#aadth ,,congress #ast ,session ,s4 #ahic ,,an ,,act ,to reauthorize and improve programs related to mental health and substance use disorders4 #a4 ,short title ,this ,act may be cited as the ,mental ,health ,awareness and ,improvement ,act of #bjae4 #b4 ,garrett ,lee ,smith ,memorial ,act reauthorization 7a7 ,suicide prevention technical assistance center ,section #ebj;,c of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cd7 is amended-- 7#a7 in the section heading1 by striking the section heading and inserting ,suicide prevention technical assistance center42 7#b7 in subsection 7a71 by striking and in consultation with and all that follows through the period at the end of paragraph 7#b7 and inserting shall establish a research1 training1 and technical assistance resource center to provide appropriate information1 training1 and technical assistance to ,states1 political subdivisions of ,states1 federally recognized ,indian tribes1 tribal organizations1 institutions of higher education1 public organizations1 or private nonprofit organizations regarding the prevention of suicide among all ages1 particularly among groups that are at high risk for suicide42 7#c7 by striking subsections 7b7 and 7c72 7#d7 by redesignating subsection 7d7 as subsection 7b72 7#e7 in subsection 7b71 as so redesignated-- 7,a7 by striking the subsection heading and inserting ,responsibilities of the center42 7,b7 in the matter preceding paragraph 7#a71 by striking ,the additional research and all that follows through nonprofit organizations for and inserting ,the center established under subsection 7a7 shall conduct activities for the purpose of2 7,c7 by striking youth suicide each place such term appears and inserting suicide2 7,d7 in paragraph 7#a7-- 7i7 by striking the development or continuation of and inserting developing and continuing2 and 7ii7 by inserting for all ages1 particularly among groups that are at high risk for suicide before the semicolon at the end2 7,e7 in paragraph 7#b71 by inserting for all ages1 particularly among groups that are at high risk for suicide before the semicolon at the end2 7,f7 in paragraph 7#c71 by inserting and tribal after statewide2 7,g7 in paragraph 7#e71 by inserting and prevention after intervention2 7,h7 in paragraph 7#h71 by striking in youth2 7,i7 in paragraph 7#i71 by striking and behavioral health and inserting health and substance use disorder2 and 7,j7 in paragraph 7#aj71 by inserting conducting before other2 and 7#f7 by striking subsection 7e7 and inserting the following3 7c7 ,authorization of appropriations ,for the purpose of carrying out this section1 there are authorized to be appropriated #f1jjj1jjj for each of fiscal years #bjaf through #bjbj4 7d7 ,annual report ,not later than #b years after the date of enactment of this subsection1 the ,secretary shall submit to ,congress a report on the activities carried out by the center established under subsection 7a7 during the year involved1 including the potential impacts of such activities1 and the ,states1 organizations1 and institutions that have worked with the center4 4 7b7 ,youth suicide early intervention and prevention strategies ,section #ebj;,e of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf7 is amended-- 7#a7 in paragraph 7#a7 of subsection 7a7 and in subsection 7c71 by striking substance abuse each place such term appears and inserting substance use disorder2 7#b7 in subsection 7b77#b7-- 7,a7 by striking each ,state is awarded only #a grant or cooperative agreement under this section and inserting a ,state does not receive more than #a grant or cooperative agreement under this section at any #a time2 and 7,b7 by striking been awarded and inserting received2 and 7#c7 in subsection 7g77#b71 by striking #b years after the date of enactment of this section1 and insert #b years after the date of enactment of the ,mental ,health ,awareness and ,improvement ,act of #bjae14 7#d7 by striking subsection 7m7 and inserting the following3 7m7 ,authorization of appropriations ,for the purpose of carrying out this section1 there are authorized to be appropriated #cj1jjj1jjj for each of fiscal years #bjaf through #bjbj4 4 7c7 ,mental health and substance use disorder services ,section #ebj;,e-#b of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cf;b7 is amended-- 7#a7 in the section heading1 by striking and behavioral health and inserting health and substance use disorder2 7#b7 in subsection 7a7-- 7,a7 by striking ,services1 and inserting ,services and2 7,b7 by striking and behavioral health problems and inserting health or substance use disorders2 and 7,c7 by striking substance abuse and inserting substance use disorders2 7#c7 in subsection 7b7-- 7,a7 in the matter preceding paragraph 7#a71 by striking for-- and inserting for one or more of the following32 and 7,b7 by striking paragraphs 7#a7 through 7#f7 and inserting the following3 7#a7 ,educating students1 families1 faculty1 and staff to increase awareness of mental health and substance use disorders4 7#b7 ,the operation of hotlines4 7#c7 ,preparing informational material4 7#d7 ,providing outreach