medication

Nothing in this section shall be construed to allow school personnel to require that a student obtain any medication as a condition of attending school or receiving services.

(i)

Prohibition

Funds appropriated to carry out this section, section 527, or section 529 shall not be used to pay for or refer for abortion.

(j)

Parental Consent

States and entities receiving funding under this section shall obtain prior written, informed consent from the child’s parent or legal guardian for assessment services, school-sponsored programs, and treatment involving medication related to youth suicide conducted in elementary and secondary schools. The requirement of the preceding sentence does not apply in the following cases:

(1)

In an emergency, where it is necessary to protect the immediate health and safety of the student or other students.

(2)

Other instances, as defined by the State, where parental consent cannot reasonably be obtained.

(k)

Relation to Education Provisions

Nothing in this section shall be construed to supersede section 444 of the General Education Provisions Act, including the requirement of prior parental consent for the disclosure of any education records. Nothing in this section shall be construed to modify or affect parental notification requirements for programs authorized under the Elementary and Secondary Education Act of 1965 (as amended by the No Child Left Behind Act of 2001; Public Law 107–110).

(l)

Definitions

In this section:

(1)

Early intervention

The term early intervention means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition.

(2)

Educational institution; institution of higher education; school

The term—

(A)

educational institution means a school or institution of higher education;

(B)

institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965; and

(C)

school means an elementary or secondary school (as such terms are defined in section 9101 of the Elementary and Secondary Education Act of 1965).

(3)

Prevention

The term prevention means a strategy or approach that reduces the likelihood or risk of onset, or delays the onset, of adverse health problems that have been known to lead to suicide.

(4)

Youth

The term youth means individuals who are between 10 and 24 years of age.

(m)

Authorization of Appropriations

For the purpose of carrying out this section, there are authorized to be appropriated $34,000,000 for fiscal year 2011, $38,000,000 for fiscal year 2012, and $42,000,000 for fiscal year 2013, $46,000,000 for fiscal year 2014, and $50,000,000 for fiscal year 2015.

529.

Mental Health and substance use disorders services on campus

(a)

In General

The Secretary, acting through the Director of the Center for Mental Health Services, in consultation with the Secretary of Education, may award grants on a competitive basis to institutions of higher education to enhance services for students with mental health or substance use disorders that can lead to school failure, such as depression, substance use disorders, and suicide attempts, so that students will successfully complete their studies.

(b)

Use of Funds

The Secretary may not make a grant to an institution of higher education under this section unless the institution agrees to use the grant only for—

(1)

educational seminars;

(2)

the operation of hot lines;

(3)

preparation of informational material;

(4)

preparation of educational materials for families of students to increase awareness of potential mental health and substance use disorders issues of students enrolled at the institution of higher education;

(5)

training programs for students and campus personnel to respond effectively to students with mental health and substance use disorders that can lead to school failure, such as depression, substance use disorders, and suicide attempts, and for staff on voluntary screening for such behavioral health problems;

(6)

the creation of a networking infrastructure to link colleges and universities that do not have mental health services with health care providers who can treat mental health and substance use disorders; or

(7)

the administration of voluntary mental health screenings and assessments, not including the provision of direct services.

(c)

Eligible Grant Recipients

Any institution of higher education receiving a grant under this section may carry out activities under the grant through—

(1)

college counseling centers;

(2)

college and university psychological service centers;

(3)

mental health centers;

(4)

psychology training clinics; or

(5)

institution of higher education supported, evidence-based, mental health and substance use disorder programs.

(d)

Application

An institution of higher education desiring a grant under this section shall prepare and submit an application to the Secretary at such time and in such manner as the Secretary may require. At a minimum, the application shall include the following:

(1)

A description of identified mental health and substance use disorder needs of students at the institution of higher education.

(2)

A description of Federal, State, local, private, and institutional resources currently available to address the needs described in paragraph (1) at the institution of higher education.

(3)

A description of the outreach strategies of the institution of higher education for promoting access to services, including a proposed plan for reaching those students most in need of mental health services.

(4)

A plan to evaluate program outcomes, including a description of the proposed use of funds, the program objectives, and how the objectives will be met.

(5)

An assurance that the institution will submit a report to the Secretary each fiscal year on the activities carried out with the grant and the results achieved through those activities.

(e)

Requirement of Matching Funds

(1)

In general

The Secretary may make a grant under this section to an institution of higher education only if the institution agrees to make available (directly or through donations from public or private entities) non-Federal contributions in an amount that is not less than $1 for each $1 of Federal funds provided in the grant, toward the costs of activities carried out with the grant (as described in subsection (b)) and other activities by the institution to reduce student mental health and substance use disorders.

(2)

Determination of amount contributed

Non-Federal contributions required under paragraph (1) may be in cash or in kind. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(3)

Waiver

The Secretary may waive the requirement established in paragraph (1) with respect to an institution of higher education if the Secretary determines that extraordinary need at the institution justifies the waiver.

(f)

Reports

For each fiscal year that grants are awarded under this section, the Secretary shall conduct a study on the results of the grants and submit to the Congress a report on such results that includes the following:

(1)

An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities.

(2)

Recommendations on how to improve access to mental health and substance use disorder services at institutions of higher education, including efforts to reduce the incidence of suicide and substance use disorders.

(g)

Definition

In this section, the term institution of higher education has the meaning given such term in section 101 of the Higher Education Act of 1965.

(h)

Authorization of Appropriations

For the purpose of carrying out this section, there are authorized to be appropriated $5,400,000 for fiscal year 2011, $5,800,000 for fiscal year 2012, $6,200,000 for fiscal year 2013, $6,600,000 for fiscal year 2014, and $7,000,000 for fiscal year 2015.

530.

Grants for jail diversion programs

(a)

Program Authorized

The Secretary shall make up to 125 grants to States, political subdivisions of States, American Indian and Alaska Native tribes and tribal organizations, acting directly or through agreements with other public or nonprofit entities, or a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, to develop and implement programs to divert individuals with a mental illness from the criminal justice system to community-based services.

(b)

Administration

(1)

Consultation

The Secretary shall consult with the Attorney General and any other appropriate officials in carrying out this section.

(2)

Regulatory authority

The Secretary shall issue regulations and guidelines necessary to carry out this section, including methodologies and outcome measures for evaluating programs carried out by States, political subdivisions of States, Indian tribes, and tribal organizations receiving grants under subsection (a).

(c)

Applications

(1)

In general

To receive a grant under subsection (a), the chief executive of a State, chief executive of a subdivision of a State, Indian tribe or tribal organization shall prepare and submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary shall reasonably require.

(2)

Content

Such application shall—

(A)

contain an assurance that—

(i)

community-based mental health services will be available for the individuals who are diverted from the criminal justice system, and that such services are based on evidence-based practices, reflect current research findings, include case management, assertive community treatment, medication management and access, integrated mental health and co-occurring substance use disorder treatment, and psychiatric rehabilitation, and will be coordinated with social services, including life skills training, housing placement, vocational training, education job placement, and health care;

(ii)

there has been relevant interagency collaboration between the appropriate criminal justice, mental health, and substance use disorder systems; and

(iii)

the Federal support provided will be used to supplement, and not supplant, State, local, Indian tribe, or tribal organization sources of funding that would otherwise be available;

(B)

demonstrate that the diversion program will be integrated with an existing system of care for those with mental illness;

(C)

explain the applicant’s inability to fund the program adequately without Federal assistance;

(D)

specify plans for obtaining necessary support and continuing the proposed program following the conclusion of Federal support; and

(E)

describe methodology and outcome measures that will be used in evaluating the program.

(d)

Use of Funds

A State, political subdivision of a State, Indian tribe, or tribal organization that receives a grant under subsection (a) may use funds received under such grant to—

(1)

integrate the diversion program into the existing system of care;

(2)

create or expand community-based mental health and co-occurring mental illness and substance use disorder services to accommodate the diversion program;

(3)

train professionals involved in the system of care, and law enforcement officers, attorneys, and judges; and

(4)

provide community outreach and crisis intervention.

(e)

Federal Share

(1)

In general

The Secretary shall pay to a State, political subdivision of a State, Indian tribe, or tribal organization receiving a grant under subsection (a) the Federal share of the cost of activities described in the application.

(2)

Federal share

The Federal share of a grant made under this section shall not exceed 75 percent of the total cost of the program carried out by the State, political subdivision of a State, Indian tribe, or tribal organization. Such share shall be used for new expenses of the program carried out by such State, political subdivision of a State, Indian tribe, or tribal organization.

(3)

Non-federal share

The non-Federal share of payments made under this section may be made in cash or in kind fairly evaluated, including planned equipment or services. The Secretary may waive the requirement of matching contributions.

(f)

Geographic Distribution

The Secretary shall ensure that such grants awarded under subsection (a) are equitably distributed among the geographical regions of the United States and between urban and rural populations.

(g)

Training and Technical Assistance

Training and technical assistance may be provided by the Secretary to assist a State, political subdivision of a State, Indian tribe, or tribal organization receiving a grant under subsection (a) in establishing and operating a diversion program.

(h)

Evaluations

The programs described in subsection (a) shall be evaluated not less than one time in every 12-month period using the methodology and outcome measures identified in the grant application.

(i)

Authorization of Appropriations

There are authorized to be appropriated to carry out this section $10,000,000 for fiscal year 2011, and such sums as may be necessary for fiscal years 2012 through 2015.

531.

Grants for the integrated treatment of serious mental illness and co-occurring substance use disorders

(a)

In General

The Secretary shall award grants, contracts, or cooperative agreements to States, political subdivisions of States, Indian tribes, tribal organizations, and private nonprofit organizations for the development or expansion of programs to provide integrated treatment services for individuals with a serious mental illness and a co-occurring substance use disorders.

(b)

Priority

In awarding grants, contracts, and cooperative agreements under subsection (a), the Secretary shall give priority to applicants that emphasize the provision of services for individuals with a serious mental illness and a co-occurring substance use disorders who—

(1)

have a history of interactions with law enforcement or the criminal justice system;

(2)

have recently been released from incarceration;

(3)

have a history of unsuccessful treatment in either an inpatient or outpatient setting;

(4)

have never followed through with outpatient services despite repeated referrals; or

(5)

are homeless.

(c)

Use of Funds

A State, political subdivision of a State, American Indian or Alaska Native tribe, tribal organization, or a health facility operated by or pursuant to a contract or grant with the Indian Health Service, or private nonprofit organization that receives a grant, contract, or cooperative agreement under subsection (a) shall use funds received under such grant—

(1)

to provide fully integrated services rather than serial or parallel services;

(2)

to employ staff that are cross-trained in the diagnosis and treatment of both serious mental illness and substance use disorders;

(3)

to provide integrated mental health and substance use disorder services at the same location;

(4)

to provide services that are linguistically appropriate and culturally competent;

(5)

to provide at least 10 programs for integrated treatment of both mental illness and substance use disorders at sites that previously provided only mental health services or only substance use disorder services; and

(6)

to provide services in coordination with other existing public and private community programs.

(d)

Condition

The Secretary shall ensure that a State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that receives a grant, contract, or cooperative agreement under subsection (a) maintains the level of effort necessary to sustain existing mental health and substance use disorder programs for other populations served by mental health systems in the community.

(e)

Distribution of Awards

The Secretary shall ensure that grants, contracts, or cooperative agreements awarded under subsection (a) are equitably distributed among the geographical regions of the United States and between urban and rural populations.

(f)

Duration

The Secretary shall award grants, contract, or cooperative agreements under this subsection for a period of not more than 5 years.

(g)

Application

A State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that desires a grant, contract, or cooperative agreement under this subsection shall prepare and submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. Such application shall include a plan for the rigorous evaluation of activities funded with an award under such subsection, including a process and outcomes evaluation.

(h)

Evaluation

A State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that receives a grant, contract, or cooperative agreement under this subsection shall prepare and submit a plan for the rigorous evaluation of the program funded under such grant, contract, or agreement, including both process and outcomes evaluation, and the submission of an evaluation at the end of the project period.

(i)

Authorization of Appropriations

There are authorized to be appropriated to carry out this section, $14,000,000 for fiscal year 2011, and such sums as may be necessary for each of fiscal years 2012 through 2015.

532.

Grants relating to the integration and Co-Locating of services

(a)

Grants for Integration of mental health and substance use disorder Services in Primary Care and Mental Health Settings

(1)

In general

The Secretary, acting through the Director of the Center for Mental Health Services, shall award grants to public and private nonprofit entities to integrate mental health and substance use disorder early intervention, prevention, treatment, referral, and recovery services into primary care settings, for projects that address mental health and substance use disorder needs, including programs that—

(A)

integrate mental health services for older adults into primary care settings, in order to provide screening, referrals, and evidence-based intervention and treatment services by individuals with appropriate training and experience in the treatment of older adults, including licensed mental health professionals; and

(B)

provide mental health and substance use disorders early intervention, prevention, treatment, referral, and recovery services, for children and adults, that are in coordination with community mental health service programs and other appropriately trained providers of care.

(2)

Application

To be eligible to receive a grant or cooperative agreement under this subsection an entity shall prepare and submit to the Secretary an application at such time, in such manner, and containing such information the Secretary may require, including—

(A)

an assessment of the mental health and substance use disorders care needs of patients served by the primary care provider and how such needs will be addressed;

(B)

assurances that the primary care setting will have appropriately qualified mental health and substance use disorders professional staff, including licensed mental health professionals, to ensure prompt treatment or triage for referral services or providers;

(C)

assurances that the primary care setting will encourage formal coordination with community mental health service programs and other appropriate providers to ensure continuity of care;

(D)

assurances that the primary care setting has experience in providing services to a variety of populations, including racial and ethnic minorities and low-income populations;

(E)

assurances that the primary care settings uses evidence-based intervention and treatment protocols (to the extent such protocols are available) for mental health and substance use disorders;

(F)

assurances to report to the Secretary standardized clinical and behavioral data and other performance data necessary to evaluate patient outcomes and to facilitate evaluations across participating projects; and

(G)

a plan for sustainability beyond the Federal grant period.

(3)

Use of funds

Amounts awarded under this subsection may be used to—

(A)

provide mental health promotion and substance use disorder prevention services;

(B)

screen individuals for mental illness or substance use;

(C)

diagnose and determine an appropriate intervention;

(D)

provide brief intervention for individuals at risk of mental illness or substance use;

(E)

treat or refer for treatment of a mental illness or substance use disorder;

(F)

provide recovery support services or referring individuals for services;

(G)

provide caregiver support and educational and transportation services to improve access and retention; or

(H)

facilitate networking between primary care professionals and mental health and substance use disorders professionals for—

(i)

case management development; and

(ii)

professional mentoring.

(4)

Duration

A project may receive funding pursuant to a grant under this subsection for a period of up to 3 years, with an extension period of 2 additional years at the discretion of the Secretary.

(5)

Supplement, not supplant

Funds made available under this subsection shall supplement, and not supplant, other Federal, State, or local funds available to an entity to carry out activities described in this subsection.

(6)

Matching requirements

With respect to the costs of the activities to be carried out by an entity under a grant or cooperative agreement under this subsection, beginning with the third year of the grant program, an entity shall provide assurances that the entity will make available (directly or through donations from public or private entities, including in-kind donations) non-Federal contributions towards such costs in an amount that is not less than $1 for each $4 of Federal funds provided under the grant or cooperative agreement.

(7)

Report

Grantees under this subsection shall, beginning with the end of the second year of the grant, submit yearly reports to the Secretary on the activities of the grantee in support of the grant and the latest performance data. Such reports shall contain recommendations as how to replicate the project.

(b)

Grants for Co-Locating Primary and Specialty Care in Community-Based Mental Health Settings

(1)

Definitions

In this subsection:

(A)

Eligible entity

The term eligible entity means a qualified community mental health program defined under section 1913(b)(1).

(B)

Special populations

The term special populations refers to the following 3 groups:

(i)

Children and adolescents with mental and emotional disturbances who have co-occurring primary care conditions and chronic diseases.

(ii)

Adults with mental illnesses who have co-occurring primary care conditions and chronic diseases.

(iii)

Older adults with mental illnesses who have co-occurring primary care conditions and chronic diseases.

(2)

Program authorized

The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration and in coordination with the Director of the Health Resources and Services Administration, shall award grants to eligible entities to establish demonstration projects for the provision of coordinated and integrated services to special populations through the co-location of primary and specialty care services in community-based mental health and substance use disorder settings.

(3)

Application

To be eligible to receive a grant under this subsection, an eligible entity shall submit an application to the Administrator at such time, in such manner, and accompanied by such information as the Administrator may require. Each such application shall include—

(A)

an assessment of the primary care needs of the patients served by the eligible entity and a description of how the eligible entity will address such needs; and

(B)

a description of partnerships, cooperative agreements, or other arrangements with local primary care providers, including community health centers, to provide services to special populations.

(4)

Use of funds

(A)

In general

For the benefit of special populations, an eligible entity shall use funds awarded under this subsection for—

(i)

the provision, by qualified primary care professionals on a reasonable cost basis, of—

(I)

primary care services on site at the eligible entity;

(II)

diagnostic and laboratory services; or

(III)

adult and pediatric eye, ear, and dental screenings;

(ii)

reasonable costs associated with medically necessary referrals to qualified specialty care professionals;

(iii)

information technology required to accommodate the clinical needs of primary and specialty care professionals; or

(iv)

equipment needed to provide primary care services on site at the eligible entity.

(B)

Limitation

Not to exceed 15 percent of grant funds may be used for activities described in clauses (iii) and (iv) of subparagraph (A).

(5)

Geographic distribution

The Secretary shall ensure that grants awarded under this subsection are equitably distributed among the geographical regions of the United States and between urban and rural populations.

(6)

Evaluation

Not later than 3 months after a grant or cooperative agreement awarded under this subsection expires, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement.

(c)

Authorization of Appropriations

There are authorized to be appropriated to carry out this section, $70,000,0000 for fiscal year 2011 and such sums as may be necessary for each of fiscal years 2012 through 2015.

533.

Training grants

(a)

In General

The Secretary shall award grants in accordance with the provisions of this section.

(b)

Mental Illness Awareness Training Grants

(1)

In general

The Secretary shall award grants to States, political subdivisions of States, American Indian and Alaska Native tribes, tribal organizations, a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, and nonprofit private entities to train teachers and other relevant school personnel to recognize symptoms of childhood and adolescent mental disorders, to refer family members to the appropriate mental health services if necessary, to train emergency services personnel to identify and appropriately respond to persons with a mental illness, and to provide education to such teachers and personnel regarding resources that are available in the community for individuals with a mental illness.

(2)

Emergency services personnel

In this subsection, the term emergency services personnel includes paramedics, firefighters, law enforcement, and emergency medical technicians.

(3)

Distribution of awards

The Secretary shall ensure that such grants awarded under this subsection are equitably distributed among the geographical regions of the United States and between urban and rural populations.

(4)

Application

A State, political subdivision of a State, Indian tribe, tribal organization, or nonprofit private entity that desires a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the rigorous evaluation of activities that are carried out with funds received under a grant under this subsection.

(5)

Use of funds

A State, political subdivision of a State, Indian tribe, tribal organization, or nonprofit private entity receiving a grant under this subsection shall use funds from such grant to—

(A)

train teachers and other relevant school personnel to recognize symptoms of childhood and adolescent mental disorders and appropriately respond;

(B)

train emergency services personnel to identify and appropriately respond to persons with a mental illness; and

(C)

provide education to such teachers and personnel regarding resources that are available in the community for individuals with a mental illness.

(6)

Evaluation

A State, political subdivision of a State, Indian tribe, tribal organization, or nonprofit private entity that receives a grant under this subsection shall prepare and submit an evaluation to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including an evaluation of activities carried out with funds received under the grant under this subsection and a process and outcome evaluation.

