--H.R.4365--
H.R.4365
One Hundred Sixth Congress
of the
United States of America
AT THE SECOND SESSION
Begun and held at the City of Washington on Monday,
the twenty-fourth day of January, two thousand
An Act
To amend the Public Health Service Act with respect to children's
health.
Be it enacted by the Senate and House of Representatives of the United
States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the `Children's Health Act of 2000'.
SEC. 2. TABLE OF CONTENTS.
The table of contents for this Act is as follows:
DIVISION A--CHILDREN'S HEALTH
TITLE I--AUTISM
Sec.101.Expansion, intensification, and coordination of activities of
National Institutes of Health with respect to research on autism.
Sec.102.Developmental disabilities surveillance and research
programs.
Sec.103.Information and education.
Sec.104.Inter-agency Autism Coordinating Committee.
Sec.105.Report to Congress.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
Sec.201.National Institute of Child Health and Human Development;
research on fragile X.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
Sec.301.National Institute of Arthritis and Musculoskeletal and Skin
Diseases; research on juvenile arthritis and related conditions.
Sec.302.Information clearinghouse.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
Sec.401.Programs of Centers for Disease Control and Prevention.
Sec.402.Programs of National Institutes of Health.
TITLE V--ASTHMA SERVICES FOR CHILDREN
Subtitle A--Asthma Services
Sec.501.Grants for children's asthma relief.
Sec.502.Technical and conforming amendments.
Subtitle B--Prevention Activities
Sec.511.Preventive health and health services block grant; systems for
reducing asthma-related illnesses through integrated pest management.
Subtitle C--Coordination of Federal Activities
Sec.521.Coordination through National Institutes of Health.
Subtitle D--Compilation of Data
Sec.531.Compilation of data by Centers for Disease Control and
Prevention.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
Sec.601.Program regarding effects of folic acid in prevention of birth
defects.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
Sec.611.National Center on Birth Defects and Developmental
Disabilities.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING LOSS
IN INFANTS
Sec.702.Programs of Health Resources and Services Administration,
Centers for Disease Control and Prevention, and National Institutes of
Health.
TITLE VIII--CHILDREN AND EPILEPSY
Sec.801.National public health campaign on epilepsy; seizure disorder
demonstration projects in medically underserved areas.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Prevention Research
Sec.901.Prevention research and other activities.
Subtitle B--Pregnant Women and Infants Health Promotion
Sec.911.Programs regarding prenatal and postnatal health.
TITLE X--PEDIATRIC RESEARCH INITIATIVE
Sec.1001.Establishment of pediatric research initiative.
Sec.1002.Investment in tomorrow's pediatric researchers.
Sec.1003.Review of regulations.
Sec.1004.Long-term child development study.
TITLE XI--CHILDHOOD MALIGNANCIES
Sec.1101.Programs of Centers for Disease Control and Prevention and
National Institutes of Health.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
Sec.1201.Grants regarding infant adoption awareness.
Subtitle B--Special Needs Adoption Awareness
Sec.1211.Special needs adoption programs; public awareness campaign and
other activities.
TITLE XIII--TRAUMATIC BRAIN INJURY
Sec.1301.Programs of Centers for Disease Control and Prevention.
Sec.1302.Study and monitor incidence and prevalence.
Sec.1303.Programs of National Institutes of Health.
Sec.1304.Programs of Health Resources and Services Administration.
Sec.1305.State grants for protection and advocacy services.
Sec.1306.Authorization of appropriations for certain programs.
TITLE XIV--CHILD CARE SAFETY AND HEALTH GRANTS
Sec.1402.Authorization of appropriations.
Sec.1404.Amounts reserved; allotments.
Sec.1405.State applications.
TITLE XV--HEALTHY START INITIATIVE
Sec.1501.Continuation of healthy start program.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
Sec.1601.Identification of interventions that reduce the burden and
transmission of oral, dental, and craniofacial diseases in high risk
populations; development of approaches for pediatric oral and craniofacial
assessment.
Sec.1602.Oral health promotion and disease prevention.
Sec.1603.Coordinated program to improve pediatric oral health.
TITLE XVII--VACCINE-RELATED PROGRAMS
Subtitle A--Vaccine Compensation Program
Sec.1701.Content of petitions.
Subtitle B--Childhood Immunizations
Sec.1711.Childhood immunizations.
TITLE XVIII--HEPATITIS C
Sec.1801.Surveillance and education regarding hepatitis C.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec.1901.Autoimmune diseases; initiative through Director of National
Institutes of Health.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S HOSPITALS
Sec.2001.Provisions to revise and extend program.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
Sec.2101.Organ Procurement and Transplantation Network; amendments
regarding needs of children.
TITLE XXII--MUSCULAR DYSTROPHY RESEARCH
Sec.2201.Muscular dystrophy research.
TITLE XXIII--CHILDREN AND TOURETTE SYNDROME AWARENESS
Sec.2301.Grants regarding Tourette Syndrome.
TITLE XXIV--CHILDHOOD OBESITY PREVENTION
Sec.2401.Programs operated through the Centers for Disease Control and
Prevention.
TITLE XXV--EARLY DETECTION AND TREATMENT REGARDING CHILDHOOD LEAD
POISONING
Sec.2501.Centers for Disease Control and Prevention efforts to combat
childhood lead poisoning.
Sec.2502.Grants for lead poisoning related activities.
Sec.2503.Training and reports by the Health Resources and Services
Administration.
Sec.2504.Screenings, referrals, and education regarding lead
poisoning.
TITLE XXVI--SCREENING FOR HERITABLE DISORDERS
Sec.2601.Program to improve the ability of States to provide newborn and
child screening for heritable disorders.
TITLE XXVII--PEDIATRIC RESEARCH PROTECTIONS
Sec.2701.Requirement for additional protections for children involved in
research.
TITLE XXVIII--MISCELLANEOUS PROVISIONS
Sec.2801.Report regarding research on rare diseases in children.
Sec.2802.Study on metabolic disorders.
TITLE XXIX--EFFECTIVE DATE
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES
TITLE XXXI--PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
Sec.3101.Children and violence.
Sec.3102.Emergency response.
Sec.3103.High risk youth reauthorization.
Sec.3104.Substance abuse treatment services for children and
adolescents.
Sec.3105.Comprehensive community services for children with serious
emotional disturbance.
Sec.3106.Services for children of substance abusers.
Sec.3107.Services for youth offenders.
Sec.3108.Grants for strengthening families through community
partnerships.
Sec.3109.Programs to reduce underage drinking.
Sec.3110.Services for individuals with fetal alcohol syndrome.
Sec.3111.Suicide prevention.
Sec.3112.General provisions.
TITLE XXXII--PROVISIONS RELATING TO MENTAL HEALTH
Sec.3201.Priority mental health needs of regional and national
significance.
Sec.3202.Grants for the benefit of homeless individuals.
Sec.3203.Projects for assistance in transition from homelessness.
Sec.3204.Community mental health services performance partnership block
grant.
Sec.3205.Determination of allotment.
Sec.3206.Protection and Advocacy for Mentally Ill Individuals Act of
1986.
Sec.3207.Requirement relating to the rights of residents of certain
facilities.
Sec.3208.Requirement relating to the rights of residents of certain
non-medical, community-based facilities for children and youth.
Sec.3209.Emergency mental health centers.
Sec.3210.Grants for jail diversion programs.
Sec.3211.Improving outcomes for children and adolescents through
services integration between child welfare and mental health services.
Sec.3212.Grants for the integrated treatment of serious mental illness
and co-occurring substance abuse.
Sec.3213.Training grants.
TITLE XXXIII--PROVISIONS RELATING TO SUBSTANCE ABUSE
Sec.3301.Priority substance abuse treatment needs of regional and
national significance.
Sec.3302.Priority substance abuse prevention needs of regional and
national significance.
Sec.3303.Substance abuse prevention and treatment performance
partnership block grant.
Sec.3304.Determination of allotments.
Sec.3305.Nondiscrimination and institutional safeguards for religious
providers.
Sec.3306.Alcohol and drug prevention or treatment services for Indians
and Native Alaskans.
Sec.3307.Establishment of commission.
TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND ACCOUNTABILITY
Sec.3401.General authorities and peer review.
Sec.3402.Advisory councils.
Sec.3403.General provisions for the performance partnership block
grants.
Sec.3404.Data infrastructure projects.
Sec.3405.Repeal of obsolete addict referral provisions.
Sec.3406.Individuals with co-occurring disorders.
Sec.3407.Services for individuals with co-occurring disorders.
TITLE XXXV--WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR PRESCRIBE
CERTAIN NARCOTIC DRUGS FOR MAINTENANCE TREATMENT OR DETOXIFICATION
TREATMENT
Sec.3502.Amendment to Controlled Substances Act.
TITLE XXXVI--METHAMPHETAMINE AND OTHER CONTROLLED SUBSTANCES
Subtitle A--Methamphetamine Production, Trafficking, and Abuse
Part I--Criminal Penalties
Sec.3611.Enhanced punishment of amphetamine laboratory operators.
Sec.3612.Enhanced punishment of amphetamine or methamphetamine
laboratory operators.
Sec.3613.Mandatory restitution for violations of Controlled Substances
Act and Controlled Substances Import and Export Act relating to amphetamine
and methamphetamine.
Sec.3614.Methamphetamine paraphernalia.
Part II--Enhanced Law Enforcement
Sec.3621.Environmental hazards associated with illegal manufacture of
amphetamine and methamphetamine.
Sec.3622.Reduction in retail sales transaction threshold for non-safe
harbor products containing pseudoephedrine or phenylpropanolamine.
Sec.3623.Training for Drug Enforcement Administration and State and
local law enforcement personnel relating to clandestine laboratories.
Sec.3624.Combating methamphetamine and amphetamine in high intensity
drug trafficking areas.
Sec.3625.Combating amphetamine and methamphetamine manufacturing and
trafficking.
Part III--Abuse Prevention and Treatment
Sec.3631.Expansion of methamphetamine research.
Sec.3632.Methamphetamine and amphetamine treatment initiative by Center
for Substance Abuse Treatment.
Sec.3633.Study of methamphetamine treatment.
Part IV--Reports
Sec.3641.Reports on consumption of methamphetamine and other illicit
drugs in rural areas, metropolitan areas, and consolidated metropolitan
areas.
Sec.3642.Report on diversion of ordinary, over-the-counter
pseudoephedrine and phenylpropanolamine products.
Subtitle B--Controlled Substances Generally
Sec.3651.Enhanced punishment for trafficking in list I chemicals.
Sec.3652.Mail order requirements.
Sec.3653.Theft and transportation of anhydrous ammonia for purposes of
illicit production of controlled substances.
Subtitle C--Ecstasy Anti-Proliferation Act of 2000
Sec.3663.Enhanced punishment of Ecstasy traffickers.
Sec.3664.Emergency authority to United States Sentencing
Commission.
Sec.3665.Expansion of Ecstasy and club drugs abuse prevention
efforts.
Subtitle D--Miscellaneous
Sec.3671.Antidrug messages on Federal Government Internet
websites.
Sec.3672.Reimbursement by Drug Enforcement Administration of expenses
incurred to remediate methamphetamine laboratories.
DIVISION A--CHILDREN'S HEALTH
TITLE I--AUTISM
SEC. 101. EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF
NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH ON AUTISM.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et
seq.) is amended by adding at the end the following section:
`EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF NATIONAL
INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH ON AUTISM
`SEC. 409C. (a) IN GENERAL-
`(1) EXPANSION OF ACTIVITIES- The Director of NIH (in this section
referred to as the `Director') shall expand, intensify, and coordinate the
activities of the National Institutes of Health with respect to research on
autism.
`(2) ADMINISTRATION OF PROGRAM; COLLABORATION AMONG AGENCIES- The
Director shall carry out this section acting through the Director of the
National Institute of Mental Health and in collaboration with any other
agencies that the Director determines appropriate.
`(b) CENTERS OF EXCELLENCE-
`(1) IN GENERAL- The Director shall under subsection (a)(1) make awards
of grants and contracts to public or nonprofit private entities to pay all
or part of the cost of planning, establishing, improving, and providing
basic operating support for centers of excellence regarding research on
autism.
`(2) RESEARCH- Each center under paragraph (1) shall conduct basic and
clinical research into autism. Such research should include investigations
into the cause, diagnosis, early detection, prevention, control, and
treatment of autism. The centers, as a group, shall conduct research
including the fields of developmental neurobiology, genetics, and
psychopharmacology.
`(3) SERVICES FOR PATIENTS-
`(A) IN GENERAL- A center under paragraph (1) may expend amounts
provided under such paragraph to carry out a program to make individuals
aware of opportunities to participate as subjects in research conducted by
the centers.
`(B) REFERRALS AND COSTS- A program under subparagraph (A) may, in
accordance with such criteria as the Director may establish, provide to
the subjects described in such subparagraph, referrals for health and
other services, and such patient care costs as are required for
research.
`(C) AVAILABILITY AND ACCESS- The extent to which a center can
demonstrate availability and access to clinical services shall be
considered by the Director in decisions about awarding grants to
applicants which meet the scientific criteria for funding under this
section.
`(4) COORDINATION OF CENTERS; REPORTS- The Director shall, as
appropriate, provide for the coordination of information among centers under
paragraph (1) and ensure regular communication between such centers, and may
require the periodic preparation of reports on the activities of the centers
and the submission of the reports to the Director.
`(5) ORGANIZATION OF CENTERS- Each center under paragraph (1) shall use
the facilities of a single institution, or be formed from a consortium of
cooperating institutions, meeting such requirements as may be prescribed by
the Director.
`(6) NUMBER OF CENTERS; DURATION OF SUPPORT-
`(A) IN GENERAL- The Director shall provide for the establishment of
not less than five centers under paragraph (1).
`(B) DURATION- Support for a center established under paragraph (1)
may be provided under this section for a period of not to exceed 5 years.
Such period may be extended for one or more additional periods not
exceeding 5 years if the operations of such center have been reviewed by
an appropriate technical and scientific peer review group established by
the Director and if such group has recommended to the Director that such
period should be extended.
`(c) FACILITATION OF RESEARCH- The Director shall under subsection (a)(1)
provide for a program under which samples of tissues and genetic materials
that are of use in research on autism are donated, collected, preserved, and
made available for such research. The program shall be carried out in
accordance with accepted scientific and medical standards for the donation,
collection, and preservation of such samples.
`(d) PUBLIC INPUT- The Director shall under subsection (a)(1) provide for
means through which the public can obtain information on the existing and
planned programs and activities of the National Institutes of Health with
respect to autism and through which the Director can receive comments from the
public regarding such programs and activities.
`(e) FUNDING- There are authorized to be appropriated such sums as may be
necessary to carry out this section. Amounts appropriated under this
subsection are in addition to any other amounts appropriated for such
purpose.'.
SEC. 102. DEVELOPMENTAL DISABILITIES SURVEILLANCE AND RESEARCH
PROGRAMS.
(a) NATIONAL AUTISM AND PERVASIVE DEVELOPMENTAL DISABILITIES SURVEILLANCE
PROGRAM-
(1) IN GENERAL- The Secretary of Health and Human Services (in this
section referred to as the `Secretary'), acting through the Director of the
Centers for Disease Control and Prevention, may make awards of grants and
cooperative agreements for the collection, analysis, and reporting of data
on autism and pervasive developmental disabilities. In making such awards,
the Secretary may provide direct technical assistance in lieu of cash.
(2) ELIGIBILITY- To be eligible to receive an award under paragraph (1)
an entity shall be a public or nonprofit private entity (including health
departments of States and political subdivisions of States, and including
universities and other educational entities).
(b) CENTERS OF EXCELLENCE IN AUTISM AND PERVASIVE DEVELOPMENTAL
DISABILITIES EPIDEMIOLOGY-
(1) IN GENERAL- The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall establish not less than
three regional centers of excellence in autism and pervasive developmental
disabilities epidemiology for the purpose of collecting and analyzing
information on the number, incidence, correlates, and causes of autism and
related developmental disabilities.
(2) RECIPIENTS OF AWARDS FOR ESTABLISHMENT OF CENTERS- Centers under
paragraph (1) shall be established and operated through the awarding of
grants or cooperative agreements to public or nonprofit private entities
that conduct research, including health departments of States and political
subdivisions of States, and including universities and other educational
entities.
(3) CERTAIN REQUIREMENTS- An award for a center under paragraph (1) may
be made only if the entity involved submits to the Secretary an application
containing such agreements and information as the Secretary may require,
including an agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report autism and pervasive
developmental disabilities data according to guidelines prescribed by the
Director, after consultation with relevant State and local public health
officials, private sector developmental disability researchers, and
advocates for those with developmental disabilities.
(B) The center will assist with the development and coordination of
State autism and pervasive developmental disabilities surveillance efforts
within a region.
(C) The center will identify eligible cases and controls through its
surveillance systems and conduct research into factors which may cause
autism and related developmental disabilities.
(D) The center will develop or extend an area of special research
expertise (including genetics, environmental exposure to contaminants,
immunology, and other relevant research specialty areas).
(c) CLEARINGHOUSE- The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, shall carry out the following:
(1) The Secretary shall establish a clearinghouse within the Centers for
Disease Control and Prevention for the collection and storage of data
generated from the monitoring programs established by this title. Through
the clearinghouse, such Centers shall serve as the coordinating agency for
autism and pervasive developmental disabilities surveillance activities. The
functions of such a clearinghouse shall include facilitating the
coordination of research and policy development relating to the epidemiology
of autism and other pervasive developmental disabilities.
(2) The Secretary shall coordinate the Federal response to requests for
assistance from State health department officials regarding potential or
alleged autism or developmental disability clusters.
(d) DEFINITION- In this title, the term `State' means each of the several
States, the District of Columbia, the Commonwealth of Puerto Rico, American
Samoa, Guam, the Commonwealth of the Northern Mariana Islands, the Virgin
Islands, and the Trust Territory of the Pacific Islands.
(e) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 103. INFORMATION AND EDUCATION.
(a) IN GENERAL- The Secretary shall establish and implement a program to
provide information and education on autism to health professionals and the
general public, including information and education on advances in the
diagnosis and treatment of autism and training and continuing education
through programs for scientists, physicians, and other health professionals
who provide care for patients with autism.
(b) STIPENDS- The Secretary may use amounts made available under this
section to provide stipends for health professionals who are enrolled in
training programs under this section.
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated such sums as may be necessary to carry out this section.
SEC. 104. INTER-AGENCY AUTISM COORDINATING COMMITTEE.
(a) ESTABLISHMENT- The Secretary shall establish a committee to be known
as the `Autism Coordinating Committee' (in this section referred to as the
`Committee') to coordinate all efforts within the Department of Health and
Human Services concerning autism, including activities carried out through the
National Institutes of Health and the Centers for Disease Control and
Prevention under this title (and the amendment made by this title).
(1) IN GENERAL- The Committee shall be composed of the Directors of such
national research institutes, of the Centers for Disease Control and
Prevention, and of such other agencies and such other officials as the
Secretary determines appropriate.
(2) ADDITIONAL MEMBERS- If determined appropriate by the Secretary, the
Secretary may appoint to the Committee--
(A) parents or legal guardians of individuals with autism or other
pervasive developmental disorders; and
(B) representatives of other governmental agencies that serve children
with autism such as the Department of Education.
(c) ADMINISTRATIVE SUPPORT; TERMS OF SERVICE; OTHER PROVISIONS- The
following shall apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate administrative
support from the Department of Health and Human Services.
(2) Members of the Committee appointed under subsection (b)(2)(A) shall
serve for a term of 3 years, and may serve for an unlimited number of terms
if reappointed.
(3) The Committee shall meet not less than two times each year.
SEC. 105. REPORT TO CONGRESS.
Not later than January 1, 2001, and each January 1 thereafter, the
Secretary shall prepare and submit to the appropriate committees of Congress,
a report concerning the implementation of this title and the amendments made
by this title.
TITLE II--RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
SEC. 201. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN DEVELOPMENT; RESEARCH
ON FRAGILE X.
Subpart 7 of part C of title IV of the Public Health Service Act is
amended by adding at the end the following section:
`FRAGILE X
`SEC. 452E. (a) EXPANSION AND COORDINATION OF RESEARCH ACTIVITIES- The
Director of the Institute, after consultation with the advisory council for
the Institute, shall expand, intensify, and coordinate the activities of the
Institute with respect to research on the disease known as fragile X.
`(1) IN GENERAL- The Director of the Institute shall make grants or
enter into contracts for the development and operation of centers to conduct
research for the purposes of improving the diagnosis and treatment of, and
finding the cure for, fragile X.
`(A) IN GENERAL- In carrying out paragraph (1), the Director of the
Institute shall, to the extent that amounts are appropriated, and subject
to subparagraph (B), provide for the establishment of at least three
fragile X research centers.
`(B) PEER REVIEW REQUIREMENT- The Director of the Institute shall make
a grant to, or enter into a contract with, an entity for purposes of
establishing a center under paragraph (1) only if the grant or contract
has been recommended after technical and scientific peer review required
by regulations under section 492.
`(3) ACTIVITIES- The Director of the Institute, with the assistance of
centers established under paragraph (1), shall conduct and support basic and
biomedical research into the detection and treatment of fragile X.
`(4) COORDINATION AMONG CENTERS- The Director of the Institute shall, as
appropriate, provide for the coordination of the activities of the centers
assisted under this section, including providing for the exchange of
information among the centers.
`(5) CERTAIN ADMINISTRATIVE REQUIREMENTS- Each center assisted under
paragraph (1) shall use the facilities of a single institution, or be formed
from a consortium of cooperating institutions, meeting such requirements as
may be prescribed by the Director of the Institute.
`(6) DURATION OF SUPPORT- Support may be provided to a center under
paragraph (1) for a period not exceeding 5 years. Such period may be
extended for one or more additional periods, each of which may not exceed 5
years, if the operations of such center have been reviewed by an appropriate
technical and scientific peer review group established by the Director and
if such group has recommended to the Director that such period be
extended.
`(7) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out
this subsection, there are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2001 through 2005.'.
TITLE III--JUVENILE ARTHRITIS AND RELATED CONDITIONS
SEC. 301. NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN
DISEASES; RESEARCH ON JUVENILE ARTHRITIS AND RELATED CONDITIONS.
(a) IN GENERAL- Subpart 4 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285d et seq.) is amended by inserting after section 442
the following section:
`JUVENILE ARTHRITIS AND RELATED CONDITIONS
`SEC. 442A. (a) EXPANSION AND COORDINATION OF ACTIVITIES- The Director of
the Institute, in coordination with the Director of the National Institute of
Allergy and Infectious Diseases, shall expand and intensify the programs of
such Institutes with respect to research and related activities concerning
juvenile arthritis and related conditions.
`(b) COORDINATION- The Directors referred to in subsection (a) shall
jointly coordinate the programs referred to in such subsection and consult
with the Arthritis and Musculoskeletal Diseases Interagency Coordinating
Committee.
`(c) 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 the fiscal years 2001 through 2005.'.
(b) PEDIATRIC RHEUMATOLOGY- Subpart 1 of part E of title VII of the Public
Health Service Act (42 U.S.C. 294n et seq.) is amended by adding at the end
the following:
`SEC. 763. PEDIATRIC RHEUMATOLOGY.
`(a) IN GENERAL- The Secretary, acting through the appropriate agencies,
shall evaluate whether the number of pediatric rheumatologists is sufficient
to address the health care needs of children with arthritis and related
conditions, and if the Secretary determines that the number is not sufficient,
shall develop strategies to help address the shortfall.
`(b) REPORT TO CONGRESS- Not later than October 1, 2001, the Secretary
shall submit to the Congress a report describing the results of the evaluation
under subsection (a), and as applicable, the strategies developed under such
subsection.
`(c) 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 the fiscal years 2001 through 2005.'.
SEC. 302. INFORMATION CLEARINGHOUSE.
Section 438(b) of the Public Health Service Act (42 U.S.C. 285d-3(b)) is
amended by inserting `, including juvenile arthritis and related conditions,'
after `diseases'.
TITLE IV--REDUCING BURDEN OF DIABETES AMONG CHILDREN AND
YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
Part B of title III of the Public Health Service Act (42 U.S.C. 243 et
seq.) is amended by inserting after section 317G the following section:
`DIABETES IN CHILDREN AND YOUTH
`SEC. 317H. (a) SURVEILLANCE ON JUVENILE DIABETES- The Secretary, acting
through the Director of the Centers for Disease Control and Prevention, shall
develop a sentinel system to collect data on juvenile diabetes, including with
respect to incidence and prevalence, and shall establish a national database
for such data.
`(b) TYPE 2 DIABETES IN YOUTH- The Secretary shall implement a national
public health effort to address type 2 diabetes in youth, including--
`(1) enhancing surveillance systems and expanding research to better
assess the prevalence and incidence of type 2 diabetes in youth and
determine the extent to which type 2 diabetes is incorrectly diagnosed as
type 1 diabetes among children; and
`(2) developing and improving laboratory methods to assist in diagnosis,
treatment, and prevention of diabetes including, but not limited to,
developing noninvasive ways to monitor blood glucose to prevent hypoglycemia
and improving existing glucometers that measure blood glucose.
`(c) 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 the fiscal years 2001 through 2005.'.
SEC. 402. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
Subpart 3 of part C of title IV of the Public Health Service Act (42
U.S.C. 285c et seq.) is amended by inserting after section 434 the following
section:
`JUVENILE DIABETES
`SEC. 434A. (a) LONG-TERM EPIDEMIOLOGY STUDIES- The Director of the
Institute shall conduct or support long-term epidemiology studies in which
individuals with or at risk for type 1, or juvenile, diabetes are followed for
10 years or more. Such studies shall investigate the causes and
characteristics of the disease and its complications.
`(b) CLINICAL TRIAL INFRASTRUCTURE/INNOVATIVE TREATMENTS FOR JUVENILE
DIABETES- The Secretary, acting through the Director of the National
Institutes of Health, shall support regional clinical research centers for the
prevention, detection, treatment, and cure of juvenile diabetes.
`(c) PREVENTION OF TYPE 1 DIABETES- The Secretary, acting through the
appropriate agencies, shall provide for a national effort to prevent type 1
diabetes. Such effort shall provide for a combination of increased efforts in
research and development of prevention strategies, including consideration of
vaccine development, coupled with appropriate ability to test the
effectiveness of such strategies in large clinical trials of children and
young adults.
`(d) 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 the fiscal years 2001 through 2005.'.
TITLE V--ASTHMA SERVICES FOR CHILDREN
Subtitle A--Asthma Services
SEC. 501. GRANTS FOR CHILDREN'S ASTHMA RELIEF.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is
amended by adding at the end the following part:
`PART P--ADDITIONAL PROGRAMS
`SEC. 399L. CHILDREN'S ASTHMA TREATMENT GRANTS PROGRAM.
`(a) AUTHORITY TO MAKE GRANTS-
`(1) IN GENERAL- In addition to any other payments made under this Act
or title V of the Social Security Act, the Secretary shall award grants to
eligible entities to carry out the following purposes:
`(A) To provide access to quality medical care for children who live
in areas that have a high prevalence of asthma and who lack access to
medical care.
`(B) To provide on-site education to parents, children, health care
providers, and medical teams to recognize the signs and symptoms of
asthma, and to train them in the use of medications to treat asthma and
prevent its exacerbations.
`(C) To decrease preventable trips to the emergency room by making
medication available to individuals who have not previously had access to
treatment or education in the management of asthma.
`(D) To provide other services, such as smoking cessation programs,
home modification, and other direct and support services that ameliorate
conditions that exacerbate or induce asthma.
`(2) CERTAIN PROJECTS- In making grants under paragraph (1), the
Secretary may make grants designed to develop and expand the following
projects:
`(A) Projects to provide comprehensive asthma services to children in
accordance with the guidelines of the National Asthma Education and
Prevention Program (through the National Heart, Lung and Blood Institute),
including access to care and treatment for asthma in a community-based
setting.
`(B) Projects to fully equip mobile health care clinics that provide
preventive asthma care including diagnosis, physical examinations,
pharmacological therapy, skin testing, peak flow meter testing, and other
asthma-related health care services.
`(C) Projects to conduct validated asthma management education
programs for patients with asthma and their families, including patient
education regarding asthma management, family education on asthma
management, and the distribution of materials, including displays and
videos, to reinforce concepts presented by medical teams.
`(i) IN GENERAL- An eligible entity shall submit an application to
the Secretary for a grant under this section in such form and manner as
the Secretary may require.
`(ii) REQUIRED INFORMATION- An application submitted under this
subparagraph shall include a plan for the use of funds awarded under the
grant and such other information as the Secretary may
require.