services to notify students about available mental health and substance use disorder services4 7#e7 ,administering voluntary mental health and substance use disorder screenings and assessments4 7#f7 ,supporting the training of students1 faculty1 and staff to respond effectively to students with mental health and substance use disorders4 7#g7 ,creating a network infrastructure to link colleges and universities with health care providers who treat mental health and substance use disorders4 2 7#d7 in subsection 7c77#e71 by striking substance abuse and inserting substance use disorder2 7#e7 in subsection 7d7-- 7,a7 in the matter preceding paragraph 7#a71 by striking ,an institution of higher education desiring a grant under this section and inserting ,to be eligible to receive a grant under this section1 an institution of higher education2 7,b7 in paragraph 7#a7-- 7i7 by striking and behavioral health and inserting health and substance use disorder2 and 7ii7 by inserting 1 including veterans whenever possible and appropriate1 after students2 and 7,c7 in paragraph 7#b71 by inserting 1 which may include1 as appropriate and in accordance with subsection 7b77#g71 a plan to seek input from relevant stakeholders in the community1 including appropriate public and private entities1 in order to carry out the program under the grant before the period at the end2 7#f7 in subsection 7e77#a71 by striking and behavioral health problems and inserting health and substance use disorders2 7#g7 in subsection 7f77#b7-- 7,a7 by striking and behavioral health and inserting health and substance use disorder2 and 7,b7 by striking suicide and substance abuse and inserting suicide and substance use disorders2 and 7#h7 in subsection 7h71 by striking #e1jjj1jjj for fiscal year #bjje and all that follows through the period at the end and inserting #f1ejj1jjj for each of fiscal years #bjaf through #bjbj44 #c4 ,mental health awareness training grants ,section #ebj;,j of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#da7 is amended-- 7#a7 in the section heading1 by inserting ,mental health awareness before ,training2 and 7#b7 in subsection 7b7-- 7,a7 in the subsection heading1 by striking illness and inserting health2 7,b7 in paragraph 7#a71 by inserting and other categories of individuals1 as determined by the ,secretary1 after emergency services personnel2 7,c7 in paragraph 7#e7-- 7i7 in the matter preceding subparagraph 7,a71 by striking to and inserting for evidence-based programs for the purpose of2 and 7ii7 by striking subparagraphs 7,a7 through 7,c7 and inserting the following3 7,a7 recognizing the signs and symptoms of mental illness2 and 7,b7 7i7 providing education to personnel regarding resources available in the community for individuals with a mental illness and other relevant resources2 or 7ii7 the safe de-escalation of crisis situations involving individuals with a mental illness4 2 and 7,d7 in paragraph 7#g71 by striking 1 #be1jjj1jjj and all that follows through the period at the end and inserting #ae1jjj1jjj for each of fiscal years #bjaf through #bjbj44 #d4 ,children's recovery from trauma ,section #ehb of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;hh-#a7 is amended-- 7#a7 in subsection 7a71 by striking developing programs and all that follows through the period at the end and inserting 8developing and maintaining programs that provide for-- 7#a7 the continued operation of the ,national ,child ,traumatic ,stress ,initiative 7referred to in this section as the ,,nctsi71 which includes a cooperative agreement with a coordinating center1 that focuses on the mental1 behavioral1 and biological aspects of psychological trauma response1 prevention of the long-term consequences of child trauma1 and early intervention services and treatment to address the long-term consequences of child trauma2 and 7#b7 the development of knowledge with regard to evidence-based practices for identifying and treating mental1 behavioral1 and biological disorders of children and youth resulting from witnessing or experiencing a traumatic event4 2 7#b7 in subsection 7b7-- 7,a7 by striking subsection 7a7 related and inserting subsection 7a77#b7 7related2 7,b7 by striking treating disorders associated with psychological trauma and inserting treating mental1 behavioral1 and biological disorders associated with psychological trauma72 and 7,c7 by striking mental health agencies and programs that have established clinical and basic research and inserting universities1 hospitals1 mental health agencies1 and other programs that have established clinical expertise and research2 7#c7 by redesignating subsections 7c7 through 7g7 as subsections 7g7 through 7k71 respectively2 7#d7 by inserting after subsection 7b71 the following3 7c7 ,child outcome data ,the ,,nctsi coordinating center shall collect1 analyze1 and report ,,nctsi-wide child treatment process and outcome data regarding the early identification and delivery of evidence-based treatment and services for children and families served by the ,,nctsi grantees4 7d7 ,training ,the ,,nctsi coordinating center shall facilitate the