(7)

Authorization of appropriations

There is authorized to be appropriated to carry out this subsection, $25,000,000 for fiscal year 2011 and such sums as may be necessary for each of fiscal years 2012 through 2015.

534.

Older adult mental Health grants

(a)

In General

The Secretary, acting through the Director of the Center for Mental Health Services, shall award grants, contracts, and cooperative agreements to public and private nonprofit entities for projects that address the mental health needs of older adults, including programs to—

(1)

support the establishment and maintenance of interdisciplinary geriatric mental health specialist outreach teams in community settings where older adults reside or receive social services, in order to provide screening, referrals, and evidence-based intervention and treatment services, including services provided by licensed mental health professionals;

(2)

develop and implement older adult suicide early intervention and prevention strategies in 1 or more settings that serve seniors, and collect and analyze data on older adult suicide early intervention and prevention services for purposes of monitoring, research, and policy development; and

(3)

other programs as designated by the Secretary, that would improve the mental health of older Americans.

(b)

Considerations in Awarding Grants

In awarding grants under this section, the Secretary, to the extent feasible, shall ensure that—

(1)

projects are funded in a variety of geographic areas, including urban and rural areas;

(2)

a variety of populations, including racial and ethnic minorities and low-income populations, are served by projects funded under this section; and

(3)

older adult suicide intervention and prevention programs are targeted towards areas with high older adult suicide rates.

(c)

Application

To be eligible to receive a grant under this section, a public or private nonprofit entity shall—

(1)

submit an application to the Secretary (in such form, containing such information, and at such time as the Secretary may specify);

(2)

agree to report to the Secretary standardized clinical and behavioral data or other performance data necessary to evaluate patient or program outcomes and to facilitate evaluations across participating projects;

(3)

demonstrate how such applicant will collaborate with other State and local public and private nonprofit organizations; and

(4)

submit a plan for the sustainability of the program beyond the Federal grant period.

(d)

Duration

A project may receive funding under a grant under this section for a period of up to 3 years, with an extension period of 2 additional years, at the discretion of the Secretary.

(e)

Supplement, Not Supplant

Funds made available under this section shall be used to supplement, and not supplant, other Federal, State, or local funds available to an entity to carry out activities described in this section.

(f)

Matching Requirement

With respect to the costs of the activities to be carried out by an entity under a grant under this section, beginning with the third year of the grant program, an entity shall provide assurances that the entity will make available (directly or through a donation from public or private entities, including in-kind donations) non-Federal contributions towards such costs in an amount that is not less than $1 for each $4 of Federal funds provided under the grant.

(g)

Report

Grantees under this section shall, beginning with the end of the second year of the grant, submit yearly reports to the Secretary on the activities of the grantee in support of the grant and the latest performance data. Such reports shall contain recommendations as how to replicate the project.

(h)

Definitions

In this section, the term older adult has the meaning given the term older individual in section 101 of the Older Americans Act of 1965.

(i)

Authorization of Appropriations

There is authorized to be appropriated to carry out this section, such sums as may be necessary for each of fiscal years 2011 through 2015.

535.

Grants for tele-mental Health in rural and medically underserved areas

(a)

Program Authorized

The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration and in coordination with the Administrator of the Health Resources and Services Administration and the National Coordinator for Health Information Technology, shall award grants to eligible entities to provide tele-mental health in rural and medically underserved areas. The Secretary shall ensure that such grant are coordinated with, and are not duplicative of, activities funded by the Federal Communications Commission.

(b)

Eligible Entity

To be eligible for assistance under the program under subsection (a), an entity shall be a qualified community program as determined by the Secretary.

(c)

Application

(1)

In general

Each eligible entity desiring a grant under this section shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require.

(2)

Assurances

The application shall include assurances that the applicant will meet the requirements of this subsection and that the applicant possesses sufficient infrastructure to manage the activities to be funded through the grant and to evaluate and report on the outcomes resulting from such activities.

(d)

Use of Funds

An eligible entity shall use funds received under a grant under this section for—

(1)

the provision of tele-mental health services, including the provision of services to children and older adults; or

(2)

technological improvements for the provision of tele-mental health services in accordance with any guidelines, as available, on health information technology that are developed by the Secretary.

(e)

Geographic Distribution

The Secretary shall ensure that grants awarded under this section are equitably distributed among the geographical regions of the United States and between urban and rural populations.

(f)

Evaluation

Not later than 3 months after the end of a project that is funded by a grant awarded under this section, the eligible entity involved shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant.

(g)

Report

Not later than 5 years after the date of enactment of this section, the Secretary shall prepare and submit to the appropriate committees of Congress a report that shall evaluate the activities funded under this section.

(h)

Authorization of Appropriations

There are authorized to be appropriated to carry out this section $20,000,000 for fiscal year 2011, and such sums as may be necessary for each of fiscal years 2012 through 2015.

536.

Improving Health Information Technology for mental Health providers

The Secretary, in consultation with the Secretary of Veterans Affairs, shall collaborate with the Administrator and the National Coordinator for Health Information Technology to develop and implement a plan for ensuring that the National Health Information Infrastructure addresses the needs of mental health and substance abuse treatment providers.

C

PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS

541.

Formula grants to States

For the purpose of carrying out section 542, the Secretary, acting through the Director of the Center for Mental Health Services, shall for each fiscal year make an allotment for each State in an amount determined in accordance with section 544. The Secretary shall make payments, as grants, each such fiscal year to each State from the allotment for the State if the Secretary approves for the fiscal year involved an application submitted by the State pursuant to section 549.

542.

Purpose of grants

(a)

In General

The Secretary may not make payments under section 541 unless the State involved agrees that the payments will be expended solely for making grants to political subdivisions of the State, and to nonprofit private entities (including community-based veterans organizations and other community organizations), for the purpose of providing the services specified in subsection (b) to individuals who—

(1)
(A)

are suffering from serious mental illness; or

(B)

are suffering from serious mental illness and from substance use disorders; and

(2)

are homeless or at imminent risk of becoming homeless.

(b)

Specification of Services

The services referred to in subsection (a) are—

(1)

outreach services;

(2)

screening and diagnostic treatment services;

(3)

habilitation and rehabilitation services;

(4)

community mental health services;

(5)

alcohol or drug treatment services;

(6)

staff training, including the training of individuals who work in shelters, mental health clinics, substance use disorder programs, and other sites where homeless individuals require services;

(7)

case management services, including—

(A)

preparing a plan for the provision of community mental health services to the eligible homeless individual involved, and reviewing such plan not less than once every 3 months;

(B)

providing assistance in obtaining and coordinating social and maintenance services for the eligible homeless individuals, including services relating to daily living activities, personal financial planning, transportation services, and habilitation and rehabilitation services, prevocational and vocational services, and housing services;

(C)

providing assistance to the eligible homeless individual in obtaining income support services, including housing assistance, food stamps, and supplemental security income benefits;

(D)

referring the eligible homeless individual for such other services as may be appropriate; and

(E)

providing representative payee services in accordance with section 1631(a)(2) of the Social Security Act if the eligible homeless individual is receiving aid under title XVI of such act and if the applicant is designated by the Secretary to provide such services;

(8)

supportive and supervisory services in residential settings;

(9)

referrals for primary health services, job training, educational services, and relevant housing services;

(10)

subject to subsection (h)(1)—

(A)

minor renovation, expansion, and repair of housing;

(B)

planning of housing;

(C)

technical assistance in applying for housing assistance;

(D)

improving the coordination of housing services;

(E)

security deposits;

(F)

the costs associated with matching eligible homeless individuals with appropriate housing situations; and

(G)

1-time rental payments to prevent eviction; and

(11)

other appropriate services, as determined by the Secretary.

(c)

Coordination

The Secretary may not make payments under section 541 unless the State involved agrees to make grants pursuant to subsection (a) only to entities that have the capacity to provide, directly or through arrangements, the services specified in section 542(b), including coordinating the provision of services in order to meet the needs of eligible homeless individuals who are both mentally ill and suffering from substance use disorder.

(d)

Special Consideration Regarding Veterans

The Secretary may not make payments under section 541 unless the State involved agrees that, in making grants to entities pursuant to subsection (a), the State will give special consideration to entities with a demonstrated effectiveness in serving homeless veterans.

(e)

Special Rules

The Secretary may not make payments under section 541 unless the State involved agrees that grants pursuant to subsection (a) will not be made to any entity that—

(1)

has a policy of excluding individuals from mental health services due to the existence or suspicion of substance use disorders; or

(2)

has a policy of excluding individuals from substance use disorder services due to the existence or suspicion of mental illness.

(f)

Administrative Expenses

The Secretary may not make payments under section 541 unless the State involved agrees that not more than 4 percent of the payments will be expended for administrative expenses regarding the payments.

(g)

Maintenance of Effort

The Secretary may not make payments under section 541 unless the State involved agrees that the State will maintain State expenditures for services specified in subsection (b) at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying to receive such payments.

(h)

Restrictions on Use of Funds

The Secretary may not make payments under section 541 unless the State involved agrees that—

(1)

not more than 20 percent of the payments will be expended for housing services under subsection (b)(10); and

(2)

the payments will not be expended—

(A)

to support emergency shelters or construction of housing facilities;

(B)

for inpatient psychiatric treatment costs or inpatient substance use disorder treatment costs; or

(C)

to make cash payments to intended recipients of mental health or substance use disorder services.

(i)

Waiver for Territories

With respect to the United States Virgin Islands, Guam, American Samoa, Palau, the Marshall Islands, and the Commonwealth of the Northern Mariana Islands, the Secretary may waive the provisions of this part that the Secretary determines to be appropriate.

543.

Requirement of matching funds

(a)

In General

The Secretary may not make payments under section 541 unless, with respect to the costs of providing services pursuant to section 542, the State involved agrees to make available, directly or through donations from public or private entities, non-Federal contributions toward such costs in an amount that is not less than $1 for each $3 of Federal funds provided in such payments.

(b)

Determination of Amount

Non-Federal contributions required in subsection (a) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, shall not be included in determining the amount of such non-Federal contributions.

(c)

Limitation Regarding Grants by States

The Secretary may not make payments under section 541 unless the State involved agrees that the State will not require the entities to which grants are provided pursuant to section 542(a) to provide non-Federal contributions in excess of the non-Federal contributions described in subsection (a).

544.

Determination of amount of allotment

(a)

Determination Under Formula

Subject to subsection (b), the allotment required in section 541 for a State for a fiscal year is the product of—

(1)

an amount equal to the amount appropriated for allotments under section 555 for the fiscal year; and

(2)

a percentage equal to the quotient of—

(A)

an amount equal to the population living in urbanized areas of the State involved, as indicated by the most recent data collected by the Bureau of the Census; and

(B)

an amount equal to the population living in urbanized areas of the United States, as indicated by the sum of the respective amounts determined for the States under subparagraph (A).

(b)

Minimum Allotment

(1)

In general

Subject to paragraph (2), the allotment for a State under section 541 for a fiscal year shall, at a minimum, be the greater of—

(A)

the amount the State received under section 541 in fiscal year 2007; and

(B)

$600,000 for each of the several States, the District of Columbia, and the Commonwealth of Puerto Rico, and $100,000 for each of Guam, the Virgin Islands, American Samoa, and the Commonwealth of the Northern Mariana Islands.

(2)

Condition

If the funds appropriated in any fiscal year under section 555 are insufficient to ensure that States receive a minimum allotment in accordance with paragraph (1), then—

(A)

no State shall receive less than the amount they received in fiscal year 2007; and

(B)

any funds remaining after amounts are provided under subparagraph (A) shall be used to meet the requirement of paragraph (1)(B), to the maximum extent possible.

(c)

Study Concerning Formula

Not later than 1 year after the date of enactment of the SAMHSA Modernization Act of 2010, the Administrator shall conduct a study concerning the formula used for allotments under subsection (a). Such study shall include an evaluation of quality indicators of need for purposes of revising such formula for determinations of the amount of subsequent allotments. The Administrator shall submit to the appropriate committees of Congress, a report concerning the results of such study.

545.

Conversion to categorical program in event of failure of State regarding expenditure of grants

(a)

In General

Subject to subsection (c), the Secretary shall, from the amounts specified in subsection (b), make grants to public and nonprofit private entities for the purpose of providing to eligible homeless individuals the services specified in section 542(b).

(b)

Specification of Funds

The amounts referred to in subsection (a) are any amounts made available in appropriations Acts for allotments under section 541 that are not paid to a State as a result of—

(1)

the failure of the State to submit an application under section 549;

(2)

the failure of the State, in the determination of the Secretary, to prepare the application in accordance with such section or to submit the application within a reasonable period of time; or

(3)

the State informing the Secretary that the State does not intend to expend the full amount of the allotment made to the State.

(c)

Requirement of Provision of Services in State Involved

With respect to grants under subsection (a), amounts made available under subsection (b) as a result of the State involved shall be available only for grants to provide services in such State.

546.

Provision of certain information from State

The Secretary may not make payments under section 541 to a State unless, as part of the application required in section 549, the State submits to the Secretary a statement—

(1)

identifying existing programs providing services and housing to eligible homeless individuals and identify gaps in the delivery systems of such programs;

(2)

containing a plan for providing services and housing to eligible homeless individuals, which plan—

(A)

describes the coordinated and comprehensive means of providing services and housing to homeless individuals; and

(B)

includes documentation that suitable housing for eligible homeless individuals will accompany the provision of services to such individuals;

(3)

describes the source of the non-Federal contributions described in section 543;

(4)

contains assurances that the non-Federal contributions described in section 543 will be available at the beginning of the grant period;

(5)

describe any voucher system that may be used to carry out this part; and

(6)

contain such other information or assurances as the Secretary may reasonably require.

547.

Description of intended expenditures of grant

(a)

In General

The Secretary may not make payments under section 541 unless—

(1)

as part of the application required in section 549, the State involved submits to the Secretary a description of the intended use for the fiscal year of the amounts for which the State is applying pursuant to such section;

(2)

such description identifies the geographic areas within the State in which the greatest numbers of homeless individuals with a need for mental health, substance use disorder, and housing services are located;

(3)

such description provides information relating to the programs and activities to be supported and services to be provided, including information relating to coordinating such programs and activities with any similar programs and activities of public and private entities; and

(4)

the State agrees that such description will be revised throughout the year as may be necessary to reflect substantial changes in the programs and activities assisted by the State pursuant to section 542.

(b)

Opportunity for Public Comment

The Secretary may not make payments under section 541 unless the State involved agrees that, in developing and carrying out the description required in subsection (a), the State will provide public notice with respect to the description (including any revisions) and such opportunities as may be necessary to provide interested persons, such as family members, consumers, and mental health, substance use disorder, and housing agencies, an opportunity to present comments and recommendations with respect to the description.

(c)

Relationship to State Comprehensive Mental Health Services Plan

(1)

In general

The Secretary may not make payments under section 541 unless the services to be provided pursuant to the description required in subsection (a) are consistent with the State comprehensive mental health services plan required in subpart I of part B of title XIX.

(2)

Special rule

The Secretary may not make payments under section 541 unless the services to be provided pursuant to the description required in subsection (a) have been considered in the preparation of, have been included in, and are consistent with, the State comprehensive mental health services plan referred to in paragraph (1).

548.

Requirement of reports by States

(a)

In General

The Secretary may not make payments under section 541 unless the State involved agrees that, by not later than January 31 of each fiscal year, the State will prepare and submit to the Secretary a report in such form and containing such information as the Secretary determines (after consultation with the Administrator of the Substance Abuse and Mental Health Services Administration) to be necessary for—

(1)

securing a record and a description of the purposes for which amounts received under section 541 were expended during the preceding fiscal year and of the recipients of such amounts; and

(2)

determining whether such amounts were expended in accordance with the provisions of this part.

(b)

Availability to Public of Reports

The Secretary may not make payments under section 541 unless the State involved agrees to make copies of the reports described in subsection (a) available for public inspection.

(c)

Evaluations by Comptroller General

The Administrator of the Substance Abuse and Mental Health Services Administration shall evaluate at least once every 3 years the expenditures of grants under this part by eligible entities in order to ensure that expenditures are consistent with the provisions of this part, and shall include in such evaluation recommendations regarding changes needed in program design or operations.

549.

Requirement of application

The Secretary may not make payments under section 541 unless the State involved—

(1)

submits to the Secretary an application for the payments containing agreements and information in accordance with this part;

(2)

the agreements are made through certification from the chief executive officer of the State; and

(3)

the application otherwise is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this part.

550.

Technical assistance

The Secretary, through the Administrator, shall provide technical assistance to eligible entities in developing planning and operating programs in accordance with the provisions of this part.

551.

Failure to comply with agreements

(a)

Repayment of Payments

(1)

The Secretary may, subject to subsection (c), require a State to repay any payments received by the State under section 541 that the Secretary determines were not expended by the State in accordance with the agreements required to be contained in the application submitted by the State pursuant to section 549.

(2)

If a State fails to make a repayment required in paragraph (1), the Secretary may offset the amount of the repayment against the amount of any payment due to be paid to the State under section 541.

(b)

Withholding of Payments

(1)

The Secretary may, subject to subsection (c), withhold payments due under section 541 if the Secretary determines that the State involved is not expending amounts received under such section in accordance with the agreements required to be contained in the application submitted by the State pursuant to section 549.

(2)

The Secretary shall cease withholding payments from a State under paragraph (1) if the Secretary determines that there are reasonable assurances that the State will expend amounts received under section 541 in accordance with the agreements referred to in such paragraph.

(3)

The Secretary may not withhold funds under paragraph (1) from a State for a minor failure to comply with the agreements referred to in such paragraph.

(c)

Opportunity for Hearing

Before requiring repayment of payments under subsection (a)(1), or withholding payments under subsection (b)(1), the Secretary shall provide to the State an opportunity for a hearing.

(d)

Rule of Construction

Notwithstanding any other provision of this part, a State receiving payments under section 541 may not, with respect to any agreements required to be contained in the application submitted under section 549, be considered to be in violation of any such agreements by reason of the fact that the State, in the regular course of providing services under section 542(b) to eligible homeless individuals, incidentally provides services to homeless individuals who are not eligible homeless individuals.

552.

Prohibition against certain false statements

(a)

In General

(1)

A person may not knowingly make or cause to be made any false statement or representation of a material fact in connection with the furnishing of items or services for which amounts may be paid by a State from payments received by the State under section 541.

(2)

A person with knowledge of the occurrence of any event affecting the right of the person to receive any amounts from payments made to the State under section 541 may not conceal or fail to disclose any such event with the intent of securing such an amount that the person is not authorized to receive or securing such an amount in an amount greater than the amount the person is authorized to receive.

(b)

Criminal Penalty for Violation of Prohibition

Any person who violates a prohibition established in subsection (a) may for each violation be fined in accordance with title 18, United States Code, or imprisoned for not more than 5 years, or both.

553.

Nondiscrimination

(a)

In General

(1)

Rule of construction regarding certain civil rights laws

For the purpose of applying the prohibitions against discrimination on the basis of age under the Age Discrimination Act of 1975, on the basis of handicap under section 504 of the Rehabilitation Act of 1973, on the basis of sex under title IX of the Education Amendments of 1972, or on the basis of race, color, or national origin under title VI of the Civil Rights Act of 1964, programs and activities funded in whole or in part with funds made available under section 541 shall be considered to be programs and activities receiving Federal financial assistance.

(2)

Prohibition

No person shall on the ground of sex or religion be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity funded in whole or in part with funds made available under section 541.