`(B) REQUIREMENT- In awarding grants under this section, the Secretary
shall give preference to eligible entities that demonstrate that the
activities to be carried out under this section shall be in localities
within areas of known or suspected high prevalence of childhood asthma or
high asthma-related mortality or high rate of hospitalization or emergency
room visits for asthma (relative to the average asthma prevalence rates
and associated mortality rates in the United States). Acceptable data sets
to demonstrate a high prevalence of childhood asthma or high
asthma-related mortality may include data from Federal, State, or local
vital statistics, claims data under title XIX or XXI of the Social
Security Act, other public health statistics or surveys, or other data
that the Secretary, in consultation with the Director of the Centers for
Disease Control and Prevention, deems appropriate.
`(3) DEFINITION OF ELIGIBLE ENTITY- For purposes of this section, the
term `eligible entity' means a public or nonprofit private entity (including
a State or political subdivision of a State), or a consortium of any of such
entities.
`(b) COORDINATION WITH OTHER CHILDREN'S PROGRAMS- An eligible entity shall
identify in the plan submitted as part of an application for a grant under
this section how the entity will coordinate operations and activities under
the grant with--
`(1) other programs operated in the State that serve children with
asthma, including any such programs operated under title V, XIX, or XXI of
the Social Security Act; and
`(2) one or more of the following--
`(A) the child welfare and foster care and adoption assistance
programs under parts B and E of title IV of such Act;
`(B) the head start program established under the Head Start Act (42
U.S.C. 9831 et seq.);
`(C) the program of assistance under the special supplemental
nutrition program for women, infants and children (WIC) under section 17
of the Child Nutrition Act of 1966 (42 U.S.C. 1786);
`(D) local public and private elementary or secondary schools;
or
`(E) public housing agencies, as defined in section 3 of the United
States Housing Act of 1937 (42 U.S.C. 1437a).
`(c) EVALUATION- An eligible entity that receives a grant under this
section shall submit to the Secretary an evaluation of the operations and
activities carried out under the grant that includes--
`(1) a description of the health status outcomes of children assisted
under the grant;
`(2) an assessment of the utilization of asthma-related health care
services as a result of activities carried out under the grant;
`(3) the collection, analysis, and reporting of asthma data according to
guidelines prescribed by the Director of the Centers for Disease Control and
Prevention; and
`(4) such other information as the Secretary may require.
`(d) 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 the fiscal years 2001 through 2005.'.
SEC. 502. TECHNICAL AND CONFORMING AMENDMENTS.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is
amended--
(1) in part L, by redesignating section 399D as section 399A;
(A) by redesignating sections 399H through 399L as sections 399B
through 399F, respectively;
(B) in section 399B (as so redesignated), in subsection (e)--
(i) by striking `section 399K(b)' and inserting `subsection (b) of
section 399E'; and
(ii) by striking `section 399C' and inserting `such
section';
(C) in section 399E (as so redesignated), in subsection (c), by
striking `section 399H(a)' and inserting `section 399B(a)'; and
(D) in section 399F (as so redesignated)--
(i) in subsection (a), by striking `section 399I' and inserting
`section 399C';
(ii) in subsection (a), by striking `subsection 399J' and inserting
`section 399D'; and
(iii) in subsection (b), by striking `subsection 399K' and inserting
`section 399E';
(3) in part N, by redesignating section 399F as section 399G; and
(A) by redesignating sections 399G through 399J as sections 399H
through 399K, respectively;
(B) in section 399H (as so redesignated), in subsection (b), by
striking `section 399H' and inserting `section 399I';
(C) in section 399J (as so redesignated), in subsection (b), by
striking `section 399G(d)' and inserting `section 399H(d)'; and
(D) in section 399K (as so redesignated), by striking `section
399G(d)(1)' and inserting `section 399H(d)(1)'.
Subtitle B--Prevention Activities
SEC. 511. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT; SYSTEMS FOR
REDUCING ASTHMA-RELATED ILLNESSES THROUGH INTEGRATED PEST MANAGEMENT.
Section 1904(a)(1) of the Public Health Service Act (42 U.S.C.
300w-3(a)(1)) is amended--
(1) by redesignating subparagraphs (E) and (F) as subparagraphs (F) and
(G), respectively;
(2) by adding a period at the end of subparagraph (G) (as so
redesignated);
(3) by inserting after subparagraph (D), the following:
`(E) The establishment, operation, and coordination of effective and
cost-efficient systems to reduce the prevalence of illness due to asthma and
asthma-related illnesses, especially among children, by reducing the level
of exposure to cockroach allergen or other known asthma triggers through the
use of integrated pest management, as applied to cockroaches or other known
allergens. Amounts expended for such systems may include the costs of
building maintenance and the costs of programs to promote community
participation in the carrying out at such sites of integrated pest
management, as applied to cockroaches or other known allergens. For purposes
of this subparagraph, the term `integrated pest management' means an
approach to the management of pests in public facilities that combines
biological, cultural, physical, and chemical tools in a way that minimizes
economic, health, and environmental risks.';
(4) in subparagraph (F) (as so redesignated), by striking `subparagraphs
(A) through (D)' and inserting `subparagraphs (A) through (E)'; and
(5) in subparagraph (G) (as so redesignated), by striking `subparagraphs
(A) through (E)' and inserting `subparagraphs (A) through (F)'.
Subtitle C--Coordination of Federal Activities
SEC. 521. COORDINATION THROUGH NATIONAL INSTITUTES OF HEALTH.
Subpart 2 of part C of title IV of the Public Health Service Act (42
U.S.C. 285b et seq.) is amended by inserting after section 424A the following
section:
`COORDINATION OF FEDERAL ASTHMA ACTIVITIES
`SEC. 424B (a) IN GENERAL- The Director of Institute shall, through the
National Asthma Education Prevention Program Coordinating Committee--
`(1) identify all Federal programs that carry out asthma-related
activities;
`(2) develop, in consultation with appropriate Federal agencies and
professional and voluntary health organizations, a Federal plan for
responding to asthma; and
`(3) not later than 12 months after the date of the enactment of the
Children's Health Act of 2000, submit recommendations to the appropriate
committees of the Congress on ways to strengthen and improve the
coordination of asthma-related activities of the Federal Government.
`(b) REPRESENTATION OF THE DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT- A
representative of the Department of Housing and Urban Development shall be
included on the National Asthma Education Prevention Program Coordinating
Committee for the purpose of performing the tasks described in subsection
(a).
`(c) 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 the fiscal years 2001 through 2005.'.
Subtitle D--Compilation of Data
SEC. 531. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 401 of this Act, is amended by inserting after section 317H the
following section:
`COMPILATION OF DATA ON ASTHMA
`SEC. 317I. (a) IN GENERAL- The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall--
`(1) conduct local asthma surveillance activities to collect data on the
prevalence and severity of asthma and the quality of asthma
management;
`(2) compile and annually publish data on the prevalence of children
suffering from asthma in each State; and
`(3) to the extent practicable, compile and publish data on the
childhood mortality rate associated with asthma nationally.
`(b) SURVEILLANCE ACTIVITIES- The Director of the Centers for Disease
Control and Prevention, acting through the representative of the Director on
the National Asthma Education Prevention Program Coordinating Committee,
shall, in carrying out subsection (a), provide an update on surveillance
activities at each Committee meeting.
`(c) COLLABORATIVE EFFORTS- The activities described in subsection (a)(1)
may be conducted in collaboration with eligible entities awarded a grant under
section 399L.
`(d) 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 the fiscal years 2001 through 2005.'.
TITLE VI--BIRTH DEFECTS PREVENTION ACTIVITIES
Subtitle A--Folic Acid Promotion
SEC. 601. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH
DEFECTS.
Part B of title III of the Public Health Service Act, as amended by
section 531 of this Act, is amended by inserting after section 317I the
following section:
`EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH DEFECTS
`SEC. 317J. (a) IN GENERAL- The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall expand and intensify
programs (directly or through grants or contracts) for the following
purposes:
`(1) To provide education and training for health professionals and the
general public for purposes of explaining the effects of folic acid in
preventing birth defects and for purposes of encouraging each woman of
reproductive capacity (whether or not planning a pregnancy) to consume on a
daily basis a dietary supplement that provides an appropriate level of folic
acid.
`(2) To conduct research with respect to such education and training,
including identifying effective strategies for increasing the rate of
consumption of folic acid by women of reproductive capacity.
`(3) To conduct research to increase the understanding of the effects of
folic acid in preventing birth defects, including understanding with respect
to cleft lip, cleft palate, and heart defects.
`(4) To provide for appropriate epidemiological activities regarding
folic acid and birth defects, including epidemiological activities regarding
neural tube defects.
`(b) CONSULTATIONS WITH STATES AND PRIVATE ENTITIES- In carrying out
subsection (a), the Secretary shall consult with the States and with other
appropriate public or private entities, including national nonprofit private
organizations, health professionals, and providers of health insurance and
health plans.
`(c) TECHNICAL ASSISTANCE- The Secretary may (directly or through grants
or contracts) provide technical assistance to public and nonprofit private
entities in carrying out the activities described in subsection (a).
`(d) EVALUATIONS- The Secretary shall (directly or through grants or
contracts) provide for the evaluation of activities under subsection (a) in
order to determine the extent to which such activities have been effective in
carrying out the purposes of the program under such subsection, including the
effects on various demographic populations. Methods of evaluation under the
preceding sentence may include surveys of knowledge and attitudes on the
consumption of folic acid and on blood folate levels. Such methods may include
complete and timely monitoring of infants who are born with neural tube
defects.
`(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 the fiscal years 2001 through 2005.'.
Subtitle B--National Center on Birth Defects and Developmental
Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES.
Section 317C of the Public Health Service Act (42 U.S.C. 247b-4) is
amended--
(1) by striking the heading for the section and inserting the
following:
`NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES';
(2) by striking `SEC. 317C. (a)' and all that follows through the end of
subsection (a) and inserting the following:
`SEC. 317C. (a) IN GENERAL-
`(1) NATIONAL CENTER- There is established within the Centers for
Disease Control and Prevention a center to be known as the National Center
on Birth Defects and Developmental Disabilities (referred to in this section
as the `Center'), which shall be headed by a director appointed by the
Director of the Centers for Disease Control and Prevention.
`(2) GENERAL DUTIES- The Secretary shall carry out programs--
`(A) to collect, analyze, and make available data on birth defects and
developmental disabilities (in a manner that facilitates compliance with
subsection (d)(2)), including data on the causes of such defects and
disabilities and on the incidence and prevalence of such defects and
disabilities;
`(B) to operate regional centers for the conduct of applied
epidemiological research on the prevention of such defects and
disabilities; and
`(C) to provide information and education to the public on the
prevention of such defects and disabilities.
`(3) FOLIC ACID- The Secretary shall carry out section 317J through the
Center.
`(A) TRANSFERS- All programs and functions described in subparagraph
(B) are transferred to the Center, effective upon the expiration of the
180-day period beginning on the date of the enactment of the Children's
Health Act of 2000.
`(B) RELEVANT PROGRAMS- The programs and functions described in this
subparagraph are all programs and functions that--
`(i) relate to birth defects; folic acid; cerebral palsy; mental
retardation; child development; newborn screening; autism; fragile X
syndrome; fetal alcohol syndrome; pediatric genetic disorders;
disability prevention; or other relevant diseases, disorders, or
conditions as determined the Secretary; and
`(ii) were carried out through the National Center for Environmental
Health as of the day before the date of the enactment of the Act
referred to in subparagraph (A).
`(C) RELATED TRANSFERS- Personnel employed in connection with the
programs and functions specified in subparagraph (B), and amounts
available for carrying out the programs and functions, are transferred to
the Center, effective upon the expiration of the 180-day period beginning
on the date of the enactment of the Act referred to in subparagraph (A).
Such transfer of amounts does not affect the period of availability of the
amounts, or the availability of the amounts with respect to the purposes
for which the amounts may be expended.'; and
(3) in subsection (b)(1), in the matter preceding subparagraph (A), by
striking `(a)(1)' and inserting `(a)(2)(A)'.
TITLE VII--EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING
LOSS IN INFANTS
SEC. 701. PURPOSES.
The purposes of this title are to clarify the authority within the Public
Health Service Act to authorize statewide newborn and infant hearing
screening, evaluation and intervention programs and systems, technical
assistance, a national applied research program, and interagency and private
sector collaboration for policy development, in order to assist the States in
making progress toward the following goals:
(1) All babies born in hospitals in the United States and its
territories should have a hearing screening before leaving the birthing
facility. Babies born in other countries and residing in the United States
via immigration or adoption should have a hearing screening as early as
possible.
(2) All babies who are not born in hospitals in the United States and
its territories should have a hearing screening within the first 3 months of
life.
(3) Appropriate audiologic and medical evaluations should be conducted
by 3 months for all newborns and infants suspected of having hearing loss to
allow appropriate referral and provisions for audiologic rehabilitation,
medical and early intervention before the age of 6 months.
(4) All newborn and infant hearing screening programs and systems should
include a component for audiologic rehabilitation, medical and early
intervention options that ensures linkage to any new and existing state-wide
systems of intervention and rehabilitative services for newborns and infants
with hearing loss.
(5) Public policy in regard to newborn and infant hearing screening and
intervention should be based on applied research and the recognition that
newborns, infants, toddlers, and children who are deaf or hard-of-hearing
have unique language, learning, and communication needs, and should be the
result of consultation with pertinent public and private sectors.
SEC. 702. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION, CENTERS
FOR DISEASE CONTROL AND PREVENTION, AND NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as added by section
501 of this Act, is amended by adding at the end the following section:
`SEC. 399M. EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING HEARING LOSS
IN INFANTS.
`(a) STATEWIDE NEWBORN AND INFANT HEARING SCREENING, EVALUATION AND
INTERVENTION PROGRAMS AND SYSTEMS- The Secretary, acting through the
Administrator of the Health Resources and Services Administration, shall make
awards of grants or cooperative agreements to develop statewide newborn and
infant hearing screening, evaluation and intervention programs and systems for
the following purposes:
`(1) To develop and monitor the efficacy of state-wide newborn and
infant hearing screening, evaluation and intervention programs and systems.
Early intervention includes referral to schools and agencies, including
community, consumer, and parent-based agencies and organizations and other
programs mandated by part C of the Individuals with Disabilities Education
Act, which offer programs specifically designed to meet the unique language
and communication needs of deaf and hard of hearing newborns, infants,
toddlers, and children.
`(2) To collect data on statewide newborn and infant hearing screening,
evaluation and intervention programs and systems that can be used for
applied research, program evaluation and policy development.
`(b) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED RESEARCH-
`(1) CENTERS FOR DISEASE CONTROL AND PREVENTION- The Secretary, acting
through the Director of the Centers for Disease Control and Prevention,
shall make awards of grants or cooperative agreements to provide technical
assistance to State agencies to complement an intramural program and to
conduct applied research related to newborn and infant hearing screening,
evaluation and intervention programs and systems. The program shall develop
standardized procedures for data management and program effectiveness and
costs, such as--
`(A) to ensure quality monitoring of newborn and infant hearing loss
screening, evaluation, and intervention programs and systems;
`(B) to provide technical assistance on data collection and
management;
`(C) to study the costs and effectiveness of newborn and infant
hearing screening, evaluation and intervention programs and systems
conducted by State-based programs in order to answer issues of importance
to State and national policymakers;
`(D) to identify the causes and risk factors for congenital hearing
loss;
`(E) to study the effectiveness of newborn and infant hearing
screening, audiologic and medical evaluations and intervention programs
and systems by assessing the health, intellectual and social
developmental, cognitive, and language status of these children at school
age; and
`(F) to promote the sharing of data regarding early hearing loss with
State-based birth defects and developmental disabilities monitoring
programs for the purpose of identifying previously unknown causes of
hearing loss.
`(2) NATIONAL INSTITUTES OF HEALTH- The Director of the National
Institutes of Health, acting through the Director of the National Institute
on Deafness and Other Communication Disorders, shall for purposes of this
section, continue a program of research and development on the efficacy of
new screening techniques and technology, including clinical studies of
screening methods, studies on efficacy of intervention, and related
research.
`(c) COORDINATION AND COLLABORATION-
`(1) IN GENERAL- In carrying out programs under this section, the
Administrator of the Health Resources and Services Administration, the
Director of the Centers for Disease Control and Prevention, and the Director
of the National Institutes of Health shall collaborate and consult with
other Federal agencies; State and local agencies, including those
responsible for early intervention services pursuant to title XIX of the
Social Security Act (Medicaid Early and Periodic Screening, Diagnosis and
Treatment Program); title XXI of the Social Security Act (State Children's
Health Insurance Program); title V of the Social Security Act (Maternal and
Child Health Block Grant Program); and part C of the Individuals with
Disabilities Education Act; consumer groups of and that serve individuals
who are deaf and hard-of-hearing and their families; appropriate national
medical and other health and education specialty organizations; persons who
are deaf and hard-of-hearing and their families; other qualified
professional personnel who are proficient in deaf or hard-of-hearing
children's language and who possess the specialized knowledge, skills, and
attributes needed to serve deaf and hard-of-hearing newborns, infants,
toddlers, children, and their families; third-party payers and managed care
organizations; and related commercial industries.
`(2) POLICY DEVELOPMENT- The Administrator of the Health Resources and
Services Administration, the Director of the Centers for Disease Control and
Prevention, and the Director of the National Institutes of Health shall
coordinate and collaborate on recommendations for policy development at the
Federal and State levels and with the private sector, including consumer,
medical and other health and education professional-based organizations,
with respect to newborn and infant hearing screening, evaluation and
intervention programs and systems.
`(3) STATE EARLY DETECTION, DIAGNOSIS, AND INTERVENTION PROGRAMS AND
SYSTEMS; DATA COLLECTION- The Administrator of the Health Resources and
Services Administration and the Director of the Centers for Disease Control
and Prevention shall coordinate and collaborate in assisting States to
establish newborn and infant hearing screening, evaluation and intervention
programs and systems under subsection (a) and to develop a data collection
system under subsection (b).
`(d) RULE OF CONSTRUCTION; RELIGIOUS ACCOMMODATION- Nothing in this
section shall be construed to preempt or prohibit any State law, including
State laws which do not require the screening for hearing loss of newborn
infants or young children of parents who object to the screening on the
grounds that such screening conflicts with the parents' religious beliefs.
`(e) DEFINITIONS- For purposes of this section:
`(1) The term `audiologic evaluation' refers to procedures to assess the
status of the auditory system; to establish the site of the auditory
disorder; the type and degree of hearing loss, and the potential effects of
hearing loss on communication; and to identify appropriate treatment and
referral options. Referral options should include linkage to State
coordinating agencies under part C of the Individuals with Disabilities
Education Act or other appropriate agencies, medical evaluation, hearing
aid/sensory aid assessment, audiologic rehabilitation treatment, national
and local consumer, self-help, parent, and education organizations, and
other family-centered services.
`(2) The terms `audiologic rehabilitation' and `audiologic intervention'
refer to procedures, techniques, and technologies to facilitate the
receptive and expressive communication abilities of a child with hearing
loss.
`(3) The term `early intervention' refers to providing appropriate
services for the child with hearing loss, including nonmedical services, and
ensuring that families of the child are provided comprehensive,
consumer-oriented information about the full range of family support,
training, information services, communication options and are given the
opportunity to consider the full range of educational and program placements
and options for their child.
`(4) The term `medical evaluation by a physician' refers to key
components including history, examination, and medical decision making
focused on symptomatic and related body systems for the purpose of
diagnosing the etiology of hearing loss and related physical conditions, and
for identifying appropriate treatment and referral options.
`(5) The term `medical intervention' refers to the process by which a
physician provides medical diagnosis and direction for medical and/or
surgical treatment options of hearing loss and/or related medical disorder
associated with hearing loss.
`(6) The term `newborn and infant hearing screening' refers to objective
physiologic procedures to detect possible hearing loss and to identify
newborns and infants who, after rescreening, require further audiologic and
medical evaluations.
`(f) AUTHORIZATION OF APPROPRIATIONS-
`(1) STATEWIDE NEWBORN AND INFANT HEARING SCREENING, EVALUATION AND
INTERVENTION PROGRAMS AND SYSTEMS- For the purpose of carrying out
subsection (a), there are authorized to be appropriated to the Health
Resources and Services Administration such sums as may be necessary for
fiscal year 2002.
`(2) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED RESEARCH;
CENTERS FOR DISEASE CONTROL AND PREVENTION- For the purpose of carrying out
subsection (b)(1), there are authorized to be appropriated to the Centers
for Disease Control and Prevention such sums as may be necessary for fiscal
year 2002.
`(3) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED RESEARCH;
NATIONAL INSTITUTE ON DEAFNESS AND OTHER COMMUNICATION DISORDERS- For the
purpose of carrying out subsection (b)(2), there are authorized to be
appropriated to the National Institute on Deafness and Other Communication
Disorders such sums as may be necessary for fiscal year 2002.'.
TITLE VIII--CHILDREN AND EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY; SEIZURE DISORDER
DEMONSTRATION PROJECTS IN MEDICALLY UNDERSERVED AREAS.
Subpart I of part D of title III of the Public Health Service Act (42
U.S.C. 254b) is amended by adding at the end the following section:
`SEC. 330E. EPILEPSY; SEIZURE DISORDER.
`(a) NATIONAL PUBLIC HEALTH CAMPAIGN-
`(1) IN GENERAL- The Secretary shall develop and implement public health
surveillance, education, research, and intervention strategies to improve
the lives of persons with epilepsy, with a particular emphasis on children.
Such projects may be carried out by the Secretary directly and through
awards of grants or contracts to public or nonprofit private entities. The
Secretary may directly or through such awards provide technical assistance
with respect to the planning, development, and operation of such
projects.
`(2) CERTAIN ACTIVITIES- Activities under paragraph (1) shall
include--
`(A) expanding current surveillance activities through existing
monitoring systems and improving registries that maintain data on
individuals with epilepsy, including children;
`(B) enhancing research activities on the diagnosis, treatment, and
management of epilepsy;
`(C) implementing public and professional information and education
programs regarding epilepsy, including initiatives which promote effective
management of the disease through children's programs which are targeted
to parents, schools, daycare providers, patients;
`(D) undertaking educational efforts with the media, providers of
health care, schools and others regarding stigmas and secondary
disabilities related to epilepsy and seizures, and its effects on
youth;
`(E) utilizing and expanding partnerships with organizations with
experience addressing the health and related needs of people with
disabilities; and
`(F) other activities the Secretary deems appropriate.
`(3) COORDINATION OF ACTIVITIES- The Secretary shall ensure that
activities under this subsection are coordinated as appropriate with other
agencies of the Public Health Service that carry out activities regarding
epilepsy and seizure.
`(b) SEIZURE DISORDER; DEMONSTRATION PROJECTS IN MEDICALLY UNDERSERVED
AREAS-
`(1) IN GENERAL- The Secretary, acting through the Administrator of the
Health Resources and Services Administration, may make grants for the
purpose of carrying out demonstration projects to improve access to health
and other services regarding seizures to encourage early detection and
treatment in children and others residing in medically underserved
areas.
`(2) APPLICATION FOR GRANT- A grant may not be awarded under paragraph
(1) unless an application therefore is submitted to the Secretary and the
Secretary approves such application. Such application shall be submitted in
such form and manner and shall contain such information as the Secretary may
prescribe.
`(c) DEFINITIONS- For purposes of this section:
`(1) The term `epilepsy' refers to a chronic and serious neurological
condition characterized by excessive electrical discharges in the brain
causing recurring seizures affecting all life activities. The Secretary may
revise the definition of such term to the extent the Secretary determines
necessary.
`(2) The term `medically underserved' has the meaning applicable under
section 799B(6).
`(d) 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 the fiscal years 2001 through 2005.'.
TITLE IX--SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A--Safe Motherhood Prevention Research
SEC. 901. PREVENTION RESEARCH AND OTHER ACTIVITIES.
Part B of title III of the Public Health Service Act, as amended by
section 601 of this Act, is amended by inserting after section 317J the
following section:
`SAFE MOTHERHOOD
`SEC. 317K. (a) SURVEILLANCE-
`(1) PURPOSE- The purpose of this subsection is to develop surveillance
systems at the local, State, and national level to better understand the
burden of maternal complications and mortality and to decrease the
disparities among population at risk of death and complications from
pregnancy.
`(2) ACTIVITIES- For the purpose described in paragraph (1), the
Secretary, acting through the Director of the Centers for Disease Control
and Prevention, may carry out the following activities:
`(A) The Secretary may establish and implement a national surveillance
program to identify and promote the investigation of deaths and severe
complications that occur during pregnancy.
`(B) The Secretary may expand the Pregnancy Risk Assessment Monitoring
System to provide surveillance and collect data in each State.
`(C) The Secretary may expand the Maternal and Child Health
Epidemiology Program to provide technical support, financial assistance,
or the time-limited assignment of senior epidemiologists to maternal and
child health programs in each State.
`(b) PREVENTION RESEARCH-
`(1) PURPOSE- The purpose of this subsection is to provide the Secretary
with the authority to further expand research concerning risk factors,
prevention strategies, and the roles of the family, health care providers
and the community in safe motherhood.
`(2) RESEARCH- The Secretary may carry out activities to expand research
relating to--
`(A) encouraging preconception counseling, especially for at risk
populations such as diabetics;
`(B) the identification of critical components of prenatal delivery
and postpartum care;
`(C) the identification of outreach and support services, such as
folic acid education, that are available for pregnant women;
`(D) the identification of women who are at high risk for
complications;
`(E) preventing preterm delivery;
`(F) preventing urinary tract infections;
`(G) preventing unnecessary caesarean sections;
`(H) an examination of the higher rates of maternal mortality among
African American women;
`(I) an examination of the relationship between domestic violence and
maternal complications and mortality;
`(J) preventing and reducing adverse health consequences that may
result from smoking, alcohol and illegal drug use before, during and after
pregnancy;
`(K) preventing infections that cause maternal and infant
complications; and
`(L) other areas determined appropriate by the Secretary.
`(c) PREVENTION PROGRAMS-
`(1) IN GENERAL- The Secretary may carry out activities to promote safe
motherhood, including--
`(A) public education campaigns on healthy pregnancies and the
building of partnerships with outside organizations concerned about safe
motherhood;
`(B) education programs for physicians, nurses and other health care
providers; and
`(C) activities to promote community support services for pregnant
women.
`(d) 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 the fiscal years 2001 through 2005.'.
Subtitle B--Pregnant Women and Infants Health Promotion
SEC. 911. PROGRAMS REGARDING PRENATAL AND POSTNATAL HEALTH.
Part B of title III of the Public Health Service Act, as amended by
section 901 of this Act, is amended by inserting after section 317K the
following section:
`PRENATAL AND POSTNATAL HEALTH
`SEC. 317L. (a) IN GENERAL- The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, shall carry out programs--
`(1) to collect, analyze, and make available data on prenatal smoking,
alcohol and illegal drug use, including data on the implications of such
activities and on the incidence and prevalence of such activities and their
implications;
`(2) to conduct applied epidemiological research on the prevention of
prenatal and postnatal smoking, alcohol and illegal drug use;
`(3) to support, conduct, and evaluate the effectiveness of educational
and cessation programs; and
`(4) to provide information and education to the public on the
prevention and implications of prenatal and postnatal smoking, alcohol and
illegal drug use.
`(b) GRANTS- In carrying out subsection (a), the Secretary may award
grants to and enter into contracts with States, local governments, scientific
and academic institutions, federally qualified health centers, and other
public and nonprofit entities, and may provide technical and consultative
assistance to such entities.
`(c) 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 the fiscal years 2001 through 2005.'.
TITLE X-- PEDIATRIC RESEARCH INITIATIVE
SEC. 1001. ESTABLISHMENT OF PEDIATRIC RESEARCH INITIATIVE.
Part B of title IV of the Public Health Service Act, as amended by section
101 of this Act, is amended by adding at the end the following:
`PEDIATRIC RESEARCH INITIATIVE
`SEC. 409D. (a) ESTABLISHMENT- The Secretary shall establish within the
Office of the Director of NIH a Pediatric Research Initiative (referred to in
this section as the `Initiative') to conduct and support research that is
directly related to diseases, disorders, and other conditions in children. The
Initiative shall be headed by the Director of NIH.
`(b) PURPOSE- The purpose of the Initiative is to provide funds to enable
the Director of NIH--
`(1) to increase support for pediatric biomedical research within the
National Institutes of Health to realize the expanding opportunities for
advancement in scientific investigations and care for children;
`(2) to enhance collaborative efforts among the Institutes to conduct
and support multidisciplinary research in the areas that the Director deems
most promising; and
`(3) in coordination with the Food and Drug Administration, to increase
the development of adequate pediatric clinical trials and pediatric use
information to promote the safer and more effective use of prescription
drugs in the pediatric population.
`(c) DUTIES- In carrying out subsection (b), the Director of NIH
shall--
`(1) consult with the Director of the National Institute of Child Health
and Human Development and the other national research institutes, in
considering their requests for new or expanded pediatric research efforts,
and consult with the Administrator of the Health Resources and Services
Administration and other advisors as the Director determines to be
appropriate;
`(2) have broad discretion in the allocation of any Initiative
assistance among the Institutes, among types of grants, and between basic
and clinical research so long as the assistance is directly related to the
illnesses and conditions of children; and
`(3) be responsible for the oversight of any newly appropriated
Initiative funds and annually report to Congress and the public on the
extent of the total funds obligated to conduct or support pediatric research
across the National Institutes of Health, including the specific support and
research awards allocated through the Initiative.