coordination of training initiatives in evidence-based and trauma-informed treatments1 interventions1 and practices offered to ,,nctsi grantees1 providers1 and partners4 7e7 ,dissemination and collaboration ,the ,,nctsi coordinating center shall1 as appropriate1 collaborate with-- 7#a7 the ,secretary1 in the dissemination of evidence-based and trauma-informed interventions1 treatments1 products1 and other resources to appropriate stakeholders2 and 7#b7 appropriate agencies that conduct or fund research within the ,department of ,health and ,human ,services1 for purposes of sharing ,,nctsi expertise1 evaluation data1 and other activities1 as appropriate4 7f7 ,review ,the ,secretary shall1 consistent with the peer review process1 ensure that ,,nctsi applications are reviewed by appropriate experts in the field as part of a consensus review process4 ,the ,secretary shall include review criteria related to expertise and experience in child trauma and evidence-based practices4 2 7#e7 in subsection 7g7 7as so redesignated71 by striking with respect to centers of excellence are distributed equitably among the regions of the country and inserting are distributed equitably among the regions of the ,united ,states2 7#f7 in subsection 7i7 7as so redesignated71 by striking recipient may not exceed #e years and inserting recipient shall not be less than #d years1 but shall not exceed #e years2 and 7#g7 in subsection 7j7 7as so redesignated71 by striking #ej1jjj1jjj and all that follows through #bjjf and inserting #df1jjj1jjj for each of fiscal years #bjaf through #bjbj4 #e4 ,assessing barriers to behavioral health integration 7a7 ,in general ,not later than #b years after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall submit a report to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives concerning ,federal requirements that impact access to treatment of mental health and substance use disorders related to integration with primary care1 administrative and regulatory issues1 quality measurement and accountability1 and data sharing4 7b7 ,contents ,the report submitted under subsection 7a7 shall include the following3 7#a7 ,an evaluation of the administrative or regulatory burden on behavioral health care providers4 7#b7 ,the identification of outcome and quality measures relevant to integrated health care1 evaluation of the data collection burden on behavioral health care providers1 and any alternative methods for evaluation4 7#c7 ,an analysis of the degree to which electronic data standards1 including interoperability and meaningful use includes behavioral health measures1 and an analysis of strategies to address barriers to health information exchange posed by part #b of title #db1 ,code of ,federal ,regulations4 7#d7 ,an analysis of the degree to which ,federal rules and regulations for behavioral and physical health care are aligned1 including recommendations to address any identified barriers4 7#e7 ,an analysis of the challenges to behavioral health and primary care integration faced by providers in rural areas4 #f4 ,increasing education and awareness of treatments for opioid use disorders 7a7 ,in general ,in order to improve the quality of care delivery and treatment outcomes among patients with opioid use disorders1 the ,secretary of ,health and ,human ,services 7referred to in this section as the ,secretary71 acting through the ,administrator for the ,substance ,abuse and ,mental ,health ,services ,administration1 may advance1 through existing programs as appropriate1 the education and awareness of providers1 patients1 and other appropriate stakeholders regarding all products approved by the ,food and ,drug ,administration to treat opioid use disorders4 7b7 ,activities ,the activities described in subsection 7a7 may include-- 7#a7 disseminating evidence-based practices for the treatment of opioid use disorders2 7#b7 facilitating continuing education programs for health professionals involved in treating opioid use disorders2 7#c7 increasing awareness among relevant stakeholders of the treatment of opioid use disorders2 7#d7 assessing current barriers to the treatment of opioid use disorders for patients and providers and development and implementation of strategies to mitigate such barriers2 and 7#e7 continuing innovative approaches to the treatment of opioid use disorders in various treatment settings1 such as prisons1 community mental health centers1 primary care1 and hospitals4 7c7 ,report ,not later than #a year after the date of enactment of this ,act1 if the ,secretary carries out the activities under this section1 the ,secretary shall submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives a report that examines-- 7#a7 the activities the ,substance ,abuse and ,mental ,health ,services ,administration conducts under this section1 including any potential impacts on health care costs associated with such activities2 7#b7 the role of adherence in the treatment of opioid use disorders and methods to reduce opioid use disorders2 and 7#c7 recommendations on priorities and strategies to address co-occurring substance use disorders and