(b)

Enforcement

(1)

Referrals to attorney general after notice

Whenever the Secretary finds that a State, or an entity that has received a payment pursuant to section 541, has failed to comply with a provision of law referred to in subsection (a)(1), with subsection (a)(2), or with an applicable regulation (including one prescribed to carry out subsection (a)(2)), the Secretary shall notify the chief executive officer of the State and shall request the chief executive officer to secure compliance. If within a reasonable period of time, not to exceed 60 days, the chief executive officer fails or refuses to secure compliance, the Secretary may—

(A)

refer the matter to the Attorney General with a recommendation that an appropriate civil action be instituted;

(B)

exercise the powers and functions provided by the Age Discrimination Act of 1975, section 504 of the Rehabilitation Act of 1973, title IX of the Education Amendments of 1972, or title VI of the Civil Rights Act of 1964, as may be applicable; or

(C)

take such other actions as may be authorized by law.

(2)

Authority of attorney general

When a matter is referred to the Attorney General pursuant to paragraph (1)(A), or whenever the Attorney General has reason to believe that a State or an entity is engaged in a pattern or practice in violation of a provision of law referred to in subsection (a)(1) or in violation of subsection (a)(2), the Attorney General may bring a civil action in any appropriate district court of the United States for such relief as may be appropriate, including injunctive relief.

554.

Definitions

For purposes of this part:

(1)

Eligible homeless individual

The term eligible homeless individual means an individual described in section 542(a).

(2)

Homeless individual

The term homeless individual has the meaning given such term in section 330(h)(5)(A).

(3)

State

The term State means each of the several States, the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.

(4)

Substance use disorder services

The term substance use disorder services has the meaning given the term substance abuse services in section 330(h)(5)(C).

555.

Funding

(a)

Authorization of Appropriations

For the purpose of carrying out this part, there is authorized to be appropriated $75,000,000 for each of the fiscal years 2011 through 2015.

(b)

Allocation for Technical Assistance

For purposes of carrying out section 550, the Administrator shall obligate 2 percent of the amounts appropriated under subsection (a) for a fiscal year.

D

MISCELLANEOUS PROVISIONS RELATING TO SUBSTANCE USE DISORDERS AND MENTAL ILLNESS

561.

Substance use disorders among government and other employees

(a)

Programs and Services

(1)

Development

The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall be responsible for fostering substance use disorder prevention and treatment programs and services in State and local governments and in private industry.

(2)

Model programs

(A)

In general

Consistent with the responsibilities described in paragraph (1), the Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall develop a variety of model programs suitable for replication on a cost-effective basis in different types of business concerns and State and local governmental entities.

(B)

Dissemination of information

The Secretary, acting through the Administrator of the Substance Abuse and Mental Health Services Administration, shall disseminate information and materials relative to such model programs to the State agencies responsible for the administration of substance use disorder prevention, treatment, and rehabilitation activities and shall, to the extent feasible provide technical assistance to such agencies as requested.

(b)

Deprivation of Employment

(1)

Prohibition

No person may be denied or deprived of Federal civilian employment or a Federal professional or other license or right solely on the grounds of prior substance use disorders.

(2)

Application

This subsection shall not apply to employment in—

(A)

the Central Intelligence Agency;

(B)

the Federal Bureau of Investigation;

(C)

the National Security Agency;

(D)

any other department or agency of the Federal Government designated for purposes of national security by the President; or

(E)

in any position in any department or agency of the Federal Government, not referred to in subparagraphs (A) through (D), which position is determined pursuant to regulations prescribed by the head of such agency or department to be a sensitive position.

(3)

Rehabilitation act

The inapplicability of the prohibition described in paragraph (1) to the employment described in paragraph (2) shall not be construed to reflect on the applicability of the Rehabilitation Act of 1973 or other anti-discrimination laws to such employment.

(c)

Construction

This section shall not be construed to prohibit the dismissal from employment of a Federal civilian employee who cannot properly function in his employment.

562.

Admission of substance abusers to private and public hospitals and outpatient facilities

(a)

Nondiscrimination

Substance abusers who are suffering from medical conditions shall not be discriminated against in admission or treatment, solely because of their substance use disorder, by any private or public general hospital, or outpatient facility (as defined in section 1624(4)) which receives support in any form from any program supported in whole or in part by funds appropriated to any Federal department or agency.

(b)

Regulations

(1)

In general

The Secretary shall issue regulations for the enforcement of the policy of subsection (a) with respect to the admission and treatment of substance abusers in hospitals and outpatient facilities which receive support of any kind from any program administered by the Secretary. Such regulations shall include procedures for determining (after opportunity for a hearing if requested) if a violation of subsection (a) has occurred, notification of failure to comply with such subsection, and opportunity for a violator to comply with such subsection. If the Secretary determines that a hospital or outpatient facility subject to such regulations has violated subsection (a) and such violation continues after an opportunity has been afforded for compliance, the Secretary may suspend or revoke, after opportunity for a hearing, all or part of any support of any kind received by such hospital from any program administered by the Secretary. The Secretary may consult with the officials responsible for the administration of any other Federal program from which such hospital or outpatient facility receives support of any kind, with respect to the suspension or revocation of such other Federal support for such hospital or outpatient facility.

(2)

Department of veterans affairs

The Secretary of Veterans Affairs, acting through the Under Secretary for Health, shall, to the maximum feasible extent consistent with their responsibilities under title 38, United States Code, prescribe regulations making applicable the regulations prescribed by the Secretary under paragraph (1) to the provision of hospital care, nursing home care, domiciliary care, and medical services under such title 38 to veterans suffering from substance use disorders. In prescribing and implementing regulations pursuant to this paragraph, the Secretary shall, from time to time, consult with the Secretary of Health and Human Services in order to achieve the maximum possible coordination of the regulations, and the implementation thereof, which they each prescribe.

563.

Confidentiality of records

(a)

Requirement

Records of the identity, diagnosis, prognosis, or treatment of any patient which are maintained in connection with the performance of any program or activity relating to substance use disorder education, prevention, training, treatment, rehabilitation, or research, which is conducted, regulated, or directly or indirectly assisted by any department or agency of the United States shall, except as provided in subsection (e), be confidential and be disclosed only for the purposes and under the circumstances expressly authorized under subsection (b).

(b)

Permitted Disclosure

(1)

Consent

The content of any record referred to in subsection (a) may be disclosed in accordance with the prior written consent of the patient with respect to whom such record is maintained, but only to such extent, under such circumstances, and for such purposes as may be allowed under regulations prescribed pursuant to subsection (g).

(2)

Method for disclosure

Whether or not the patient, with respect to whom any given record referred to in subsection (a) is maintained, gives written consent, the content of such record may be disclosed as follows:

(A)

To medical personnel to the extent necessary to meet a bona fide medical emergency.

(B)

To qualified personnel for the purpose of conducting scientific research, management audits, financial audits, or program evaluation, but such personnel may not identify, directly or indirectly, any individual patient in any report of such research, audit, or evaluation, or otherwise disclose patient identities in any manner.

(C)

If authorized by an appropriate order of a court of competent jurisdiction granted after application showing good cause therefore, including the need to avert a substantial risk of death or serious bodily harm. In assessing good cause the court shall weigh the public interest and the need for disclosure against the injury to the patient, to the physician-patient relationship, and to the treatment services. Upon the granting of such order, the court, in determining the extent to which any disclosure of all or any part of any record is necessary, shall impose appropriate safeguards against unauthorized disclosure.

(c)

Use of Records in Criminal Proceedings

Except as authorized by a court order granted under subsection (b)(2)(C), no record referred to in subsection (a) may be used to initiate or substantiate any criminal charges against a patient or to conduct any investigation of a patient.

(d)

Application

The prohibitions of this section continue to apply to records concerning any individual who has been a patient, irrespective of whether or when such individual ceases to be a patient.

(e)

Nonapplicability

The prohibitions of this section do not apply to any interchange of records—

(1)

within the Uniformed Services or within those components of the Department of Veterans Affairs furnishing health care to veterans; or

(2)

between such components and the Uniformed Services.

The prohibitions of this section do not apply to the reporting under State law of incidents of suspected child abuse and neglect to the appropriate State or local authorities.
(f)

Penalties

Any person who violates any provision of this section or any regulation issued pursuant to this section shall be fined in accordance with title 18, United States Code.

(g)

Regulations

Except as provided in subsection (h), the Secretary shall prescribe regulations to carry out the purposes of this section. Such regulations may contain such definitions, and may provide for such safeguards and procedures, including procedures and criteria for the issuance and scope of orders under subsection (b)(2)(C), as in the judgment of the Secretary are necessary or proper to effectuate the purposes of this section, to prevent circumvention or evasion thereof, or to facilitate compliance therewith.

(h)

Application to Department of Veterans Affairs

The Secretary of Veterans Affairs, acting through the Chief Medical Director, shall, to the maximum feasible extent consistent with their responsibilities under title 38, United States Code, prescribe regulations making applicable the regulations prescribed by the Secretary of Health and Human Services under subsection (g) of this section to records maintained in connection with the provision of hospital care, nursing home care, domiciliary care, and medical services under such title 38 to veterans suffering from substance use disorders. In prescribing and implementing regulations pursuant to this subsection, the Secretary of Veterans Affairs shall, from time to time, consult with the Secretary of Health and Human Services in order to achieve the maximum possible coordination of the regulations, and the implementation thereof, which they each prescribe.

E

CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES

571.

Comprehensive community Mental Health Services for children with serious emotional disturbances

(a)

Grants to Certain Public Entities

(1)

In general

The Secretary, acting through the Director of the Center for Mental Health Services, shall make grants to public entities for the purpose of providing comprehensive community mental health services to children with a serious emotional disturbance, which may include efforts to identify and serve children at risk.

(2)

Definition of public entity

For purposes of this part, the term public entity means any State, any political subdivision of a State, and any Indian tribe or tribal organization (as defined in section 4(b) and section 4(c) of the Indian Self-Determination and Education Assistance Act).

(b)

Considerations in Making Grants

(1)

Requirement of status as grantee under part B of title XIX

The Secretary may make a grant under subsection (a) to a public entity only if—

(A)

in the case of a public entity that is a State, the State is such a grantee under section 1911;

(B)

in the case of a public entity that is a political subdivision of a State, the State in which the political subdivision is located is such a grantee; and

(C)

in the case of a public entity that is an Indian tribe or tribal organization, the State in which the tribe or tribal organization is located is such a grantee.

(2)

Requirement of status as medicaid provider

(A)

Subject to subparagraph (B), the Secretary may make a grant under subsection (a) only if, in the case of any service under such subsection that is covered in the State plan approved under title XIX of the Social Security Act for the State involved—

(i)

the public entity involved will provide the service directly, and the entity has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or

(ii)

the public entity will enter into an agreement with an organization under which the organization will provide the service, and the organization has entered into such a participation agreement and is qualified to receive such payments.

(B)
(i)

In the case of an organization making an agreement under subparagraph (A)(ii) regarding the provision of services under subsection (a), the requirement established in such subparagraph regarding a participation agreement shall be waived by the Secretary if the organization does not, in providing health or mental health services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits program.

(ii)

A determination by the Secretary of whether an organization referred to in clause (i) meets the criteria for a waiver under such clause shall be made without regard to whether the organization accepts voluntary donations regarding the provision of services to the public.

(3)

Certain considerations

In making grants under subsection (a), the Secretary shall—

(A)

equitably allocate such assistance among the principal geographic regions of the United States;

(B)

consider the extent to which the public entity involved has a need for the grant; and

(C)

in the case of any public entity that is a political subdivision of a State or that is an Indian tribe or tribal organization—

(i)

shall consider any comments regarding the application of the entity for such a grant that are received by the Secretary from the State in which the entity is located; and

(ii)

shall give special consideration to the entity if the State agrees to provide a portion of the non-Federal contributions required in subsection (c) regarding such a grant.

(c)

Matching Funds

(1)

In general

A funding agreement for a grant under subsection (a) is that the public entity involved will, with respect to the costs to be incurred by the entity in carrying out the purpose described in such subsection, make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that—

(A)

for the first fiscal year for which the entity receives payments from a grant under such subsection, is not less than $1 for each $3 of Federal funds provided in the grant;

(B)

for any second or third such fiscal year, is not less than $1 for each $3 of Federal funds provided in the grant;

(C)

for any fourth such fiscal year, is not less than $1 for each $1 of Federal funds provided in the grant; and

(D)

for any fifth and sixth such fiscal year, is not less than $2 for each $1 of Federal funds provided in the grant.

(2)

Determination of amount contributed

(A)

Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(B)

In making a determination of the amount of non-Federal contributions for purposes of subparagraph (A), the Secretary may include only non-Federal contributions in excess of the average amount of non-Federal contributions made by the public entity involved toward the purpose described in subsection (a) for the 2-year period preceding the first fiscal year for which the entity receives a grant under such section.

(3)

Waiver regarding native american and alaskan native tribes and tribal organizations

In the case of a grantee that is a Native Americans or Alaskan Native tribe or tribal organization, the Secretary may waive, in whole or in part, the requirements of this subsection.

572.

Requirements with respect to carrying out purpose of grants

(a)

Systems of Comprehensive Care

(1)

In general

A funding agreement for a grant under section 571(a) is that, with respect to children with a serious emotional disturbance, the public entity involved will carry out the purpose described in such section only through establishing and operating 1 or more systems of care for making each of the mental health services specified in subsection (c) available to each child provided access to the system. In providing for such a system, the public entity may make grants to, and enter into contracts with, public and nonprofit private entities.

(2)

Structure of system

A funding agreement for a grant under section 571(a) is that a system of care under paragraph (1) will—

(A)

be established in a community selected by the public entity involved;

(B)

consist of such public agencies and nonprofit private entities in the community as are necessary to ensure that each of the services specified in subsection (c) is available to each child provided access to the system;

(C)

be established pursuant to agreements that the public entity enters into with the agencies and entities described in subparagraph (B);

(D)

coordinate the provision of the services of the system; and

(E)

establish an office whose functions are to serve as the location through which children are provided access to the system, to coordinate the provision of services of the system, and to provide information to the public regarding the system.

(3)

Collaboration of local public entities

A funding agreement for a grant under section 571(a) is that, for purposes of the establishment and operation of a system of care under paragraph (1), the public entity involved will seek collaboration among all public agencies that provide human services in the community in which the system is established, including but not limited to those providing mental health services, educational services, child welfare services, or juvenile justice services.

(b)

Limitation on Age of Children Provided Access to System

A funding agreement for a grant under section 571(a) is that a system of care under subsection (a) will provide an individual with access to the system through the age of 21 years.

(c)

Required Mental Health Services of System

A funding agreement for a grant under section 571(a) is that mental health services provided by a system of care under subsection (a) will include, with respect to a serious emotional disturbance in a child—

(1)

diagnostic and evaluation services;

(2)

outpatient services provided in a clinic, office, school or other appropriate location, including individual, group and family counseling services, professional consultation, and review and management of medications;

(3)

emergency services, available 24-hours a day, 7 days a week;

(4)

intensive home-based services for children and their families when the child is at imminent risk of out-of-home placement;

(5)

intensive day-treatment services;

(6)

respite care;

(7)

therapeutic foster care services, and services in therapeutic foster family homes or individual therapeutic residential homes, and groups homes caring for not more than 10 children; and

(8)

assisting the child in making the transition from the services received as a child to the services to be received as an adult.

(d)

Required Arrangements Regarding Other Appropriate Services

(1)

In general

A funding agreement for a grant under section 571(a) is that—

(A)

a system of care under subsection (a) will enter into a memorandum of understanding with each of the providers specified in paragraph (2) in order to facilitate the availability of the services of the provider involved to each child provided access to the system; and

(B)

the grant under such section 571(a), and the non-Federal contributions made with respect to the grant, will not be expended to pay the costs of providing such non-mental health services to any individual.

(2)

Specification of non-mental health services

The providers referred to in paragraph (1) are providers of medical services other than mental health services, providers of educational services, providers of vocational counseling and vocational rehabilitation services, and providers of protection and advocacy services with respect to mental health.

(3)

Facilitation of services of certain programs

A funding agreement for a grant under section 571(a) is that a system of care under subsection (a) will, for purposes of paragraph (1), enter into a memorandum of understanding regarding facilitation of—

(A)

services available pursuant to title XIX of the Social Security Act, including services regarding early periodic screening, diagnosis, and treatment;

(B)

services available under parts B and C of the Individuals with Disabilities Education Act; and

(C)

services available under other appropriate programs, as identified by the Secretary.

(e)

General Provisions Regarding Services of System

(1)

Case management services

A funding agreement for a grant under section 571(a) is that a system of care under subsection (a) will provide for the case management of each child provided access to the system in order to ensure that—

(A)

the services provided through the system to the child are coordinated and that the need of each such child for the services is periodically reassessed;

(B)

information is provided to the family of the child on the extent of progress being made toward the objectives established for the child under the plan of services implemented for the child pursuant to section 573; and

(C)

the system provides assistance with respect to—

(i)

establishing the eligibility of the child, and the family of the child, for financial assistance and services under Federal, State, or local programs providing for health services, mental health services, educational services, social services, or other services; and

(ii)

seeking to ensure that the child receives appropriate services available under such programs.

(2)

Other provisions

A funding agreement for a grant under section 571(a) is that a system of care under subsection (a), in providing the services of the system, will—

(A)

provide the services of the system in the cultural context that is most appropriate for the child and family involved;

(B)

ensure that individuals providing such services to the child can effectively communicate with the child and family in the most direct manner;

(C)

provide the services without discriminating against the child or the family of the child on the basis of race, religion, national origin, sex, disability, or age;

(D)

seek to ensure that each child provided access to the system of care remains in the least restrictive, most normative environment that is clinically appropriate; and

(E)

provide outreach services to inform individuals, as appropriate, of the services available from the system, including identifying children with a serious emotional disturbance who are in the early stages of such disturbance.

(3)

Rule of construction

An agreement made under paragraph (2) may not be construed—

(A)

with respect to subparagraph (C) of such paragraph—

(i)

to prohibit a system of care under subsection (a) from requiring that, in housing provided by the grantee for purposes of residential treatment services authorized under subsection (c), males and females be segregated to the extent appropriate in the treatment of the children involved; or

(ii)

to prohibit the system of care from complying with the agreement made under subsection (b); or

(B)

with respect to subparagraph (D) of such paragraph, to authorize the system of care to expend the grant under section 571(a) (or the non-Federal contributions made with respect to the grant) to provide legal services or any service with respect to which expenditures regarding the grant are prohibited under subsection (d)(1)(B).

(f)

Restrictions on Use of Grant

A funding agreement for a grant under section 571(a) is that the grant, and the non-Federal contributions made with respect to the grant, will not be expended—

(1)

to purchase or improve real property (including the construction or renovation of facilities);

(2)

to provide for room and board in residential programs serving 10 or fewer children;

(3)

to provide for room and board or other services or expenditures associated with care of children in residential treatment centers serving more than 10 children or in inpatient hospital settings, except intensive home-based services and other services provided on an ambulatory or outpatient basis; or

(4)

to provide for the training of any individual, except training authorized in section 574(a)(2) and training provided through any appropriate course in continuing education whose duration does not exceed 2 days.

(g)

Waivers

The Secretary may waive one or more of the requirements of subsection (c) for a public entity that is an Indian Tribe or tribal organization, or American Samoa, Guam, the Marshall Islands, the Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, the Republic of Palau, or the United States Virgin Islands if the Secretary determines, after peer review, that the system of care is family-centered and uses the least restrictive environment that is clinically appropriate.

573.

Individualized plan for services

(a)

In General

A funding agreement for a grant under section 571(a) is that a system of care under section 572(a) will develop and carry out an individualized plan of services for each child provided access to the system, and that the plan will be developed and carried out with the participation of the family of the child and, unless clinically inappropriate, with the participation of the child.