`(d) AUTHORIZATION- For the purpose of carrying out this section, there
are authorized to be appropriated $50,000,000 for fiscal year 2001, and such
sums as may be necessary for each of the fiscal years 2002 through 2005.
`(e) TRANSFER OF FUNDS- The Director of NIH may transfer amounts
appropriated under this section to any of the Institutes for a fiscal year to
carry out the purposes of the Initiative under this section.'.
SEC. 1002. INVESTMENT IN TOMORROW'S PEDIATRIC RESEARCHERS.
(a) IN GENERAL- Subpart 7 of part C of title IV of the Public Health
Service Act, as amended by section 921 of this Act, is amended by adding at
the end the following:
`INVESTMENT IN TOMORROW'S PEDIATRIC RESEARCHERS
`SEC. 452G. (a) ENHANCED SUPPORT- In order to ensure the future supply of
researchers dedicated to the care and research needs of children, the Director
of the Institute, after consultation with the Administrator of the Health
Resources and Services Administration, shall support activities to provide
for--
`(1) an increase in the number and size of institutional training grants
to institutions supporting pediatric training; and
`(2) an increase in the number of career development awards for health
professionals who intend to build careers in pediatric basic and clinical
research.
`(b) AUTHORIZATION- For the purpose of carrying out subsection (a), there
are authorized to be appropriated such sums as may be necessary for each of
the fiscal years 2001 through 2005.'.
(b) PEDIATRIC RESEARCH LOAN REPAYMENT PROGRAM- Part G of title IV of the
Public Health Service Act (42 U.S.C. 288 et seq.) is amended by inserting
after section 487E the following section:
`PEDIATRIC RESEARCH LOAN REPAYMENT PROGRAM
`SEC. 487F. (a) IN GENERAL- The Secretary, in consultation with the
Director of NIH, may establish a pediatric research loan repayment program.
Through such program--
`(1) the Secretary shall enter into contracts with qualified health
professionals under which such professionals will agree to conduct pediatric
research, in consideration of the Federal Government agreeing to repay, for
each year of such service, not more than $35,000 of the principal and
interest of the educational loans of such professionals; and
`(2) the Secretary shall, for the purpose of providing reimbursements
for tax liability resulting from payments made under paragraph (1) on behalf
of an individual, make payments, in addition to payments under such
paragraph, to the individual in an amount equal to 39 percent of the total
amount of loan repayments made for the taxable year involved.
`(b) APPLICATION OF OTHER PROVISIONS- The provisions of sections 338B,
338C, and 338E shall, except as inconsistent with paragraph (1), apply to the
program established under such paragraph to the same extent and in the same
manner as such provisions apply to the National Health Service Corps Loan
Repayment Program established under subpart III of part D of title III.
`(1) IN GENERAL- For the purpose of carrying out this section with
respect to a national research institute the Secretary may reserve, from
amounts appropriated for such institute for the fiscal year involved, such
amounts as the Secretary determines to be appropriate.
`(2) AVAILABILITY OF FUNDS- Amounts made available to carry out this
section shall remain available until the expiration of the second fiscal
year beginning after the fiscal year for which such amounts were made
available.'.
SEC. 1003. REVIEW OF REGULATIONS.
(a) REVIEW- By not later than 6 months after the date of the enactment of
this Act, the Secretary of Health and Human Services shall conduct a review of
the regulations under subpart D of part 46 of title 45, Code of Federal
Regulations, consider any modifications necessary to ensure the adequate and
appropriate protection of children participating in research, and report the
findings of the Secretary to Congress.
(b) AREAS OF REVIEW- In conducting the review under subsection (a), the
Secretary of Health and Human Services shall consider--
(1) the appropriateness of the regulations for children of differing
ages and maturity levels, including legal status;
(2) the definition of `minimal risk' for a healthy child or for a child
with an illness;
(3) the definitions of `assent' and `permission' for child clinical
research participants and their parents or guardians and of `adequate
provisions' for soliciting assent or permission in research as such
definitions relate to the process of obtaining the agreement of children
participating in research and the parents or guardians of such
children;
(4) the definitions of `direct benefit to the individual subjects' and
`generalizable knowledge about the subject's disorder or condition';
(5) whether payment (financial or otherwise) may be provided to a child
or his or her parent or guardian for the participation of the child in
research, and if so, the amount and type given;
(6) the expectations of child research participants and their parent or
guardian for the direct benefits of the child's research involvement;
(7) safeguards for research involving children conducted in emergency
situations with a waiver of informed assent;
(8) parent and child notification in instances in which the regulations
have not been complied with;
(9) compliance with the regulations in effect on the date of the
enactment of this Act, the monitoring of such compliance, and enforcement
actions for violations of such regulations; and
(10) the appropriateness of current practices for recruiting children
for participation in research.
(c) CONSULTATION- In conducting the review under subsection (a), the
Secretary of Health and Human Services shall consult broadly with experts in
the field, including pediatric pharmacologists, pediatricians, pediatric
professional societies, bioethics experts, clinical investigators,
institutional review boards, industry experts, appropriate Federal agencies,
and children who have participated in research studies and the parents,
guardians, or families of such children.
(d) CONSIDERATION OF ADDITIONAL PROVISIONS- In conducting the review under
subsection (a), the Secretary of Health and Human Services shall consider and,
not later than 6 months after the date of the enactment of this Act, report to
Congress concerning--
(1) whether the Secretary should establish data and safety monitoring
boards or other mechanisms to review adverse events associated with research
involving children; and
(2) whether the institutional review board oversight of clinical trials
involving children is adequate to protect children.
SEC. 1004. LONG-TERM CHILD DEVELOPMENT STUDY.
(a) PURPOSE- It is the purpose of this section to authorize the National
Institute of Child Health and Human Development to conduct a national
longitudinal study of environmental influences (including physical, chemical,
biological, and psychosocial) on children's health and development.
(b) IN GENERAL- The Director of the National Institute of Child Health and
Human Development shall establish a consortium of representatives from
appropriate Federal agencies (including the Centers for Disease Control and
Prevention, the Environmental Protection Agency) to--
(1) plan, develop, and implement a prospective cohort study, from birth
to adulthood, to evaluate the effects of both chronic and intermittent
exposures on child health and human development; and
(2) investigate basic mechanisms of developmental disorders and
environmental factors, both risk and protective, that influence health and
developmental processes.
(c) REQUIREMENT- The study under subsection (b) shall--
(1) incorporate behavioral, emotional, educational, and contextual
consequences to enable a complete assessment of the physical, chemical,
biological and psychosocial environmental influences on children's
well-being;
(2) gather data on environmental influences and outcomes on diverse
populations of children, which may include the consideration of prenatal
exposures; and
(3) consider health disparities among children which may include the
consideration of prenatal exposures.
(d) REPORT- Beginning not later than 3 years after the date of the
enactment of this Act, and periodically thereafter for the duration of the
study under this section, the Director of the National Institute of Child
Health and Human Development shall prepare and submit to the appropriate
committees of Congress a report on the implementation and findings made under
the planning and feasibility study conducted under this section.
(e) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section $18,000,000 for fiscal year 2001, and
such sums as may be necessary for each the fiscal years 2002 through 2005.
TITLE XI--CHILDHOOD MALIGNANCIES
SEC. 1101. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION AND
NATIONAL INSTITUTES OF HEALTH.
Part P of title III of the Public Health Service Act, as amended by
section 702 of this Act, is amended by adding at the end the following
section:
`SEC. 399N. CHILDHOOD MALIGNANCIES.
`(a) IN GENERAL- The Secretary, acting as appropriate through the Director
of the Centers for Disease Control and Prevention and the Director of the
National Institutes of Health, shall study environmental and other risk
factors for childhood cancers (including skeletal malignancies, leukemias,
malignant tumors of the central nervous system, lymphomas, soft tissue
sarcomas, and other malignant neoplasms) and carry out projects to improve
outcomes among children with childhood cancers and resultant secondary
conditions, including limb loss, anemia, rehabilitation, and palliative care.
Such projects shall be carried out by the Secretary directly and through
awards of grants or contracts.
`(b) CERTAIN ACTIVITIES- Activities under subsection (a) include--
`(1) the expansion of current demographic data collection and population
surveillance efforts to include childhood cancers nationally;
`(2) the development of a uniform reporting system under which treating
physicians, hospitals, clinics, and States report the diagnosis of childhood
cancers, including relevant associated epidemiological data; and
`(3) support for the National Limb Loss Information Center to address,
in part, the primary and secondary needs of persons who experience childhood
cancers in order to prevent or minimize the disabling nature of these
cancers.
`(c) COORDINATION OF ACTIVITIES- The Secretary shall assure that
activities under this section are coordinated as appropriate with other
agencies of the Public Health Service that carry out activities focused on
childhood cancers and limb loss.
`(d) DEFINITION- For purposes of this section, the term `childhood cancer'
refers to a spectrum of different malignancies that vary by histology, site of
disease, origin, race, sex, and age. The Secretary may for purposes of this
section revise the definition of such term to the extent determined by the
Secretary to be appropriate.
`(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 the fiscal years 2001 through 2005.'.
TITLE XII--ADOPTION AWARENESS
Subtitle A--Infant Adoption Awareness
SEC. 1201. GRANTS REGARDING INFANT ADOPTION AWARENESS.
Subpart I of part D of title III of the Public Health Service Act, as
amended by section 801 of this Act, is amended by adding at the end the
following section:
`SEC. 330F. CERTAIN SERVICES FOR PREGNANT WOMEN.
`(a) INFANT ADOPTION AWARENESS-
`(1) IN GENERAL- The Secretary shall make grants to national, regional,
or local adoption organizations for the purpose of developing and
implementing programs to train the designated staff of eligible health
centers in providing adoption information and referrals to pregnant women on
an equal basis with all other courses of action included in nondirective
counseling to pregnant women.
`(2) BEST-PRACTICES GUIDELINES-
`(A) IN GENERAL- A condition for the receipt of a grant under
paragraph (1) is that the adoption organization involved agree that, in
providing training under such paragraph, the organization will follow the
guidelines developed under subparagraph (B).
`(B) PROCESS FOR DEVELOPMENT OF GUIDELINES-
`(i) IN GENERAL- The Secretary shall establish and supervise a
process described in clause (ii) in which the participants
are--
`(I) an appropriate number and variety of adoption organizations
that, as a group, have expertise in all models of adoption practice
and that represent all members of the adoption triad (birth mother,
infant, and adoptive parent); and
`(II) affected public health entities.
`(ii) DESCRIPTION OF PROCESS- The process referred to in clause (i)
is a process in which the participants described in such clause
collaborate to develop best-practices guidelines on the provision of
adoption information and referrals to pregnant women on an equal basis
with all other courses of action included in nondirective counseling to
pregnant women.
`(iii) DATE CERTAIN FOR DEVELOPMENT- The Secretary shall ensure that
the guidelines described in clause (ii) are developed not later than 180
days after the date of the enactment of the Children's Health Act of
2000.
`(C) RELATION TO AUTHORITY FOR GRANTS- The Secretary may not make any
grant under paragraph (1) before the date on which the guidelines under
subparagraph (B) are developed.
`(A) IN GENERAL- With respect to a grant under paragraph
(1)--
`(i) an adoption organization may expend the grant to carry out the
programs directly or through grants to or contracts with other adoption
organizations;
`(ii) the purposes for which the adoption organization expends the
grant may include the development of a training curriculum, consistent
with the guidelines developed under paragraph (2)(B); and
`(iii) a condition for the receipt of the grant is that the adoption
organization agree that, in providing training for the designated staff
of eligible health centers, such organization will make reasonable
efforts to ensure that the individuals who provide the training are
individuals who are knowledgeable in all elements of the adoption
process and are experienced in providing adoption information and
referrals in the geographic areas in which the eligible health centers
are located, and that the designated staff receive the training in such
areas.
`(B) RULE OF CONSTRUCTION REGARDING TRAINING OF TRAINERS- With respect
to individuals who under a grant under paragraph (1) provide training for
the designated staff of eligible health centers (referred to in this
subparagraph as `trainers'), subparagraph (A)(iii) may not be construed as
establishing any limitation regarding the geographic area in which the
trainers receive instruction in being such trainers. A trainer may receive
such instruction in a different geographic area than the area in which the
trainer trains (or will train) the designated staff of eligible health
centers.
`(4) ADOPTION ORGANIZATIONS; ELIGIBLE HEALTH CENTERS; OTHER DEFINITIONS-
For purposes of this section:
`(A) The term `adoption organization' means a national, regional, or
local organization--
`(i) among whose primary purposes are adoption;
`(ii) that is knowledgeable in all elements of the adoption process
and on providing adoption information and referrals to pregnant women;
and
`(iii) that is a nonprofit private entity.
`(B) The term `designated staff', with respect to an eligible health
center, means staff of the center who provide pregnancy or adoption
information and referrals (or will provide such information and referrals
after receiving training under a grant under paragraph (1)).
`(C) The term `eligible health centers' means public and nonprofit
private entities that provide health services to pregnant women.
`(5) TRAINING FOR CERTAIN ELIGIBLE HEALTH CENTERS- A condition for the
receipt of a grant under paragraph (1) is that the adoption organization
involved agree to make reasonable efforts to ensure that the eligible health
centers with respect to which training under the grant is provided
include--
`(A) eligible health centers that receive grants under section 1001
(relating to voluntary family planning projects);
`(B) eligible health centers that receive grants under section 330
(relating to community health centers, migrant health centers, and centers
regarding homeless individuals and residents of public housing);
and
`(C) eligible health centers that receive grants under this Act for
the provision of services in schools.
`(6) PARTICIPATION OF CERTAIN ELIGIBLE HEALTH CLINICS- In the case of
eligible health centers that receive grants under section 330 or 1001:
`(A) Within a reasonable period after the Secretary begins making
grants under paragraph (1), the Secretary shall provide eligible health
centers with complete information about the training available from
organizations receiving grants under such paragraph. The Secretary shall
make reasonable efforts to encourage eligible health centers to arrange
for designated staff to participate in such training. Such efforts shall
affirm Federal requirements, if any, that the eligible health center
provide nondirective counseling to pregnant women.
`(B) All costs of such centers in obtaining the training shall be
reimbursed by the organization that provides the training, using grants
under paragraph (1).
`(C) Not later than 1 year after the date of the enactment of the
Children's Health Act of 2000, the Secretary shall submit to the
appropriate committees of the Congress a report evaluating the extent to
which adoption information and referral, upon request, are provided by
eligible health centers. Within a reasonable time after training under
this section is initiated, the Secretary shall submit to the appropriate
committees of the Congress a report evaluating the extent to which
adoption information and referral, upon request, are provided by eligible
health centers in order to determine the effectiveness of such training
and the extent to which such training complies with subsection (a)(1). In
preparing the reports required by this subparagraph, the Secretary shall
in no respect interpret the provisions of this section to allow any
interference in the provider-patient relationship, any breach of patient
confidentiality, or any monitoring or auditing of the counseling process
or patient records which breaches patient confidentiality or reveals
patient identity. The reports required by this subparagraph shall be
conducted by the Secretary acting through the Administrator of the Health
Resources and Services Administration and in collaboration with the
Director of the Agency for Healthcare Research and Quality.
`(b) APPLICATION FOR GRANT- The Secretary may make a grant under
subsection (a) 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 section.
`(c) 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 the fiscal years 2001 through 2005.'.
Subtitle B--Special Needs Adoption Awareness
SEC. 1211. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN AND
OTHER ACTIVITIES.
Subpart I of part D of title III of the Public Health Service Act, as
amended by section 1201 of this Act, is amended by adding at the end the
following section:
`SEC. 330G. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN AND
OTHER ACTIVITIES.
`(a) SPECIAL NEEDS ADOPTION AWARENESS CAMPAIGN-
`(1) IN GENERAL- The Secretary shall, through making grants to nonprofit
private entities, provide for the planning, development, and carrying out of
a national campaign to provide information to the public regarding the
adoption of children with special needs.
`(2) INPUT ON PLANNING AND DEVELOPMENT- In providing for the planning
and development of the national campaign under paragraph (1), the Secretary
shall provide for input from a number and variety of adoption organizations
throughout the States in order that the full national diversity of interests
among adoption organizations is represented in the planning and development
of the campaign.
`(3) CERTAIN FEATURES- With respect to the national campaign under
paragraph (1):
`(A) The campaign shall be directed at various populations, taking
into account as appropriate differences among geographic regions, and
shall be carried out in the language and cultural context that is most
appropriate to the population involved.
`(B) The means through which the campaign may be carried out
include--
`(i) placing public service announcements on television, radio, and
billboards; and
`(ii) providing information through means that the Secretary
determines will reach individuals who are most likely to adopt children
with special needs.
`(C) The campaign shall provide information on the subsidies and
supports that are available to individuals regarding the adoption of
children with special needs.
`(D) The Secretary may provide that the placement of public service
announcements, and the dissemination of brochures and other materials, is
subject to review by the Secretary.
`(4) MATCHING REQUIREMENT-
`(A) IN GENERAL- With respect to the costs of the activities to be
carried out by an entity pursuant to paragraph (1), a condition for the
receipt of a grant under such paragraph is that the entity agree 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 25 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.
`(b) NATIONAL RESOURCES PROGRAM- The Secretary shall (directly or through
grant or contract) carry out a program that, through toll-free
telecommunications, makes available to the public information regarding the
adoption of children with special needs. Such information shall include the
following:
`(1) A list of national, State, and regional organizations that provide
services regarding such adoptions, including exchanges and other information
on communicating with the organizations. The list shall represent the full
national diversity of adoption organizations.
`(2) Information beneficial to individuals who adopt such children,
including lists of support groups for adoptive parents and other
postadoptive services.
`(c) OTHER PROGRAMS- With respect to the adoption of children with special
needs, the Secretary shall make grants--
`(1) to provide assistance to support groups for adoptive parents,
adopted children, and siblings of adopted children; and
`(2) to carry out studies to identify--
`(A) the barriers to completion of the adoption process; and
`(B) those components that lead to favorable long-term outcomes for
families that adopt children with special needs.
`(d) APPLICATION FOR GRANT- The Secretary may make an award of a grant or
contract under this section only if an application for the award 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 section.
`(e) FUNDING- For the purpose of carrying out this section, there are
authorized to be appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.'.
TITLE XIII--TRAUMATIC BRAIN INJURY
SEC. 1301. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND PREVENTION.
(a) IN GENERAL- Section 393A of the Public Health Service Act (42 U.S.C.
280b-1b) is amended--
(A) in paragraph (1), by striking `and' at the end;
(B) in paragraph (2), by striking the period and inserting `; and';
and
(C) by adding at the end the following:
`(3) the implementation of a national education and awareness campaign
regarding such injury (in conjunction with the program of the Secretary
regarding health-status goals for 2010, commonly referred to as Healthy
People 2010), including--
`(A) the national dissemination of information on--
`(i) incidence and prevalence; and
`(ii) information relating to traumatic brain injury and the
sequelae of secondary conditions arising from traumatic brain injury
upon discharge from hospitals and trauma centers; and
`(B) the provision of information in primary care settings, including
emergency rooms and trauma centers, concerning the availability of State
level services and resources.';
(A) in the second sentence, by striking `anoxia due to near drowning.'
and inserting `anoxia due to trauma.'; and
(B) in the third sentence, by inserting before the period the
following: `, after consultation with States and other appropriate public
or nonprofit private entities'.
(b) NATIONAL REGISTRY- Part J of title III of the Public Health Service
Act (42 U.S.C. 280b et seq.) is amended by inserting after section 393A the
following section:
`NATIONAL PROGRAM FOR TRAUMATIC BRAIN INJURY REGISTRIES
`SEC. 393B. (a) IN GENERAL- The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, may make grants to States or
their designees to operate the State's traumatic brain injury registry, and to
academic institutions to conduct applied research that will support the
development of such registries, to collect data concerning--
`(1) demographic information about each traumatic brain injury;
`(2) information about the circumstances surrounding the injury event
associated with each traumatic brain injury;
`(3) administrative information about the source of the collected
information, dates of hospitalization and treatment, and the date of injury;
and
`(4) information characterizing the clinical aspects of the traumatic
brain injury, including the severity of the injury, outcomes of the injury,
the types of treatments received, and the types of services
utilized.'.
SEC. 1302. STUDY AND MONITOR INCIDENCE AND PREVALENCE.
Section 4 of Public Law 104-166 (42 U.S.C. 300d-61 note) is amended--
(1) in subsection (a)(1)(A)--
(A) by striking clause (i) and inserting the following:
`(i)(I) determine the incidence and prevalence of traumatic brain
injury in all age groups in the general population of the United States,
including institutional settings; and
`(II) determine appropriate methodological strategies to obtain data
on the incidence and prevalence of mild traumatic brain injury and
report to Congress concerning such within 18 months of the date of the
enactment of the Children's Health Act of 2000; and'; and
(B) in clause (ii), by striking `, if the Secretary determines that
such a system is appropriate';
(2) in subsection (a)(1)(B)(i), by inserting `, including return to work
or school and community participation,' after `functioning'; and
(3) in subsection (d), to read as follows:
`(d) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.'.
SEC. 1303. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.
(a) INTERAGENCY PROGRAM- Section 1261(d)(4) of the Public Health Service
Act (42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (A), by striking `degree of injury' and inserting
`degree of brain injury';
(2) in subparagraph (B), by striking `acute injury' and inserting `acute
brain injury'; and
(3) in subparagraph (D), by striking `injury treatment' and inserting
`brain injury treatment'.
(b) DEFINITION- Section 1261(h)(4) of the Public Health Service Act (42
U.S.C. 300d-61(h)(4)) is amended--
(1) in the second sentence, by striking `anoxia due to near drowning.'
and inserting `anoxia due to trauma.'; and
(2) in the third sentence, by inserting before the period the following:
`, after consultation with States and other appropriate public or nonprofit
private entities'.
(c) RESEARCH ON COGNITIVE AND NEUROBEHAVIORAL DISORDERS ARISING FROM
TRAUMATIC BRAIN INJURY- Section 1261(d)(4) of the Public Health Service Act
(42 U.S.C. 300d-61(d)(4)) is amended--
(1) in subparagraph (C), by striking `and' after the semicolon at the
end;
(2) in subparagraph (D), by striking the period at the end and inserting
`; and'; and
(3) by adding at the end the following:
`(E) carrying out subparagraphs (A) through (D) with respect to
cognitive disorders and neurobehavioral consequences arising from
traumatic brain injury, including the development, modification, and
evaluation of therapies and programs of rehabilitation toward reaching or
restoring normal capabilities in areas such as reading, comprehension,
speech, reasoning, and deduction.'.
(d) AUTHORIZATION OF APPROPRIATIONS- Section 1261 of the Public Health
Service Act (42 U.S.C. 300d-61) is amended by adding at the end the
following:
`(i) 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 the fiscal years 2001 through 2005.'.
SEC. 1304. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION.
Section 1252 of the Public Health Service Act (42 U.S.C. 300d-51) is
amended--
(1) in the section heading by striking `demonstration';
(2) in subsection (a), by striking `demonstration';
(3) in subsection (b)(3)--
(A) in subparagraph (A)(iv), by striking `representing traumatic brain
injury survivors' and inserting `representing individuals with traumatic
brain injury'; and
(B) in subparagraph (B), by striking `who are survivors of' and
inserting `with';
(A) in paragraph (1), by striking `, in cash,'; and
(B) in paragraph (2), by amending the paragraph to read as
follows:
`(2) DETERMINATION OF AMOUNT CONTRIBUTED- Non-Federal contributions
under 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
contributions.';
(5) by redesignating subsections (e) through (h) as subsections (g)
through (j), respectively;
(6) by inserting after subsection (d) the following subsections:
`(e) CONTINUATION OF PREVIOUSLY AWARDED DEMONSTRATION PROJECTS- A State
that received a grant under this section prior to the date of the enactment of
the Children's Health Act of 2000 may compete for new project grants under
this section after such date of the enactment.
`(f) USE OF STATE GRANTS-
`(1) COMMUNITY SERVICES AND SUPPORTS- A State shall (directly or through
awards of contracts to nonprofit private entities) use amounts received
under a grant under this section for the following:
`(A) To develop, change, or enhance community-based service delivery
systems that include timely access to comprehensive appropriate services
and supports. Such service and supports--
`(i) shall promote full participation by individuals with brain
injury and their families in decision making regarding the services and
supports; and
`(ii) shall be designed for children and other individuals with
traumatic brain injury.
`(B) To focus on outreach to underserved and inappropriately served
individuals, such as individuals in institutional settings, individuals
with low socioeconomic resources, individuals in rural communities, and
individuals in culturally and linguistically diverse communities.
`(C) To award contracts to nonprofit entities for consumer or family
service access training, consumer support, peer mentoring, and parent to
parent programs.
`(D) To develop individual and family service coordination or case
management systems.
`(E) To support other needs identified by the advisory board under
subsection (b) for the State involved.
`(A) IN GENERAL- State services and supports provided under a grant
under this section shall reflect the best practices in the field of
traumatic brain injury, shall be in compliance with title II of the
Americans with Disabilities Act of 1990, and shall be supported by quality
assurance measures as well as state-of-the-art health care and integrated
community supports, regardless of the severity of injury.
`(B) DEMONSTRATION BY STATE AGENCY- The State agency responsible for
administering amounts received under a grant under this section shall
demonstrate that it has obtained knowledge and expertise of traumatic
brain injury and the unique needs associated with traumatic brain
injury.
`(3) STATE CAPACITY BUILDING- A State may use amounts received under a
grant under this section to--
`(A) educate consumers and families;
`(B) train professionals in public and private sector financing (such
as third party payers, State agencies, community-based providers, schools,
and educators);
`(C) develop or improve case management or service coordination
systems;
`(D) develop best practices in areas such as family or consumer
support, return to work, housing or supportive living personal assistance
services, assistive technology and devices, behavioral health services,
substance abuse services, and traumatic brain injury treatment and
rehabilitation;
`(E) tailor existing State systems to provide accommodations to the
needs of individuals with brain injury (including systems administered by
the State departments responsible for health, mental health,
labor/employment, education, mental retardation/developmental disorders,
transportation, and correctional systems);
`(F) improve data sets coordinated across systems and other needs
identified by a State plan supported by its advisory council; and
`(G) develop capacity within targeted communities.';
(7) in subsection (g) (as so redesignated), by striking `agencies of the
Public Health Service' and inserting `Federal agencies';
(8) in subsection (i) (as redesignated by paragraph (3))--
(A) in the second sentence, by striking `anoxia due to near drowning.'
and inserting `anoxia due to trauma.'; and
(B) in the third sentence, by inserting before the period the
following: `, after consultation with States and other appropriate public
or nonprofit private entities'; and
(9) in subsection (j) (as so redesignated), by amending the subsection
to read as follows:
`(j) 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 the fiscal years 2001 through 2005.'.
SEC. 1305. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.
Part E of title XII of the Public Health Service Act (42 U.S.C. 300d-51 et
seq.) is amended by adding at the end the following:
`SEC. 1253. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.
`(a) IN GENERAL- The Secretary, acting through the Administrator of the
Health Resources and Services Administration (referred to in this section as
the `Administrator'), shall make grants to protection and advocacy systems for
the purpose of enabling such systems to provide services to individuals with
traumatic brain injury.
`(b) SERVICES PROVIDED- Services provided under this section may include
the provision of--
`(1) information, referrals, and advice;
`(2) individual and family advocacy;
`(3) legal representation; and
`(4) specific assistance in self-advocacy.
`(c) APPLICATION- To be eligible to receive a grant under this section, a
protection and advocacy system shall submit an application to the
Administrator at such time, in such form and manner, and accompanied by such
information and assurances as the Administrator may require.
`(d) APPROPRIATIONS LESS THAN $2,700,000-
`(1) IN GENERAL- With respect to any fiscal year in which the amount
appropriated under subsection (i) to carry out this section is less than
$2,700,000, the Administrator shall make grants from such amount to
individual protection and advocacy systems within States to enable such
systems to plan for, develop outreach strategies for, and carry out services
authorized under this section for individuals with traumatic brain
injury.
`(2) AMOUNT- The amount of each grant provided under paragraph (1) shall
be determined as set forth in paragraphs (2) and (3) of subsection
(e).
`(e) APPROPRIATIONS OF $2,700,000 OR MORE-
`(1) POPULATION BASIS- Except as provided in paragraph (2), with respect
to each fiscal year in which the amount appropriated under subsection (i) to
carry out this section is $2,700,000 or more, the Administrator shall make a
grant to a protection and advocacy system within each State.