mental illnesses4 #g4 ,examining mental health care for children 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall conduct an independent evaluation1 and submit to the ,committee on ,health1 ,education1 ,labor1 and ,pensions of the ,senate and the ,committee on ,energy and ,commerce of the ,house of ,representatives1 a report concerning the utilization of mental health services for children1 including the usage of psychotropic medications4 7b7 ,content ,the report submitted under subsection 7a7 shall review and assess-- 7#a7 the ways in which children access mental health care1 including information on whether children are treated by primary care or specialty providers1 what types of referrals for additional care are recommended1 and any barriers to accessing this care2 7#b7 the extent to which children are prescribed psychotropic medications in the ,united ,states including the frequency of concurrent medication usage2 and 7#c7 the tools1 assessments1 and medications that are available and used to diagnose and treat children with mental health disorders4 #h4 ,evidence based practices for older adults ,section #ebj;,a7e7 of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;bb-#cb7;e77 is amended by adding at the end the following3 7#c7 ,geriatric mental health disorders ,the ,secretary shall1 as appropriate1 provide technical assistance to grantees regarding evidence-based practices for the prevention and treatment of geriatric mental health disorders and co-occurring mental health and substance use disorders among geriatric populations1 as well as disseminate information about such evidence-based practices to ,states and nongrantees throughout the ,united ,states4 4 #i4 ,national violent death reporting system ,the ,secretary of ,health and ,human ,services1 acting through the ,director of the ,centers for ,disease ,control and ,prevention1 is encouraged to improve1 particularly through the inclusion of additional ,states1 the ,national ,violent ,death ,reporting ,system as authorized by title ,,iii of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bda et seq474 ,participation in the system by the ,states shall be voluntary4 #aj4 ,,gao study on ,virginia ,tech recommendations 7a7 ,in general ,not later than #a year after the date of enactment of this ,act1 the ,comptroller ,general of the ,united ,states shall conduct an independent evaluation1 and submit to the appropriate committees of ,congress a report concerning the status of implementation of recommendations made in the report to the ,president1 ,on ,issues ,raised by the ,virginia ,tech ,tragedy1 by the ,secretaries of ,health and ,human ,services and ,education and the ,attorney ,general of the ,united ,states1 submitted to the ,president on ,june #ac1 #bjjg4 7b7 ,content ,the report submitted to the committees of ,congress under subsection 7a7 shall review and assess-- 7#a7 the extent to which the recommendations in the report that include participation by the ,department of ,health and ,human ,services were implemented2 7#b7 whether there are any barriers to implementation of such recommendations2 and 7#c7 identification of any additional actions the ,federal government can take to support ,states and local communities and ensure that the ,federal government and ,federal law are not obstacles to addressing at the community level-- 7,a7 school violence2 and 7,b7 mental illness4 #aa4 ,performance metrics 7a7 ,evaluation of current programs 7#a7 ,in general ,not later than #ahj days after the date of enactment of this ,act1 the ,assistant ,secretary for ,planning and ,evaluation of the ,department of ,health and ,human ,services shall conduct an evaluation of the impact of activities related to the prevention and treatment of mental illness and substance use disorders conducted by the ,substance ,abuse and ,mental ,health ,services ,administration4 7#b7 ,assessment of performance metrics ,the evaluation conducted under paragraph 7#a7 shall include an assessment of the use of performance metrics to evaluate activities carried out by entities receiving grants1 contracts1 or cooperative agreements related to mental illness or substance use disorders under title ,v or title ,,xix of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #bij;aa et seq42 #db ,u4,s4,c4 #cjjw et seq474 7#c7 ,recommendations ,the evaluation conducted under paragraph 7#a7 shall include recommendations for the use of performance metrics to improve the quality of programs related to the prevention and treatment of mental illness and substance use disorders4 7b7 ,use of performance metrics ,not later than #a year after the date of enactment of this ,act1 the ,secretary of ,health and ,human ,services1 acting through the ,administrator of the ,substance ,abuse and ,mental ,health ,services ,administration1 shall advance1 through existing programs1 the use of performance metrics1 taking into consideration the recommendations under subsection 7a77#c71 to improve programs related to the prevention and treatment of mental illness and substance use disorders4 ,passed the ,senate ,december #ah1 #bjae4,secretary