(b)

Multidisciplinary Team

A funding agreement for a grant under section 571(a) is that the plan required in subsection (a) will be developed, and reviewed and as appropriate revised not less than once each year, by a multidisciplinary team of appropriately qualified individuals who provide services through the system, including as appropriate mental health services, other health services, educational services, social services, and vocational counseling and rehabilitation;

(c)

Coordination With Services Under Individuals With Disabilities Education Act

A funding agreement for a grant under section 571(a) is that, with respect to a plan under subsection (a) for a child, the multidisciplinary team required in subsection (b) will—

(1)

in developing, carrying out, reviewing, and revising the plan consider any individualized education program in effect for the child pursuant to part B of the Individuals with Disabilities Education Act;

(2)

ensure that the plan is consistent with such individualized education program and provides for coordinating services under the plan with services under such program; and

(3)

ensure that the memorandum of understanding entered into under section 572(d)(3)(B) regarding such Act includes provisions regarding compliance with this subsection.

(d)

Contents of Plan

A funding agreement for a grant under section 571(a) is that the plan required in subsection (a) for a child will—

(1)

identify and state the needs of the child for the services available pursuant to section 572 through the system;

(2)

provide for each of such services that is appropriate to the circumstances of the child, including, except in the case of children who are less than 14 years of age, the provision of appropriate vocational counseling and rehabilitation, and transition services (as defined in section 602 of the Individuals with Disabilities Education Act);

(3)

establish objectives to be achieved regarding the needs of the child and the methodology for achieving the objectives; and

(4)

designate an individual to be responsible for providing the case management required in section 572(e)(1) or certify that case management services will be provided to the child as part of the individualized education program of the child under the Individuals with Disabilities Education Act.

574.

Additional provisions

(a)

Optional Services

In addition to services described in subsection (c) of section 572, a system of care under subsection (a) of such section may, in expending a grant under section 571(a), provide for—

(1)

preliminary assessments to determine whether a child should be provided access to the system;

(2)

training in—

(A)

the administration of the system;

(B)

the provision of intensive home-based services under paragraph (4) of section 572(c), intensive day treatment under paragraph (5) of such section, and foster care or group homes under paragraph (7) of such section; and

(C)

the development of individualized plans for purposes of section 573;

(3)

recreational activities for children provided access to the system; and

(4)

such other services as may be appropriate in providing for the comprehensive needs with respect to mental health of children with a serious emotional disturbance.

(b)

Comprehensive Plan

The Secretary may make a grant under section 571(a) only if, with respect to the jurisdiction of the public entity involved, the entity has submitted to the Secretary, and has had approved by the Secretary, a plan for the development of a jurisdiction-wide system of care for community-based services for children with a serious emotional disturbance that specifies the progress the public entity has made in developing the jurisdiction-wide system, the extent of cooperation across agencies serving children in the establishment of the system, the Federal and non-Federal resources currently committed to the establishment of the system, and the current gaps in community services and the manner in which the grant under section 571(a) will be expended to address such gaps and establish local systems of care.

(c)

Limitation on Imposition of Fees for Services

A funding agreement for a grant under section 571(a) is that, if a charge is imposed for the provision of services under the grant, such charge—

(1)

will be made according to a schedule of charges that is made available to the public;

(2)

will be adjusted to reflect the income of the family of the child involved; and

(3)

will not be imposed on any child whose family has income and resources of equal to or less than 100 percent of the official poverty line, as established by the Director of the Office of Management and Budget and revised by the Secretary in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981.

(d)

Relationship to Items and Services Under Other Programs

A funding agreement for a grant under section 571(a) is that the grant, and the non-Federal contributions made with respect to the grant, will not be expended to make payment for any item or service to the extent that payment has been made, or can reasonably be expected to be made, with respect to such item or service—

(1)

under any State compensation program, under an insurance policy, or under any Federal or State health benefits program; or

(2)

by an entity that provides health services on a prepaid basis.

(e)

Limitation on Administrative Expenses

A funding agreement for a grant under section 571(a) is that not more than 2 percent of the grant will be expended for administrative expenses incurred with respect to the grant by the public entity involved.

(f)

Reports to Secretary

A funding agreement for a grant under section 571(a) is that the public entity involved will annually submit to the Secretary (and provide a copy to the State involved) a report on the activities of the entity under the grant that includes a description of the number of children provided access to systems of care operated pursuant to the grant, the demographic characteristics of the children, the types and costs of services provided pursuant to the grant, the availability and use of third-party reimbursements, estimates of the unmet need for such services in the jurisdiction of the entity, and the manner in which the grant has been expended toward the establishment of a jurisdiction-wide system of care for children with a serious emotional disturbance, and such other information as the Secretary may require with respect to the grant.

(g)

Description of Intended Uses of Grant

The Secretary may make a grant under section 571(a) only if—

(1)

the public entity involved submits to the Secretary a description of the purposes for which the entity intends to expend the grant;

(2)

the description identifies the populations, areas, and localities in the jurisdiction of the entity with a need for services under this section; and

(3)

the description provides information relating to the services and activities to be provided, including a description of the manner in which the services and activities will be coordinated with any similar services or activities of public or nonprofit entities.

(h)

Requirement of Application

The Secretary may make a grant under section 571(a) only if an application for the grant is submitted to the Secretary, the application contains the description of intended uses required in subsection (g), and the application is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section.

575.

General provisions

(a)

Duration of Support

The period during which payments are made to a public entity from a grant under section 571(a) may not exceed 6 fiscal years.

(b)

Technical Assistance

(1)

In general

The Secretary shall, upon the request of a public entity—

(A)

provide technical assistance to the entity regarding the process of submitting to the Secretary applications for grants under section 571(a) and 576; and

(B)

provide to the entity training and technical assistance with respect to the planning, development, and operation of systems of care pursuant to section 572.

(2)

Authority for grants and contracts

The Secretary may provide technical assistance under subsection (a) directly or through grants to, or contracts with, public and nonprofit private entities.

(c)

Evaluations and Reports by Secretary

(1)

In general

The Secretary shall, directly or through contracts with public or private entities, provide for annual evaluations of programs carried out pursuant to section 571(a). The evaluations shall assess the effectiveness of the systems of care operated pursuant to such section, including longitudinal studies of outcomes of services provided by such systems, other studies regarding such outcomes, the effect of activities under this part on the utilization of hospital and other institutional settings, the barriers to and achievements resulting from interagency collaboration in providing community-based services to children with a serious emotional disturbance, and assessments by parents of the effectiveness of the systems of care.

(2)

Report to congress

The Secretary shall, not later than 1 year after the date on which amounts are first appropriated under subsection (c), and annually thereafter, submit to the Congress a report summarizing evaluations carried out pursuant to paragraph (1) during the preceding fiscal year and making such recommendations for administrative and legislative initiatives with respect to this section as the Secretary determines to be appropriate.

(d)

Definitions

For purposes of this part:

(1)

The term child means an individual through the age of 21 years.

(2)

The term family, with respect to a child provided access to a system of care under section 572(a), means—

(A)

the legal guardian of the child; and

(B)

as appropriate regarding mental health services for the child, the parents of the child (biological or adoptive, as the case may be) and any foster parents of the child.

(3)

The term funding agreement, with respect to a grant under section 571(a) to a public entity, means that the Secretary may make such a grant only if the public entity makes the agreement involved.

(4)

The term serious emotional disturbance includes, with respect to a child, any child who has a serious emotional disorder, a serious behavioral disorder, or a serious mental disorder.

(e)

Rule of Construction

Nothing in this part shall be construed as limiting the rights of a child with a serious emotional disturbance under the Individuals with Disabilities Education Act.

576.

State integrated systems of care grants for keeping families together

(a)

In General

The Secretary, acting through the Director of the Center for Mental Health Services, shall award grants or cooperative agreements to States for the purpose of facilitating and promoting the implementation in local communities of an integrated system of care for children with mental illness, especially for those with serious emotional disturbance.

(b)

Applications

To be eligible for a grant under subsection (a), a State shall submit to the Secretary an applications that shall include, at a minimum, the following:

(1)

An assurance that the State will establish a board to be made up of, at least, the directors of the State departments or agencies responsible for mental health, substance use disorder, child welfare, education, medicaid, juvenile justice, and consumers and families of consumers to carry out the purpose of the grant.

(2)

A description of the specific population that the State wishes to focus on under the grant.

(3)

An assurance that the plan required under subsection (e) will be submitted within 18 months of the receipt of the grant.

(4)

Otherwise be in such form, made in such manner, and contain such agreements, assurances, and information as the Secretary determines to be necessary.

(c)

Duration of Grants

The period during which payments are made under a grant under this section may not exceed 5 years.

(d)

Priority

In awarding grants under this section, the Secretary shall give priority to States that elect to use grant funds to focus on children who are, or are at risk of being placed, in the child welfare or juvenile justice systems as a direct result of parents relinquishing their rights in order to get the mental health services their child needs.

(e)

Plan

To be eligible to receive a grant under this section, a State shall agree to submit to the Secretary for approval, a plan, within 18 months of the receipt of the grant, that at a minimum includes the following:

(1)

A description of the population that the State will focus on, including indications on the number of individuals in the population and the severity of their mental illness.

(2)

A description of how these individuals are being served or not served by the State system.

(3)

A description of the finances that are currently being used throughout the State to serve this population, including funds from the mental health agency.

(4)

A description of the types of services such population is receiving, including if applicable, services provided under section 571.

(5)

A description of the coordination that exists among the various agencies serving children, including child welfare, education, health, and juvenile justice agencies.

(6)

A description of the barriers that exist in the provision of services, including State policies and procedures.

(7)

A description of how the State intends to overcome these barriers, including changing the barriers within State policies and procedures.

(8)

A description of how the State will finance the implementation of systems of care for children.

(9)

A description of how the State intends to promote a comprehensive system of care that includes a shift in reliance on residential and institutional services to increased home and community-based services.

(10)

A description of the number of children in the child welfare or juvenile justice system as a direct result of parents relinquishing their rights in order to get the mental health services that their child needed.

(11)

A description of how the State intends to track outcomes through data collection for individuals that receive services in the system of care, including improved school attendance and achievement, reduced substance use, reduced contact with law enforcement, detention and arrest rates, reductions in out-of-home placement, and mental health improvements sustained.

(f)

Use of Funds

Amounts received under a grant under this section may be used for any activity necessary for the development of the plan submitted under subsection (e) and any costs associated with the implementation of the approved plan.

(g)

Training and Technical Assistance

The Secretary shall, upon the request of the State, provide training and technical assistance to the State in the development and implementation of the plan submitted under subsection (e).

(h)

Reports

Beginning with the second year in which a State receives a grant under this section, and each grant year thereafter, the State shall submit a report to the Secretary detailing the State’s progress in implementing the plan submitted under subsection (e).

577.

Authorization of appropriations

(a)

Authorization of Appropriations

For the purpose of carrying out this part, there are authorized to be appropriated $150,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

(b)

Grants Under Section 576

Not to exceed $10,000,000 of the amount appropriated under subsection (a) for each fiscal year may be used for grants under section 576.

F

WORKFORCE DEVELOPMENT

581.

Workforce development grants, contracts, and cooperative agreements for mental Health and substance use disorders

(a)

Purpose

It is the purpose of this section to promote workforce development by identifying and implementing innovative and effective strategies to recruit and retain qualified mental health promotion and treatment and substance use disorder prevention and treatment staff and by disseminating those strategies to States and public and non-profit private providers of mental health and substance use disorder services.

(b)

Grants and Contracts

The Secretary shall award grants, contracts, or cooperative agreements to eligible entities to identify and implement effective, innovative strategies to recruit and retain a workforce qualified to provide mental health and substance use disorder prevention and treatment services in the public sector.

(c)

Eligibility

To be eligible to receive a grant, contract, or cooperative agreement under this section, an entity shall—

(1)

be a State, American Indian or Alaska Native tribe, tribal organization, a health facility or program operated by or pursuant to a contract or grant with the Indian Health Service, or non-profit entity;

(2)

submit to the Secretary an application at such time, in such manner, and containing such information as the Secretary may require;

(3)

agree to collect and provide to the Secretary such data as required by the Secretary to objectively demonstrate the effect of the strategy implemented through such grant, contract, or cooperative agreement; and

(4)

agree to participate in conferences conducted by the Secretary expressly for the purposes of developing recommendations on best practices for recruiting and retaining a qualified workforce.

(d)

Use of Funds

(1)

In general

An entity shall use amounts received under this section to identify and implement innovative strategies to—

(A)

identify and recruit individuals into the mental health and substance use disorder public service workforce, including paraprofessionals and individuals in recovery and their families;

(B)

assist individuals in obtaining basic or specialized competencies for providing mental health promotion and treatment services and substance use disorder prevention, treatment, and recovery services; and

(C)

retain qualified mental health and substance use disorder treatment staff, including staff who provide services that promote mental health, prevent substance use, or treat mental illness and substance use disorders.

(2)

Limitation

Eligible entities that receive funds under this section may not use such funds to pay for loan repayment or forgiveness programs, or for a degree at an institution of higher education or at any other institution.

(e)

Priorities

In awarding grants, contracts, or cooperative agreements under this section the Secretary shall ensure that priority is given to—

(1)

entities in rural areas and mental health and substance use disorder manpower shortage areas; and

(2)

entities that agree to focus on the inclusion of racial and ethnic minorities in the workforce.

(f)

Geographic Distribution

The Secretary shall ensure that to the extent practicable, an equitable distribution of grants, contracts, and cooperative agreements among the geographical regions of the United States and between urban and rural populations.

(g)

Technical Assistance

The Secretary shall provide technical assistance to eligible entities and conduct conferences to promote the sharing of ideas for the development of best practices in the recruitment and retention of a qualified mental health and substance use disorder prevention and treatment workforce.

(h)

Evaluation

Not later than 3 years after the receipt of a grant, contract, or cooperative agreement under this section, an entity shall—

(1)

conduct an evaluation of the activities carried out with funds received under the grant, contract, or cooperative agreement;

(2)

submit to the Secretary a report concerning the results of the evaluation under paragraph (1); and

(3)

participate in any further evaluation of the program by the Secretary.

(i)

Dissemination

The Secretary shall disseminate to States and public and non-profit private providers of mental health and substance use disorder services the proven effective strategies developed under this section.

(j)

Authorization of Appropriations

There is authorized to be appropriated to carry out this section, $25,000,000 for fiscal year 2011, and such sums as may be necessary for each of fiscal years 2012 through 2015.

582.

Data collection and report on workforce issues

Not later than 5 years after the date of enactment of the SAMHSA Modernization Act of 2010, the Administrator shall submit to the appropriate committees of Congress a report based on the data collected pursuant to sections 1912(b) and 1931(b). Such report shall contain—

(1)

an assessment of the mental health and substance use disorder workforce capacity, strengths, and weaknesses as of the date of the report;

(2)

recommendations for legislation to assist Congress in reauthorizing this title in fiscal year 2014;

(3)

specific recommendations for States, communities, and public and non-profit private providers of mental health and substance use disorder services;

(4)

data and best practices identified under section 581; and

(5)

recommendations for national outcomes measures of workforce.

G

SCHOOL–BASED MENTAL HEALTH

585.

School-based mental Health and children and violence

(a)

In General

The Secretary, in collaboration with the Secretary of Education and in consultation with the Attorney General, shall, directly or through grants, contracts or cooperative agreements awarded to public entities and local education agencies, assist local communities and schools in applying a public health approach to mental health services both in schools and in the community. Such approach should provide comprehensive age appropriate services and supports and incorporate age appropriate strategies of positive behavioral interventions and supports. A comprehensive school mental health program funded under this section shall assist children in dealing with violence.

(b)

Activities

Under the program under subsection (a), the Secretary may—

(1)

provide financial support to enable local communities to implement a comprehensive school mental health program that incorporates positive behavioral interventions and supports to foster the health and development of children;

(2)

provide technical assistance to local communities with respect to the development of programs described in paragraph (1);

(3)

provide assistance to local communities in the development of policies to address child and adolescent mental health issues and violence when and if it occurs;

(4)

facilitate community partnerships among families, students, law enforcement agencies, education systems, mental health and substance use disorder service systems, family-based mental health service systems, welfare agencies, healthcare service systems, and other community-based systems; and

(5)

establish mechanisms for children and adolescents to report incidents of violence or plans by other children or adolescents to commit violence.

(c)

Requirements

(1)

In general

To be eligible for a grant, contract, or cooperative agreement under subsection (a) an entity shall—

(A)

be a partnership between a local education agency and at least one community program or agency that is involved in mental health; and

(B)

submit an application, that is endorsed by all members of the partnership, that makes the assurances described in paragraph (2).

(2)

Required assurances

An application under paragraph (1) shall assure the following:

(A)

That the applicant will ensure that, in carrying out activities under this section, the local educational agency involved will enter into a memorandum of understanding—

(i)

with, at a minimum, public or private mental health entities, healthcare entities, law enforcement or juvenile justice entities, child welfare agencies, family-based mental health entities, families and family organizations, and other community-based entities; and

(ii)

that clearly states—

(I)

the responsibilities of each partner with respect to the activities to be carried out;

(II)

how each partner will be accountable for carrying out such responsibilities; and

(III)

the amount of non-Federal funding or in-kind contributions that each such partner will contribute in order to sustain the program.

(B)

That the comprehensive school-based mental health program carried out under this section support the flexible use of funds to address—

(i)

the promotion of the social, emotional, and mental health of all students in an environment that is conducive to learning;

(ii)

the reduction in the likelihood of at risk students developing social or emotional problems or mental health and substance use disorders;

(iii)

the early identification of social or emotional problems or mental health and substance use disorders and the provision of early intervention services;

(iv)

the treatment or referral for treatment of students with existing social or emotional problems or mental health and substance use disorders; and

(v)

the development and implementation of programs to assist children in dealing with violence.

(C)

That the comprehensive mental health program carried out under this section will provide for in-service training of all school personnel, including ancillary staff and volunteers, in—

(i)

the techniques and support needed to identify early children with, or at risk of, mental illness;

(ii)

the use of referral mechanisms that effectively link such children to treatment intervention services;

(iii)

strategies that promote a schoolwide positive environment, and includes an on-going training and coaching component;

(iv)

strategies for promoting the social, emotional, and mental health of all students; and

(v)

strategies to increase the knowledge and skills of school and community leaders on the application of a public health approach to comprehensive school-based mental health programs.

(D)

That the comprehensive school-based mental health programs carried out under this section will demonstrate the measures to be taken to sustain the program after funding under this section terminates.

(E)

That the local education agency partnership involved is supported by the State educational and mental health system to ensure that the sustainability of the programs is established after funding under this section terminates.

(F)

That the comprehensive school-based mental health program carried out under this section is based on scientifically valid research, when available, or evidence-based practices.

(G)

That the comprehensive school-based mental health program carried out under this section is coordinated with early intervening activities carried out under the Individuals with Disabilities Education Act.

(d)

Geographical Distribution

The Secretary shall ensure that grants, contracts or cooperative agreements under subsection (a) will be distributed equitably among the regions of the country and among urban and rural areas.

(e)

Duration of Awards

With respect to a grant, contract or cooperative agreement under subsection (a), the period during which payments under such an award will be made to the recipient shall be 5 years. An entity may only receive one award under this section, except that an entity that is providing services and supports on a regional basis may receive additional funding after the expiration of the preceding grant period.

(f)

Evaluation and Measures of Outcomes

(1)

Development of process

The Administrator shall develop a process for evaluating activities carried out under this section. Such process shall include—

(A)

the development of guidelines for the submission of program data by such recipients;

(B)

the development of measures of outcomes (in accordance with paragraph (2)) to be applied by such recipients in evaluating programs carried out under this section; and

(C)

the submission of annual reports by such recipients concerning the effectiveness of programs carried out under this section.

(2)

Measures of outcomes

(A)

In general

The Administrator shall develop measures of outcomes to be applied by recipients of assistance under this section, and the Administrator, in evaluating the effectiveness of programs carried out under this section. Such measures shall include student and family measures as provided for in subparagraph (B) and local educational measures as provided for under subparagraph (C).