`(2) AMOUNT- The amount of a grant provided to a system under paragraph
(1) shall be equal to an amount bearing the same ratio to the total amount
appropriated for the fiscal year involved under subsection (i) as the
population of the State in which the grantee is located bears to the
population of all States.
`(3) MINIMUMS- Subject to the availability of appropriations, the amount
of a grant a protection and advocacy system under paragraph (1) for a fiscal
year shall--
`(A) in the case of a protection and advocacy system located in
American Samoa, Guam, the United States Virgin Islands, or the
Commonwealth of the Northern Mariana Islands, and the protection and
advocacy system serving the American Indian consortium, not be less than
$20,000; and
`(B) in the case of a protection and advocacy system in a State not
described in subparagraph (A), not be less than $50,000.
`(4) INFLATION ADJUSTMENT- For each fiscal year in which the total
amount appropriated under subsection (i) to carry out this section is
$5,000,000 or more, and such appropriated amount exceeds the total amount
appropriated to carry out this section in the preceding fiscal year, the
Administrator shall increase each of the minimum grants amount described in
subparagraphs (A) and (B) of paragraph (3) by a percentage equal to the
percentage increase in the total amount appropriated under subsection (i) to
carry out this section between the preceding fiscal year and the fiscal year
involved.
`(f) CARRYOVER- Any amount paid to a protection and advocacy system that
serves a State or the American Indian consortium for a fiscal year under this
section that remains unobligated at the end of such fiscal year shall remain
available to such system for obligation during the next fiscal year for the
purposes for which such amount was originally provided.
`(g) DIRECT PAYMENT- Notwithstanding any other provision of law, the
Administrator shall pay directly to any protection and advocacy system that
complies with the provisions of this section, the total amount of the grant
for such system, unless the system provides otherwise for such payment.
`(h) ANNUAL REPORT- Each protection and advocacy system that receives a
payment under this section shall submit an annual report to the Administrator
concerning the services provided to individuals with traumatic brain injury by
such system.
`(i) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section $5,000,000 for fiscal year 2001, and
such sums as may be necessary for each the fiscal years 2002 through 2005.
`(j) DEFINITIONS- In this section:
`(1) AMERICAN INDIAN CONSORTIUM- The term `American Indian consortium'
means a consortium established under part C of the Developmental
Disabilities Assistance Bill of Rights Act (42 U.S.C. 6042 et seq.).
`(2) PROTECTION AND ADVOCACY SYSTEM- The term `protection and advocacy
system' means a protection and advocacy system established under part C of
the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C.
6042 et seq.).
`(3) STATE- The term `State', unless otherwise specified, means the
several States of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, the United States Virgin Islands, Guam,
American Samoa, and the Commonwealth of the Northern Mariana
Islands.'.
SEC. 1306. AUTHORIZATION OF APPROPRIATIONS FOR CERTAIN PROGRAMS.
Section 394A of the Public Health Service Act (42 U.S.C. 280b-3) is
amended by striking `and' after `1994' and by inserting before the period the
following: `, and such sums as may be necessary for each of the fiscal years
2001 through 2005.'.
TITLE XIV--CHILD CARE SAFETY AND HEALTH GRANTS
SEC. 1401. DEFINITIONS.
(1) CHILD WITH A DISABILITY; INFANT OR TODDLER WITH A DISABILITY- The
terms `child with a disability' and `infant or toddler with a disability'
have the meanings given the terms in sections 602 and 632 of the Individuals
with Disabilities Education Act (20 U.S.C. 1401 and 1431).
(2) ELIGIBLE CHILD CARE PROVIDER- The term `eligible child care
provider' means a provider of child care services for compensation,
including a provider of care for a school-age child during non-school hours,
that--
(A) is licensed, regulated, registered, or otherwise legally
operating, under State and local law; and
(B) satisfies the State and local requirements,
applicable to the child care services the provider provides.
(3) SECRETARY- The term `Secretary' means the Secretary of Health and
Human Services.
(4) STATE- The term `State' means any of the several States of the
United States, the District of Columbia, the Commonwealth of Puerto Rico,
the United States Virgin Islands, Guam, American Samoa, and the Commonwealth
of the Northern Mariana Islands.
SEC. 1402. AUTHORIZATION OF APPROPRIATIONS.
There are authorized to be appropriated to carry out this title
$200,000,000 for fiscal year 2001, and such sums as may be necessary for each
subsequent fiscal year.
SEC. 1403. PROGRAMS.
The Secretary shall make allotments to eligible States under section 1404.
The Secretary shall make the allotments to enable the States to establish
programs to improve the health and safety of children receiving child care
outside the home, by preventing illnesses and injuries associated with that
care and promoting the health and well-being of children receiving that
care.
SEC. 1404. AMOUNTS RESERVED; ALLOTMENTS.
(a) AMOUNTS RESERVED- The Secretary shall reserve not more than one-half
of 1 percent of the amount appropriated under section 1402 for each fiscal
year to make allotments to Guam, American Samoa, the United States Virgin
Islands, and the Commonwealth of the Northern Mariana Islands to be allotted
in accordance with their respective needs.
(1) GENERAL RULE- From the amounts appropriated under section 1402 for
each fiscal year and remaining after reservations are made under subsection
(a), the Secretary shall allot to each State an amount equal to the sum
of--
(A) an amount that bears the same ratio to 50 percent of such
remainder as the product of the young child factor of the State and the
allotment percentage of the State bears to the sum of the corresponding
products for all States; and
(B) an amount that bears the same ratio to 50 percent of such
remainder as the product of the school lunch factor of the State and the
allotment percentage of the State bears to the sum of the corresponding
products for all States.
(2) YOUNG CHILD FACTOR- In this subsection, the term `young child
factor' means the ratio of the number of children under 5 years of age in a
State to the number of such children in all States, as provided by the most
recent annual estimates of population in the States by the Census Bureau of
the Department of Commerce.
(3) SCHOOL LUNCH FACTOR- In this subsection, the term `school lunch
factor' means the ratio of the number of children who are receiving free or
reduced price lunches under the school lunch program established under the
National School Lunch Act (42 U.S.C. 1751 et seq.) in the State to the
number of such children in all States, as determined annually by the
Department of Agriculture.
(4) Allotment percentage-
(A) IN GENERAL- For purposes of this subsection, the allotment
percentage for a State shall be determined by dividing the per capita
income of all individuals in the United States, by the per capita income
of all individuals in the State.
(B) LIMITATIONS- If an allotment percentage determined under
subparagraph (A) for a State--
(i) is more than 1.2 percent, the allotment percentage of the State
shall be considered to be 1.2 percent; and
(ii) is less than 0.8 percent, the allotment percentage of the State
shall be considered to be 0.8 percent.
(C) PER CAPITA INCOME- For purposes of subparagraph (A), per capita
income shall be--
(i) determined at 2-year intervals;
(ii) applied for the 2-year period beginning on October 1 of the
first fiscal year beginning after the date such determination is made;
and
(iii) equal to the average of the annual per capita incomes for the
most recent period of 3 consecutive years for which satisfactory data
are available from the Department of Commerce on the date such
determination is made.
(c) DATA AND INFORMATION- The Secretary shall obtain from each appropriate
Federal agency, the most recent data and information necessary to determine
the allotments provided for in subsection (b).
(d) DEFINITION- In this section, the term `State' includes only the
several States of the United States, the District of Columbia, and the
Commonwealth of Puerto Rico.
SEC. 1405. STATE APPLICATIONS.
To be eligible to receive an allotment under section 1404, a State shall
submit an application to the Secretary at such time, in such manner, and
containing such information as the Secretary may require. The application
shall contain information assessing the needs of the State with regard to
child care health and safety, the goals to be achieved through the program
carried out by the State under this title, and the measures to be used to
assess the progress made by the State toward achieving the goals.
SEC. 1406. USE OF FUNDS.
(a) IN GENERAL- A State that receives an allotment under section 1404
shall use the funds made available through the allotment to carry out two or
more activities consisting of--
(1) providing training and education to eligible child care providers on
preventing injuries and illnesses in children, and promoting health-related
practices;
(2) strengthening licensing, regulation, or registration standards for
eligible child care providers;
(3) assisting eligible child care providers in meeting licensing,
regulation, or registration standards, including rehabilitating the
facilities of the providers, in order to bring the facilities into
compliance with the standards;
(4) enforcing licensing, regulation, or registration standards for
eligible child care providers, including holding increased unannounced
inspections of the facilities of those providers;
(5) providing health consultants to provide advice to eligible child
care providers;
(6) assisting eligible child care providers in enhancing the ability of
the providers to serve children with disabilities and infants and toddlers
with disabilities;
(7) conducting criminal background checks for eligible child care
providers and other individuals who have contact with children in the
facilities of the providers;
(8) providing information to parents on what factors to consider in
choosing a safe and healthy child care setting; or
(9) assisting in improving the safety of transportation practices for
children enrolled in child care programs with eligible child care
providers.
(b) SUPPLEMENT, NOT SUPPLANT- Funds appropriated pursuant to the authority
of this title shall be used to supplement and not supplant other Federal,
State, and local public funds expended to provide services for eligible
individuals.
SEC. 1407. REPORTS.
Each State that receives an allotment under section 1404 shall annually
prepare and submit to the Secretary a report that describes--
(1) the activities carried out with funds made available through the
allotment; and
(2) the progress made by the State toward achieving the goals described
in the application submitted by the State under section 1405.
TITLE XV--HEALTHY START INITIATIVE
SEC. 1501. CONTINUATION OF HEALTHY START PROGRAM.
Subpart I of part D of title III of the Public Health Service Act, as
amended by section 1211 of this Act, is amended by adding at the end the
following section:
`SEC. 330H. HEALTHY START FOR INFANTS.
`(1) CONTINUATION AND EXPANSION OF PROGRAM- The Secretary, acting
through the Administrator of the Health Resources and Services
Administration, Maternal and Child Health Bureau, shall under authority of
this section continue in effect the Healthy Start Initiative and may, during
fiscal year 2001 and subsequent years, carry out such program on a national
basis.
`(2) DEFINITION- For purposes of paragraph (1), the term `Healthy Start
Initiative' is a reference to the program that, as an initiative to reduce
the rate of infant mortality and improve perinatal outcomes, makes grants
for project areas with high annual rates of infant mortality and that, prior
to the effective date of this section, was a demonstration program carried
out under section 301.
`(3) ADDITIONAL GRANTS- Effective upon increased funding beyond fiscal
year 1999 for such Initiative, additional grants may be made to States to
assist communities with technical assistance, replication of successful
projects, and State policy formation to reduce infant and maternal mortality
and morbidity.
`(b) REQUIREMENTS FOR MAKING GRANTS- In making grants under subsection
(a), the Secretary shall require that applicants (in addition to meeting all
eligibility criteria established by the Secretary) establish, for project
areas under such subsection, community-based consortia of individuals and
organizations (including agencies responsible for administering block grant
programs under title V of the Social Security Act, consumers of project
services, public health departments, hospitals, health centers under section
330, and other significant sources of health care services) that are
appropriate for participation in projects under subsection (a).
`(c) COORDINATION- Recipients of grants under subsection (a) shall
coordinate their services and activities with the State agency or agencies
that administer block grant programs under title V of the Social Security Act
in order to promote cooperation, integration, and dissemination of information
with Statewide systems and with other community services funded under the
Maternal and Child Health Block Grant.
`(d) RULE OF CONSTRUCTION- Except to the extent inconsistent with this
section, this section may not be construed as affecting the authority of the
Secretary to make modifications in the program carried out under subsection
(a).
`(e) ADDITIONAL SERVICES FOR AT-RISK PREGNANT WOMEN AND INFANTS-
`(1) IN GENERAL- The Secretary may make grants to conduct and support
research and to provide additional health care services for pregnant women
and infants, including grants to increase access to prenatal care, genetic
counseling, ultrasound services, and fetal or other surgery.
`(2) ELIGIBLE PROJECT AREA- The Secretary may make a grant under
paragraph (1) only if the geographic area in which services under the grant
will be provided is a geographic area in which a project under subsection
(a) is being carried out, and if the Secretary determines that the grant
will add to or expand the level of health services available in such area to
pregnant women and infants.
`(3) EVALUATION BY GENERAL ACCOUNTING OFFICE-
`(A) IN GENERAL- During fiscal year 2004, the Comptroller General of
the United States shall conduct an evaluation of activities under grants
under paragraph (1) in order to determine whether the activities have been
effective in serving the needs of pregnant women with respect to services
described in such paragraph. The evaluation shall include an analysis of
whether such activities have been effective in reducing the disparity in
health status between the general population and individuals who are
members of racial or ethnic minority groups. Not later than January 10,
2004, the Comptroller General shall submit to the Committee on Commerce in
the House of Representatives, and to the Committee on Health, Education,
Labor, and Pensions in the Senate, a report describing the findings of the
evaluation.
`(B) RELATION TO GRANTS REGARDING ADDITIONAL SERVICES FOR AT-RISK
PREGNANT WOMEN AND INFANTS- Before the date on which the evaluation under
subparagraph (A) is submitted in accordance with such
subparagraph--
`(i) the Secretary shall ensure that there are not more than five
grantees under paragraph (1); and
`(ii) an entity is not eligible to receive grants under such
paragraph unless the entity has substantial experience in providing the
health services described in such paragraph.
`(A) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out
this section (other than subsection (e)), there are authorized to be
appropriated such sums as may be necessary for each of the fiscal years
2001 through 2005.
`(i) PROGRAM ADMINISTRATION- Of the amounts appropriated under
subparagraph (A) for a fiscal year, the Secretary may reserve up to 5
percent for coordination, dissemination, technical assistance, and data
activities that are determined by the Secretary to be appropriate for
carrying out the program under this section.
`(ii) EVALUATION- Of the amounts appropriated under subparagraph (A)
for a fiscal year, the Secretary may reserve up to 1 percent for
evaluations of projects carried out under subsection (a). Each such
evaluation shall include a determination of whether such projects have
been effective in reducing the disparity in health status between the
general population and individuals who are members of racial or ethnic
minority groups.
`(2) ADDITIONAL SERVICES FOR AT-RISK PREGNANT WOMEN AND INFANTS-
`(A) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out
subsection (e), there are authorized to be appropriated such sums as may
be necessary for each of the fiscal years 2001 through 2005.
`(B) ALLOCATION FOR COMMUNITY-BASED MOBILE HEALTH UNITS- Of the
amounts appropriated under subparagraph (A) for a fiscal year, the
Secretary shall make available not less than 10 percent for providing
services under subsection (e) (including ultrasound services) through
visits by mobile units to communities that are eligible for services under
subsection (a).'.
TITLE XVI--ORAL HEALTH PROMOTION AND DISEASE PREVENTION
SEC. 1601. IDENTIFICATION OF INTERVENTIONS THAT REDUCE THE BURDEN AND
TRANSMISSION OF ORAL, DENTAL, AND CRANIOFACIAL DISEASES IN HIGH RISK
POPULATIONS; DEVELOPMENT OF APPROACHES FOR PEDIATRIC ORAL AND CRANIOFACIAL
ASSESSMENT.
(a) IN GENERAL- The Secretary of Health and Human Services, through the
Maternal and Child Health Bureau, the Indian Health Service, and in
consultation with the National Institutes of Health and the Centers for
Disease Control and Prevention, shall--
(1) support community-based research that is designed to improve
understanding of the etiology, pathogenesis, diagnosis, prevention, and
treatment of pediatric oral, dental, craniofacial diseases and conditions
and their sequelae in high risk populations;
(2) support demonstrations of preventive interventions in high risk
populations including nutrition, parenting, and feeding techniques;
and
(3) develop clinical approaches to assess individual patients for the
risk of pediatric dental disease.
(b) COMPLIANCE WITH STATE PRACTICE LAWS- Treatment and other services
shall be provided pursuant to this section by licensed dental health
professionals in accordance with State practice and licensing laws.
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated such sums as may be necessary to carry out this section for each
the fiscal years 2001 through 2005.
SEC. 1602. ORAL HEALTH PROMOTION AND DISEASE PREVENTION.
Part B of title III of the Public Health Service Act, as amended by
section 911 of this Act, is amended by inserting after section 317L the
following section:
`ORAL HEALTH PROMOTION AND DISEASE PREVENTION
`SEC. 317M. (a) GRANTS TO INCREASE RESOURCES FOR COMMUNITY WATER
FLUORIDATION-
`(1) IN GENERAL- The Secretary, acting through the Director of the
Centers for Disease Control and Prevention, may make grants to States and
Indian tribes for the purpose of increasing the resources available for
community water fluoridation.
`(2) USE OF FUNDS- A State shall use amounts provided under a grant
under paragraph (1)--
`(A) to purchase fluoridation equipment;
`(B) to train fluoridation engineers;
`(C) to develop educational materials on the benefits of fluoridation;
or
`(D) to support the infrastructure necessary to monitor and maintain
the quality of water fluoridation.
`(b) COMMUNITY WATER FLUORIDATION-
`(1) IN GENERAL- The Secretary, acting through the Director of the
Centers for Disease Control and Prevention and in collaboration with the
Director of the Indian Health Service, shall establish a demonstration
project that is designed to assist rural water systems in successfully
implementing the water fluoridation guidelines of the Centers for Disease
Control and Prevention that are entitled `Engineering and Administrative
Recommendations for Water Fluoridation, 1995' (referred to in this
subsection as the `EARWF').
`(A) COLLABORATION- In collaborating under paragraph (1), the
Directors referred to in such paragraph shall ensure that technical
assistance and training are provided to tribal programs located in each of
the 12 areas of the Indian Health Service. The Director of the Indian
Health Service shall provide coordination and administrative support to
tribes under this section.
`(B) GENERAL USE OF FUNDS- Amounts made available under paragraph (1)
shall be used to assist small water systems in improving the effectiveness
of water fluoridation and to meet the recommendations of the
EARWF.
`(C) FLUORIDATION SPECIALISTS-
`(i) IN GENERAL- In carrying out this subsection, the Secretary
shall provide for the establishment of fluoridation specialist
engineering positions in each of the Dental Clinical and Preventive
Support Centers through which technical assistance and training will be
provided to tribal water operators, tribal utility operators and other
Indian Health Service personnel working directly with fluoridation
projects.
`(ii) LIAISON- A fluoridation specialist shall serve as the
principal technical liaison between the Indian Health Service and the
Centers for Disease Control and Prevention with respect to engineering
and fluoridation issues.
`(iii) CDC- The Director of the Centers for Disease Control and
Prevention shall appoint individuals to serve as the fluoridation
specialists.
`(D) IMPLEMENTATION- The project established under this subsection
shall be planned, implemented and evaluated over the 5-year period
beginning on the date on which funds are appropriated under this section
and shall be designed to serve as a model for improving the effectiveness
of water fluoridation systems of small rural communities.
`(3) EVALUATION- In conducting the ongoing evaluation as provided for in
paragraph (2)(D), the Secretary shall ensure that such evaluation
includes--
`(A) the measurement of changes in water fluoridation compliance
levels resulting from assistance provided under this section;
`(B) the identification of the administrative, technical and
operational challenges that are unique to the fluoridation of small water
systems;
`(C) the development of a practical model that may be easily utilized
by other tribal, State, county or local governments in improving the
quality of water fluoridation with emphasis on small water systems;
and
`(D) the measurement of any increased percentage of Native Americans
or Alaskan Natives who receive the benefits of optimally fluoridated
water.
`(c) SCHOOL-BASED DENTAL SEALANT PROGRAM-
`(1) IN GENERAL- The Secretary, acting through the Director of the
Centers for Disease Control and Prevention and in collaboration with the
Administrator of the Health Resources and Services Administration, may award
grants to States and Indian tribes to provide for the development of
school-based dental sealant programs to improve the access of children to
sealants.
`(2) USE OF FUNDS- A State shall use amounts received under a grant
under paragraph (1) to provide funds to eligible school-based entities or to
public elementary or secondary schools to enable such entities or schools to
provide children with access to dental care and dental sealant services.
Such services shall be provided by licensed dental health professionals in
accordance with State practice licensing laws.
`(3) ELIGIBILITY- To be eligible to receive funds under paragraph (1),
an entity shall--
`(A) prepare and submit to the State an application at such time, in
such manner and containing such information as the State may require;
and
`(B) be a public elementary or secondary school--
`(i) that is located in an urban area in which and more than 50
percent of the student population is participating in Federal or State
free or reduced meal programs; or
`(ii) that is located in a rural area and, with respect to the
school district in which the school is located, the district involved
has a median income that is at or below 235 percent of the poverty line,
as defined in section 673(2) of the Community Services Block Grant Act
(42 U.S.C. 9902(2)).
`(d) DEFINITIONS- For purposes of this section, the term `Indian tribe'
means an Indian tribe or tribal organization as defined in section 4(b) and
section 4(c) of the Indian Self-Determination and Education Assistance Act.
`(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 the fiscal years 2001 through 2005.'.
SEC. 1603. COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL HEALTH.
Part B of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended
by adding at the end the following:
`COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL HEALTH
`SEC. 320A. (a) IN GENERAL- The Secretary, acting through the
Administrator of the Health Resources and Services Administration, shall
establish a program to fund innovative oral health activities that improve the
oral health of children under 6 years of age who are eligible for services
provided under a Federal health program, to increase the utilization of dental
services by such children, and to decrease the incidence of early childhood
and baby bottle tooth decay.
`(b) GRANTS- The Secretary shall award grants to or enter into contracts
with public or private nonprofit schools of dentistry or accredited dental
training institutions or programs, community dental programs, and programs
operated by the Indian Health Service (including federally recognized Indian
tribes that receive medical services from the Indian Health Service, urban
Indian health programs funded under title V of the Indian Health Care
Improvement Act, and tribes that contract with the Indian Health Service
pursuant to the Indian Self-Determination and Education Assistance Act) to
enable such schools, institutions, and programs to develop programs of oral
health promotion, to increase training of oral health services providers in
accordance with State practice laws, or to increase the utilization of dental
services by eligible children.
`(c) DISTRIBUTION- In awarding grants under this section, the Secretary
shall, to the extent practicable, ensure an equitable national geographic
distribution of the grants, including areas of the United States where the
incidence of early childhood caries is highest.
`(d) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section $10,000,000 for each the fiscal years
2001 through 2005.'.
TITLE XVII--VACCINE-RELATED PROGRAMS
Subtitle A--Vaccine Compensation Program
SEC. 1701. CONTENT OF PETITIONS.
(a) IN GENERAL- Section 2111(c)(1)(D) of the Public Health Service Act (42
U.S.C. 300aa-11(c)(1)(D)) is amended by striking `and' at the end and
inserting `or (iii) suffered such illness, disability, injury, or condition
from the vaccine which resulted in inpatient hospitalization and surgical
intervention, and'.
(b) EFFECTIVE DATE- The amendment made by subsection (a) takes effect upon
the date of the enactment of this Act, including with respect to petitions
under section 2111 of the Public Health Service Act that are pending on such
date.
Subtitle B--Childhood Immunizations
SEC. 1711. CHILDHOOD IMMUNIZATIONS.
Section 317(j)(1) of the Public Health Service Act (42 U.S.C. 247b(j)(1))
is amended in the first sentence by striking `1998' and all that follows and
inserting `1998 through 2005.'.
TITLE XVIII--HEPATITIS C
SEC. 1801. SURVEILLANCE AND EDUCATION REGARDING HEPATITIS C.
Part B of title III of the Public Health Service Act, as amended by
section 1602 of this Act, is amended by inserting after section 317M the
following section:
`SURVEILLANCE AND EDUCATION REGARDING HEPATITIS C VIRUS
`SEC. 317N. (a) IN GENERAL- The Secretary, acting through the Director of
the Centers for Disease Control and Prevention, may (directly and through
grants to public and nonprofit private entities) provide for programs to carry
out the following:
`(1) To cooperate with the States in implementing a national system to
determine the incidence of hepatitis C virus infection (in this section
referred to as `HCV infection') and to assist the States in determining the
prevalence of such infection, including the reporting of chronic HCV
cases.
`(2) To identify, counsel, and offer testing to individuals who are at
risk of HCV infection as a result of receiving blood transfusions prior to
July 1992, or as a result of other risk factors.
`(3) To provide appropriate referrals for counseling, testing, and
medical treatment of individuals identified under paragraph (2) and to
ensure, to the extent practicable, the provision of appropriate follow-up
services.
`(4) To develop and disseminate public information and education
programs for the detection and control of HCV infection, with priority given
to high risk populations as determined by the Secretary.
`(5) To improve the education, training, and skills of health
professionals in the detection and control of HCV infection, with priority
given to pediatricians and other primary care physicians, and obstetricians
and gynecologists.
`(b) LABORATORY PROCEDURES- The Secretary may (directly and through grants
to public and nonprofit private entities) carry out programs to provide for
improvements in the quality of clinical-laboratory procedures regarding
hepatitis C, including reducing variability in laboratory results on hepatitis
C antibody and PCR testing.
`(c) 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 the fiscal years 2001 through 2005.'.
TITLE XIX--NIH INITIATIVE ON AUTOIMMUNE DISEASES
SEC. 1901. AUTOIMMUNE DISEASES; INITIATIVE THROUGH DIRECTOR OF NATIONAL
INSTITUTES OF HEALTH.
Part B of title IV of the Public Health Service Act (42 U.S.C. 284 et
seq.), as amended by section 1001 of this Act, is amended by adding at the end
the following:
`SEC. 409E. AUTOIMMUNE DISEASES.
`(a) EXPANSION, INTENSIFICATION, AND COORDINATION OF ACTIVITIES-
`(1) IN GENERAL- The Director of NIH shall expand, intensify, and
coordinate research and other activities of the National Institutes of
Health with respect to autoimmune diseases.
`(2) ALLOCATIONS BY DIRECTOR OF NIH- With respect to amounts
appropriated to carry out this section for a fiscal year, the Director of
NIH shall allocate the amounts among the national research institutes that
are carrying out paragraph (1).
`(3) DEFINITION- The term `autoimmune disease' includes, for purposes of
this section such diseases or disorders with evidence of autoimmune
pathogensis as the Secretary determines to be appropriate.
`(b) COORDINATING COMMITTEE-
`(1) IN GENERAL- The Secretary shall ensure that the Autoimmune Diseases
Coordinating Committee (referred to in this section as the `Coordinating
Committee') coordinates activities across the National Institutes and with
other Federal health programs and activities relating to such
diseases.
`(2) COMPOSITION- The Coordinating Committee shall be composed of the
directors or their designees of each of the national research institutes
involved in research with respect to autoimmune diseases and representatives
of all other Federal departments and agencies whose programs involve health
functions or responsibilities relevant to such diseases, including the
Centers for Disease Control and Prevention and the Food and Drug
Administration.
`(A) IN GENERAL- With respect to autoimmune diseases, the Chair of the
Committee shall serve as the principal advisor to the Secretary, the
Assistant Secretary for Health, and the Director of NIH, and shall provide
advice to the Director of the Centers for Disease Control and Prevention,
the Commissioner of Food and Drugs, and other relevant agencies.
`(B) DIRECTOR OF NIH- The Chair of the Committee shall be directly
responsible to the Director of NIH.
`(c) PLAN FOR NIH ACTIVITIES-
`(1) IN GENERAL- Not later than 1 year after the date of the enactment
of this section, the Coordinating Committee shall develop a plan for
conducting and supporting research and education on autoimmune diseases
through the national research institutes and shall periodically review and
revise the plan. The plan shall--
`(A) provide for a broad range of research and education activities
relating to biomedical, psychosocial, and rehabilitative issues, including
studies of the disproportionate impact of such diseases on women;
`(B) identify priorities among the programs and activities of the
National Institutes of Health regarding such diseases; and
`(C) reflect input from a broad range of scientists, patients, and
advocacy groups.
`(2) CERTAIN ELEMENTS OF PLAN- The plan under paragraph (1) shall, with
respect to autoimmune diseases, provide for the following as
appropriate:
`(A) Research to determine the reasons underlying the incidence and
prevalence of the diseases.
`(B) Basic research concerning the etiology and causes of the
diseases.
`(C) Epidemiological studies to address the frequency and natural
history of the diseases, including any differences among the sexes and
among racial and ethnic groups.
`(D) The development of improved screening techniques.
`(E) Clinical research for the development and evaluation of new
treatments, including new biological agents.
`(F) Information and education programs for health care professionals
and the public.
`(3) IMPLEMENTATION OF PLAN- The Director of NIH shall ensure that
programs and activities of the National Institutes of Health regarding
autoimmune diseases are implemented in accordance with the plan under
paragraph (1).
`(d) REPORTS TO CONGRESS- The Coordinating Committee under subsection
(b)(1) shall biennially submit to the Committee on Commerce of the House of
Representatives, and the Committee on Health, Education, Labor and Pensions of
the Senate, a report that describes the research, education, and other
activities on autoimmune diseases being conducted or supported through the
national research institutes, and that in addition includes the following:
`(1) The plan under subsection (c)(1) (or revisions to the plan, as the
case may be).
`(2) Provisions specifying the amounts expended by the National
Institutes of Health with respect to each of the autoimmune diseases
included in the plan.
`(3) Provisions identifying particular projects or types of projects
that should in the future be considered by the national research institutes
or other entities in the field of research on autoimmune diseases.
`(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 the fiscal years 2001 through 2005. The authorization of
appropriations established in the preceding sentence is in addition to any
other authorization of appropriations that is available for conducting or
supporting through the National Institutes of Health research and other
activities with respect to autoimmune diseases.'.
TITLE XX--GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN'S
HOSPITALS
SEC. 2001. PROVISIONS TO REVISE AND EXTEND PROGRAM.
(a) PAYMENTS- Section 340E(a) of the Public Health Service Act (42 U.S.C.
256e(a)) is amended--
(1) by striking `and 2001' and inserting `through 2005'; and
(2) by adding at the end the following: `The Secretary shall promulgate
regulations pursuant to the rulemaking requirements of title 5, United
States Code, which shall govern payments made under this subpart.'.
(b) UPDATING RATES- Section 340E(c)(2)(F) of the Public Health Service Act
(42 U.S.C. 256e(c)(2)(F)) is amended by striking `hospital's cost reporting
period that begins during fiscal year 2000' and inserting `Federal fiscal year
for which payments are made'.
(c) RESIDENT COUNT FOR INTERIM PAYMENTS- Section 340E(e)(1) of the Public
Health Service Act (42 U.S.C. 256e(e)(1)) is amended by adding at the end the
following: `Such interim payments to each individual hospital shall be based
on the number of residents reported in the hospital's most recently filed
Medicare cost report prior to the application date for the Federal fiscal year
for which the interim payment amounts are established. In the case of a
hospital that does not report residents on a Medicare cost report, such
interim payments shall be based on the number of residents trained during the
hospital's most recently completed Medicare cost report filing period.'.
(d) WITHHOLDING- Section 340E(e)(2) of the Public Health Service Act (42
U.S.C. 256e(e)(2)) is amended--
(1) by adding `and indirect' after `direct'; and
(2) by adding at the end the following: `The Secretary shall withhold up
to 25 percent from each interim installment for direct and indirect graduate
medical education paid under paragraph (1) as necessary to ensure a hospital
will not be overpaid on an interim basis.'.
(e) RECONCILIATION- Section 340E(e)(3) of the Public Health Service Act
(42 U.S.C. 256e(e)(3)) is amended to read as follows:
`(3) RECONCILIATION- Prior to the end of each fiscal year, the Secretary
shall determine any changes to the number of residents reported by a
hospital in the application of the hospital for the current fiscal year to
determine the final amount payable to the hospital for the current fiscal
year for both direct expense and indirect expense amounts. Based on such
determination, the Secretary shall recoup any overpayments made to pay any
balance due to the extent possible. The final amount so determined shall be
considered a final intermediary determination for the purposes of section
1878 of the Social Security Act and shall be subject to administrative and
judicial review under that section in the same manner as the amount of
payment under section 1186(d) of such Act is subject to review under such
section.'.
(f) AUTHORIZATION OF APPROPRIATIONS- Section 340E(f) of the Public Health
Service Act (42 U.S.C. 256e(f)) is amended--
(1) in paragraph (1)(A)--
(A) in clause (i), by striking `and' at the end;
(B) in clause (ii), by striking the period and inserting `; and';
and
(C) by adding at the end the following:
`(iii) for each of the fiscal years 2002 through 2005, such sums as
may be necessary.'; and
(A) in subparagraph (A), by striking `and' at the end;
(B) in subparagraph (B), by striking the period and inserting `; and';
and
(C) by adding at the end the following:
`(C) for each of the fiscal years 2002 through 2005, such sums as may
be necessary.'.
(g) DEFINITION OF CHILDREN'S HOSPITAL- Section 340E(g)(2) of the Public
Health Service Act (42 U.S.C. 256e(g)(2)) is amended by striking `described
in' and all that follows and inserting the following: `with a Medicare payment
agreement and which is excluded from the Medicare inpatient prospective
payment system pursuant to section 1886(d)(1)(B)(iii) of the Social Security
Act and its accompanying regulations.'.
TITLE XXI--SPECIAL NEEDS OF CHILDREN REGARDING ORGAN
TRANSPLANTATION
SEC. 2101. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK; AMENDMENTS
REGARDING NEEDS OF CHILDREN.
(a) IN GENERAL- Section 372(b)(2) of the Public Health Service Act (42
U.S.C. 274(b)(2)) is amended--
(1) in subparagraph (J), by striking `and' at the end;
(2) in each of subparagraphs (K) and (L), by striking the period and
inserting a comma; and
(3) by adding at the end the following subparagraphs:
`(M) recognize the differences in health and in organ transplantation
issues between children and adults throughout the system and adopt
criteria, polices, and procedures that address the unique health care
needs of children,
`(N) carry out studies and demonstration projects for the purpose of
improving procedures for organ donation procurement and allocation,
including but not limited to projects to examine and attempt to increase
transplantation among populations with special needs, including children
and individuals who are members of racial or ethnic minority groups, and
among populations with limited access to transportation, and
`(O) provide that for purposes of this paragraph, the term `children'
refers to individuals who are under the age of 18.'.
(b) STUDY REGARDING IMMUNOSUPPRESSIVE DRUGS-
(1) IN GENERAL- The Secretary of Health and Human Services (referred to
in this subsection as the `Secretary') shall provide for a study to
determine the costs of immunosuppressive drugs that are provided to children
pursuant to organ transplants and to determine the extent to which health
plans and health insurance cover such costs. The Secretary may carry out the
study directly or through a grant to the Institute of Medicine (or other
public or nonprofit private entity).
(2) RECOMMENDATIONS REGARDING CERTAIN ISSUES- The Secretary shall ensure
that, in addition to making determinations under paragraph (1), the study
under such paragraph makes recommendations regarding the following
issues:
(A) The costs of immunosuppressive drugs that are provided to children
pursuant to organ transplants and to determine the extent to which health
plans, health insurance and government programs cover such costs.
(B) The extent of denial of organs to be released for transplant by
coroners and medical examiners.
(C) The special growth and developmental issues that children have
pre- and post-organ transplantation.
(D) Other issues that are particular to the special health and
transplantation needs of children.
(3) REPORT- The Secretary shall ensure that, not later than December 31,
2001, the study under paragraph (1) is completed and a report describing the
findings of the study is submitted to the Congress.
TITLE XXII--MUSCULAR DYSTROPHY RESEARCH
SEC. 2201. MUSCULAR DYSTROPHY RESEARCH.
Part B of title IV of the Public Health Service Act, as amended by section
1901 of this Act, is amended by adding at the end the following:
`MUSCULAR DYSTROPHY RESEARCH
`SEC. 409F. (a) COORDINATION OF ACTIVITIES- The Director of NIH shall
expand and increase coordination in the activities of the National Institutes
of Health with respect to research on muscular dystrophies, including Duchenne
muscular dystrophy.
`(b) ADMINISTRATION OF PROGRAM; COLLABORATION AMONG AGENCIES- The Director
of NIH shall carry out this section through the appropriate institutes,
including the National Institute of Neurological Disorders and Stroke and in
collaboration with any other agencies that the Director determines
appropriate.
`(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated such sums as may be necessary to carry out this section for each
of the fiscal years 2001 through 2005. Amounts appropriated under this
subsection shall be in addition to any other amounts appropriated for such
purpose.'.
TITLE XXIII--CHILDREN AND TOURETTE SYNDROME AWARENESS
SEC. 2301. GRANTS REGARDING TOURETTE SYNDROME.
Part A of title XI of the Public Health Service Act is amended by adding
at the end the following section:
`TOURETTE SYNDROME
`SEC. 1108. (a) IN GENERAL- The Secretary shall develop and implement
outreach programs to educate the public, health care providers, educators and
community based organizations about the etiology, symptoms, diagnosis and
treatment of Tourette Syndrome, with a particular emphasis on children with
Tourette Syndrome. Such programs may be carried out by the Secretary directly
and through awards of grants or contracts to public or nonprofit private
entities.
`(b) CERTAIN ACTIVITIES- Activities under subsection (a) shall
include--
`(1) the production and translation of educational materials, including
public service announcements;
`(2) the development of training material for health care providers,
educators and community based organizations; and
`(3) outreach efforts directed at the misdiagnosis and underdiagnosis of
Tourette Syndrome in children and in minority groups.
`(c) 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 the fiscal years 2001 through 2005.'.
TITLE XXIV--CHILDHOOD OBESITY PREVENTION
SEC. 2401. PROGRAMS OPERATED THROUGH THE CENTERS FOR DISEASE CONTROL AND
PREVENTION.
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.), as
amended by section 1101 of this Act, is amended by adding at the end the
following part:
`PART Q--PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN
`SEC. 399W. GRANTS TO PROMOTE CHILDHOOD NUTRITION AND PHYSICAL
ACTIVITY.
`(a) IN GENERAL- The Secretary, acting though the Director of the Centers
for Disease Control and Prevention, shall award competitive grants to States
and political subdivisions of States for the development and implementation of
State and community-based intervention programs to promote good nutrition and
physical activity in children and adolescents.
`(b) ELIGIBILITY- To be eligible to receive a grant under this section a
State or political subdivision of a State shall prepare and submit to the
Secretary an application at such time, in such manner, and containing such
information as the Secretary may require, including a plan that describes--
`(1) how the applicant proposes to develop a comprehensive program of
school- and community-based approaches to encourage and promote good
nutrition and appropriate levels of physical activity with respect to
children or adolescents in local communities;
`(2) the manner in which the applicant shall coordinate with appropriate
State and local authorities, such as State and local school departments,
State departments of health, chronic disease directors, State directors of
programs under section 17 of the Child Nutrition Act of 1966, 5-a-day
coordinators, governors councils for physical activity and good nutrition,
and State and local parks and recreation departments; and
`(3) the manner in which the applicant will evaluate the effectiveness
of the program carried out under this section.
`(c) USE OF FUNDS- A State or political subdivision of a State shall use
amount received under a grant under this section to--
`(1) develop, implement, disseminate, and evaluate school- and
community-based strategies in States to reduce inactivity and improve
dietary choices among children and adolescents;
`(2) expand opportunities for physical activity programs in school- and
community-based settings; and
`(3) develop, implement, and evaluate programs that promote good eating
habits and physical activity including opportunities for children with
cognitive and physical disabilities.
`(d) TECHNICAL ASSISTANCE- The Secretary may set-aside an amount not to
exceed 10 percent of the amount appropriated for a fiscal year under
subsection (h) to permit the Director of the Centers for Disease Control and
Prevention to--
`(1) provide States and political subdivisions of States with technical
support in the development and implementation of programs under this
section; and
`(2) disseminate information about effective strategies and
interventions in preventing and treating obesity through the promotion of
good nutrition and physical activity.
`(e) LIMITATION ON ADMINISTRATIVE COSTS- Not to exceed 10 percent of the
amount of a grant awarded to the State or political subdivision under
subsection (a) for a fiscal year may be used by the State or political
subdivision for administrative expenses.
`(f) TERM- A grant awarded under subsection (a) shall be for a term of 3
years.
`(g) DEFINITION- In this section, the term `children and adolescents'
means individuals who do not exceed 18 years of age.
`(h) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.
`SEC. 399X. APPLIED RESEARCH PROGRAM.
`(a) IN GENERAL- The Secretary, acting through the Centers for Disease
Control and Prevention and in consultation with the Director of the National
Institutes of Health, shall--
`(1) conduct research to better understand the relationship between
physical activity, diet, and health and factors that influence
health-related behaviors;
`(2) develop and evaluate strategies for the prevention and treatment of
obesity to be used in community-based interventions and by health
professionals;
`(3) develop and evaluate strategies for the prevention and treatment of
eating disorders, such as anorexia and bulimia;
`(4) conduct research to establish the prevalence, consequences, and
costs of childhood obesity and its effects in adulthood;
`(5) identify behaviors and risk factors that contribute to
obesity;
`(6) evaluate materials and programs to provide nutrition education to
parents and teachers of children in child care or pre-school and the food
service staff of such child care and pre-school entities; and
`(7) evaluate materials and programs that are designed to educate and
encourage physical activity in child care and pre-school facilities.
`(b) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.
`SEC. 399Y. EDUCATION CAMPAIGN.
`(a) IN GENERAL- The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, and in collaboration with national, State,
and local partners, physical activity organizations, nutrition experts, and
health professional organizations, shall develop a national public campaign to
promote and educate children and their parents concerning--
`(1) the health risks associated with obesity, inactivity, and poor
nutrition;
`(2) ways in which to incorporate physical activity into daily living;
and
`(3) the benefits of good nutrition and strategies to improve eating
habits.
`(b) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.
`SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND TRAINING.
`(a) IN GENERAL- The Secretary, acting through the Director of the Centers
for Disease Control and Prevention, in collaboration with the Administrator of
the Health Resources and Services Administration and the heads of other
agencies, and in consultation with appropriate health professional
associations, shall develop and carry out a program to educate and train
health professionals in effective strategies to--
`(1) better identify and assess patients with obesity or an eating
disorder or patients at-risk of becoming obese or developing an eating
disorder;
`(2) counsel, refer, or treat patients with obesity or an eating
disorder; and
`(3) educate patients and their families about effective strategies to
improve dietary habits and establish appropriate levels of physical
activity.
`(b) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.'.
TITLE XXV--EARLY DETECTION AND TREATMENT REGARDING CHILDHOOD LEAD
POISONING
SEC. 2501. CENTERS FOR DISEASE CONTROL AND PREVENTION EFFORTS TO COMBAT
CHILDHOOD LEAD POISONING.
(a) REQUIREMENTS FOR LEAD POISONING PREVENTION GRANTEES- Section 317A of
the Public Health Service Act (42 U.S.C. 247b-1) is amended--
(A) by redesignating paragraph (7) as paragraph (8); and
(B) by inserting after paragraph (6) the following:
`(7) Assurances satisfactory to the Secretary that the applicant will
ensure complete and consistent reporting of all blood lead test results from
laboratories and health care providers to State and local health departments
in accordance with guidelines of the Centers for Disease Control and
Prevention for standardized reporting as described in subsection (m).';
and
(2) in subsection (j)(2)--
(A) in subparagraph (F) by striking `(E)' and inserting
`(F)';
(B) by redesignating subparagraph (F) as subparagraph (G);
and
(C) by inserting after subparagraph (E) the following:
`(F) The number of grantees that have established systems to ensure
mandatory reporting of all blood lead tests from laboratories and health
care providers to State and local health departments.'.
(b) GUIDELINES FOR STANDARDIZED REPORTING- Section 317A of the Public
Health Service Act (42 U.S.C. 247b-1) is amended by adding at the end the
following:
`(m) GUIDELINES FOR STANDARDIZED REPORTING- The Secretary, acting through
the Director of the Centers for Disease Control and Prevention, shall develop
national guidelines for the uniform reporting of all blood lead test results
to State and local health departments.'.
(c) DEVELOPMENT AND IMPLEMENTATION OF EFFECTIVE DATA MANAGEMENT BY THE
CENTERS FOR DISEASE CONTROL AND PREVENTION-
(1) IN GENERAL- The Director of the Centers for Disease Control and
Prevention shall--
(A) assist with the improvement of data linkages between State and
local health departments and between State health departments and the
Centers for Disease Control and Prevention;
(B) assist States with the development of flexible, comprehensive
State-based data management systems for the surveillance of children with
lead poisoning that have the capacity to contribute to a national data
set;
(C) assist with the improvement of the ability of State-based data
management systems and federally-funded means-tested public benefit
programs (including the special supplemental food program for women,
infants and children (WIC) under section 17 of the Child Nutrition Act of
1966 (42 U.S.C. 1786) and the early head start program under section 645A
of the Head Start Act (42 U.S.C. 9840a(h)) to respond to ad hoc inquiries
and generate progress reports regarding the lead blood level screening of
children enrolled in those programs;
(D) assist States with the establishment of a capacity for assessing
how many children enrolled in the Medicaid, WIC, early head start, and
other federally-funded means-tested public benefit programs are being
screened for lead poisoning at age-appropriate intervals;
(E) use data obtained as result of activities under this section to
formulate or revise existing lead blood screening and case management
policies; and
(F) establish performance measures for evaluating State and local
implementation of the requirements and improvements described in
subparagraphs (A) through (E).
(2) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this subsection such sums as may be necessary for
each the fiscal years 2001 through 2005.
(3) EFFECTIVE DATE- This subsection takes effect on the date of the
enactment of this Act.
SEC. 2502. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.
(a) IN GENERAL- Part B of title III of the Public Health Service Act (42
U.S.C. 243 et seq.), as amended by section 1801 of this Act, is amended by
inserting after section 317N the following section:
`GRANTS FOR LEAD POISONING RELATED ACTIVITIES
`SEC. 317O. (a) AUTHORITY TO MAKE GRANTS-
`(1) IN GENERAL- The Secretary shall make grants to States to support
public health activities in States and localities where data suggests that
at least 5 percent of preschool-age children have an elevated blood lead
level through--
`(A) effective, ongoing outreach and community education targeted to
families most likely to be at risk for lead poisoning;
`(B) individual family education activities that are designed to
reduce ongoing exposures to lead for children with elevated blood lead
levels, including through home visits and coordination with other programs
designed to identify and treat children at risk for lead poisoning;
and
`(C) the development, coordination and implementation of
community-based approaches for comprehensive lead poisoning prevention
from surveillance to lead hazard control.
`(2) STATE MATCH- A State is not eligible for a grant under this section
unless the State agrees to expend (through State or local funds) $1 for
every $2 provided under the grant to carry out the activities described in
paragraph (1).
`(3) APPLICATION- To be eligible to receive a grant under this section,
a State shall submit an application to the Secretary in such form and manner
and containing such information as the Secretary may require.
`(b) COORDINATION WITH OTHER CHILDREN'S PROGRAMS- A State shall identify
in the application for a grant under this section how the State will
coordinate operations and activities under the grant with--
`(1) other programs operated in the State that serve children with
elevated blood lead levels, including any such programs operated under title
V, XIX, or XXI of the Social Security Act; and
`(2) one or more of the following--
`(A) the child welfare and foster care and adoption assistance
programs under parts B and E of title IV of such Act;
`(B) the head start program established under the Head Start Act (42
U.S.C. 9831 et seq.);
`(C) the program of assistance under the special supplemental
nutrition program for women, infants and children (WIC) under section 17
of the Child Nutrition Act of 1966 (42 U.S.C. 1786);
`(D) local public and private elementary or secondary schools;
or
`(E) public housing agencies, as defined in section 3 of the United
States Housing Act of 1937 (42 U.S.C. 1437a).
`(c) PERFORMANCE MEASURES- The Secretary shall establish needs indicators
and performance measures to evaluate the activities carried out under grants
awarded under this section. Such indicators shall be commensurate with
national measures of maternal and child health programs and shall be developed
in consultation with the Director of the Centers for Disease Control and
Prevention.
`(d) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.'.
(b) CONFORMING AMENDMENT- Section 340D(c)(1) of the Public Health Service
Act (42 U.S.C. 256d(c)(1)) is amended by striking `317E' and inserting
`317F'.
SEC. 2503. TRAINING AND REPORTS BY THE HEALTH RESOURCES AND SERVICES
ADMINISTRATION.
(a) TRAINING- The Secretary of Health and Human Services, acting through
the Administrator of the Health Resources and Services Administration and in
collaboration with the Administrator of the Health Care Financing
Administration and the Director of the Centers for Disease Control and
Prevention, shall conduct education and training programs for physicians and
other health care providers regarding childhood lead poisoning, current
screening and treatment recommendations and requirements, and the scientific,
medical, and public health basis for those policies.
(b) REPORT- The Secretary of Health and Human Services, acting through the
Administrator of the Health Resources and Services Administration, annually
shall report to Congress on the number of children who received services
through health centers established under section 330 of the Public Health
Service Act (42 U.S.C. 254b) and received a blood lead screening test during
the prior fiscal year, noting the percentage that such children represent as
compared to all children who received services through such health centers.
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
the fiscal years 2001 through 2005.
SEC. 2504. SCREENINGS, REFERRALS, AND EDUCATION REGARDING LEAD
POISONING.
Section 317A(l)(1) of the Public Health Service Act (42 U.S.C.
247b-1(l)(1)) is amended by striking `1994' and all that follows and inserting
`1994 through 2005.'.
TITLE XXVI--SCREENING FOR HERITABLE DISORDERS
SEC. 2601. PROGRAM TO IMPROVE THE ABILITY OF STATES TO PROVIDE NEWBORN AND
CHILD SCREENING FOR HERITABLE DISORDERS.
Part A of title XI of the Public Health Service Act, as amended by section
2301 of this Act, is amended by adding at the end the following:
`SEC. 1109. IMPROVED NEWBORN AND CHILD SCREENING FOR HERITABLE
DISORDERS.
`(a) IN GENERAL- The Secretary shall award grants to eligible entities to
enhance, improve or expand the ability of State and local public health
agencies to provide screening, counseling or health care services to newborns
and children having or at risk for heritable disorders.
`(b) USE OF FUNDS- Amounts provided under a grant awarded under subsection
(a) shall be used to--
`(1) establish, expand, or improve systems or programs to provide
screening, counseling, testing or specialty services for newborns and
children at risk for heritable disorders;
`(2) establish, expand, or improve programs or services to reduce
mortality or morbidity from heritable disorders;
`(3) establish, expand, or improve systems or programs to provide
information and counseling on available therapies for newborns and children
with heritable disorders;
`(4) improve the access of medically underserved populations to
screening, counseling, testing and specialty services for newborns and
children having or at risk for heritable disorders; or
`(5) conduct such other activities as may be necessary to enable
newborns and children having or at risk for heritable disorders to receive
screening, counseling, testing or specialty services, regardless of income,
race, color, religion, sex, national origin, age, or disability.
`(c) ELIGIBLE ENTITIES- To be eligible to receive a grant under subsection
(a) an entity shall--
`(1) be a State or political subdivision of a State, or a consortium of
two or more States or political subdivisions of States; and
`(2) prepare and submit to the Secretary an application that
includes--
`(A) a plan to use amounts awarded under the grant to meet specific
health status goals and objectives relative to heritable disorders,
including attention to needs of medically underserved
populations;
`(B) a plan for the collection of outcome data or other methods of
evaluating the degree to which amounts awarded under this grant will be
used to achieve the goals and objectives identified under subparagraph
(A);
`(C) a plan for monitoring and ensuring the quality of services
provided under the grant;
`(D) an assurance that amounts awarded under the grant will be used
only to implement the approved plan for the State;
`(E) an assurance that the provision of services under the plan is
coordinated with services provided under programs implemented in the State
under title V, XVIII, XIX, XX, or XXI of the Social Security Act (subject
to Federal regulations applicable to such programs) so that the coverage
of services under such titles is not substantially diminished by the use
of granted funds; and
`(F) such other information determined by the Secretary to be
necessary.
`(d) LIMITATION- An eligible entity may not use amounts received under
this section to--
`(1) provide cash payments to or on behalf of affected
individuals;
`(2) provide inpatient services;
`(3) purchase land or make capital improvements to property; or
`(4) provide for proprietary research or training.
`(e) VOLUNTARY PARTICIPATION- The participation by any individual in any
program or portion thereof established or operated with funds received under
this section shall be wholly voluntary and shall not be a prerequisite to
eligibility for or receipt of any other service or assistance from, or to
participation in, another Federal or State program.
`(f) SUPPLEMENT NOT SUPPLANT- Funds appropriated under this section shall
be used to supplement and not supplant other Federal, State, and local public
funds provided for activities of the type described in this section.
`(1) IN GENERAL- An application submitted under subsection (c)(2) shall
be made public by the State in such a manner as to facilitate comment from
any person, including through hearings and other methods used to facilitate
comments from the public.
`(2) COMMENTS- Comments received by the State after the publication
described in paragraph (1) shall be addressed in the application submitted
under subsection (c)(2).
`(h) TECHNICAL ASSISTANCE- The Secretary shall provide to entities
receiving grants under subsection (a) such technical assistance as may be
necessary to ensure the quality of programs conducted under this section.
`(i) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2005.
`SEC. 1110. EVALUATING THE EFFECTIVENESS OF NEWBORN AND CHILD SCREENING
PROGRAMS.
`(a) IN GENERAL- The Secretary shall award grants to eligible entities to
provide for the conduct of demonstration programs to evaluate the
effectiveness of screening, counseling or health care services in reducing the
morbidity and mortality caused by heritable disorders in newborns and
children.
`(b) DEMONSTRATION PROGRAMS- A demonstration program conducted under a
grant under this section shall be designed to evaluate and assess, within the
jurisdiction of the entity receiving such grant--
`(1) the effectiveness of screening, counseling, testing or specialty
services for newborns and children at risk for heritable disorders in
reducing the morbidity and mortality associated with such disorders;
`(2) the effectiveness of screening, counseling, testing or specialty
services in accurately and reliably diagnosing heritable disorders in
newborns and children; or
`(3) the availability of screening, counseling, testing or specialty
services for newborns and children at risk for heritable disorders.
`(c) ELIGIBLE ENTITIES- To be eligible to receive a grant under subsection
(a) an entity shall be a State or political subdivision of a State, or a
consortium of two or more States or political subdivisions of States.
`SEC. 1111. ADVISORY COMMITTEE ON HERITABLE DISORDERS IN NEWBORNS AND
CHILDREN.
`(a) ESTABLISHMENT- The Secretary shall establish an advisory committee to
be known as the `Advisory Committee on Heritable Disorders in Newborns and
Children' (referred to in this section as the `Advisory Committee').
`(b) DUTIES- The Advisory Committee shall--
`(1) provide advice and recommendations to the Secretary concerning
grants and projects awarded or funded under section 1109;
`(2) provide technical information to the Secretary for the development
of policies and priorities for the administration of grants under section
1109; and
`(3) provide such recommendations, advice or information as may be
necessary to enhance, expand or improve the ability of the Secretary to
reduce the mortality or morbidity from heritable disorders.
`(1) IN GENERAL- The Secretary shall appoint not to exceed 15 members to
the Advisory Committee. In appointing such members, the Secretary shall
ensure that the total membership of the Advisory Committee is an odd
number.
`(2) REQUIRED MEMBERS- The Secretary shall appoint to the Advisory
Committee under paragraph (1)--
`(A) the Administrator of the Health Resources and Services
Administration;
`(B) the Director of the Centers for Disease Control and
Prevention;
`(C) the Director of the National Institutes of Health;
`(D) the Director of the Agency for Healthcare Research and
Quality;
`(E) medical, technical, or scientific professionals with special
expertise in heritable disorders, or in providing screening, counseling,
testing or specialty services for newborns and children at risk for
heritable disorders;
`(F) members of the public having special expertise about or concern
with heritable disorders; and
`(G) representatives from such Federal agencies, public health
constituencies, and medical professional societies as determined to be
necessary by the Secretary, to fulfill the duties of the Advisory
Committee, as established under subsection (b).'.
TITLE XXVII--PEDIATRIC RESEARCH PROTECTIONS
SEC. 2701. REQUIREMENT FOR ADDITIONAL PROTECTIONS FOR CHILDREN INVOLVED IN
RESEARCH.
Notwithstanding any other provision of law, not later than 6 months after
the date of the enactment of this Act, the Secretary of Health and Human
Services shall require that all research involving children that is conducted,
supported, or regulated by the Department of Health and Human Services be in
compliance with subpart D of part 46 of title 45, Code of Federal
Regulations.
TITLE XXVIII--MISCELLANEOUS PROVISIONS
SEC. 2801. REPORT REGARDING RESEARCH ON RARE DISEASES IN CHILDREN.
Not later than 180 days after the date of the enactment of this Act, the
Director of the National Institutes of Health shall submit to the Congress a
report on--
(1) the activities that, during fiscal year 2000, were conducted and
supported by such Institutes with respect to rare diseases in children,
including Friedreich's ataxia and Hutchinson-Gilford progeria syndrome;
and
(2) the activities that are planned to be conducted and supported by
such Institutes with respect to such diseases during the fiscal years 2001
through 2005.
SEC. 2802. STUDY ON METABOLIC DISORDERS.
(a) IN GENERAL- The Secretary of Health and Human Services (in this
section referred to as the `Secretary') shall, in consultation with relevant
experts or through the Institute of Medicine, study issues related to
treatment of PKU and other metabolic disorders for children, adolescents, and
adults, and mechanisms to assure access to effective treatment, including
special diets, for children and others with PKU and other metabolic disorders.
Such mechanisms shall be evidence-based and reflect the best scientific
knowledge regarding effective treatment and prevention of disease
progression.
(b) DISSEMINATION OF RESULTS- Upon completion of the study referred to in
subsection (a), the Secretary shall disseminate and otherwise make available
the results of the study to interested groups and organizations, including
insurance commissioners, employers, private insurers, health care
professionals, State and local public health agencies, and State agencies that
carry out the Medicaid program under title XIX of the Social Security Act or
the State children's health insurance program under title XXI of such Act.