(B)

Student and family measures of outcomes

The measures of outcomes developed under paragraph (1)(B) relating to students and families shall, with respect to activities carried out under a program under this section, at a minimum include provisions to evaluate—

(i)

whether the program resulted in an increase in social and emotional competency;

(ii)

whether the program resulted in an increase in student academic achievement;

(iii)

whether the program resulted in a reduction in disruptive and aggressive behaviors;

(iv)

whether the program resulted in improved family functioning;

(v)

whether the program resulted in a reduction in substance use disorders;

(vi)

whether the program resulted in a reduction in suspensions, truancy, expulsions and violence; and

(vii)

whether the program resulted in improved access to care for mental health disorders.

(C)

Local educational outcomes

The outcome measures developed under paragraph (1)(B) relating to local educational systems shall, with respect to activities carried out under a program under this section, at a minimum include provisions to evaluate—

(i)

the effectiveness of comprehensive school mental health programs established under this section;

(ii)

the effectiveness of formal partnership linkages among child and family serving institutions, community support systems, and the educational system;

(iii)

the progress made in sustaining the program once funding under the grant has expired; and

(iv)

the effectiveness of training and professional development programs for all school personnel.

(3)

Submission of annual data

An entity that receives a grant, contract, or cooperative agreement under this section shall annually submit to the Administrator a report that include data to evaluate the success of the program carried out by the entity based on whether such program is achieving the purposes of the program. Such reports shall utilize the measures of outcomes under paragraph (2) in a reasonable manner to demonstrate the progress of the program in achieving such purposes.

(4)

Evaluation by administrator

Based on the data submitted under paragraph (3), the Administrator shall annually submit to Congress a report concerning the results and effectiveness of the programs carried out with assistance received under this section.

(g)

Information and Education

The Secretary shall establish comprehensive information and education programs to disseminate the findings of the knowledge development and application under this section to the general public and to health care professionals.

(h)

Amount of Grants and Authorization of Appropriations

(1)

Amount of grants

A grant under this section shall be in an amount that is not more than $1,000,000 for each of grant years 2011 through 2015. The Secretary shall determine the amount of each such grant based on criteria determined by the Secretary.

(2)

Authorization of appropriations

There is authorized to be appropriated to carry out this section, $200,000,000 for each of fiscal years 2011 through 2015.

586.

Grants to address the problems of persons who experience violence related stress

(a)

In General

The Secretary shall award grants, contracts or cooperative agreements to public and nonprofit private entities, as well as to Indian tribes and tribal organizations, for the purpose of developing and maintaining programs that provide for the continued operation of the National Child Traumatic Stress Initiative, that focus on the behavioral and biological aspects of psychological trauma response and for developing knowledge with regard to evidence-based practices for treating trauma-related disorders of children and youth resulting from witnessing or experiencing a traumatic event.

(b)

Priorities

In awarding grants, contracts or cooperative agreements under subsection (a) related to the development of knowledge and provision of services based on evidence-based practices for treating disorders associated with psychological trauma, the Secretary shall give priority to mental health agencies and programs that have established clinical and basic research experience in the field of trauma-related mental disorders, and that contribute to the establishment of a national trauma infrastructure.

(c)

Geographical Distribution

The Secretary shall ensure that grants, contracts or cooperative agreements under subsection (a) with respect to centers of excellence are distributed equitably among the regions of the country and among urban and rural areas.

(d)

Evaluation

The Secretary, as part of the application process, shall require that each applicant for a grant, contract or cooperative agreement under subsection (a) submit a plan for the rigorous evaluation of the activities funded under the grant, contract or agreement, including both process and outcomes evaluation, and the submission of an evaluation at the end of the project period.

(e)

Duration of Awards

With respect to a grant, contract or cooperative agreement under subsection (a), the period during which payments under such an award will be made to the recipient for 5 years. Such grants, contracts or agreements may be renewed, except that expertise and experience in the field of trauma-related disorders shall be the priority criterion for new and continuing grant, contract, or cooperative agreement awards.

(f)

Authorization of Appropriations

There is authorized to be appropriated to carry out this section, $50,000,000 for fiscal year 2011, and such sums as may be necessary for each of fiscal years 2012 through 2015.

H

REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN FACILITIES

I

Medical Facilities

591.

Requirement relating to the rights of residents of certain medical facilities

(a)

In General

A public or private general hospital, nursing facility, intermediate care facility, or other health care facility, that receives support in any form from any program supported in whole or in part with funds appropriated to any Federal department or agency shall protect and promote the rights of each resident of the facility, including the right to be free from physical or mental abuse, corporal punishment, and any restraints or involuntary seclusions imposed for purposes of discipline or convenience.

(b)

Requirements

Restraints and seclusion may only be imposed on a resident of a facility described in subsection (a) if—

(1)

the restraints or seclusion are imposed to ensure the physical safety of the resident, a staff member, or others; and

(2)

the restraints or seclusion are imposed only upon the written order of a physician, or other licensed practitioner permitted by the State and the facility to order such restraint or seclusion, that specifies the duration and circumstances under which the restraints are to be used (except in emergency circumstances specified by the Secretary until such an order could reasonably be obtained).

(c)

Current Law

This part shall not be construed to affect or impede any Federal or State law or regulations that provide greater protections than this part regarding seclusion and restraint.

(d)

Definitions

In this section:

(1)

Restraints

The term restraints means—

(A)

any physical restraint that is a mechanical or personal restriction that immobilizes or reduces the ability of an individual to move his or her arms, legs, or head freely, not including devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or any other methods that involves the physical holding of a resident for the purpose of conducting routine physical examinations or tests or to protect the resident from falling out of bed or to permit the resident to participate in activities without the risk of physical harm to the resident (such term does not include a physical escort); and

(B)

a drug or medication that is used as a restraint to control behavior or restrict the resident’s freedom of movement that is not a standard treatment for the resident’s medical or psychiatric condition.

(2)

Seclusion

The term seclusion means a behavior control technique involving locked isolation. Such term does not include a time out.

(3)

Physical escort

The term physical escort means the temporary touching or holding of the hand, wrist, arm, shoulder or back for the purpose of inducing a resident who is acting out to walk to a safe location.

(4)

Time out

The term time out means a behavior management technique that is part of an approved treatment program and may involve the separation of the resident from the group, in a non-locked setting, for the purpose of calming. Time out is not seclusion.

592.

Reporting requirement

(a)

In General

Each facility to which the Protection and Advocacy for Mentally Ill Individuals Act of 1986 applies shall notify the appropriate agency, as determined by the Secretary, of each death that occurs at each such facility while a patient is restrained or in seclusion, of each death occurring within 24 hours after the patient has been removed from restraints and seclusion, or where it is reasonable to assume that a patient’s death is a result of such seclusion or restraint. A notification under this section shall include the name of the resident and shall be provided not later than 7 days after the date of the death of the individual involved.

(b)

Facility

In this section, the term facility has the meaning given the term facilities in section 102(3) of the Protection and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. 10802(3)).

593.

Regulations and enforcement

(a)

Training

Not later than 1 year after the date of the enactment of this part, the Secretary, after consultation with appropriate State and local protection and advocacy organizations, physicians, facilities, and other health care professionals and patients, shall promulgate regulations that require facilities to which the Protection and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C. 10801 et seq.) applies, to meet the requirements of subsection (b).

(b)

Requirements

The regulations promulgated under subsection (a) shall require that—

(1)

facilities described in subsection (a) ensure that there is an adequate number of qualified professional and supportive staff to evaluate patients, formulate written individualized, comprehensive treatment plans, and to provide active treatment measures;

(2)

appropriate training be provided for the staff of such facilities in the use of restraints and any alternatives to the use of restraints; and

(3)

such facilities provide complete and accurate notification of deaths, as required under section 592(a).

(c)

Enforcement

A facility to which this part applies that fails to comply with any requirement of this part, including a failure to provide appropriate training, shall not be eligible for participation in any program supported in whole or in part by funds appropriated to any Federal department or agency.

II

Non-Medical and Community-Based Facilities

595.

Requirement relating to the rights of Individuals of certain non-medical, Community-Based facilities for children and youth

(a)

Protection of Rights

(1)

In general

(A)

Community-based facilities

A public or private non-medical, community-based facility for children and youth (as defined in regulations to be promulgated by the Secretary) that receives support in any form from any program supported in whole or in part with funds appropriated under this Act shall protect and promote the rights of each resident of the facility, including the right to be free from physical or mental abuse, corporal punishment, and any restraints or involuntary seclusions imposed for purposes of discipline or convenience.

(B)

Schools

A public, private, residential or non-residential school (as defined in regulations to be promulgated by the Secretary in consultation with the Secretary of Education) that receives support in any form from any program supported in whole or in part with funds appropriated to any Federal department or agency shall protect and promote the rights of each individual of the facility, including the right to be free from physical or mental abuse, corporal punishment (as defined by State law), and any restraints or involuntary seclusions imposed for purposes of discipline or convenience.

(2)

Nonapplicability

Notwithstanding this part, a facility that provides inpatient psychiatric treatment services for individuals under the age of 21, as authorized and defined in subsections (a)(16) and (h) of section 1905 of the Social Security Act, shall comply with the requirements of part H.

(3)

Applicability of medicaid provisions

A non-medical, community-based facility for children and youth funded under the Medicaid program under title XIX of the Social Security Act shall continue to meet all existing requirements for participation in such program that are not affected by this part.

(b)

Requirements

(1)

In general

Physical restraints and seclusion may only be imposed on an individual by a facility described in subsection (a)(1) if—

(A)

the restraints or seclusion are imposed only in emergency circumstances and only to ensure the immediate physical safety of the individual, a staff member, students, or others and less restrictive interventions have been determined to be ineffective; and

(B)

the restraints or seclusion are imposed only by an individual trained and certified, by a State-recognized body (as defined in regulation promulgated by the Secretary, and in the case of facilities described in subsection (a)(1)(B) promulgated by the Secretary in consultation with the Secretary of Education) and pursuant to a process determined appropriate by the State and approved by the Secretary, and in the case of facilities described in subsection (a)(1)(B) approved by the Secretary in consultation with the Secretary of Education, in the prevention and use of physical restraint and seclusion, including the needs and behaviors of the population served, relationship building, alternatives to restraint and seclusion, de-escalation methods, avoiding power struggles, thresholds for restraints and seclusion, the physiological and psychological impact of restraint and seclusion, monitoring physical signs of distress and obtaining medical assistance, legal issues, position asphyxia, escape and evasion techniques, time limits, the process for obtaining approval for continued restraints, procedures to address problematic restraints, documentation, processing with children, and follow-up with staff, and investigation of injuries and complaints.

(2)

Interim procedures relating to training and certification

(A)

In general

Until such time as the State develops a process to assure the proper training and certification of facility personnel in the skills and competencies referred to in paragraph (1)(B), the facility involved shall develop and implement an interim procedure that meets the requirements of subparagraph (B).

(B)

Requirements

A procedure developed under subparagraph (A) shall—

(i)

ensure that a supervisory or senior staff person with training in restraint and seclusion who is competent to conduct a face-to-face assessment (as defined in regulations promulgated by the Secretary, and in the case of facilities described in subsection (a)(1)(B) promulgated by the Secretary in consultation with the Secretary of Education), will assess the mental and physical well-being of the child or youth being restrained or secluded and assure that the restraint or seclusion is being done in a safe manner;

(ii)

ensure that the assessment required under clause (i) take place as soon as practicable, but in no case later than 1 hour after the initiation of the restraint or seclusion; and

(iii)

ensure that the supervisory or senior staff person continues to monitor the situation for the duration of the restraint and seclusion.

(3)

Limitations

(A)

In general

The use of a drug or medication that is used as a restraint to control behavior or restrict the individual’s freedom of movement that is not a standard treatment for the individual’s medical or psychiatric condition in a facility described in subsection (a)(1) is prohibited.

(B)

Prohibition

The use of mechanical restraints in a facility described in subsection (a)(1) is prohibited.

(C)

Limitation

A facility for children and youth described in subsection (a)(1) may only use seclusion when a staff member is continuously face-to-face monitoring the individual and when strong licensing or accreditation and internal controls are in place.

(c)

Rule of Construction

(1)

In general

Nothing in this section shall be construed as prohibiting the use of restraints for medical immobilization, adaptive support, or medical protection.

(2)

Current law

This part shall not be construed to affect or impede any Federal or State law or regulations that provide greater protections than this part regarding seclusion and restraint.

(d)

Definitions

In this section:

(1)

Mechanical restraint

The term mechanical restraint means the use of devices as a means of restricting an individual’s freedom of movement.

(2)

Physical escort

The term physical escort means the temporary touching or holding of the hand, wrist, arm, shoulder or back for the purpose of inducing an individual who is acting out to walk to a safe location.

(3)

Physical restraint

The term physical restraint means a personal restriction that immobilizes or reduces the ability of an individual to move his or her arms, legs, or head freely. Such term does not include a physical escort.

(4)

Seclusion

The term seclusion means a behavior control technique involving locked isolation. Such term does not include a time out.

(5)

Time out

The term time out means a behavior management technique that is part of an approved treatment program or individual service plan and may involve the separation of the individual from the group, in a non-locked setting, for the purpose of calming. Time out is not seclusion.

596.

Reporting requirement

Each facility (described in section 595(a)(1)) shall notify the appropriate State licensing or regulatory agency, as determined by the Secretary, and in the case of facilities described in section 595(a)(1)(B) determined by the Secretary in consultation with the Secretary of Education—

(1)

of each death that occurs at each such facility. A notification under this section shall include the name of the resident and shall be provided not later than 24 hours after the time of the individuals death; and

(2)

of the use of seclusion or restraints in accordance with regulations promulgated by the Secretary, in consultation with the Secretary of Education in the case of facilities described in section 595(a)(1)(B), and the States.

597.

Regulations and enforcement

(a)

Training

Not later than 6 months after the date of the enactment of the SAMHSA Modernization Act of 2010, the Secretary, after consultation with the Secretary of Education in the case of facilities described in section 595(a)(1)(B), appropriate State, local, public and private protection and advocacy organizations, health care professionals, social workers, facilities described in section 595(a)(1), and individuals receiving services from such facilities, shall promulgate regulations that—

(1)

require States that license non-medical, community-based residential facilities for children and youth to develop licensing rules and monitoring requirements concerning behavior management practice that will ensure compliance with Federal regulations and to meet the requirements of subsection (b);

(2)

require States that monitor compliance of facilities described in section 595(a)(1)(B) with Federal and State laws and standards to develop rules and monitoring requirements concerning behavior management practice that will ensure compliance with Federal regulations and meet the requirements of subsection (b);

(3)

require States to develop and implement such licensing rules and monitoring requirements within 1 year after the promulgation of the regulations referred to in the matter preceding paragraph (1); and

(4)

support the development of national guidelines and standards on the quality, quantity, orientation and training, required under this part, as well as the certification or licensure of those staff responsible for the implementation of behavioral intervention concepts and techniques.

(b)

Requirements

The regulations promulgated under subsection (a) shall require—

(1)

that facilities described in subsection (a) ensure that there is an adequate number of qualified professional and supportive staff to evaluate individuals, formulate written individualized, comprehensive treatment plans, and to provide active treatment measures;

(2)

the provision of appropriate training and certification of the staff of such facilities in the prevention and use of physical restraint and seclusion, including the needs and behaviors of the population served, relationship building, alternatives to restraint, de-escalation methods, avoiding power struggles, thresholds for restraints, the physiological impact of restraint and seclusion, monitoring physical signs of distress and obtaining medical assistance, legal issues, position asphyxia, escape and evasion techniques, time limits for the use of restraint and seclusion, the process for obtaining approval for continued restraints and seclusion, procedures to address problematic restraints, documentation, processing with children, and follow-up with staff, and investigation of injuries and complaints; and

(3)

that such facilities provide complete and accurate notification of deaths, as required under section 596.

(c)

Enforcement

A State to which this part applies that fails to comply with any requirement of this part, including a failure to provide appropriate training and certification, shall not be eligible for participation in any program supported in whole or in part by funds appropriated to any Federal department or agency.

.

(b)

Technical Amendments

Part G of title V of the Public Health Service Act (42 U.S.C. 290kk et seq.), as added by section 144 of the Community Renewal Tax Relief Act of 2000 (as enacted into law by section 1(a)(7) of Public Law 106–554; 114 Stat. 2763A–619), is amended—

(1)

by redesignating such part as part I;

(2)

by transferring such part so as to appear after part H (as so designated by the amendment made by subsection (a)); and

(3)

by redesignating sections 581 through 584 as sections 599 through 599C, respectively.

3.

Amendments to title XIX of the Public Health Service Act

(a)

In general

Part B of title XIX of the Public Health Service Act (42 U.S.C. 300x–1 et seq.), except for section 1955 (42 U.S.C. 300x–65), is amended to read as follows:

B

BLOCK GRANTS REGARDING MENTAL HEALTH AND SUBSTANCE USE DISORDERS

I

Block Grants for Community Mental Health Services

1911.

Formula grants to States

(a)

In General

For the purpose described in subsection (b), the Secretary, acting through the Director of the Center for Mental Health Services, shall make an allotment each fiscal year for each State in an amount determined in accordance with section 1918. The Secretary shall make a grant to the State of the allotment made for the State for the fiscal year if the State submits to the Secretary an application in accordance with section 1917.

(b)

Purpose of Grants

A funding agreement for a grant under subsection (a) is that, subject to section 1916, the State involved will expend the grant only for the purpose of—

(1)

providing community mental health services for adults with serious mental illness and children with serious emotional disturbances as defined in accordance with section 1912(c);

(2)

carrying out the plan submitted under section 1912(a) by the State for the fiscal year involved;

(3)

evaluating programs and services carried out under this subpart; and

(4)

planning, administration, and educational activities related to providing services under the plan.

1912.

State plan for comprehensive community Mental Health Services for certain Individuals

(a)

In General

The Secretary may make a grant under section 1911 only if—

(1)

the State involved submits to the Secretary a plan for providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance;

(2)

the plan meets the criteria specified in subsection (b); and

(3)

the plan is approved by the Secretary.

(b)

Criteria for Plan

(1)

In general

In accordance with subsection (a), a State shall, at least once every 3 years, submit to the Secretary a plan that, at a minimum, includes the following:

(A)

System of care

A description of the State’s system of care that contains the following:

(i)

Comprehensive community-based mental health systems

The plan shall—

(I)

identify the single State agency to be responsible for the administration of the program under the grant, including any third party who administers mental health services and is responsible for complying with the requirements of this part with respect to the grant;

(II)

provide for an organized community-based system of care for individuals with mental illness and describe available services and resources in a comprehensive system of care, including services for individuals with co-occurring disorders;

(III)

include a description of the manner in which the State and local entities will coordinate services (including health services, rehabilitation services, employment services, housing services, educational services, substance use disorder services, juvenile justice services, law enforcement services, social services, child welfare services, medical and dental care services, and other support services to be provided with Federal, State, and local public and private resources) with other agencies to enable individuals receiving services to function outside of inpatient or residential institutions, to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with Disabilities Education Act;

(IV)

include a description of how the State promotes evidence-based practices;

(V)

include a description of case management services;

(VI)

provide for activities leading to a reduction of hospitalization;

(VII)

include a description of how the State integrates mental health and substance use disorder services and primary health care, which may include providing mental health and substance use disorder services in primary care settings or providing primary and specialty care services in community-based mental health and substance use disorder service settings; and

(VIII)

include a description of how the State assures a smooth transition of children with serious emotional disturbances from the children’s service system to the adult service system.