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section such sums as may be necessary for each
of the fiscal years 2001 through 2003.
TITLE XXIX--EFFECTIVE DATE
SEC. 2901. EFFECTIVE DATE.
This division and the amendments made by this division take effect October
1, 2000, or upon the date of the enactment of this Act, whichever occurs
later.
DIVISION B--YOUTH DRUG AND MENTAL HEALTH SERVICES
SEC. 3001. SHORT TITLE.
This division may be cited as the `Youth Drug and Mental Health Services
Act'.
TITLE XXXI--PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
SEC. 3101. CHILDREN AND VIOLENCE.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is
amended by adding at the end the following:
`Part G--Projects for Children and Violence
`SEC. 581. CHILDREN AND VIOLENCE.
`(a) IN GENERAL- The Secretary, in consultation with the Secretary of
Education and the Attorney General, shall carry out directly or through
grants, contracts or cooperative agreements with public entities a program to
assist local communities in developing ways to assist children in dealing with
violence.
`(b) ACTIVITIES- Under the program under subsection (a), the Secretary
may--
`(1) provide financial support to enable local communities to implement
programs to foster the health and development of children;
`(2) provide technical assistance to local communities with respect to
the development of programs described in paragraph (1);
`(3) provide assistance to local communities in the development of
policies to address violence when and if it occurs;
`(4) assist in the creation of community partnerships among law
enforcement, education systems and mental health and substance abuse service
systems; and
`(5) establish mechanisms for children and adolescents to report
incidents of violence or plans by other children or adolescents to commit
violence.
`(c) REQUIREMENTS- An application for a grant, contract or cooperative
agreement under subsection (a) shall demonstrate that--
`(1) the applicant will use amounts received to create a partnership
described in subsection (b)(4) to address issues of violence in
schools;
`(2) the activities carried out by the applicant will provide a
comprehensive method for addressing violence, that will include--
`(C) the review and updating of school policies;
`(D) alcohol and drug abuse prevention and early intervention
services;
`(E) mental health prevention and treatment services; and
`(F) early childhood development and psychosocial services;
and
`(3) the applicant will use amounts received only for the services
described in subparagraphs (D), (E), and (F) of paragraph (2).
`(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 may not exceed 5 years.
`(f) EVALUATION- The Secretary shall conduct an evaluation of each project
carried out under this section and shall disseminate the results of such
evaluations to appropriate public and private entities.
`(g) 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) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section, $100,000,000 for fiscal year 2001, and
such sums as may be necessary for each of fiscal years 2002 and 2003.
`SEC. 582. 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 programs
focusing on the behavioral and biological aspects of psychological trauma
response and for developing knowledge with regard to evidence-based practices
for treating psychiatric 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 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.
`(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 may not exceed 5 years. Such grants,
contracts or agreements may be renewed.
`(f) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section, $50,000,000 for fiscal year 2001, and
such sums as may be necessary for each of fiscal years 2002 and 2003.'.
SEC. 3102. EMERGENCY RESPONSE.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa) is
amended--
(1) by redesignating subsection (m) as subsection (o);
(2) by inserting after subsection (l) the following:
`(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 abuse 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 abuse or mental health emergency exists and publish such
criteria in the Federal Register prior to providing funds under this
subsection.
`(n) 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 505 may be used for any purpose other than the purpose for which
it was supplied unless such establishment or person has consented (as
determined under regulations of the Secretary) to its use for such other
purpose. Such information may not be published or released in other form if
the person who supplied the information or who is described in it is
identifiable unless such person has consented (as determined under regulations
of the Secretary) to its publication or release in other form.'; and
(3) in subsection (o) (as so redesignated), by striking `1993' and all
that follows through the period and inserting `2001, and such sums as may be
necessary for each of the fiscal years 2002 and 2003.'.
SEC. 3103. HIGH RISK YOUTH REAUTHORIZATION.
Section 517(h) of the Public Health Service Act (42 U.S.C. 290bb-23(h)) is
amended by striking `$70,000,000' and all that follows through `1994' and
inserting `such sums as may be necessary for each of the fiscal years 2001
through 2003'.
SEC. 3104. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN AND
ADOLESCENTS.
(a) SUBSTANCE ABUSE TREATMENT SERVICES- Subpart 1 of part B of title V of
the Public Health Service Act (42 U.S.C. 290bb et seq.) is amended by adding
at the end the following:
`SEC. 514. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN AND
ADOLESCENTS.
`(a) IN GENERAL- The Secretary shall award grants, contracts, or
cooperative agreements to public and private nonprofit entities, including
Native Alaskan entities and Indian tribes and tribal organizations, for the
purpose of providing substance abuse treatment services for children and
adolescents.
`(b) PRIORITY- In awarding grants, contracts, or cooperative agreements
under subsection (a), the Secretary shall give priority to applicants who
propose to--
`(1) apply evidenced-based and cost effective methods for the treatment
of substance abuse among children and adolescents;
`(2) coordinate the provision of treatment services with other social
service agencies in the community, including educational, juvenile justice,
child welfare, and mental health agencies;
`(3) provide a continuum of integrated treatment services, including
case management, for children and adolescents with substance abuse disorders
and their families;
`(4) provide treatment that is gender-specific and culturally
appropriate;
`(5) involve and work with families of children and adolescents
receiving treatment;
`(6) provide aftercare services for children and adolescents and their
families after completion of substance abuse treatment; and
`(7) address the relationship between substance abuse and
violence.
`(c) DURATION OF GRANTS- The Secretary shall award grants, contracts, or
cooperative agreements under subsection (a) for periods not to exceed 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, $40,000,000 for fiscal year 2001, and
such sums as may be necessary for fiscal years 2002 and 2003.
`SEC. 514A. 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
local educational agencies (as defined in section 14101 of the Elementary and
Secondary Education Act of 1965 (20 U.S.C. 8801)), for the purpose of
providing early intervention substance abuse services for children and
adolescents.
`(b) PRIORITY- In awarding grants, contracts, or cooperative agreements
under subsection (a), the Secretary shall give priority to applicants who
demonstrate an ability to--
`(1) screen for and assess substance use and abuse by children and
adolescents;
`(2) make appropriate referrals for children and adolescents who are in
need of treatment for substance abuse;
`(3) provide early intervention services, including counseling and
ancillary services, that are designed to meet the developmental needs of
children and adolescents who are at risk for substance abuse; and
`(4) develop networks with the educational, juvenile justice, social
services, and other agencies and organizations in the State or local
community involved that will work to identify children and adolescents who
are in need of substance abuse treatment services.
`(c) CONDITION- In awarding grants, contracts, or cooperative agreements
under subsection (a), the Secretary shall ensure that such grants, contracts,
or cooperative agreements are allocated, subject to the availability of
qualified applicants, among the principal geographic regions of the United
States, to Indian tribes and tribal organizations, and to urban and rural
areas.
`(d) DURATION OF GRANTS- The Secretary shall award grants, contracts, or
cooperative agreements under subsection (a) for periods not to exceed 5 fiscal
years.
`(e) 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.
`(f) 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.
`(g) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section, $20,000,000 for fiscal year 2001, and
such sums as may be necessary for fiscal years 2002 and 2003.'.
(b) YOUTH INTERAGENCY CENTERS- Subpart 3 of part B of title V of the
Public Health Service Act (42 U.S.C. 290bb-31 et seq.) is amended by adding
the following:
`SEC. 520C. YOUTH INTERAGENCY RESEARCH, TRAINING, AND TECHNICAL ASSISTANCE
CENTERS.
`(a) PROGRAM AUTHORIZED- The Secretary, acting through the Administrator
of the Substance Abuse and Mental Health Services Administration, and in
consultation with the Administrator of the Office of Juvenile Justice and
Delinquency Prevention, the Director of the Bureau of Justice Assistance and
the Director of the National Institutes of Health, shall award grants or
contracts to public or nonprofit private entities to establish not more than
four research, training, and technical assistance centers to carry out the
activities described in subsection (c).
`(b) APPLICATION- A public or private nonprofit entity desiring a grant or
contract under subsection (a) shall prepare and submit an application to the
Secretary at such time, in such manner, and containing such information as the
Secretary may require.
`(c) AUTHORIZED ACTIVITIES- A center established under a grant or contract
under subsection (a) shall--
`(1) provide training with respect to state-of-the-art mental health and
justice-related services and successful mental health and substance
abuse-justice collaborations that focus on children and adolescents, to
public policymakers, law enforcement administrators, public defenders,
police, probation officers, judges, parole officials, jail administrators
and mental health and substance abuse providers and administrators;
`(2) engage in research and evaluations concerning State and local
justice and mental health systems, including system redesign initiatives,
and disseminate information concerning the results of such
evaluations;
`(3) provide direct technical assistance, including assistance provided
through toll-free telephone numbers, concerning issues such as how to
accommodate individuals who are being processed through the courts under the
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.), what
types of mental health or substance abuse service approaches are effective
within the judicial system, and how community-based mental health or
substance abuse services can be more effective, including relevant regional,
ethnic, and gender-related considerations; and
`(4) provide information, training, and technical assistance to State
and local governmental officials to enhance the capacity of such officials
to provide appropriate services relating to mental health or substance
abuse.
`(d) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out this
section, there is authorized to be appropriated $4,000,000 for fiscal year
2001, and such sums as may be necessary for fiscal years 2002 and 2003.'.
(c) PREVENTION OF ABUSE AND ADDICTION- Subpart 2 of part B of title V of
the Public Health Service Act (42 U.S.C. 290bb-21 et seq.) is amended by
adding the following:
`SEC. 519E. PREVENTION OF METHAMPHETAMINE AND INHALANT ABUSE AND
ADDICTION.
`(a) GRANTS- The Director of the Center for Substance Abuse Prevention
(referred to in this section as the `Director') may make grants to and enter
into contracts and cooperative agreements with public and nonprofit private
entities to enable such entities--
`(1) to carry out school-based programs concerning the dangers of
methamphetamine or inhalant abuse and addiction, using methods that are
effective and evidence-based, including initiatives that give students the
responsibility to create their own anti-drug abuse education programs for
their schools; and
`(2) to carry out community-based methamphetamine or inhalant abuse and
addiction prevention programs that are effective and evidence-based.
`(b) USE OF FUNDS- Amounts made available under a grant, contract or
cooperative agreement under subsection (a) shall be used for planning,
establishing, or administering methamphetamine or inhalant prevention programs
in accordance with subsection (c).
`(c) PREVENTION PROGRAMS AND ACTIVITIES-
`(1) IN GENERAL- Amounts provided under this section may be used--
`(A) to carry out school-based programs that are focused on those
districts with high or increasing rates of methamphetamine or inhalant
abuse and addiction and targeted at populations which are most at risk to
start methamphetamine or inhalant abuse;
`(B) to carry out community-based prevention programs that are focused
on those populations within the community that are most at-risk for
methamphetamine or inhalant abuse and addiction;
`(C) to assist local government entities to conduct appropriate
methamphetamine or inhalant prevention activities;
`(D) to train and educate State and local law enforcement officials,
prevention and education officials, members of community anti-drug
coalitions and parents on the signs of methamphetamine or inhalant abuse
and addiction and the options for treatment and prevention;
`(E) for planning, administration, and educational activities related
to the prevention of methamphetamine or inhalant abuse and
addiction;
`(F) for the monitoring and evaluation of methamphetamine or inhalant
prevention activities, and reporting and disseminating resulting
information to the public; and
`(G) for targeted pilot programs with evaluation components to
encourage innovation and experimentation with new methodologies.
`(2) PRIORITY- The Director shall give priority in making grants under
this section to rural and urban areas that are experiencing a high rate or
rapid increases in methamphetamine or inhalant abuse and addiction.
`(d) ANALYSES AND EVALUATION-
`(1) IN GENERAL- Up to $500,000 of the amount available in each fiscal
year to carry out this section shall be made available to the Director,
acting in consultation with other Federal agencies, to support and conduct
periodic analyses and evaluations of effective prevention programs for
methamphetamine or inhalant abuse and addiction and the development of
appropriate strategies for disseminating information about and implementing
these programs.
`(2) ANNUAL REPORTS- The Director shall submit to the Committee on
Health, Education, Labor, and Pensions and the Committee on Appropriations
of the Senate and the Committee on Commerce and Committee on Appropriations
of the House of Representatives, an annual report with the results of the
analyses and evaluation under paragraph (1).
`(e) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out subsection (a), $10,000,000 for fiscal year 2001,
and such sums as may be necessary for each of fiscal years 2002 and 2003.'.
SEC. 3105. COMPREHENSIVE COMMUNITY SERVICES FOR CHILDREN WITH SERIOUS
EMOTIONAL DISTURBANCE.
(a) MATCHING FUNDS- Section 561(c)(1)(D) of the Public Health Service Act
(42 U.S.C. 290ff(c)(1)(D)) is amended by striking `fifth' and inserting `fifth
and sixth'.
(b) FLEXIBILITY FOR INDIAN TRIBES AND TERRITORIES- Section 562 of the
Public Health Service Act (42 U.S.C. 290ff-1) is amended by adding at the end
the following:
`(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.'.
(c) DURATION OF GRANTS- Section 565(a) of the Public Health Service Act
(42 U.S.C. 290ff-4(a)) is amended by striking `5 fiscal' and inserting `6
fiscal'.
(d) AUTHORIZATION OF APPROPRIATIONS- Section 565(f)(1) of the Public
Health Service Act (42 U.S.C. 290ff-4(f)(1)) is amended by striking `1993' and
all that follows and inserting `2001, and such sums as may be necessary for
each of the fiscal years 2002 and 2003.'.
(1) IN GENERAL- Entities with active grants under section 561 of the
Public Health Service Act (42 U.S.C. 290ff) on the date of the enactment of
this Act shall be eligible to receive a sixth year of funding under the
grant in an amount not to exceed the amount that such grantee received in
the fifth year of funding under such grant. Such sixth year may be funded
without requiring peer and Advisory Council review as required under section
504 of such Act (42 U.S.C. 290aa-3).
(2) LIMITATION- Paragraph (1) shall apply with respect to a grantee only
if the grantee agrees to comply with the provisions of section 561 as
amended by subsection (a).
SEC. 3106. SERVICES FOR CHILDREN OF SUBSTANCE ABUSERS.
(a) ADMINISTRATION AND ACTIVITIES-
(1) ADMINISTRATION- Section 399D(a) of the Public Health Service Act (42
U.S.C. 280d(a)(1)) is amended--
(A) in paragraph (1), by striking `Administrator' and all that follows
through `Administration' and inserting `Administrator of the Substance
Abuse and Mental Health Services Administration'; and
(B) in paragraph (2), by striking `Administrator of the Substance
Abuse and Mental Health Services Administration' and inserting
`Administrator of the Health Resources and Services
Administration'.
(2) ACTIVITIES- Section 399D(a)(1) of the Public Health Service Act (42
U.S.C. 280d(a)(1)) is amended--
(A) in subparagraph (B), by striking `and' at the end;
(B) in subparagraph (C), by striking the period and inserting the
following: `through youth service agencies, family social services, child
care providers, Head Start, schools and after-school programs, early
childhood development programs, community-based family resource and
support centers, the criminal justice system, health, substance abuse and
mental health providers through screenings conducted during regular
childhood examinations and other examinations, self and family member
referrals, substance abuse treatment services, and other providers of
services to children and families; and'; and
(C) by adding at the end the following:
`(D) to provide education and training to health, substance abuse and
mental health professionals, and other providers of services to children
and families through youth service agencies, family social services, child
care, Head Start, schools and after-school programs, early childhood
development programs, community-based family resource and support centers,
the criminal justice system, and other providers of services to children
and families.'.
(3) IDENTIFICATION OF CERTAIN CHILDREN- Section 399D(a)(3)(A) of the
Public Health Service Act (42 U.S.C. 280d(a)(3)(A)) is amended--
(A) in clause (i), by striking `(i) the entity' and inserting `(i)(I)
the entity';
(i) by striking `(ii) the entity' and inserting `(II) the entity';
and
(ii) by striking the period and inserting `; and'; and
(C) by adding at the end the following:
`(ii) the entity will identify children who may be eligible for
medical assistance under a State program under title XIX or XXI of the
Social Security Act.'.
(b) SERVICES FOR CHILDREN- Section 399D(b) of the Public Health Service
Act (42 U.S.C. 280d(b)) is amended--
(1) in paragraph (1), by inserting `alcohol and drug,' after
`psychological,';
(2) by striking paragraph (5) and inserting the following:
`(5) Developmentally and age-appropriate drug and alcohol early
intervention, treatment and prevention services.'; and
(3) by inserting after paragraph (8), the following:
`Services shall be provided under paragraphs (2) through (8) by a public
health nurse, social worker, or similar professional, or by a trained worker
from the community who is supervised by a professional, or by an entity, where
the professional or entity provides assurances that the professional or entity
is licensed or certified by the State if required and is complying with
applicable licensure or certification requirements.'.
(c) SERVICES FOR AFFECTED FAMILIES- Section 399D(c) of the Public Health
Service Act (42 U.S.C. 280d(c)) is amended--
(A) in the matter preceding subparagraph (A), by inserting before the
colon the following: `, or by an entity, where the professional or entity
provides assurances that the professional or entity is licensed or
certified by the State if required and is complying with applicable
licensure or certification requirements'; and
(B) by adding at the end the following:
`(D) Aggressive outreach to family members with substance abuse
problems.
`(E) Inclusion of consumer in the development, implementation, and
monitoring of Family Services Plan.';
(A) by striking subparagraph (A) and inserting the following:
`(A) Alcohol and drug treatment services, including screening and
assessment, diagnosis, detoxification, individual, group and family
counseling, relapse prevention, pharmacotherapy treatment, after-care
services, and case management.';
(B) in subparagraph (C), by striking `, including educational and
career planning' and inserting `and counseling on the human
immunodeficiency virus and acquired immune deficiency syndrome';
(C) in subparagraph (D), by striking `conflict and'; and
(D) in subparagraph (E), by striking `Remedial' and inserting `Career
planning and'; and
(3) in paragraph (3)(D), by inserting `which include child abuse and
neglect prevention techniques' before the period.
(d) ELIGIBLE ENTITIES- Section 399D(d) of the Public Health Service Act
(42 U.S.C. 280d(d)) is amended--
(1) by striking the matter preceding paragraph (1) and inserting:
`(d) ELIGIBLE ENTITIES- The Secretary shall distribute the grants through
the following types of entities:';
(2) in paragraph (1), by striking `drug treatment' and inserting `drug
early intervention, prevention or treatment'; and
(A) in subparagraph (A), by striking `; and' and inserting `; or';
and
(B) in subparagraph (B), by inserting `or pediatric health or mental
health providers and family mental health providers' before the
period.
(e) SUBMISSION OF INFORMATION- Section 399D(h) of the Public Health
Service Act (42 U.S.C. 280d(h)) is amended--
(A) by inserting `including maternal and child health' before
`mental';
(B) by striking `treatment programs'; and
(C) by striking `and the State agency responsible for administering
public maternal and child health services' and inserting `, the State
agency responsible for administering alcohol and drug programs, the State
lead agency, and the State Interagency Coordinating Council under part H
of the Individuals with Disabilities Education Act; and'; and
(2) by striking paragraph (3) and redesignating paragraph (4) as
paragraph (3).
(f) REPORTS TO THE SECRETARY- Section 399D(i)(6) of the Public Health
Service Act (42 U.S.C. 280d(i)(6)) is amended--
(1) in subparagraph (B), by adding `and' at the end; and
(2) by striking subparagraphs (C), (D), and (E) and inserting the
following:
`(C) the number of case workers or other professionals trained to
identify and address substance abuse issues.'.
(g) EVALUATIONS- Section 399D(l) of the Public Health Service Act (42
U.S.C. 280d(l)) is amended--
(1) in paragraph (3), by adding `and' at the end;
(2) in paragraph (4), by striking the semicolon and inserting the
following: `, including increased participation in work or
employment-related activities and decreased participation in welfare
programs.'; and
(3) by striking paragraphs (5) and (6).
(h) REPORT TO CONGRESS- Section 399D(m) of the Public Health Service Act
(42 U.S.C. 280d(m)) is amended--
(1) in paragraph (2), by adding `and' at the end;
(A) in subparagraph (A), by adding `and' at the end;
(B) in subparagraph (B), by striking the semicolon and inserting a
period; and
(C) by striking subparagraphs (C), (D), and (E); and
(3) by striking paragraphs (4) and (5).
(i) DATA COLLECTION- Section 399D(n) of the Public Health Service Act (42
U.S.C. 280d(n)) is amended by adding at the end the following: `The periodic
report shall include a quantitative estimate of the prevalence of alcohol and
drug problems in families involved in the child welfare system, the barriers
to treatment and prevention services facing these families, and policy
recommendations for removing the identified barriers, including training for
child welfare workers.'.
(j) DEFINITION- Section 399D(o)(2)(B) of the Public Health Service Act (42
U.S.C. 280d(o)(2)(B)) is amended by striking `dangerous'.
(k) AUTHORIZATION OF APPROPRIATIONS- Section 399D(p) of the Public Health
Service Act (42 U.S.C. 280d(p)) is amended to read as follows:
`(p) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out this
section, there are authorized to be appropriated $50,000,000 for fiscal year
2001, and such sums as may be necessary for each of fiscal years 2002 and
2003.'.
(l) GRANTS FOR TRAINING AND CONFORMING AMENDMENTS- Section 399D of the
Public Health Service Act (42 U.S.C. 280d) is amended--
(1) by striking subsection (f);
(2) by striking subsection (k);
(3) by redesignating subsections (d), (e), (g), (h), (i), (j), (l), (m),
(n), (o), and (p) as subsections (e) through (o), respectively;
(4) by inserting after subsection (c), the following:
`(d) TRAINING FOR PROVIDERS OF SERVICES TO CHILDREN AND FAMILIES- The
Secretary may make a grant under subsection (a) for the training of health,
substance abuse and mental health professionals and other providers of
services to children and families through youth service agencies, family
social services, child care providers, Head Start, schools and after-school
programs, early childhood development programs, community-based family
resource centers, the criminal justice system, and other providers of services
to children and families. Such training shall be to assist professionals in
recognizing the drug and alcohol problems of their clients and to enhance
their skills in identifying and understanding the nature of substance abuse,
and obtaining substance abuse early intervention, prevention and treatment
resources.';
(5) in subsection (k)(2) (as so redesignated), by striking `(h)' and
inserting `(i)'; and
(6) in paragraphs (3)(E) and (5) of subsection (m) (as so redesignated),
by striking `(d)' and inserting `(e)'.
(m) TRANSFER AND REDESIGNATION- Section 399D of the Public Health Service
Act (42 U.S.C. 280d), as amended by this section--
(1) is transferred to title V;
(2) is redesignated as section 519; and
(3) is inserted after section 518.
(n) CONFORMING AMENDMENT- Title III of the Public Health Service Act (42
U.S.C. 241 et seq.) is amended by striking the heading of part L.
SEC. 3107. SERVICES FOR YOUTH OFFENDERS.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3104(b), is further amended by adding
at the end the following:
`SEC. 520D. SERVICES FOR YOUTH OFFENDERS.
`(a) IN GENERAL- The Secretary, acting through the Director of the Center
for Mental Health Services, and in consultation with the Director of the
Center for Substance Abuse Treatment, the Administrator of the Office of
Juvenile Justice and Delinquency Prevention, and the Director of the Special
Education Programs, shall award grants on a competitive basis to State or
local juvenile justice agencies to enable such agencies to provide aftercare
services for youth offenders who have been discharged from facilities in the
juvenile or criminal justice system and have serious emotional disturbances or
are at risk of developing such disturbances.
`(b) USE OF FUNDS- A State or local juvenile justice agency receiving a
grant under subsection (a) shall use the amounts provided under the grant--
`(1) to develop a plan describing the manner in which the agency will
provide services for each youth offender who has a serious emotional
disturbance and has been detained or incarcerated in facilities within the
juvenile or criminal justice system;
`(2) to provide a network of core or aftercare services or access to
such services for each youth offender, including diagnostic and evaluation
services, substance abuse treatment services, outpatient mental health care
services, medication management services, intensive home-based therapy,
intensive day treatment services, respite care, and therapeutic foster
care;
`(3) to establish a program that coordinates with other State and local
agencies providing recreational, social, educational, vocational, or
operational services for youth, to enable the agency receiving a grant under
this section to provide community-based system of care services for each
youth offender that addresses the special needs of the youth and helps the
youth access all of the aforementioned services; and
`(4) using not more than 20 percent of funds received, to provide
planning and transition services as described in paragraph (3) for youth
offenders while such youth are incarcerated or detained.
`(c) APPLICATION- A State or local juvenile justice agency that desires a
grant 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.
`(d) REPORT- Not later than 3 years after the date of the enactment of
this section and annually thereafter, the Secretary shall prepare and submit,
to the Committee on Health, Education, Labor, and Pensions of the Senate and
the Committee on Commerce of the House of Representatives, a report that
describes the services provided pursuant to this section.
`(e) DEFINITIONS- In this section:
`(1) SERIOUS EMOTIONAL DISTURBANCE- The term `serious emotional
disturbance' with respect to a youth offender means an offender who
currently, or at any time within the 1-year period ending on the day on
which services are sought under this section, has a diagnosable mental,
behavioral, or emotional disorder that functionally impairs the offender's
life by substantially limiting the offender's role in family, school, or
community activities, and interfering with the offender's ability to achieve
or maintain one or more developmentally-appropriate social, behavior,
cognitive, communicative, or adaptive skills.
`(2) COMMUNITY-BASED SYSTEM OF CARE- The term `community-based system of
care' means the provision of services for the youth offender by various
State or local agencies that in an interagency fashion or operating as a
network addresses the recreational, social, educational, vocational, mental
health, substance abuse, and operational needs of the youth offender.
`(3) YOUTH OFFENDER- The term `youth offender' means an individual who
is 21 years of age or younger who has been discharged from a State or local
juvenile or criminal justice system, except that if the individual is
between the ages of 18 and 21 years, such individual has had contact with
the State or local juvenile or criminal justice system prior to attaining 18
years of age and is under the jurisdiction of such a system at the time
services are sought.
`(f) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section $40,000,000 for fiscal year 2001, and
such sums as may be necessary for each of fiscal years 2002 and 2003.'.
SEC. 3108. GRANTS FOR STRENGTHENING FAMILIES THROUGH COMMUNITY
PARTNERSHIPS.
Subpart 2 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-21 et seq.) is amended by adding at the end the following:
`SEC. 519A. GRANTS FOR STRENGTHENING FAMILIES.
`(a) PROGRAM AUTHORIZED- The Secretary, acting through the Director of the
Prevention Center, may make grants to public and nonprofit private entities to
develop and implement model substance abuse prevention programs to provide
early intervention and substance abuse prevention services for individuals of
high-risk families and the communities in which such individuals reside.
`(b) PRIORITY- In awarding grants under subsection (a), the Secretary
shall give priority to applicants that--
`(1) have proven experience in preventing substance abuse by individuals
of high-risk families and reducing substance abuse in communities of such
individuals;
`(2) have demonstrated the capacity to implement community-based
partnership initiatives that are sensitive to the diverse backgrounds of
individuals of high-risk families and the communities of such
individuals;
`(3) have experience in providing technical assistance to support
substance abuse prevention programs that are community-based;
`(4) have demonstrated the capacity to implement research-based
substance abuse prevention strategies; and
`(5) have implemented programs that involve families, residents,
community agencies, and institutions in the implementation and design of
such programs.
`(c) DURATION OF GRANTS- The Secretary shall award grants under subsection
(a) for a period not to exceed 5 years.
`(d) USE OF FUNDS- An applicant that is awarded a grant under subsection
(a) shall--
`(1) in the first fiscal year that such funds are received under the
grant, use such funds to develop a model substance abuse prevention program;
and
`(2) in the fiscal year following the first fiscal year that such funds
are received, use such funds to implement the program developed under
paragraph (1) to provide early intervention and substance abuse prevention
services to--
`(A) strengthen the environment of children of high risk families by
targeting interventions at the families of such children and the
communities in which such children reside;
`(B) strengthen protective factors, such as--
`(i) positive adult role models;
`(ii) messages that oppose substance abuse;
`(iii) community actions designed to reduce accessibility to and use
of illegal substances; and
`(iv) willingness of individuals of families in which substance
abuse occurs to seek treatment for substance abuse;
`(C) reduce family and community risks, such as family violence,
alcohol or drug abuse, crime, and other behaviors that may effect healthy
child development and increase the likelihood of substance abuse;
and
`(D) build collaborative and formal partnerships between community
agencies, institutions, and businesses to ensure that comprehensive high
quality services are provided, such as early childhood education, health
care, family support programs, parent education programs, and home visits
for infants.