(ii)

Mental health system data and epidemiology

Utilizing the definitions for adults with a serious mental illness and children with a serious emotional disturbance established in accordance with subsection (c), the plan shall—

(I)

provide estimates on the incidence and prevalence of individuals who are adults with a serious mental illness and children with a serious emotional disturbance in the State, by age, sex, race, and ethnicity;

(II)

provide information on the number of adults with a serious mental illness and children with a serious emotional disturbance in community-based treatment within the State by age, sex, race, and ethnicity;

(III)

provide estimates on the number of adults with a serious mental illness and children with a serious emotional disturbance who are homeless or have a co-occurring mental health and substance use disorder; and

(IV)

provide the latest national outcome measurement data in accordance with section 504(b).

(iii)

Children’s services

In the case of children with a serious emotional disturbance (as defined pursuant to subsection (c)), the plan shall provide for a system of integrated social services, educational services, child welfare services, juvenile justice services, law enforcement services, and substance use disorder services that, together with health and mental health services, will be provided in order for such children to receive care that is appropriate for their multiple needs (such system to include services provided under the Individuals with Disabilities Education Act).

(iv)

Targeted services to rural, homeless, and older adult populations

The plan shall describe the State’s outreach to and services for individuals who are homeless and older adults with mental illness, and the manner in which community-based services will be provided to individuals residing in rural areas.

(v)

Management services

The plan shall describe—

(I)

the resources available in the State to pay for the services including funding under Medicaid, other Federal programs such as grants to the State, local jurisdictions of the State, or non-profit private entities awarded grants under title V and how the State is maximizing these resources, and the manner in which the State intends to expend the grant under section 1911 for the fiscal year involved;

(II)

the manner in which the State intends to comply with each of the funding agreements in this subpart and subpart III; and

(III)

the existing mental health and substance use disorders workforce, including data on the number of individuals who serve in the system of care designated by profession, the need for additional professionals and paraprofessionals, the efforts of the State to recruit and retain a qualified mental health and substance use disorders workforce, and a copy of the standards the State uses in certifying or licensing community-based mental health services facilities and mental health providers.

(B)

System analysis

An analysis of the mental health system of care within the State that identifies the strengths and weaknesses of that system of care, and an assessment of the adequacy of that system of care to respond to the need for services.

(C)

Goal and objectives

A set of quantifiable goals and objectives for the period of the plan, including goals and objectives related to the national outcomes measures established in accordance with section 504, including targets and milestones that are intended to be met and the activities that will be undertaken to achieve those targets.

(D)

Other information

Any other information determined appropriate by the Secretary.

(2)

Authority regarding modifications

As a condition of awarding a grant to a State under section 1911 for a fiscal year, the Secretary may require that the State modify any provision of the plan submitted by the State under this section (including provisions on priorities in carrying out authorized activities). If the Secretary approves such plan and awards a grant to the State for the fiscal year, the Secretary may not during such year require the State to modify the plan.

(3)

State request for modifications

If the State determines that modifications to the State plan under this section are necessary, the State may request the approval of the Secretary for such modifications through the annual report of the State under section 1942.

(4)

Mental health emergency response

(A)

Requirements

The State plan under this section shall include the State’s plan for addressing the mental health and substance use disorder needs of individuals in the State in the event of an emergency or major disaster.

(B)

Demonstration

The State shall demonstrate how the mental health and substance use disorder plan under subparagraph (A) for providing for the mental health needs of individuals in the event of an emergency or major disaster is incorporated into the State’s All-Hazards Public Health Emergency Preparedness and Response Plan required under section 319C–1. If the mental health emergency response plan under subparagraph (A) is not so incorporated, the State shall describe how such plan will be incorporated into the State Emergency Response Plan during the period that the State plan under this section is in effect.

(C)

Definitions

In this paragraph, the terms emergency and major disaster have the meanings given such terms in section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act.

(c)

Definitions Regarding Mental Illness and Emotional Disturbance; Methods for Estimate of Incidence and Prevalence

(1)

Establishment by secretary of definitions; dissemination

For purposes of this subpart, the Secretary shall establish definitions for the terms adults with a serious mental illness and children with a serious emotional disturbance. The Secretary shall disseminate the definitions to the States.

(2)

Standardized methods

The Secretary shall establish standardized methods for making the estimates required in subsection (b)(1) with respect to a State. A funding agreement for a grant under section 1911 for the State is that the State will utilize such methods in making the estimates.

1913.

Certain agreements

(a)

Allocation for Systems of Integrated Services for Children

(1)

In general

With respect to children with a serious emotional disturbance, a funding agreement for a grant under section 1911 is that the State involved will expend not less than an amount equal to the amount expended by the State for fiscal year 2006.

(2)

Waiver

(A)

Upon the request of a State, the Secretary may provide to the State a waiver of all or part of the requirement established in paragraph (1) if the Secretary determines that the State is providing an adequate level of comprehensive community mental health services for children with a serious emotional disturbance, as indicated by a comparison of the number of such children for which such services are sought with the availability in the State of the services.

(B)

The Secretary shall approve or deny a request for a waiver under subparagraph (A) not later than 120 days after the date on which the request is made.

(C)

Any waiver provided by the Secretary under subparagraph (A) shall be applicable only to the fiscal year involved.

(b)

Providers of Services

A funding agreement for a grant under section 1911 for a State is that, with respect to the plan submitted under section 1912(a) for the fiscal year involved—

(1)

services under the plan will be provided only through appropriate, qualified community programs (which may include community mental health centers, child mental-health programs, psychosocial rehabilitation programs, mental health peer-support programs, and mental-health primary consumer-directed programs); and

(2)

services under the plan will be provided through community mental health centers only if the centers meet the criteria specified in subsection (c).

(c)

Criteria for Mental Health Centers

The criteria referred to in subsection (b)(2) regarding community mental health centers are as follows:

(1)

With respect to mental health services, the centers provide services as follows:

(A)

Services principally to individuals residing in a defined geographic area (hereafter in this subsection referred to as a service area).

(B)

Outpatient services, including specialized outpatient services for children, older Americans, individuals with a serious mental illness, and residents of the service areas of the centers who have been discharged from inpatient treatment at a mental health facility.

(C)

24-hour-a-day emergency care services.

(D)

Day treatment or other partial hospitalization services, or psychosocial rehabilitation services.

(E)

Screening for patients being considered for admission to State mental health facilities to determine the appropriateness of such admission.

(2)

The mental health services of the centers are provided, within the limits of the capacities of the centers, to any individual residing or employed in the service area of the center regardless of ability to pay for such services.

(3)

The mental health services of the centers are available and accessible promptly, as appropriate and in a manner which preserves human dignity and assures continuity and high quality care.

1914.

State mental Health planning Council

(a)

In General

A funding agreement for a grant under section 1911 is that the State involved will establish and maintain a State mental health planning council in accordance with the conditions described in this section.

(b)

Duties

A condition under subsection (a) for a Council is that the duties of the Council are—

(1)

to review plans provided to the Council pursuant to section 1915(a) by the State involved and to submit to the State any recommendations of the Council for modifications to the plans;

(2)

to serve as an advocate for adults with a serious mental illness, children with a severe emotional disturbance, and other individuals with mental illnesses or emotional problems; and

(3)

to monitor, review, and evaluate, not less than once each year, the allocation and adequacy of mental health services within the State.

(c)

Membership

(1)

In general

A condition under subsection (a) for a Council is that the Council be composed of residents of the State, including representatives of—

(A)

the principal State agencies with respect to—

(i)

mental health, education, vocational rehabilitation, criminal justice, housing, and social services; and

(ii)

the development of the plan submitted pursuant to title XIX of the Social Security Act;

(B)

public and private entities concerned with the need, planning, operation, funding, and use of mental health services and related support services;

(C)

adults with serious mental illnesses who are receiving (or have received) mental health services; and

(D)

the families of such adults or families of children with emotional disturbance.

(2)

Certain requirements

A condition under subsection (a) for a Council is that—

(A)

with respect to the membership of the Council, the ratio of parents of children with a serious emotional disturbance to other members of the Council is sufficient to provide adequate representation of such children in the deliberations of the Council; and

(B)

not less than 50 percent of the members of the Council are individuals who are not State employees or providers of mental health services.

(d)

Definition

For purposes of this section, the term Council means a State mental health planning council.

1915.

Additional provisions

(a)

Review of State Plan by Mental Health Planning Council

The Secretary may make a grant under section 1911 to a State only if—

(1)

the plan submitted under section 1912(a) with respect to the grant and the report of the State under section 1942(a) concerning the preceding fiscal year has been reviewed by the State mental health planning council under section 1914; and

(2)

the State submits to the Secretary any recommendations received by the State from such council for modifications to the plan (without regard to whether the State has made the recommended modifications) and any comments concerning the annual report.

(b)

Maintenance of Effort Regarding State Expenditures for Mental Health

(1)

Requirement

(A)

In general

A funding agreement for a grant under section 1911 is that the State involved will maintain State expenditures for community mental health services at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant.

(B)

Condition

A State shall be deemed to be in compliance with subparagraph (A) for a fiscal year if State expenditures of the type described in subparagraph (A) for such fiscal year are at least 97 percent of the average of such State expenditures for the preceding 2-year period.

(2)

Future fiscal years

Determinations of whether a State has complied with paragraph (1) for each fiscal year shall be based on the State funding level for the preceding 2-year period as required under paragraph (1)(A) without regard to reduction in the actual amount of State expenditures as permitted under paragraph (1)(B) or under a waiver under paragraph (4).

(3)

Exclusion of certain funds

The Secretary may exclude from the aggregate State expenditures under paragraph (1), funds appropriated for authorized activities which are of a non-recurring nature and for a specific purpose.

(4)

Waiver

(A)

In general

The Secretary may, upon the request of a State, waive the requirements established in paragraph (1), in whole or in part, if—

(i)

the Secretary determines that extraordinary economic conditions in the State in the year involved or in the previous year justify the waiver; or

(ii)

the State or any part of the State has experienced a natural disaster that has received a Presidential Disaster Declaration under section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act.

(B)

Date certain for acting upon request

The Secretary shall approve or deny a request for a waiver under subparagraph (A) not later than 120 days after the date on which the request is made.

(C)

Applicability of waiver

A waiver provided by the Secretary under subparagraph (A) shall be applicable only to the fiscal year involved.

(5)

Noncompliance by state

(A)

In general

In making a grant under section 1911 to a State for a fiscal year, the Secretary shall make a determination of whether, for the previous fiscal year, the State complied with the agreement made under paragraph (1). If the Secretary determines that a State has failed to maintain such compliance, the Secretary shall reduce the amount of the allotment under section 1911 for the State in the year in which the determination is made by an amount equal to the amount constituting such failure for the previous fiscal year.

(B)

Alternative penalty

A State that has failed to comply with this section and that would otherwise be subject to a reduction in the State’s allotment under section 1911, may, with the approval of the Secretary, in lieu of having the State’s allotment under section 1911 reduced, agree to comply with the results of a negotiated agreement that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary.

(C)

Submission of information to the Secretary

The Secretary may make a grant under section 1911 for a fiscal year only if the State involved submits to the Secretary information sufficient to enable the Secretary to make the determination required in subparagraph (A).

1916.

Restrictions on use of payments

(a)

In General

A funding agreement for a grant under section 1911 is that the State involved will not expend the grant—

(1)

to provide inpatient services;

(2)

to make cash payments to intended recipients of health services;

(3)

to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;

(4)

to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds; or

(5)

to provide financial assistance to any entity other than a public or nonprofit private entity.

(b)

Limitation on Administrative Expenses

A funding agreement for a grant under section 1911 is that the State involved will not expend more than 5 percent of the grant for administrative expenses with respect to the grant.

1917.

Application for grant

(a)

In General

For purposes of section 1911, an application for a grant under such section for a fiscal year is in accordance with this section if, subject to subsection (b)—

(1)

the plan is received by the Secretary not later than September 1 of the fiscal year prior to the fiscal year for which a State is seeking funds, and the report from the previous fiscal year as required under section 1942(a) is received by December 1 of the fiscal year of the grant;

(2)

the application contains each funding agreement that is described in this subpart or subpart III for such a grant (other than any such agreement that is not applicable to the State);

(3)

the agreements are made through certification from the chief executive officer of the State;

(4)

with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary;

(5)

the application contains the plan required in section 1912(a), the information required in section 1915(b), and the report required in section 1942(a);

(6)

the application contains recommendations in compliance with section 1915(a), or if no such recommendations are received by the State, the application otherwise demonstrates compliance with such section; and

(7)

the application (including the plan under section 1912(a)) is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this subpart.

(b)

Waivers Regarding Certain Territories

In the case of any territory of the United States except Puerto Rico, the Secretary may waive such provisions of this subpart and subpart III as the Secretary determines to be appropriate, other than the provisions of section 1916.

1918.

Determination of amount of allotment

(a)

States

(1)

Determination under formula

Subject to subsection (b), the Secretary shall determine the amount of the allotment required in section 1911 for a State for a fiscal year in accordance with the following formula:

x
A(——)
u
(2)

Determination of term a

For purposes of paragraph (1), the term A means the difference between—

(A)

the amount appropriated under section 1920(a) for allotments under section 1911 for the fiscal year involved; and

(B)

an amount equal to 1.5 percent of the amount referred to in subparagraph (A).

(3)

Determination of term u

For purposes of paragraph (1), the term U means the sum of the respective terms X determined for the States under paragraph (4).

(4)

Determination of term x

For purposes of paragraph (1), the term X means the product of—

(A)

an amount equal to the product of—

(i)

the term P, as determined for the State involved under paragraph (5); and

(ii)

the factor determined under paragraph (8) for the State; and

(B)

the greater of—

(i)

0.4; and

(ii)

an amount equal to an amount determined for the State in accordance with the following formula:

R%
1 = .35(——)
P%
(5)

Determination of term p

(A)

For purposes of paragraph (4), the term P means the sum of—

(i)

an amount equal to the product of 0.107 and the number of individuals in the State who are between 18 and 24 years of age (inclusive);

(ii)

an amount equal to the product of 0.166 and the number of individuals in the State who are between 25 and 44 years of age (inclusive);

(iii)

an amount equal to the product of 0.099 and the number of individuals in the State who are between 45 and 64 years of age (inclusive); and

(iv)

an amount equal to the product of 0.082 and the number of individuals in the State who are 65 years of age or older.

(B)

With respect to data on population that is necessary for purposes of making a determination under subparagraph (A), the Secretary shall use the most recent data that is available from the Secretary of Commerce pursuant to the decennial census and pursuant to reasonable estimates by such Secretary of changes occurring in the data in the ensuing period.

(6)

Determination of term r%

(A)

For purposes of paragraph (4), the term R%, except as provided in subparagraph (D), means the percentage constituted by the ratio of the amount determined under subparagraph (B) for the State involved to the amount determined under subparagraph (C).

(B)

The amount determined under this subparagraph for the State involved is the quotient of—

(i)

the most recent 3-year arithmetic mean of the total taxable resources of the State, as determined by the Secretary of the Treasury; divided by

(ii)

the factor determined under paragraph (8) for the State.

(C)

The amount determined under this subparagraph is the sum of the respective amounts determined for the States under subparagraph (B) (including the District of Columbia).

(D)
(i)

In the case of the District of Columbia, for purposes of paragraph (4), the term R% means the percentage constituted by the ratio of the amount determined under clause (ii) for such District to the amount determined under clause (iii).

(ii)

The amount determined under this clause for the District of Columbia is the quotient of—

(I)

the most recent 3-year arithmetic mean of total personal income in such District, as determined by the Secretary of Commerce; divided by

(II)

the factor determined under paragraph (8) for the District.

(iii)

The amount determined under this clause is the sum of the respective amounts determined for the States (including the District of Columbia) by making, for each State, the same determination as is described in clause (ii) for the District of Columbia.

(7)

Determination of term p%

For purposes of paragraph (4), the term P% means the percentage constituted by the ratio of the term P determined under paragraph (5) for the State involved to the sum of the respective terms P determined for the States.

(8)

Determination of certain factor

(A)

The factor determined under this paragraph for the State involved is a factor whose purpose is to adjust the amount determined under clause (i) of paragraph (4)(A), and the amounts determined under each of subparagraphs (B)(i) and (D)(ii)(I) of paragraph (6), to reflect the differences that exist between the State and other States in the costs of providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance.

(B)

Subject to subparagraph (C), the factor determined under this paragraph and in effect for the fiscal year involved shall be determined according to the methodology described in the report entitled Adjusting the Alcohol, Drug Abuse and Mental Health Services Block Grant Allocations for Poverty Populations and Cost of Service, dated March 30, 1990, and prepared by Health Economics Research, a corporation, pursuant to a contract with the National Institute on Drug Abuse.

(C)

The factor determined under this paragraph for the State involved may not for any fiscal year be greater than 1.1 or less than 0.9.

(D)
(i)

Not later than October 1, 1992, the Secretary, after consultation with the Comptroller General, shall in accordance with this section make a determination for each State of the factor that is to be in effect for the State under this paragraph. The factor so determined shall remain in effect through fiscal year 1994, and shall be recalculated every third fiscal year thereafter.

(ii)

After consultation with the Comptroller General, the Secretary shall, through publication in the Federal Register, periodically make such refinements in the methodology referred to in subparagraph (B) as are consistent with the purpose described in subparagraph (A).

(b)

Minimum Allotments for States

With respect to fiscal year 2000, and subsequent fiscal years, the amount of the allotment of a State under section 1911 shall not be less than the amount the State received under such section for fiscal year 1998.

(c)

Territories

(1)

Determination under formula

Subject to paragraphs (2) and (4), the amount of an allotment under section 1911 for a territory of the United States for a fiscal year shall be the product of—

(A)

an amount equal to the amounts reserved under paragraph (3) for the fiscal year; and

(B)

a percentage equal to the quotient of—

(i)

the civilian population of the territory, as indicated by the most recently available data; divided by

(ii)

the aggregate civilian population of the territories of the United States, as indicated by such data.

(2)

Minimum allotment for territories

The amount of an allotment under section 1911 for a territory of the United States for a fiscal year shall be the greater of—

(A)

the amount determined under paragraph (1) for the territory for the fiscal year;

(B)

$50,000; and

(C)

with respect to fiscal years 1993 and 1994, an amount equal to 20.6 percent of the amount received by the territory from allotments made pursuant to this part for fiscal year 1992.

(3)

Reservation of amounts

The Secretary shall each fiscal year reserve for the territories of the United States 1.5 percent of the amounts appropriated under section 1920(a) for allotments under section 1911 for the fiscal year.

(4)

Availability of data on population

With respect to data on the civilian population of the territories of the United States, if the Secretary determines for a fiscal year that recent such data for purposes of paragraph (1)(B) do not exist regarding a territory, the Secretary shall for such purposes estimate the civilian population of the territory by modifying the data on the territory to reflect the average extent of change occurring during the ensuing period in the population of all territories with respect to which recent such data do exist.

(5)

Applicability of certain provisions

For purposes of subsection (a), the term State does not include the territories of the United States.

1919.

Definitions

For purposes of this subpart:

(1)

The terms adults with a serious mental illness and children with a serious emotional disturbance have the meanings given such terms under section 1912(c)(1).

(2)

The term funding agreement, with respect to a grant under section 1911 to a State, means that the Secretary may make such a grant only if the State makes the agreement involved.

1920.

Funding

(a)

Authorization of Appropriations

For the purpose of carrying out this subpart, and subpart III and section 504 with respect to mental health, there are authorized to be appropriated $450,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

(b)

Allocations for Technical Assistance, Data Collection, and Program Evaluation

(1)

In general

For the purpose of carrying out section 1948(a) and 1945(g) with respect to mental health and the purposes specified in paragraphs (2) and (3), the Secretary shall obligate 5 percent of the amounts appropriated under subsection (a) for a fiscal year.

(2)

Data collection

The purpose specified in this paragraph is carrying out section 504 with respect to mental health.