`(e) APPLICATION- To be eligible to receive a grant under subsection (a),
an applicant shall prepare and submit to the Secretary an application
that--
`(1) describes a model substance abuse prevention program that such
applicant will establish;
`(2) describes the manner in which the services described in subsection
(d)(2) will be provided; and
`(3) describe in as much detail as possible the results that the entity
expects to achieve in implementing such a program.
`(f) MATCHING FUNDING- The Secretary may not make a grant to a entity
under subsection (a) unless that entity agrees that, with respect to the costs
to be incurred by the entity in carrying out the program for which the grant
was awarded, the entity will make available non-Federal contributions in an
amount that is not less than 40 percent of the amount provided under the
grant.
`(g) REPORT TO SECRETARY- An applicant that is awarded a grant under
subsection (a) shall prepare and submit to the Secretary a report in such form
and containing such information as the Secretary may require, including an
assessment of the efficacy of the model substance abuse prevention program
implemented by the applicant and the short, intermediate, and long term
results of such program.
`(h) EVALUATIONS- The Secretary shall conduct evaluations, based in part
on the reports submitted under subsection (g), to determine the effectiveness
of the programs funded under subsection (a) in reducing substance use in
high-risk families and in making communities in which such families reside in
stronger. The Secretary shall submit such evaluations to the appropriate
committees of Congress.
`(i) HIGH-RISK FAMILIES- In this section, the term `high-risk family'
means a family in which the individuals of such family are at a significant
risk of using or abusing alcohol or any illegal substance.
`(j) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section, $3,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years 2002 and 2003.'.
SEC. 3109. PROGRAMS TO REDUCE UNDERAGE DRINKING.
Subpart 2 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-21 et seq.), as amended by section 3108, is further amended by adding at
the end the following:
`SEC. 519B. PROGRAMS TO REDUCE UNDERAGE DRINKING.
`(a) IN GENERAL- The Secretary shall make awards of grants, cooperative
agreements, or contracts to public and nonprofit private entities, including
Indian tribes and tribal organizations, to enable such entities to develop
plans for and to carry out school-based (including institutions of higher
education) and community-based programs for the prevention of
alcoholic-beverage consumption by individuals who have not attained the legal
drinking age.
`(b) ELIGIBILITY REQUIREMENTS- To be eligible to receive an award under
subsection (a), an entity shall provide any assurances to the Secretary which
the Secretary may require, including that the entity will--
`(1) annually report to the Secretary on the effectiveness of the
prevention approaches implemented by the entity;
`(2) use science based and age appropriate approaches; and
`(3) involve local public health officials and community prevention
program staff in the planning and implementation of the program.
`(c) EVALUATION- The Secretary shall evaluate each project under
subsection (a) and shall disseminate the findings with respect to each such
evaluation to appropriate public and private entities.
`(d) GEOGRAPHICAL DISTRIBUTION- The Secretary shall ensure that awards
will be distributed equitably among the regions of the country and among urban
and rural areas.
`(e) DURATION OF AWARD- 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. The preceding sentence may not be construed as
establishing a limitation on the number of awards under such subsection that
may be made to the recipient.
`(f) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out this
section, there are authorized to be appropriated $25,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years 2002 and
2003.'.
SEC. 3110. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.
Subpart 2 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-21 et seq.), as amended by sections 3108 and 3109, is further amended by
adding at the end the following:
`SEC. 519C. 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
Indian tribes and tribal organizations, 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 abuse 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 abuse 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; and
`(12) 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 abuse 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.
`(1) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out
this section, there are authorized to be appropriated $25,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the fiscal years
2002 and 2003.
`(2) ALLOCATION- Of the amounts appropriated under paragraph (1) for a
fiscal year, not less than $300,000 shall, for purposes relating to fetal
alcohol syndrome and alcohol-related birth defects, be made available for
collaborative, coordinated interagency efforts with the National Institute
on Alcohol Abuse and Alcoholism, the National Institute on Child Health and
Human Development, the Health Resources and Services Administration, the
Agency for Healthcare Research and Quality, the Centers for Disease Control
and Prevention, the Department of Education, and the Department of
Justice.
`SEC. 519D. 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 abuse
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;
`(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.
`(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 use among women
of child bearing years.
`(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 $5,000,000 for fiscal year
2001, and such sums as may be necessary for each of the fiscal years 2002 and
2003.'.
SEC. 3111. SUICIDE PREVENTION.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3107, is further amended by adding at
the end the following:
`SEC. 520E. SUICIDE PREVENTION FOR CHILDREN AND ADOLESCENTS.
`(a) IN GENERAL- The Secretary shall award grants, contracts, or
cooperative agreements to States, political subdivisions of States, Indian
tribes, tribal organizations, public organizations, or private nonprofit
organizations to establish programs to reduce suicide deaths in the United
States among children and adolescents.
`(b) COLLABORATION- In carrying out subsection (a), the Secretary shall
ensure that activities under this section are coordinated among the Substance
Abuse and Mental Health Services Administration, the relevant institutes at
the National Institutes of Health, the Centers for Disease Control and
Prevention, the Health Resources and Services Administration, and the
Administration on Children and Families.
`(c) REQUIREMENTS- A State, political subdivision of a State, Indian
tribe, tribal organization, public organization, or private nonprofit
organization desiring a grant, contract, or cooperative agreement under this
section shall demonstrate that the suicide prevention program such entity
proposes will--
`(1) provide for the timely assessment, treatment, or referral for
mental health or substance abuse services of children and adolescents at
risk for suicide;
`(2) be based on best evidence-based, suicide prevention practices and
strategies that are adapted to the local community;
`(3) integrate its suicide prevention program into the existing health
care system in the community including primary health care, mental health
services, and substance abuse services;
`(4) be integrated into other systems in the community that address the
needs of children and adolescents including the educational system, juvenile
justice system, welfare and child protection systems, and community youth
support organizations;
`(5) use primary prevention methods to educate and raise awareness in
the local community by disseminating evidence-based information about
suicide prevention;
`(6) include suicide prevention, mental health, and related information
and services for the families and friends of those who completed suicide, as
needed;
`(7) provide linguistically appropriate and culturally competent
services, as needed;
`(8) provide a plan for the evaluation of outcomes and activities at the
local level, according to standards established by the Secretary, and agree
to participate in a national evaluation; and
`(9) ensure that staff used in the program are trained in suicide
prevention and that professionals involved in the system of care have
received training in identifying persons at risk of suicide.
`(d) USE OF FUNDS- Amounts provided under grants, contracts, or
cooperative agreements under subsection (a) shall be used to supplement and
not supplant other Federal, State, and local public funds that are expended to
provide services for eligible individuals.
`(e) CONDITION- An applicant for a grant, contract, or cooperative
agreement under subsection (a) shall demonstrate to the Secretary that the
applicant has the support of the local community and relevant public health
officials.
`(f) SPECIAL POPULATIONS- In awarding grants, contracts, and cooperative
agreements under subsection (a), the Secretary shall ensure that such awards
are made in a manner that will focus on the needs of communities or groups
that experience high or rapidly rising rates of suicide.
`(g) APPLICATION- A State, political subdivision of a State, Indian tribe,
tribal organization, public organization, or private nonprofit organization
receiving a grant, contract, or cooperative agreement under subsection (a)
shall prepare and submit an application to the Secretary at such time, in such
manner, and containing such information as the Secretary may reasonably
require. Such application shall include a plan for the rigorous evaluation of
activities funded under the grant, contract, or cooperative agreement,
including a process and outcome evaluation.
`(h) DISTRIBUTION OF AWARDS- In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary shall ensure that
such awards are distributed among the geographical regions of the United
States and between urban and rural settings.
`(i) EVALUATION- A State, political subdivision of a State, Indian tribe,
tribal organization, public organization, or private nonprofit organization
receiving a grant, contract, or cooperative agreement under subsection (a)
shall prepare and submit to the Secretary at the end of the program period, an
evaluation of all activities funded under this section.
`(j) DISSEMINATION AND EDUCATION- The Secretary shall ensure that findings
derived from activities carried out under this section are disseminated to
State, county and local governmental agencies and public and private nonprofit
organizations active in promoting suicide prevention and family support
activities.
`(k) DURATION OF PROJECTS- With respect to a grant, contract, or
cooperative agreement awarded under this section, the period during which
payments under such award may be made to the recipient may not exceed 5
years.
`(l) STUDY- Within 1 year after the date of the enactment of this section,
the Secretary shall, directly or by grant or contract, initiate a study to
assemble and analyze data to identify--
`(1) unique profiles of children under 13 who attempt or complete
suicide;
`(2) unique profiles of youths between ages 13 and 21 who attempt or
complete suicide; and
`(3) a profile of services which might have been available to these
groups and the use of these services by children and youths from paragraphs
(1) and (2).
`(m) AUTHORIZATION OF APPROPRIATION-
`(1) IN GENERAL- For purposes of carrying out this section, there is
authorized to be appropriated $75,000,000 for fiscal year 2001 and such sums
as may be necessary for each of the fiscal years 2002 through 2003.
`(2) PROGRAM MANAGEMENT- In carrying out this section, the Secretary
shall use 1 percent of the amount appropriated under paragraph (1) for each
fiscal year for managing programs under this section.'.
SEC. 3112. GENERAL PROVISIONS.
(a) DUTIES OF THE CENTER FOR SUBSTANCE ABUSE TREATMENT- Section 507(b) of
the Public Health Service Act (42 U.S.C. 290bb(b)) is amended--
(1) by redesignating paragraphs (2) through (12) as paragraphs (4)
through (14), respectively;
(2) by inserting after paragraph (1), the following:
`(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 abuse treatment services to individuals who have had
contact with the Justice system, especially adolescents;';
(3) in paragraph (7) (as so redesignated), by striking `services, and
monitor' and all that follows through `1925' and inserting `services';
(4) in paragraph (13) (as so redesignated), by striking `treatment,
including' and all that follows through `which shall' and inserting
`treatment, which shall'; and
(5) in paragraph 14 (as so redesignated), by striking `paragraph (11)'
and inserting `paragraph (13)'.
(b) OFFICE FOR SUBSTANCE ABUSE PREVENTION- Section 515(b) of the Public
Health Service Act (42 U.S.C. 290bb-21(b)) is amended--
(1) by redesignating paragraphs (9) and (10) as (10) and (11);
(2) by inserting after paragraph (8), the following:
`(9) collaborate with the Attorney General of the Department of Justice
to develop programs to prevent drug abuse among high risk youth;'; and
(3) in paragraph (10) (as so redesignated), by striking `public
concerning' and inserting `public, especially adolescent audiences,
concerning'.
(c) DUTIES OF THE CENTER FOR MENTAL HEALTH SERVICES- Section 520(b) of the
Public Health Service Act (42 U.S.C. 290bb-3(b)) is amended--
(1) by redesignating paragraphs (3) through (14) as paragraphs (4)
through (15), respectively;
(2) by inserting after paragraph (2), the following:
`(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;';
(3) in paragraph (8) (as so redesignated), by striking `programs
authorized' and all that follows through `Programs' and inserting `programs
under part C'; and
(4) in paragraph (9) (as so redesignated), by striking `program and
programs' and all that follows through `303' and inserting `programs'.
TITLE XXXII--PROVISIONS RELATING TO MENTAL HEALTH
SEC. 3201. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
(a) IN GENERAL- Section 520A of the Public Health Service Act (42 U.S.C.
290bb-32) is amended to read as follows:
`SEC. 520A. 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.
The Secretary may carry out the activities described in this subsection
directly or through grants or cooperative agreements with States, 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.
`(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.
`(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 2001, and such sums as may be
necessary for each of the fiscal years 2002 and 2003.
`(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.'.
(b) CONFORMING AMENDMENTS-
(1) Section 303 of the Public Health Service Act (42 U.S.C. 242a) is
repealed.
(2) Section 520B of the Public Health Service Act (42 U.S.C. 290bb-33)
is repealed.
(3) Section 612 of the Stewart B. McKinney Homeless Assistance Act (42
U.S.C. 290aa-3 note) is repealed.
SEC. 3202. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
Section 506 of the Public Health Service Act (42 U.S.C. 290aa-5) is
amended to read as follows:
`SEC. 506. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
`(a) 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 abuse
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).
`(b) PREFERENCES- In awarding grants, contracts, and cooperative
agreements under subsection (a), the Secretary shall give a preference to--
`(1) entities that provide integrated primary health, substance abuse,
and mental health services to homeless individuals;
`(2) entities that demonstrate effectiveness in serving runaway,
homeless, and street youth;
`(3) entities that have experience in providing substance abuse and
mental health services to homeless individuals;
`(4) entities that demonstrate experience in providing housing for
individuals in treatment for or in recovery from mental illness or substance
abuse; and
`(5) entities that demonstrate effectiveness in serving homeless
veterans.
`(c) SERVICES FOR CERTAIN INDIVIDUALS- In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary shall not--
`(1) prohibit the provision of services under such subsection to
homeless individuals who are suffering from a substance abuse disorder and
are not suffering from a mental health disorder; and
`(2) make payments under subsection (a) to any entity that has a policy
of--
`(A) excluding individuals from mental health services due to the
existence or suspicion of substance abuse; or
`(B) has a policy of excluding individuals from substance abuse
services due to the existence or suspicion of mental illness.
`(d) TERM OF THE AWARDS- No entity may receive a grant, contract, or
cooperative agreement under subsection (a) for more than 5 years.
`(e) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section, $50,000,000 for fiscal year 2001, and
such sums as may be necessary for each of the fiscal years 2002 and 2003.'.
SEC. 3203. PROJECTS FOR ASSISTANCE IN TRANSITION FROM HOMELESSNESS.
(a) WAIVERS FOR TERRITORIES- Section 522 of the Public Health Service Act
(42 U.S.C. 290cc-22) is amended by adding at the end the following:
`(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.'.
(b) AUTHORIZATION OF APPROPRIATION- Section 535(a) of the Public Health
Service Act (42 U.S.C. 290cc-35(a)) is amended by striking `1991 through 1994'
and inserting `2001 through 2003'.
SEC. 3204. COMMUNITY MENTAL HEALTH SERVICES PERFORMANCE PARTNERSHIP BLOCK
GRANT.
(a) CRITERIA FOR PLAN- Section 1912(b) of the Public Health Service Act
(42 U.S.C. 300x-2(b)) is amended by striking paragraphs (1) through (12) and
inserting the following:
`(1) COMPREHENSIVE COMMUNITY-BASED MENTAL HEALTH SYSTEMS- The plan
provides for an organized community-based system of care for individuals
with mental illness and describes available services and resources in a
comprehensive system of care, including services for dually diagnosed
individuals. The description of the system of care shall include health and
mental health services, rehabilitation services, employment services,
housing services, educational services, substance abuse services, medical
and dental care, and other support services to be provided to individuals
with Federal, State and local public and private resources to enable such
individuals 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. The plan shall include a separate description of case management
services and provide for activities leading to reduction of
hospitalization.
`(2) MENTAL HEALTH SYSTEM DATA AND EPIDEMIOLOGY- The plan contains an
estimate of the incidence and prevalence in the State of serious mental
illness among adults and serious emotional disturbance among children and
presents quantitative targets to be achieved in the implementation of the
system described in paragraph (1).
`(3) CHILDREN'S SERVICES- In the case of children with serious emotional
disturbance, the plan--
`(A) subject to subparagraph (B), provides for a system of integrated
social services, educational services, juvenile services, and substance
abuse services that, together with health and mental health services, will
be provided in order for such children to receive care appropriate for
their multiple needs (such system to include services provided under the
Individuals with Disabilities Education Act);
`(B) provides that the grant under section 1911 for the fiscal year
involved will not be expended to provide any service under such system
other than comprehensive community mental health services; and
`(C) provides for the establishment of a defined geographic area for
the provision of the services of such system.
`(4) TARGETED SERVICES TO RURAL AND HOMELESS POPULATIONS- The plan
describes the State's outreach to and services for individuals who are
homeless and how community-based services will be provided to individuals
residing in rural areas.
`(5) MANAGEMENT SYSTEMS- The plan describes the financial resources,
staffing and training for mental health providers that is necessary to
implement the plan, and provides for the training of providers of emergency
health services regarding mental health. The plan further describes the
manner in which the State intends to expend the grant under section 1911 for
the fiscal year involved.
Except as provided for in paragraph (3), the State plan shall contain the
information required under this subsection with respect to both adults with
serious mental illness and children with serious emotional disturbance.'.
(b) REVIEW OF PLANNING COUNCIL OF STATE'S REPORT- Section 1915(a) of the
Public Health Service Act (42 U.S.C. 300x-4(a)) is amended--
(1) in paragraph (1), by inserting `and the report of the State under
section 1942(a) concerning the preceding fiscal year' after `to the grant';
and
(2) in paragraph (2), by inserting before the period `and any comments
concerning the annual report'.
(c) MAINTENANCE OF EFFORT- Section 1915(b) of the Public Health Service
Act (42 U.S.C. 300x-4(b)) is amended--
(1) by redesignating paragraphs (2) and (3) as paragraphs (3) and (4),
respectively; and
(2) by inserting after paragraph (1), the following:
`(2) 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.'.
(d) APPLICATION FOR GRANTS- Section 1917(a)(1) of the Public Health
Service Act (42 U.S.C. 300x-6(a)(1)) is amended to read as follows:
`(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 1941
is received by December 1 of the fiscal year of the grant;'.
(e) WAIVERS FOR TERRITORIES- Section 1917(b) of the Public Health Service
Act (42 U.S.C. 300x-6(b)) is amended by striking `whose allotment under
section 1911 for the fiscal year is the amount specified in section
1918(c)(2)(B)' and inserting in its place `except Puerto Rico'.
(f) AUTHORIZATION OF APPROPRIATION- Section 1920 of the Public Health
Service Act (42 U.S.C. 300x-9) is amended--
(1) in subsection (a), by striking `$450,000,000' and all that follows
through the end and inserting `$450,000,000 for fiscal year 2001, and such
sums as may be necessary for each of the fiscal years 2002 and 2003.';
and
(2) in subsection (b)(2), by striking `section 505' and inserting
`sections 505 and 1971'.
SEC. 3205. DETERMINATION OF ALLOTMENT.
Section 1918(b) of the Public Health Service Act (42 U.S.C. 300x-7(b)) is
amended to read as follows:
`(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.'.
SEC. 3206. PROTECTION AND ADVOCACY FOR MENTALLY ILL INDIVIDUALS ACT OF
1986.
(a) SHORT TITLE- The first section of the Protection and Advocacy for
Mentally Ill Individuals Act of 1986 (Public Law 99-319) is amended to read as
follows:
`SECTION 1. SHORT TITLE.
`This Act may be cited as the `Protection and Advocacy for Individuals
with Mental Illness Act'.'.
(b) DEFINITIONS- Section 102 of the Protection and Advocacy for
Individuals with Mental Illness Act (as amended by subsection (a)) (42 U.S.C.
10802) is amended--
(A) in the matter preceding subparagraph (A), by inserting `, except
as provided in section 104(d),' after `means';
(B) in subparagraph (B)--
(i) by striking `(i)' who' and inserting `(i)(I) who';
(ii) by redesignating clauses (ii) and (iii) as subclauses (II) and
(III);
(iii) in subclause (III) (as so redesignated), by striking the
period and inserting `; or'; and
(iv) by adding at the end the following:
`(ii) who satisfies the requirements of subparagraph (A) and lives in
a community setting, including their own home.'; and
(2) by adding at the end the following:
`(8) The term `American Indian consortium' means a consortium
established under part C of the Developmental Disabilities Assistance and
Bill of Rights Act (42 U.S.C. 6042 et seq.).'.
(c) USE OF ALLOTMENTS- Section 104 of the Protection and Advocacy for
Individuals with Mental Illness Act (as amended by subsection (a)) (42 U.S.C.
10804) is amended by adding at the end the following:
`(d) The definition of `individual with a mental illness' contained in
section 102(4)(B)(iii) shall apply, and thus an eligible system may use its
allotment under this title to provide representation to such individuals, only
if the total allotment under this title for any fiscal year is $30,000,000 or
more, and in such case, an eligible system must give priority to representing
persons with mental illness as defined in subparagraphs (A) and (B)(i) of
section 102(4).'.
(d) MINIMUM AMOUNT- Paragraph (2) of section 112(a) of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended by subsection
(a)) (42 U.S.C. 10822(a)(2)) is amended to read as follows:
`(2)(A) The minimum amount of the allotment of an eligible system shall
be the product (rounded to the nearest $100) of the appropriate base amount
determined under subparagraph (B) and the factor specified in subparagraph
(C).
`(B) For purposes of subparagraph (A), the appropriate base
amount--
`(i) for American Samoa, Guam, the Marshall Islands, the Federated
States of Micronesia, the Commonwealth of the Northern Mariana Islands,
the Republic of Palau, and the Virgin Islands, is $139,300; and
`(ii) for any other State, is $260,000.
`(C) The factor specified in this subparagraph is the ratio of the
amount appropriated under section 117 for the fiscal year for which the
allotment is being made to the amount appropriated under such section for
fiscal year 1995.
`(D) If the total amount appropriated for a fiscal year is at least
$25,000,000, the Secretary shall make an allotment in accordance with
subparagraph (A) to the eligible system serving the American Indian
consortium.'.
(e) TECHNICAL AMENDMENTS- Section 112(a) of the Protection and Advocacy
for Individuals with Mental Illness Act (as amended by subsection (a)) (42
U.S.C. 10822(a)) is amended--
(1) in paragraph (1)(B), by striking `Trust Territory of the Pacific
Islands' and inserting `Marshall Islands, the Federated States of
Micronesia, the Republic of Palau'; and
(2) by striking paragraph (3).
(f) REAUTHORIZATION- Section 117 of the Protection and Advocacy for
Individuals with Mental Illness Act (as amended by subsection (a)) (42 U.S.C.
10827) is amended by striking `1995' and inserting `2003'.
SEC. 3207. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.) is
amended by adding at the end the following:
`PART H--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES
`SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
FACILITIES.
`(a) IN GENERAL- A public or private general hospital, nursing facility,
intermediate care facility, or other health care facility, that receives
support in any form from any program supported in whole or in part with funds
appropriated to any Federal department or agency shall protect and promote the
rights of each resident of the facility, including the right to be free from
physical or mental abuse, corporal punishment, and any restraints or
involuntary seclusions imposed for purposes of discipline or convenience.
`(b) REQUIREMENTS- Restraints and seclusion may only be imposed on a
resident of a facility described in subsection (a) if--
`(1) the restraints or seclusion are imposed to ensure the physical
safety of the resident, a staff member, or others; and
`(2) the restraints or seclusion are imposed only upon the written order
of a physician, or other licensed practitioner permitted by the State and
the facility to order such restraint or seclusion, that specifies the
duration and circumstances under which the restraints are to be used (except
in emergency circumstances specified by the Secretary until such an order
could reasonably be obtained).
`(c) CURRENT LAW- This part shall not be construed to affect or impede any
Federal or State law or regulations that provide greater protections than this
part regarding seclusion and restraint.
`(d) DEFINITIONS- In this section:
`(1) RESTRAINTS- The term `restraints' means--
`(A) any physical restraint that is a mechanical or personal
restriction that immobilizes or reduces the ability of an individual to
move his or her arms, legs, or head freely, not including devices, such as
orthopedically prescribed devices, surgical dressings or bandages,
protective helmets, or any other methods that involves the physical
holding of a resident for the purpose of conducting routine physical
examinations or tests or to protect the resident from falling out of bed
or to permit the resident to participate in activities without the risk of
physical harm to the resident (such term does not include a physical
escort); and
`(B) a drug or medication that is used as a restraint to control
behavior or restrict the resident's freedom of movement that is not a
standard treatment for the resident's medical or psychiatric
condition.
`(2) SECLUSION- The term `seclusion' means a behavior control technique
involving locked isolation. Such term does not include a time out.
`(3) PHYSICAL ESCORT- The term `physical escort' means the temporary
touching or holding of the hand, wrist, arm, shoulder or back for the
purpose of inducing a resident who is acting out to walk to a safe
location.
`(4) TIME OUT- The term `time out' means a behavior management technique
that is part of an approved treatment program and may involve the separation
of the resident from the group, in a non-locked setting, for the purpose of
calming. Time out is not seclusion.
`SEC. 592. REPORTING REQUIREMENT.
`(a) IN GENERAL- Each facility to which the Protection and Advocacy for
Mentally Ill Individuals Act of 1986 applies shall notify the appropriate
agency, as determined by the Secretary, of each death that occurs at each such
facility while a patient is restrained or in seclusion, of each death
occurring within 24 hours after the patient has been removed from restraints
and seclusion, or where it is reasonable to assume that a patient's death is a
result of such seclusion or restraint. A notification under this section shall
include the name of the resident and shall be provided not later than 7 days
after the date of the death of the individual involved.
`(b) FACILITY- In this section, the term `facility' has the meaning given
the term `facilities' in section 102(3) of the Protection and Advocacy for
Mentally Ill Individuals Act of 1986 (42 U.S.C. 10802(3)).'.
`SEC. 593. REGULATIONS AND ENFORCEMENT.
`(a) TRAINING- Not later than 1 year after the date of the enactment of
this part, the Secretary, after consultation with appropriate State and local
protection and advocacy organizations, physicians, facilities, and other
health care professionals and patients, shall promulgate regulations that
require facilities to which the Protection and Advocacy for Mentally Ill
Individuals Act of 1986 (42 U.S.C. 10801 et seq.) applies, to meet the
requirements of subsection (b).
`(b) REQUIREMENTS- The regulations promulgated under subsection (a) shall
require that--
`(1) facilities described in subsection (a) ensure that there is an
adequate number of qualified professional and supportive staff to evaluate
patients, formulate written individualized, comprehensive treatment plans,
and to provide active treatment measures;
`(2) appropriate training be provided for the staff of such facilities
in the use of restraints and any alternatives to the use of restraints;
and
`(3) such facilities provide complete and accurate notification of
deaths, as required under section 592(a).
`(c) ENFORCEMENT- A facility to which this part applies that fails to
comply with any requirement of this part, including a failure to provide
appropriate training, shall not be eligible for participation in any program
supported in whole or in part by funds appropriated to any Federal department
or agency.'.
SEC. 3208. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH.
Title V of the Public Health Service Act (42 U.S.C. 290aa et seq.), as
amended by section 3207, is further amended by adding at the end the
following:
`PART I--REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH
`SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS OF CERTAIN
NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH.
`(a) PROTECTION OF RIGHTS-
`(1) IN GENERAL- 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.
`(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.
`(1) IN GENERAL- Physical restraints and seclusion may only be imposed
on a resident of a facility described in subsection (a) if--
`(A) the restraints or seclusion are imposed only in emergency
circumstances and only to ensure the immediate physical safety of the
resident, a staff member, 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 pursuant to a process
determined appropriate by the State and approved by the Secretary, in the
prevention and use of physical restraint and seclusion, including the
needs and behaviors of the population served, relationship building,
alternatives to restraint and seclusion, de-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 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),
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.
`(A) IN GENERAL- The use of a drug or medication that is used as a
restraint to control behavior or restrict the resident's freedom of
movement that is not a standard treatment for the resident's medical or
psychiatric condition in nonmedical community-based facilities for
children and youth described in subsection (a)(1) is prohibited.
`(B) PROHIBITION- The use of mechanical restraints in non-medical,
community-based facilities for children and youth described in subsection
(a)(1) is prohibited.
`(C) LIMITATION- A non-medical, community-based 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 resident 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 a resident'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 a resident 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 and may involve the separation
of the resident from the group, in a non-locked setting, for the purpose of
calming. Time out is not seclusion.
`SEC. 595A. REPORTING REQUIREMENT.
`Each facility to which this part applies shall notify the appropriate
State licensing or regulatory agency, as determined by the Secretary--
`(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
States.
`SEC. 595B. REGULATIONS AND ENFORCEMENT.
`(a) TRAINING- Not later than 6 months after the date of the enactment of
this part, the Secretary, after consultation with appropriate State, local,
public and private protection and advocacy organizations, health care
professionals, social workers, facilities, and patients, shall promulgate
regulations that--
`(1) require States that license non-medical, community-based
residential facilities for children and youth to develop 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 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
`(3) support the development of national guidelines and standards on the
quality, quantity, orientation and training, required under this part, as
well as the certification or 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
residents, 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 595A(1).
`(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 under this
Act.'.
SEC. 3209. EMERGENCY MENTAL HEALTH CENTERS.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3111, is further amended by adding at
the end the following:
`SEC. 520F. GRANTS FOR EMERGENCY MENTAL HEALTH CENTERS.
`(a) PROGRAM AUTHORIZED- The Secretary shall award grants to States,
political subdivisions of States, Indian tribes, and tribal organizations to
support the designation of hospitals and health centers as Emergency Mental
Health Centers.
`(b) HEALTH CENTER- In this section, the term `health center' has the
meaning given such term in section 330, and includes community health centers
and community mental health centers.