(3)

Program evaluation

The purpose specified in this paragraph is the conduct of evaluations of prevention and treatment programs and services with respect to mental health to determine methods for improving the availability and quality of such programs and services.

II

Block Grants for Prevention and Treatment of Substance Use Disorders

1921.

Formula grants to States

(a)

In General

For the purpose described in subsection (b), the Secretary, acting through the Center for Substance Abuse Treatment, shall make an allotment each fiscal year for each State in an amount determined in accordance with section 1932. The Secretary shall make a grant to the State of the allotment made for the State for the fiscal year if the State submits to the Secretary an application in accordance with section 1931.

(b)

Authorized Activities

A funding agreement for a grant under subsection (a) is that, subject to section 1930, the State involved will expend the grant only for the purpose of carrying out the plan developed in accordance with section 1931(b) and for planning, carrying out, and evaluating activities to prevent and treat substance use disorders and for related activities authorized in section 1924.

1922.

Certain allocations

(a)

Allocation Regarding Primary Prevention Programs

A funding agreement for a grant under section 1921 is that, in expending the grant, the State involved will expend not less than 20 percent for programs to prevent the abuse of alcohol and drugs that are—

(1)

designed to reach an entire population or large audience, including activities intended to address environmental issues related to the use of alcohol and drugs;

(2)

designed to target subgroups that may be at risk of using substances; and

(3)

designed to identify and intervene with individuals who are experiencing early signs of substance use or abuse.

(b)

Allocations Regarding Women

(1)

In general

Subject to paragraph (2), a funding agreement for a grant under section 1921 for a fiscal year is that the State will expend not less than it expended in fiscal year 2006 on treatment services for pregnant women and women with dependent children.

(2)

Waiver

(A)

Upon the request of a State, the Secretary may provide to the State a waiver of all or part of the requirement established in paragraph (1) if the Secretary determines that the State is providing an adequate level of treatments services for women described in such paragraph, as indicated by a comparison of the number of such women seeking the services with the availability in the State of the services.

(B)

The Secretary shall approve or deny a request for a waiver under subparagraph (A) not later than 120 days after the date on which the request is made.

(C)

Any waiver provided by the Secretary under subparagraph (A) shall be applicable only to the fiscal year involved.

(3)

Childcare and prenatal care

A funding agreement for a grant under section 1921 for a State is that each entity providing treatment services with amounts reserved under paragraph (1) by the State will, directly or through arrangements with other public or nonprofit private entities, make available prenatal care to women receiving such services and, while the women are receiving the services, childcare.

1923.

Intravenous substance abuse

A funding agreement for a grant under section 1921 is that the State involved, in providing amounts from the grant to any entity for treatment services, will require the entity to carry out activities to encourage individuals in need of such treatment who are intravenous drug users to undergo treatment.

1924.

Requirements regarding tuberculosis and other communicable diseases, and the human immunodeficiency virus

(a)

Tuberculosis and Other Communicable Diseases

(1)

In general

A funding agreement for a grant under section 1921 is that the State involved will require that any entity receiving amounts from the grant for operating a program of treatment for substance use disorders—

(A)

will, directly or through arrangements with other public or nonprofit private entities, routinely make available services for tuberculosis and other communicable diseases to each individual receiving treatment for such abuse; and

(B)

in the case of an individual in need of such treatment who is denied admission to the program on the basis of the lack of the capacity of the program to admit the individual, will refer the individual to another provider of tuberculosis and other communicable diseases services.

(2)

Services

For purposes of paragraph (1), the term tuberculosis and other communicable diseases services, with respect to an individual, means—

(A)

counseling the individual with respect to tuberculosis and other communicable diseases;

(B)

testing to determine whether the individual has contracted and of such diseases and testing to determine the form of treatment for the disease that is appropriate for the individual; and

(C)

providing such treatment to the individual.

(b)

Human Immunodeficiency Virus

(1)

Requirement for certain states

(A)

In general

In the case of a State described in paragraph (2), a funding agreement for a grant under section 1921 is that—

(i)

with respect to individuals undergoing treatment for substance use disorders, the State will, subject to subsection (c), carry out 1 or more projects to make available to the individuals early intervention services for HIV disease at the sites at which the individuals are undergoing such treatment;

(ii)

for the purpose of providing such early intervention services through such projects, the State will make available 5 percent of the amount of the grant; and

(iii)

the State will, subject to subsection (d), carry out such projects only in geographic areas of the State that have the greatest need for the projects.

(B)

Other states

In the case of a State that is not a designated State as described in paragraph (2), the State may expend not to exceed 5 percent of the amount of the grant for the provision of HIV early intervention services on the condition that the State provides such services in accordance with this subsection.

(2)

Designated states

For purposes of this subsection, a State described in this paragraph is any State whose rate of cases of acquired immune deficiency syndrome is 10 or more such cases per 100,000 individuals (as indicated by the number of such cases reported to and confirmed by the Director of the Centers for Disease Control and Prevention for the most recent calendar year for which such data are available).

(3)

Use of existing programs regarding substance use disorders

With respect to programs that provide treatment services for substance use disorders, a funding agreement for a grant under section 1921 for a designated State is that each such program participating in a project under paragraph (1) will be a program that began operation prior to the fiscal year for which the State is applying to receive the grant. A program that so began operation may participate in a project under paragraph (1) without regard to whether the program has been providing early intervention services for HIV disease.

(4)

Requirement regarding rural areas

(1)

In general

A funding agreement for a grant under section 1921 for a designated State is that, if the State will carry out 2 or more projects under subsection (a), the State will carry out 1 such project in a rural area of the State, subject to subparagraph (B).

(2)

Waiver

The Secretary shall waive the requirement established in subparagraph (A) if the State involved certifies to the Secretary that—

(A)

there is insufficient demand in the State to carry out a project under subsection (a) in any rural area of the State; or

(B)

there are no rural areas in the State.

(5)

Manner of providing services

With respect to the provision of early intervention services for HIV disease to an individual, a funding agreement for a grant under section 1921 for a designated State is that—

(1)

such services will be undertaken voluntarily by, and with the informed consent of, the individual; and

(2)

undergoing such services will not be required as a condition of receiving treatment services for substance use disorders or any other services.

(c)

Expenditure of Grant for Compliance With Agreements

(1)

In general

A grant under section 1921 may be expended for purposes of compliance with the agreements required in this section, subject to paragraph (2).

(2)

Limitation

A funding agreement for a grant under section 1921 for a State is that the grant will not be expended to make payment for any service provided for purposes of compliance with this section to the extent that payment has been made, or can reasonably be expected to be made, with respect to such service—

(A)

under any State compensation program, under any insurance policy, or under any Federal or State health benefits program (including the program established in title XVIII of the Social Security Act and the program established in title XIX of such Act); or

(B)

by an entity that provides health services on a prepaid basis.

(d)

Applicability of Certain Provision

Section 1930 applies to this section (and to each other provision of this subpart).

(e)

Definitions

For purposes of this section:

(1)

Early intervention services

The term early intervention services, with respect to HIV disease, means—

(A)

appropriate pretest counseling;

(B)

testing individuals with respect to such disease, including tests to confirm the presence of the disease, tests to diagnose the extent of the deficiency in the immune system, and tests to provide information on appropriate therapeutic measures for preventing and treating the deterioration of the immune system and for preventing and treating conditions arising from the disease;

(C)

appropriate post-test counseling; and

(D)

providing the therapeutic measures described in subparagraph (B).

(2)

HIV disease

The term HIV disease means infection with the etiologic agent for acquired immune deficiency syndrome.

1925.

Group homes for recovering substance abusers

(a)

State Revolving Funds for Establishment of Homes

A State, using funds available under section 1921, may establish and maintain the ongoing operation of a revolving fund in accordance with this section to support group homes for recovering substance abusers as follows:

(1)

The purpose of the fund is to make loans for the costs of establishing programs for the provision of housing in which individuals recovering from alcohol or drug abuse may reside in groups of not less than 6 individuals. The fund is established directly by the State or through the provision of a grant or contract to a nonprofit private entity.

(2)

The programs are carried out in accordance with guidelines issued under subsection (b).

(3)

Not less than $100,000 is available for the fund.

(4)

Loans made from the revolving fund do not exceed $4,000 and each such loan is repaid to the revolving fund by the residents of the housing involved not later than 2 years after the date on which the loan is made.

(5)

Each such loan is repaid by such residents through monthly installments, and a reasonable penalty is assessed for each failure to pay such periodic installments by the date specified in the loan agreement involved.

(6)

Such loans are made only to nonprofit private entities agreeing that, in the operation of the program established pursuant to the loan—

(A)

the use of alcohol or any illegal drug in the housing provided by the program will be prohibited;

(B)

any resident of the housing who violates such prohibition will be expelled from the housing;

(C)

the costs of the housing, including fees for rent and utilities, will be paid by the residents of the housing; and

(D)

the residents of the housing will, through a majority vote of the residents, otherwise establish policies governing residence in the housing, including the manner in which applications for residence in the housing are approved.

(b)

Issuance by Secretary of Guidelines

The Secretary shall ensure that there are in effect guidelines under this subpart for the operation of programs described in subsection (a).

(c)

Applicability to Territories

The requirements established in subsection (a) shall not apply to any territory of the United States other than the Commonwealth of Puerto Rico.

1926.

State law regarding sale of tobacco products to Individuals under age of 18

(a)

Relevant Law

The Secretary may make a grant under section 1921 only if the State involved has in effect a law providing that it is unlawful for any manufacturer, retailer, or distributor of tobacco products to sell or distribute any such product to any individual under the age of 18.

(b)

Enforcement

(1)

In general

A funding agreement for a grant under section 1921 is that the State involved will enforce the law described in subsection (a) in a manner that can reasonably be expected to reduce the extent to which tobacco products are available to individuals under the age of 18.

(2)

Activities and reports regarding enforcement

A funding agreement for a grant under section 1921 is that the State involved will—

(A)

annually conduct random, unannounced inspections to ensure compliance with the law described in subsection (a); and

(B)

annually submit to the Secretary a report describing—

(i)

the activities carried out by the State to enforce such law during the fiscal year preceding the fiscal year for which the State is seeking the grant;

(ii)

the extent of success the State has achieved in reducing the availability of tobacco products to individuals under the age of 18; and

(iii)

the strategies to be utilized by the State for enforcing such law during the fiscal year for which the grant is sought.

(c)

Noncompliance of State

(1)

In general

Before making a grant under section 1921 to a State, the Secretary shall make a determination of whether the State has maintained compliance with subsection (b). If, after notice to the State and an opportunity for a hearing, the Secretary determines that the State is not in compliance with such subsection, the Secretary shall—

(A)

reduce the amount of the allotment under such section for the State for the fiscal year involved by an amount equal to 40 percent of the amount determined under section 1933 for the State for the fiscal year; or

(B)

require the State to certify to the Secretary by May 1 of the fiscal year for which the State is seeking grant funds, that the State will—

(i)

maintain State expenditures in such fiscal year for tobacco prevention programs and for compliance activities, including enforcement, at a level that is not less than the level of expenditures maintained by the State for such activities for the previous fiscal year; and

(ii)

increase State expenditures to ensure compliance with the State law required under subsection (a) by an amount equal to the product of—

(I)

1 percent of such State’s allocation under section 1921 for the fiscal year; and

(II)

the number of percentage points by which the State has failed to achieve the retailer compliance rate goal established by the Secretary for such State under this section.

(2)

Expenditure report

A State to which paragraph (1)(B) applies shall, not later than July 31 of the fiscal year for which such paragraph is being applied, submit to the Secretary a report concerning—

(A)

all expenditures of the State for tobacco prevention and compliance activities, including enforcement, during the fiscal year immediately preceding such fiscal year; and

(B)

all obligations for such activities (listed by program) for the fiscal year for which such paragraph is being applied.

(3)

Discretion of secretary

The Secretary shall have discretion relating to the timing of the State’s obligation of the additional funds as required under the State certification described in paragraph (1)(B)(ii).

(d)

Territories

A funding agreement for a grant under section 1921 is that a territory involved will submit to the Secretary for approval, a comprehensive tobacco prevention and control plan to reduce the availability of tobacco products to minors within the territory.

(e)

Definition

For purposes of this section:

(1)

State

The term State includes the States, the District of Columbia, and the Commonwealth of Puerto Rico.

(2)

Territory

The term territory means American Samoa, the Republic of Palau, the Federated States of Micronesia, the Marshall Islands, the Commonwealth of the Northern Mariana Islands, the United States Virgin Islands, and Guam.

1927.

Treatment services for pregnant women

(a)

In General

A funding agreement for a grant under section 1921 is that the State involved—

(1)

will ensure that each pregnant woman in the State who seeks or is referred for and would benefit from such services is given preference in admissions to treatment facilities receiving funds pursuant to the grant; and

(2)

will, in carrying out paragraph (1), publicize the availability to such women of services from the facilities and the fact that the women receive such preference.

(b)

Referrals Regarding States

A funding agreement for a grant under section 1921 is that, in carrying out subsection (a)(1)—

(1)

the State involved will require that, in the event that a treatment facility has insufficient capacity to provide treatment services to any woman described in such subsection who seeks the services from the facility, the facility refer the woman to the State; and

(2)

the State, in the case of each woman for whom a referral under paragraph (1) is made to the State—

(A)

will refer the woman to a treatment facility that has the capacity to provide treatment services to the woman; or

(B)

will, if no treatment facility has the capacity to admit the woman, make interim services available to the woman not later than 48 hours after the women seeks the treatment services.

1928.

Additional agreements

(a)

Improvement of Process for Appropriate Referrals for Treatment

With respect to individuals seeking treatment services, a funding agreement for a grant under section 1921 is that the State involved will improve the process in the State for referring the individuals to treatment facilities that can provide to the individuals the treatment modality that is most appropriate for the individuals.

(b)

Professional development

A funding agreement for a grant under section 1921 is that the State involved will ensure that prevention and treatment professionals operating in the State’s substance use disorder prevention and treatment system have an opportunity to receive training, on an ongoing basis, concerning—

(1)

recent trends in drug abuse in the State;

(2)

improved methods and evidence-based practices for providing substance use disorder prevention and treatment services;

(3)

performance-based accountability;

(4)

data collection and reporting requirements;

(5)

any other matters that would serve to further improve the delivery of substance use disorder prevention and treatment services with the State; and

(6)

innovative practices developed under section 581.

(c)

Coordination of Various Activities and Services

A funding agreement for a grant under section 1921 is that the State involved will coordinate prevention and treatment activities with the provision of other appropriate services (including health, social, correctional and criminal justice, educational, vocational rehabilitation, housing, and employment services).

(d)

Waiver of Requirement

(1)

In general

Upon the request of a State, the Secretary may provide to a State a waiver of any or all of the requirements established in this section if the Secretary determines that, with respect to services for the prevention and treatment of substance use disorders, the requirement involved is unnecessary for maintaining quality in the provision of such services in the State.

(2)

Date certain for acting upon request

The Secretary shall approve or deny a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.

(3)

Applicability of waiver

Any waiver provided by the Secretary under paragraph (1) shall be applicable only to the fiscal year involved.

1929.

Maintenance of effort regarding State expenditures

(a)

Requirement

(1)

In general

With respect to the principal agency of a State for carrying out authorized activities, a funding agreement for a grant under section 1921 for the State for a fiscal year is that such agency will for such year maintain aggregate State expenditures for authorized activities at a level that is not less than the average level of such expenditures maintained by the State for the 2-year period preceding the fiscal year for which the State is applying for the grant.

(2)

Material compliance

A State shall be deemed to be in compliance with paragraph (1) for a fiscal year if State expenditures of the type described in such paragraph for such fiscal year are at least 97 percent of such State expenditures for the preceding 2-year period.

(3)

Future obligations

In applying paragraph (1) to a State, the Secretary shall determine such State’s compliance with such paragraph based on the amount of State expenditures that constituted actual compliance, not material compliance (as provided for in paragraph (2)), or that would have been required if the State had not been granted a waiver under subsection (c).

(b)

Exclusion of Certain Funds

The Secretary may exclude from the aggregate State expenditures under subsection (a), funds appropriated to the principle agency for authorized activities which are of a non-recurring nature and for a specific purpose.

(c)

Waiver

(1)

In general

Upon the request of a State, the Secretary may waive all or part of the requirement established in subsection (a)(1)—

(A)

if the Secretary determines that extraordinary economic conditions in the State in the fiscal year involved or in the previous fiscal year justify the waiver; and

(B)

if the State or any part of the State has experienced an emergency or a natural disaster that has received a Presidential Disaster Declaration under section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act.

(2)

Date certain for acting upon request

The Secretary shall approve or deny a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.

(3)

Applicability of waiver

Any waiver provided by the Secretary under paragraph (1) shall be applicable only to the fiscal year involved.

(d)

Noncompliance by State

(1)

In general

In making a grant under section 1921 to a State for a fiscal year, the Secretary shall make a determination of whether, for the previous fiscal year, the State complied with any agreement made under subsection (a). If the Secretary determines that a State has failed to maintain such compliance, the Secretary shall reduce the amount of the allotment under section 1921 for the State for the year in which a final determination is made, by an amount equal to the amount constituting such failure.

(2)

Alternative penalty

A State that has failed to comply with this section and that would otherwise be subject to a reduction in the State’s allotment under section 1921, may, with the approval of the Secretary, in lieu of having the State’s allotment under section 1921 reduced, agree to comply with a negotiated agreement that is approved by the Secretary and carried out in accordance with guidelines issued by the Secretary.

(3)

Submission of information to secretary

The Secretary may make a grant under section 1921 for a fiscal year only if the State involved submits to the Secretary information sufficient for the Secretary to make the determination required in paragraph (1).

1930.

Restrictions on expenditure of grant

(a)

In General

(1)

Certain restrictions

A funding agreement for a grant under section 1921 is that the State involved will not expend the grant—

(A)

to provide inpatient hospital services, except as provided in subsection (b);

(B)

to make cash payments to intended recipients of health services;

(C)

to purchase or improve land, purchase, construct, or permanently improve (other than minor remodeling) any building or other facility, or purchase major medical equipment;

(D)

to satisfy any requirement for the expenditure of non-Federal funds as a condition for the receipt of Federal funds;

(E)

to provide financial assistance to any entity other than a public or nonprofit private entity; or

(F)

to carry out any program prohibited by section 256(b) of the Health Omnibus Programs Extension of 1988 (42 U.S.C. 300ee–5).

(2)

Limitation on administrative expenses

A funding agreement for a grant under section 1921 is that the State involved will not expend more than 5 percent of the grant to pay the costs of administering the grant.

(3)

Limitation regarding penal and correctional institutions

A funding agreement for a State for a grant under section 1921 is that, in expending the grant for the purpose of providing treatment services in penal or correctional institutions of the State, the State will not expend more than an amount equal to the amount expended for such purpose by the State from the grant made under section 1912A to the State for fiscal year 1991 (as section 1912A was in effect for such fiscal year).

(b)

Exception Regarding Inpatient Hospital Services

(1)

Medical necessity as precondition

With respect to compliance with the agreement made under subsection (a), a State may expend a grant under section 1921 to provide inpatient hospital services as treatment for substance use disorders only if it has been determined, in accordance with guidelines issued by the Secretary, that such treatment is a medical necessity for the individual involved, and that the individual cannot be effectively treated in a community-based, nonhospital, residential program of treatment.

(2)

Rate of payment

In the case of an individual for whom a grant under section 1921 is expended to provide inpatient hospital services described in paragraph (1), a funding agreement for the grant for the State involved is that the daily rate of payment provided to the hospital for providing the services to the individual will not exceed the comparable daily rate provided for community-based, nonhospital, residential programs of treatment for substance use disorders.

(c)

Waiver Regarding Construction of Facilities

(1)

In general

The Secretary may provide to any State a waiver of the restriction established in subsection (a)(1)(C) for the purpose of authorizing the State to expend a grant under section 1921 for the construction of a new facility or rehabilitation of an existing facility, but not for land acquisition.

(2)

Standard regarding need for waiver

The Secretary may approve a waiver under paragraph (1) only if the State demonstrates to the Secretary that adequate treatment cannot be provided through the use of existing facilities and that alternative facilities in existing suitable buildings are not available.

(3)

Amount

In granting a waiver under paragraph (1), the Secretary shall allow the use of a specified amount of funds to construct or rehabilitate a specified number of beds for residential treatment and a specified number of slots for outpatient treatment, based on reasonable estimates by the State of the costs of construction or rehabilitation. In considering waiver applications, the Secretary shall ensure that the State has carefully designed a program that will minimize the costs of additional beds.

(4)

Matching funds

The Secretary may grant a waiver under paragraph (1) only if the State agrees, with respect to the costs to be incurred by the State in carrying out the purpose of the waiver, to make available non-Federal contributions in cash toward such costs in an amount equal to not less than $1 for each $1 of Federal funds provided under section 1921.

(5)

Date certain for acting upon request

The Secretary shall act upon a request for a waiver under paragraph (1) not later than 120 days after the date on which the request is made.

1931.

Application for grant; approval of State plan

(a)

In General

For purposes of section 1921, an application for a grant under such section for a fiscal year is in accordance with this section if, subject to subsection (c)—

(1)

the application is received by the Secretary not later than October 1 of the fiscal year for which the State is seeking funds;

(2)

the application contains each funding agreement that is described in this subpart or subpart III for such a grant (other than any such agreement that is not applicable to the State);

(3)

the agreements are made through certification from the chief executive officer of the State;

(4)

with respect to such agreements, the application provides assurances of compliance satisfactory to the Secretary;

(5)

the application contains the information required in section 1929 and the report required in section 1942;

(6)
(A)

the application contains a plan in accordance with subsection (b) and the plan is approved by the Secretary; and

(B)

the State provides assurances satisfactory to the Secretary that the State complied with the provisions of the plan under subparagraph (A) that was approved by the Secretary for the most recent fiscal year for which the State received a grant under section 1921; and

(7)

the application (including the plan under paragraph (6)) is otherwise in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines to be necessary to carry out this subpart.

(b)

State Plans

(1)

In general

In order for a State to be in compliance with subsection (a)(6), the State shall submit to the Secretary, every 3 years, a plan that, at a minimum, includes the following:

(A)

A description of the State’s system of care that—

(i)

identifies the single State agency responsible for the administration of the program, including any third party who administers substance use disorder services and is responsible for complying with the requirements of the grant;

(ii)

provides information on the need for substance use disorder prevention and treatment services in the State by age, sex, race, and ethnicity including estimates on the number of individuals who need treatment, who are women, who are pregnant, who are women with children, who are individuals with a co-occurring mental health and substance use disorder, who are intravenous drug users and who are homeless individuals;

(iii)

provides a description of consequences and consumption patterns by location, age, sex, race, and ethnicity;

(iv)

provides information on the current number of individuals in treatment within the State by age, sex, race, and ethnicity including the number of such individuals who are women, who are pregnant, who have children, individuals with a co-occurring mental health and substance use disorder, intravenous drug users and who are homeless individuals;

(v)

provides a description of the system that is available to provide services by modality, including the provision of recovery support services;

(vi)

provides an assessment on the adequacy of the system to respond to the need;

(vii)

provides the latest performance outcome data, including outcome data determined in accordance with section 504(b);

(viii)

provides a description of the State’s comprehensive statewide prevention effort, including the number of individuals being served in the system, and provides a description of the amount of funds from the prevention set-aside expended on primary prevention;

(ix)

identifies target populations and priority needs for prevention services;

(x)

provides a description of the resources available in the State to pay for the services, including funding under Medicaid, title XXVI, and other Federal programs such as grants to the State, local jurisdiction of the State or nonprofit private entities awarded under title V and how the State is maximizing these resources;

(xi)

provides a description of the manner in which the State and local entities coordinate prevention and treatment services with other agencies, including health, mental health, juvenile justice, law enforcement, education, social services, and child welfare;

(xii)

describes the existing mental health and substance use disorders workforce, including data on the number of individuals who serve in the system of care designated by profession, the need for additional professionals and paraprofessionals, the efforts of the State to recruit and retain a qualified mental health and substance use disorders workforce, and a copy of the standards the State uses in certifying or licensing facilities and counselors for prevention and treatment facilities;

(xiii)

includes a description of how the State promotes evidenced-based practices; and

(xiv)

a description of how the State integrates mental health and substance use disorder services and primary health care, which may include providing mental health and substance use disorder services in primary care settings or providing primary and specialty care services in community-based mental health and substance use disorder service settings.

(B)

An analysis of the system that identifies the strengths and weaknesses of the system of care, and an assessment of the adequacy of the system to respond to the need for services.

(C)

The establishment of goals and objectives, including goals and objectives for the outcome measures established under section 504(b), for the period of the plan including targets and milestones that are intended to be met and the activities that will be undertaken to achieve those targets.

(D)

A description of how the State will comply with each funding agreement for a grant under section 1921 that is applicable to the State, including a description of the manner in which the State intends to expend the grant.

(E)

Data on the percentage of grant funds expended for primary prevention services.

(2)

Authority of the secretary regarding modifications

As a condition of awarding a grant under section 1921 to a State for a fiscal year, the Secretary may require that the State modify any provision of the plan submitted by the State under subsection (a)(6) (including provisions on priorities in carrying out authorized activities) only after significant dialogue and negotiations between the State and the Secretary concerning the identified modifications. If the Secretary approves the plan and awards the grant to the State for the fiscal year, the Secretary may not during such year require the State to modify the plan.

(3)

State request for modification

If the State determines that modifications to the plan are necessary, the State may request the Secretary to approve such modifications through its annual report required under section 1942.

(4)

Substance use disorder emergency response

(A)

Requirements

The State plan under this section shall includes the State’s plan for addressing the mental health and substance use disorder needs of individuals in the State in the event of an emergency or major disaster.

(B)

Demonstration

The State shall demonstrate how the mental health and substance use disorder plan under subparagraph (A) for providing for the substance use disorder health needs of individuals in the event of an emergency or major disaster is incorporated into the State’s All-Hazards Public Health Emergency Preparedness and Response Plan required under section 319C–1. If the substance use disorder emergency response plan under subparagraph (A) is not so incorporated, the State shall describe how such plan will be incorporated into the State Emergency Response Plan during the period that the State plan under this section is in effect.

(C)

Definitions

In this paragraph, the terms emergency and major disaster have the meanings given such terms in section 102 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act.

(c)

Waivers Regarding Certain Territories

In the case of any territory of the United States except Puerto Rico, the Secretary may waive such provisions of this subpart and subpart III as the Secretary determines to be appropriate, other than the provisions of section 1930.

(d)

Issuance of Regulations

The Secretary shall establish standards specifying the circumstances in which the Secretary will consider an application for a grant under section 1921 to be in accordance with this section.

1932.

Determination of amount of allotment

(a)

States

(1)

In general

Subject to subsection (b), the Secretary shall determine the amount of the allotment required in section 1921 for a State for a fiscal year as follows:

(A)

The formula established in paragraph (1) of section 1918(a) shall apply to this subsection to the same extent and in the same manner as the formula applies for purposes of section 1918(a), except that, in the application of such formula for purposes of this subsection, the modifications described in subparagraph (B) shall apply.

(B)

For purposes of subparagraph (A), the modifications described in this subparagraph are as follows:

(i)

The amount specified in paragraph (2)(A) of section 1918(a) is deemed to be the amount appropriated under section 1935(a) for allotments under section 1921 for the fiscal year involved.

(ii)

The term P is deemed to have the meaning given in paragraph (2) of this subsection. Section 1918(a)(5)(B) applies to the data used in determining such term for the States.

(iii)

The factor determined under paragraph (8) of section 1918(a) is deemed to have the purpose of reflecting the differences that exist between the State involved and other States in the costs of providing authorized services.

(2)

Determination of term p

For purposes of this subsection, the term P means the percentage that is the arithmetic mean of the percentage determined under subparagraph (A) and the percentage determined under subparagraph (B), as follows:

(A)

The percentage constituted by the ratio of—

(i)

an amount equal to the sum of the total number of individuals who reside in the State involved and are between 18 and 24 years of age (inclusive) and the number of individuals in the State who reside in urbanized areas of the State and are between such years of age; to

(ii)

an amount equal to the total of the respective sums determined for the States under clause (i).

(B)

The percentage constituted by the ratio of—

(i)

the total number of individuals in the State who are between 25 and 64 years of age (inclusive); to

(ii)

an amount equal to the sum of the respective amounts determined for the States under clause (i).

(b)

Minimum Allotments for States

(1)

In general

With respect to fiscal year 2000, and each subsequent fiscal year, the amount of the allotment of a State under section 1921 shall not be less than the amount the State received under such section for the previous fiscal year increased by an amount equal to 30.65 percent of the percentage by which the aggregate amount allotted to all States for such fiscal year exceeds the aggregate amount allotted to all States for the previous fiscal year.

(2)

Limitations

(A)

In general

Except as provided in subparagraph (B), a State shall not receive an allotment under section 1921 for a fiscal year in an amount that is less than an amount equal to 0.375 percent of the amount appropriated under section 1935(a) for such fiscal year.

(B)

Exception

In applying subparagraph (A), the Secretary shall ensure that no State receives an increase in its allotment under section 1921 for a fiscal year (as compared to the amount allotted to the State in the prior fiscal year) that is in excess of an amount equal to 300 percent of the percentage by which the amount appropriated under section 1935(a) for such fiscal year exceeds the amount appropriated for the prior fiscal year.

(3)

Decrease in or equal appropriations

If the amount appropriated under section 1935(a) for a fiscal year is equal to or less than the amount appropriated under such section for the prior fiscal year, the amount of the State allotment under section 1921 shall be equal to the amount that the State received under section 1921 in the prior fiscal year decreased by the percentage by which the amount appropriated for such fiscal year is less than the amount appropriated or such section for the prior fiscal year.

(c)

Territories

(1)

Determination under formula

Subject to paragraphs (2) and (4), the amount of an allotment under section 1921 for a territory of the United States for a fiscal year shall be the product of—

(A)

an amount equal to the amounts reserved under paragraph (3) for the fiscal year; and

(B)

a percentage equal to the quotient of—

(i)

the civilian population of the territory, as indicated by the most recently available data; divided by

(ii)

the aggregate civilian population of the territories of the United States, as indicated by such data.

(2)

Minimum allotment for territories

The amount of an allotment under section 1921 for a territory of the United States for a fiscal year shall be the greater of—

(A)

the amount determined under paragraph (1) for the territory for the fiscal year;

(B)

$50,000; and

(C)

with respect to fiscal years 1993 and 1994, an amount equal to 79.4 percent of the amount received by the territory from allotments made pursuant to this part for fiscal year 1992.

(3)

Reservation of amounts

The Secretary shall each fiscal year reserve for the territories of the United States 1.5 percent of the amounts appropriated under section 1935(a) for allotments under section 1921 for the fiscal year.

(4)

Availability of data on population

With respect to data on the civilian population of the territories of the United States, if the Secretary determines for a fiscal year that recent such data for purposes of paragraph (1)(B) do not exist regarding a territory, the Secretary shall for such purposes estimate the civilian population of the territory by modifying the data on the territory to reflect the average extent of change occurring during the ensuing period in the population of all territories with respect to which recent such data do exist.

(5)

Applicability of certain provisions

For purposes of subsections (a) and (b), the term State does not include the territories of the United States.

(d)

Indian tribes and tribal organizations

(1)

In general

If the Secretary—

(A)

receives a request from the governing body of an Indian tribe or tribal organization within any State that funds under this subpart be provided directly by the Secretary to such tribe or organization; and

(B)

makes a determination that the members of such tribe or tribal organization would be better served by means of grants made directly by the Secretary under this;

the Secretary shall reserve from the allotment under section 1921 for the State for the fiscal year involved an amount that bears the same ratio to the allotment as the amount provided under this subpart to the tribe or tribal organization for fiscal year 1991 for activities relating to the prevention and treatment of the abuse of alcohol and other drugs bore to the amount of the portion of the allotment under this subpart for the State for such fiscal year that was expended for such activities.
(2)

Tribe or tribal organization as grantee

The amount reserved by the Secretary on the basis of a determination under this paragraph shall be granted to the Indian tribe or tribal organization serving the individuals for whom such a determination has been made.

(3)

Application

In order for an Indian tribe or tribal organization to be eligible for a grant for a fiscal year under this paragraph, it shall submit to the Secretary a plan for such fiscal year that meets such criteria as the Secretary may prescribe.

(4)

Definition

The terms Indian tribe and tribal organization have the same meaning given such terms in subsections (b) and (c) of section 4 of the Indian Self-Determination and Education Assistance Act.

1933.

Definitions

For purposes of this subpart:

(1)

The term authorized activities, subject to section 1931, means the activities described in section 1921(b).

(2)

The term funding agreement, with respect to a grant under section 1921 to a State, means that the Secretary may make such a grant only if the State makes the agreement involved.

(3)

The term prevention activities, subject to section 1931, means activities to prevent substance use disorders.

(4)

The term substance use disorder means the abuse of alcohol or other drugs.

(5)

The term treatment activities means treatment services and, subject to section 1931, authorized activities that are related to treatment services.

(6)

The term treatment facility means an entity that provides treatment services.

(7)

The term treatment services, subject to section 1931, means treatment for substance use disorder.

1934.

Funding

(a)

Authorization of Appropriations

For the purpose of carrying out this subpart, subpart III and section 504 with respect to substance use disorders and section 1945(g) with respect to investigations, there are authorized to be appropriated $2,000,000,000 for fiscal year 2011, and such sums as may be necessary for each of the fiscal years 2012 through 2015.

(b)

Allocations for Technical Assistance, National Data Base, Data Collection, and Program Evaluations

(1)

In general

(A)

For the purpose of carrying out section 1948(a) with respect to substance use disorders, section 1945(g), and the purposes specified in subparagraphs (B) and (C), the Secretary shall obligate 5 percent of the amounts appropriated under subsection (a) each fiscal year.

(B)

The purpose specified in this subparagraph is the collection of data in this paragraph is carrying out section 504 with respect to substance use disorders.

(C)

The purpose specified in this subparagraph is the conduct of evaluations of authorized activities to determine methods for improving the availability and quality of such activities.

(2)

Activities of center for substance abuse prevention

Of the amounts reserved under paragraph (1) for a fiscal year, the Secretary, acting through the Director of the Center for Substance Abuse Prevention, shall obligate 20 percent for carrying out paragraph (1)(C), section 1948(a) with respect to prevention activities, and section 1945(g).

III

General Provisions

1941.

Opportunity for public comment on State plans

A funding agreement for a grant under section 1911 or 1921 is that the State involved will make the plan required in section 1912, and the plan required in section 1931, respectively, public within the State in such manner as to facilitate comment from any person (including any Federal or other public agency) during the development of the plan (including any revisions) and after the submission of the plan to the Secretary.

1942.

Requirement of reports and audits by States

(a)

Report

A funding agreement for a grant under section 1911 or 1921 is that the State involved will submit to the Secretary an annual report in such form and containing such information as the Secretary determines (after consultation with the States) to be necessary for securing a record, including—

(1)

a description of the purposes for which the grant received by the State for the preceding fiscal year under the program involved were expended and a description of the activities of the State under the program;

(2)

a list of providers, and contact information for such providers, who are receiving funds under the program whether directly from the State or a third party (including another State, a local government, or some other agent of the State including an administrative services organization or a managed care program);

(3)

an evaluation of the progress being made towards meeting the goals and objectives of the State plans required in sections 1912(b) and 1931(a)(6)(A), an assessment as to whether the activities described in such plans are helping to meet such goals and objectives, and any obstacles the State is encountering in meeting specific targets established to achieve such goals; and

(4)

information to enable the Secretary to determine State compliance with all of the funding agreements in each grant.

(b)

Review, Determination, and Enforcement

(1)

Review

With respect to grants under sections 1911 and 1921, the Secretary shall review the annual reports submitted by the States under subsection (a).

(2)

Determination

(A)

In general

Based on the information provided by a State in a report submitted under subsection (a), information obtained through monitoring visits, and any other public information made available, the Secretary shall evaluate the performance of the State in meeting its goals and objectives, as established in the State plan under section 1912(b) and 1931(b), respectively, for the year involved, and make a determination as to whether the State—

(i)

has met such goals and objectives;

(ii)

is making a serious effort to meet such goals and objectives but requires technical assistance; or

(iii)

has failed to make a serious effort to meet such goals and objectives.

(B)

Technical assistance

If the Secretary makes a determination under subparagraph (A)(ii), the Secretary, in conjunction with the State, shall make an additional determination of what technical assistance is needed and either provide such assistance or advise the State on where such assistance may be obtained.

(C)

Failure of effort by state

If the Secretary makes a determination under subparagraph (A)(iii) with respect to a State for 3 consecutive years, the Secretary shall require the State to meet with the Secretary to develop a corrective action plan that includes the redirection of funds to meet State goals and objectives, and that contains deadlines for State action.

(D)

Failure to comply with corrective action plan

If the Secretary determines that a State has failed to comply with a corrective action plan under subparagraph (C), the Secretary may suspend, terminate, or withhold funds in accordance with section 1945.

(E)

Notice

Prior to taking action under subparagraph (C) or (D), the Secretary shall provide the State with adequate notice and an opportunity for a hearing.

(c)

Audits

A funding agreement for a grant under section 1911 or 1921 is that the State will, with respect to the grant, comply with chapter 75 of title 31, United States Code.

(d)

Availability to Public

A funding agreement for a grant under section 1911 or 1921 is that the State involved will—

(1)

make copies of the reports and audits described in this section available for public inspection within the State; and

(2)

provide copies of the report under subsection (a), upon request, to any interested person (including any public agency).

1943.

Patient records

The Secretary may make a grant under section 1911 or 1921 only if the State involved has in effect a system to protect from inappropriate disclosure patient records maintained by the State in connection with an activity funded under the program involved or by any entity which is receiving amounts from the grant.

1944.

Disposition of certain funds appropriated for allotments

(a)

In General

Amounts described in subsection (b) and available for a fiscal year pursuant to section 1911 or 1921, shall be allotted by the Secretary and paid to the States receiving a grant under the program involved, other than any State referred to in subsection (b) with respect to such program. Such amounts shall be allotted in a manner equivalent to the manner in which the allotment under the program involved was determined.

(b)

Specification of Amounts

The amounts referred to in subsection (a) are any amounts that—

(1)

are not paid to States under the program involved as a result of—

(A)

the failure of any State to submit an application in accordance with the program;

(B)

the failure of any State to prepare such application in compliance with the program; or

(C)

any State informing the Secretary that the State does not intend to expend the full amount of the allotment made to the State under the program;

(2)

are terminated, repaid, or offset under section 1945;

(3)

in the case of the program established in section 1911, are available as a result of reductions in allotments under such section pursuant to section 1915(b); or

(4)

in the case of the program established in section 1921, are available as a result of reductions in allotments under such section pursuant to section 1926 or 1929.

1945.

Failure to comply with agreements

(a)

Suspension or Termination of Payments

Subject to subsection (e), if the Secretary determines that a State has materially failed to comply with the agreements or other conditions required for the receipt of a grant under the program involved, the Secretary may in whole or in part suspend payments under the grant, terminate the grant for cause, or employ such other remedies (including the remedies provided for in subsections (b) and (c)) as may be legally available and appropriate in the circumstances involved.

(b)

Repayment of Payments