`(c) DISTRIBUTION OF AWARDS- The Secretary shall ensure that such grants
awarded under subsection (a) are equitably distributed among the geographical
regions of the United States, between urban and rural populations, and between
different settings of care including health centers, mental health centers,
hospitals, and other psychiatric units or facilities.
`(d) APPLICATION- A State, political subdivision of a State, Indian tribe,
or tribal organization that desires a grant under subsection (a) 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 carried out with funds received under this
section.
`(1) IN GENERAL- A State, political subdivision of a State, Indian
tribe, or tribal organization receiving a grant under subsection (a) shall
use funds from such grant to establish or designate hospitals and health
centers as Emergency Mental Health Centers.
`(2) EMERGENCY MENTAL HEALTH CENTERS- Such Emergency Mental Health
Centers described in paragraph (1)--
`(i) serve as a central receiving point in the community for
individuals who may be in need of emergency mental health
services;
`(ii) purchase, if needed, any equipment necessary to evaluate,
diagnose and stabilize an individual with a mental illness;
`(iii) provide training, if needed, to the medical personnel
staffing the Emergency Mental Health Center to evaluate, diagnose,
stabilize, and treat an individual with a mental illness;
and
`(iv) provide any treatment that is necessary for an individual with
a mental illness or a referral for such individual to another facility
where such treatment may be received; and
`(B) may establish and train a mobile crisis intervention team to
respond to mental health emergencies within the community.
`(f) EVALUATION- A State, political subdivision of a State, Indian tribe,
or tribal organization that receives a grant under subsection (a) 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 this section and a process and outcomes evaluation.
`(g) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section, $25,000,000 for fiscal year 2001 and
such sums as may be necessary for each of the fiscal years 2002 through
2003.'.
SEC. 3210. GRANTS FOR JAIL DIVERSION PROGRAMS.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3209, is further amended by adding at
the end the following:
`SEC. 520G. GRANTS FOR JAIL DIVERSION PROGRAMS.
`(a) PROGRAM AUTHORIZED- The Secretary shall make up to 125 grants to
States, political subdivisions of States, Indian tribes, and tribal
organizations, acting directly or through agreements with other public or
nonprofit entities, to develop and implement programs to divert individuals
with a mental illness from the criminal justice system to community-based
services.
`(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).
`(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 the best known practices, reflect
current research findings, include case management, assertive community
treatment, medication management and access, integrated mental health
and co-occurring substance abuse 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 abuse
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 abuse 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.
`(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 2001, and
such sums as may be necessary for fiscal years 2002 through 2003.'.
SEC. 3211. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS THROUGH SERVICES
INTEGRATION BETWEEN CHILD WELFARE AND MENTAL HEALTH SERVICES.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3210, is further amended by adding at
the end the following:
`SEC. 520H. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS THROUGH SERVICES
INTEGRATION BETWEEN CHILD WELFARE AND MENTAL HEALTH SERVICES.
`(a) IN GENERAL- The Secretary shall award grants, contracts or
cooperative agreements to States, political subdivisions of States, Indian
tribes, and tribal organizations to provide integrated child welfare and
mental health services for children and adolescents under 19 years of age in
the child welfare system or at risk for becoming part of the system, and
parents or caregivers with a mental illness or a mental illness and a
co-occurring substance abuse disorder.
`(b) DURATION- 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.
`(1) IN GENERAL- To be eligible to receive an award under subsection
(a), a State, political subdivision of a State, Indian tribe, or tribal
organization shall submit an application to the Secretary at such time, in
such manner, and accompanied by such information as the Secretary may
reasonably require.
`(2) CONTENT- An application submitted under paragraph (1) shall--
`(A) describe the program to be funded under the grant, contract or
cooperative agreement;
`(B) explain how such program reflects best practices in the provision
of child welfare and mental health services; and
`(C) provide assurances that--
`(i) persons providing services under the grant, contract or
cooperative agreement are adequately trained to provide such services;
and
`(ii) the services will be provided in accordance with subsection
(d).
`(d) USE OF FUNDS- A State, political subdivision of a State, Indian
tribe, or tribal organization that receives a grant, contract, or cooperative
agreement under subsection (a) shall use amounts made available through such
grant, contract or cooperative agreement to--
`(1) provide family-centered, comprehensive, and coordinated child
welfare and mental health services, including prevention, early intervention
and treatment services for children and adolescents, and for their parents
or caregivers;
`(2) ensure a single point of access for such coordinated
services;
`(3) provide integrated mental health and substance abuse treatment for
children, adolescents, and parents or caregivers with a mental illness and a
co-occurring substance abuse disorder;
`(4) provide training for the child welfare, mental health and substance
abuse professionals who will participate in the program carried out under
this section;
`(5) provide technical assistance to child welfare and mental health
agencies;
`(6) develop cooperative efforts with other service entities in the
community, including education, social services, juvenile justice, and
primary health care agencies;
`(7) coordinate services with services provided under the Medicaid
program and the State Children's Health Insurance Program under titles XIX
and XXI of the Social Security Act;
`(8) provide linguistically appropriate and culturally competent
services; and
`(9) evaluate the effectiveness and cost-efficiency of the integrated
services that measure the level of coordination, outcome measures for
parents or caregivers with a mental illness or a mental illness and a
co-occurring substance abuse disorder, and outcome measures for
children.
`(e) DISTRIBUTION OF AWARDS- The Secretary shall ensure that grants,
contracts, and cooperative agreements awarded under subsection (a) are
equitably distributed among the geographical regions of the United States and
between urban and rural populations.
`(f) EVALUATION- The Secretary shall evaluate each program carried out by
a State, political subdivision of a State, Indian tribe, or tribal
organization under subsection (a) and shall disseminate the findings with
respect to each such evaluation to appropriate public and private entities.
`(g) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section, $10,000,000 for fiscal year 2001, and
such sums as may be necessary for each of fiscal years 2002 and 2003.'.
SEC. 3212. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS MENTAL ILLNESS AND
CO-OCCURRING SUBSTANCE ABUSE.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3211, is further amended by adding at
the end the following:
`SEC. 520I. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS MENTAL ILLNESS
AND CO-OCCURRING SUBSTANCE ABUSE.
`(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
abuse disorder.
`(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 abuse disorder who--
`(1) have a history of interactions with law enforcement or the criminal
justice system;
`(2) have recently been released from incarceration;
`(3) have a history of unsuccessful treatment in either an inpatient or
outpatient setting;
`(4) have never followed through with outpatient services despite
repeated referrals; or
`(c) USE OF FUNDS- 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) 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 abuse;
`(3) to provide integrated mental health and substance abuse services at
the same location;
`(4) to provide services that are linguistically appropriate and
culturally competent;
`(5) to provide at least 10 programs for integrated treatment of both
mental illness and substance abuse at sites that previously provided only
mental health services or only substance abuse 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 abuse 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 APPROPRIATION- There is authorized to be
appropriated to carry out this subsection $40,000,000 for fiscal year 2001,
and such sums as may be necessary for fiscal years 2002 through 2003.'.
SEC. 3213. TRAINING GRANTS.
Subpart 3 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb-31 et seq.), as amended by section 3212, is further amended by adding at
the end the following:
`SEC. 520J. 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, Indian tribes, tribal organizations, 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, 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 2001
and such sums as may be necessary for each of fiscal years 2002 through
2003.'.
TITLE XXXIII--PROVISIONS RELATING TO SUBSTANCE ABUSE
SEC. 3301. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
(a) RESIDENTIAL TREATMENT PROGRAMS FOR PREGNANT AND POSTPARTUM WOMEN-
Section 508(r) of the Public Health Service Act (42 U.S.C. 290bb-1(r)) is
amended to read as follows:
`(r) AUTHORIZATION OF APPROPRIATIONS- For the purpose of carrying out this
section, there are authorized to be appropriated such sums as may be necessary
to fiscal years 2001 through 2003.'.
(b) PRIORITY SUBSTANCE ABUSE TREATMENT- Section 509 of the Public Health
Service Act (42 U.S.C. 290bb-1) is amended to read as follows:
`SEC. 509. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF REGIONAL AND NATIONAL
SIGNIFICANCE.
`(a) PROJECTS- The Secretary shall address priority substance abuse
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.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States, political
subdivisions of States, Indian tribes and tribal organizations, other public
or nonprofit private entities.
`(b) PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS-
`(1) IN GENERAL- Priority substance abuse 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 abuse treatment services into primary health
care systems.
`(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 abuse 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 2001 and
such sums as may be necessary for each of the fiscal years 2002 and 2003.'.
(c) CONFORMING AMENDMENTS- The following sections of the Public Health
Service Act are repealed:
(1) Section 510 (42 U.S.C. 290bb-3).
(2) Section 511 (42 U.S.C. 290bb-4).
(3) Section 512 (42 U.S.C. 290bb-5).
(4) Section 571 (42 U.S.C. 290gg).
SEC. 3302. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
(a) IN GENERAL- Section 516 of the Public Health Service Act (42 U.S.C.
290bb-1) is amended to read as follows:
`SEC. 516. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.
`(a) PROJECTS- The Secretary shall address priority substance abuse
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.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States, political
subdivisions of States, Indian tribes and tribal organizations, or other
public or nonprofit private entities.
`(b) PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS-
`(1) IN GENERAL- Priority substance abuse 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 CONSIDERATION- In developing program priorities under
paragraph (1), the Secretary shall give special consideration to--
`(A) applying the most promising strategies and research-based primary
prevention approaches; and
`(B) promoting the integration of substance abuse prevention
information and activities into primary health care systems.
`(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 abuse
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 2001, and
such sums as may be necessary for each of the fiscal years 2002 and 2003.'.
(b) CONFORMING AMENDMENTS- Section 518 of the Public Health Service Act
(42 U.S.C. 290bb-24) is repealed.
SEC. 3303. SUBSTANCE ABUSE PREVENTION AND TREATMENT PERFORMANCE PARTNERSHIP
BLOCK GRANT.
(a) ALLOCATION REGARDING ALCOHOL AND OTHER DRUGS- Section 1922 of the
Public Health Service Act (42 U.S.C. 300x-22) is amended by--
(1) striking subsection (a); and
(2) redesignating subsections (b) and (c) as subsections (a) and
(b).
(b) GROUP HOMES FOR RECOVERING SUBSTANCE ABUSERS- Section 1925(a) of the
Public Health Service Act (42 U.S.C. 300x-25(a)) is amended by striking `For
fiscal year 1993' and all that follows through the colon and inserting the
following: `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:'.
(c) MAINTENANCE OF EFFORT- Section 1930 of the Public Health Service Act
(42 U.S.C. 300x-30) is amended--
(1) by redesignating subsections (b) and (c) as subsections (c) and (d)
respectively; and
(2) by inserting after subsection (a), the following:
`(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.'.
(d) APPLICATIONS FOR GRANTS- Section 1932(a)(1) of the Public Health
Service Act (42 U.S.C. 300x-32(a)(1)) is amended to read as follows:
`(1) the application is received by the Secretary not later than October
1 of the fiscal year for which the State is seeking funds;'.
(e) WAIVER FOR TERRITORIES- Section 1932(c) of the Public Health Service
Act (42 U.S.C. 300x-32(c)) is amended by striking `whose allotment under
section 1921 for the fiscal year is the amount specified in section
1933(c)(2)(B)' and inserting `except Puerto Rico'.
(f) WAIVER AUTHORITY FOR CERTAIN REQUIREMENTS-
(1) IN GENERAL- Section 1932 of the Public Health Service Act (42 U.S.C.
300x-32) is amended by adding at the end the following:
`(e) WAIVER AUTHORITY FOR CERTAIN REQUIREMENTS-
`(1) IN GENERAL- Upon the request of a State, the Secretary may waive
the requirements of all or part of the sections described in paragraph (2)
using objective criteria established by the Secretary by regulation after
consultation with the States and other interested parties including
consumers and providers.
`(2) SECTIONS- The sections described in paragraph (1) are sections
1922(c), 1923, 1924 and 1928.
`(3) DATE CERTAIN FOR ACTING UPON REQUEST- The Secretary shall approve
or deny a request for a waiver under paragraph (1) and inform the State of
that decision not later than 120 days after the date on which the request
and all the information needed to support the request are submitted.
`(4) ANNUAL REPORTING REQUIREMENT- The Secretary shall annually report
to the general public on the States that receive a waiver under this
subsection.'.
(2) CONFORMING AMENDMENTS- Effective upon the publication of the
regulations developed in accordance with section 1932(e)(1) of the Public
Health Service Act (42 U.S.C. 300x-32(d))--
(A) section 1922(c) of the Public Health Service Act (42 U.S.C.
300x-22(c)) is amended by--
(i) striking paragraph (2); and
(ii) redesignating paragraph (3) as paragraph (2); and
(B) section 1928(d) of the Public Health Service Act (42 U.S.C.
300x-28(d)) is repealed.
(g) AUTHORIZATION OF APPROPRIATION- Section 1935 of the Public Health
Service Act (42 U.S.C. 300x-35) is amended--
(1) in subsection (a), by striking `$1,500,000,000' and all that follows
through the end and inserting `$2,000,000,000 for fiscal year 2001, and such
sums as may be necessary for each of the fiscal years 2002 and 2003.';
(2) in subsection (b)(1), by striking `section 505' and inserting
`sections 505 and 1971';
(3) in subsection (b)(2), by striking `1949(a)' and inserting `1948(a)';
and
(4) in subsection (b), by adding at the end the following:
`(3) CORE DATA SET- A State that receives a new grant, contract, or
cooperative agreement from amounts available to the Secretary under
paragraph (1), for the purposes of improving the data collection, analysis
and reporting capabilities of the State, shall be required, as a condition
of receipt of funds, to collect, analyze, and report to the Secretary for
each fiscal year subsequent to receiving such funds a core data set to be
determined by the Secretary in conjunction with the States.'.
SEC. 3304. DETERMINATION OF ALLOTMENTS.
Section 1933(b) of the Public Health Service Act (42 U.S.C. 300x-33(b)) is
amended to read as follows:
`(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.
`(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.'.
SEC. 3305. NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS FOR RELIGIOUS
PROVIDERS.
Subpart III of part B of title XIX of the Public Health Service Act (42
U.S.C. 300x-51 et seq.) is amended by adding at the end the following:
`SEC. 1955. SERVICES PROVIDED BY NONGOVERNMENTAL ORGANIZATIONS.
`(a) PURPOSES- The purposes of this section are--
`(1) to prohibit discrimination against nongovernmental organizations
and certain individuals on the basis of religion in the distribution of
government funds to provide substance abuse services under this title and
title V, and the receipt of services under such titles; and
`(2) to allow the organizations to accept the funds to provide the
services to the individuals without impairing the religious character of the
organizations or the religious freedom of the individuals.
`(b) RELIGIOUS ORGANIZATIONS INCLUDED AS NONGOVERNMENTAL PROVIDERS-
`(1) IN GENERAL- A State may administer and provide substance abuse
services under any program under this title or title V through grants,
contracts, or cooperative agreements to provide assistance to beneficiaries
under such titles with nongovernmental organizations.
`(2) REQUIREMENT- A State that elects to utilize nongovernmental
organizations as provided for under paragraph (1) shall consider, on the
same basis as other nongovernmental organizations, religious organizations
to provide services under substance abuse programs under this title or title
V, so long as the programs under such titles are implemented in a manner
consistent with the Establishment Clause of the first amendment to the
Constitution. Neither the Federal Government nor a State or local government
receiving funds under such programs shall discriminate against an
organization that provides services under, or applies to provide services
under, such programs, on the basis that the organization has a religious
character.
`(c) RELIGIOUS CHARACTER AND INDEPENDENCE-
`(1) IN GENERAL- A religious organization that provides services under
any substance abuse program under this title or title V shall retain its
independence from Federal, State, and local governments, including such
organization's control over the definition, development, practice, and
expression of its religious beliefs.
`(2) ADDITIONAL SAFEGUARDS- Neither the Federal Government nor a State
or local government shall require a religious organization--
`(A) to alter its form of internal governance; or
`(B) to remove religious art, icons, scripture, or other
symbols,
in order to be eligible to provide services under any substance abuse
program under this title or title V.
`(d) EMPLOYMENT PRACTICES-
`(1) SUBSTANCE ABUSE- A religious organization that provides services
under any substance abuse program under this title or title V may require
that its employees providing services under such program adhere to rules
forbidding the use of drugs or alcohol.
`(2) TITLE VII EXEMPTION- The exemption of a religious organization
provided under section 702 or 703(e)(2) of the Civil Rights Act of 1964 (42
U.S.C. 2000e-1, 2000e-2(e)(2)) regarding employment practices shall not be
affected by the religious organization's provision of services under, or
receipt of funds from, any substance abuse program under this title or title
V.
`(e) RIGHTS OF BENEFICIARIES OF ASSISTANCE-
`(1) IN GENERAL- If an individual described in paragraph (3) has an
objection to the religious character of the organization from which the
individual receives, or would receive, services funded under any substance
abuse program under this title or title V, the appropriate Federal, State,
or local governmental entity shall provide to such individual (if otherwise
eligible for such services) within a reasonable period of time after the
date of such objection, services that--
`(A) are from an alternative provider that is accessible to the
individual; and
`(B) have a value that is not less than the value of the services that
the individual would have received from such organization.
`(2) NOTICE- The appropriate Federal, State, or local governmental
entity shall ensure that notice is provided to individuals described in
paragraph (3) of the rights of such individuals under this section.
`(3) INDIVIDUAL DESCRIBED- An individual described in this paragraph is
an individual who receives or applies for services under any substance abuse
program under this title or title V.
`(f) NONDISCRIMINATION AGAINST BENEFICIARIES- A religious organization
providing services through a grant, contract, or cooperative agreement under
any substance abuse program under this title or title V shall not
discriminate, in carrying out such program, against an individual described in
subsection (e)(3) on the basis of religion, a religious belief, a refusal to
hold a religious belief, or a refusal to actively participate in a religious
practice.
`(g) FISCAL ACCOUNTABILITY-
`(1) IN GENERAL- Except as provided in paragraph (2), any religious
organization providing services under any substance abuse program under this
title or title V shall be subject to the same regulations as other
nongovernmental organizations to account in accord with generally accepted
accounting principles for the use of such funds provided under such
program.
`(2) LIMITED AUDIT- Such organization shall segregate government funds
provided under such substance abuse program into a separate account. Only
the government funds shall be subject to audit by the government.
`(h) COMPLIANCE- Any party that seeks to enforce such party's rights under
this section may assert a civil action for injunctive relief exclusively in an
appropriate Federal or State court against the entity, agency or official that
allegedly commits such violation.
`(i) LIMITATIONS ON USE OF FUNDS FOR CERTAIN PURPOSES- No funds provided
through a grant or contract to a religious organization to provide services
under any substance abuse program under this title or title V shall be
expended for sectarian worship, instruction, or proselytization.
`(j) EFFECT ON STATE AND LOCAL FUNDS- If a State or local government
contributes State or local funds to carry out any substance abuse program
under this title or title V, the State or local government may segregate the
State or local funds from the Federal funds provided to carry out the program
or may commingle the State or local funds with the Federal funds. If the State
or local government commingles the State or local funds, the provisions of
this section shall apply to the commingled funds in the same manner, and to
the same extent, as the provisions apply to the Federal funds.
`(k) TREATMENT OF INTERMEDIATE CONTRACTORS- If a nongovernmental
organization (referred to in this subsection as an `intermediate
organization'), acting under a contract or other agreement with the Federal
Government or a State or local government, is given the authority under the
contract or agreement to select nongovernmental organizations to provide
services under any substance abuse program under this title or title V, the
intermediate organization shall have the same duties under this section as the
government but shall retain all other rights of a nongovernmental organization
under this section.'.
SEC. 3306. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES FOR INDIANS AND
NATIVE ALASKANS.
Part A of title V of the Public Health Service Act (42 U.S.C. 290aa et
seq.) is amended by adding at the end the following:
`SEC. 506A. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES FOR INDIANS
AND NATIVE ALASKANS.
`(a) IN GENERAL- The Secretary shall award grants, contracts, or
cooperative agreements to public and private nonprofit entities, including
Native Alaskan entities and Indian tribes and tribal organizations, for the
purpose of providing alcohol and drug prevention or treatment services for
Indians and Native Alaskans.
`(b) PRIORITY- In awarding grants, contracts, or cooperative agreements
under subsection (a), the Secretary shall give priority to applicants
that--
`(1) propose to provide alcohol and drug prevention or treatment
services on reservations;
`(2) propose to employ culturally-appropriate approaches, as determined
by the Secretary, in providing such services; and
`(3) have provided prevention or treatment services to Native Alaskan
entities and Indian tribes and tribal organizations for at least 1 year
prior to applying for a grant under this section.
`(c) DURATION- The Secretary shall award grants, contracts, or cooperative
agreements under subsection (a) for a period not to exceed 5 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, 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. The
final evaluation submitted by such entity shall include a recommendation as to
whether such project shall continue.
`(f) REPORT- Not later than 3 years after the date of the enactment of
this section and annually thereafter, the Secretary shall prepare and submit,
to the Committee on Health, Education, Labor, and Pensions of the Senate, a
report describing the services provided pursuant to this section.
`(g) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated to carry out this section, $15,000,000 for fiscal year 2001, and
such sums as may be necessary for fiscal years 2002 and 2003.'.
SEC. 3307. ESTABLISHMENT OF COMMISSION.
(a) IN GENERAL- There is established a commission to be known as the
Commission on Indian and Native Alaskan Health Care that shall examine the
health concerns of Indians and Native Alaskans who reside on reservations and
tribal lands (hereafter in this section referred to as the `Commission').
(1) IN GENERAL- The Commission established under subsection (a) shall
consist of--
(B) 15 members who are experts in the health care field and issues
that the Commission is established to examine; and
(C) the Director of the Indian Health Service and the Commissioner of
Indian Affairs, who shall be nonvoting members.
(2) APPOINTING AUTHORITY- Of the 15 members of the Commission described
in paragraph (1)(B)--
(A) two shall be appointed by the Speaker of the House of
Representatives;
(B) two shall be appointed by the Minority Leader of the House of
Representatives;
(C) two shall be appointed by the Majority Leader of the
Senate;
(D) two shall be appointed by the Minority Leader of the Senate;
and
(E) seven shall be appointed by the Secretary.
(3) LIMITATION- Not fewer than 10 of the members appointed to the
Commission shall be Indians or Native Alaskans.
(4) CHAIRPERSON- The Secretary shall serve as the Chairperson of the
Commission.
(5) EXPERTS- The Commission may seek the expertise of any expert in the
health care field to carry out its duties.
(c) PERIOD OF APPOINTMENT- Members shall be appointed for the life of the
Commission. Any vacancy in the Commission shall not affect its powers, but
shall be filed in the same manner as the original appointment.
(d) DUTIES OF THE COMMISSION- The Commission shall--
(1) study the health concerns of Indians and Native Alaskans; and
(2) prepare the reports described in subsection (i).
(e) POWERS OF THE COMMISSION-
(1) HEARINGS- The Commission may hold such hearings, including hearings
on reservations, sit and act at such times and places, take such testimony,
and receive such information as the Commission considers advisable to carry
out the purpose for which the Commission was established.
(2) INFORMATION FROM FEDERAL AGENCIES- The Commission may secure
directly from any Federal department or agency such information as the
Commission considers necessary to carry out the purpose for which the
Commission was established. Upon request of the Chairperson of the
Commission, the head of such department or agency shall furnish such
information to the Commission.
(f) COMPENSATION OF MEMBERS-
(1) IN GENERAL- Except as provided in subparagraph (B), each member of
the Commission may be compensated at a rate not to exceed the daily
equivalent of the annual rate of basic pay prescribed for level IV of the
Executive Schedule under section 5315 of title 5, United States Code, for
each day (including travel time), during which that member is engaged in the
actual performance of the duties of the Commission.
(2) LIMITATION- Members of the Commission who are officers or employees
of the United States shall receive no additional pay on account of their
service on the Commission.
(g) TRAVEL EXPENSES OF MEMBERS- The members of the Commission shall be
allowed travel expenses, including per diem in lieu of subsistence, at rates
authorized for employees of agencies under section 5703 of title 5, United
States Code, while away from their homes or regular places of business in the
performance of services for the Commission.
(h) COMMISSION PERSONNEL MATTERS-
(1) IN GENERAL- The Secretary, in accordance with rules established by
the Commission, may select and appoint a staff director and other personnel
necessary to enable the Commission to carry out its duties.
(2) COMPENSATION OF PERSONNEL- The Secretary, in accordance with rules
established by the Commission, may set the amount of compensation to be paid
to the staff director and any other personnel that serve the
Commission.
(3) DETAIL OF GOVERNMENT EMPLOYEES- Any Federal Government employee may
be detailed to the Commission without reimbursement, and the detail shall be
without interruption or loss of civil service status or privilege.
(4) CONSULTANT SERVICES- The Chairperson of the Commission is authorized
to procure the temporary and intermittent services of experts and
consultants in accordance with section 3109 of title 5, United States Code,
at rates not to exceed the daily equivalent of the annual rate of basic pay
prescribed for level IV of the Executive Schedule under section 5315 of such
title.
(1) IN GENERAL- Not later than 3 years after the date of the enactment
of the Youth Drug and Mental Health Services Act, the Secretary shall
prepare and submit, to the Committee on Health, Education, Labor, and
Pensions of the Senate, a report that shall--
(A) detail the health problems faced by Indians and Native Alaskans
who reside on reservations;
(B) examine and explain the causes of such problems;
(C) describe the health care services available to Indians and Native
Alaskans who reside on reservations and the adequacy of such
services;
(D) identify the reasons for the provision of inadequate health care
services for Indians and Native Alaskans who reside on reservations,
including the availability of resources;
(E) develop measures for tracking the health status of Indians and
Native Americans who reside on reservations; and
(F) make recommendations for improvements in the health care services
provided for Indians and Native Alaskans who reside on reservations,
including recommendations for legislative change.
(2) EXCEPTION- In addition to the report required under paragraph (1),
not later than 2 years after the date of the enactment of the Youth Drug and
Mental Health Services Act, the Secretary shall prepare and submit, to the
Committee on Health, Education, Labor, and Pensions of the Senate, a report
that describes any alcohol and drug abuse among Indians and Native Alaskans
who reside on reservations.
(j) PERMANENT COMMISSION- Section 14 of the Federal Advisory Committee Act
(5 U.S.C. App.) shall not apply to the Commission.
(k) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section $5,000,000 for fiscal year 2001, and
such sums as may be necessary for fiscal years 2002 and 2003.
TITLE XXXIV--PROVISIONS RELATING TO FLEXIBILITY AND
ACCOUNTABILITY
SEC. 3401. GENERAL AUTHORITIES AND PEER REVIEW.
(a) GENERAL AUTHORITIES- Paragraph (1) of section 501(e) of the Public
Health Service Act (42 U.S.C. 290aa(e)) is amended to read as follows:
`(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 functions of 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 abuse
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.'.
(b) PEER REVIEW- Section 504 of the Public Health Service (42 U.S.C.
290aa-3) is amended as follows:
`SEC. 504. 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) ADVISORY COUNCIL REVIEW- If the direct cost of a grant or cooperative
agreement (described in subsection (a)) exceeds the simple acquisition
threshold as defined by section 4(11) of the Office of Federal Procurement
Policy Act, the Secretary may make such a grant or cooperative agreement only
if such grant or cooperative agreement is recommended--
`(1) after peer review required under subsection (a); and
`(2) by the appropriate advisory council.
`(d) CONDITIONS- The Secretary may establish limited exceptions to the
limitations contained in this section regarding participation of Federal
employees and advisory council approval. The circumstances under which the
Secretary may make such an exception shall be made public.'.
SEC. 3402. ADVISORY COUNCILS.
Section 502(e) of the Public Health Service Act (42 U.S.C. 290aa-1(e)) is
amended in the first sentence by striking `3 times' and inserting `2
times'.
SEC. 3403. GENERAL PROVISIONS FOR THE PERFORMANCE PARTNERSHIP BLOCK
GRANTS.
(a) PLANS FOR PERFORMANCE PARTNERSHIPS- Section 1949 of the Public Health
Service Act (42 U.S.C. 300x-59) is amended as follows:
`SEC. 1949. PLANS FOR PERFORMANCE PARTNERSHIPS.
`(a) DEVELOPMENT- The Secretary in conjunction with States and other
interested groups shall develop separate plans for the programs authorized
under subparts I and II for creating more flexibility for States and
accountability based on outcome and other performance measures. The plans
shall each include--
`(1) a description of the flexibility that would be given to the States
under the plan;
`(2) the common set of performance measures that would be used for
accountability, including measures that would be used for the program under
subpart II for pregnant addicts, HIV transmission, tuberculosis, and those
with a co-occurring substance abuse and mental disorders, and for programs
under subpart I for children with serious emotional disturbance and adults
with serious mental illness and for individuals with co-occurring mental
health and substance abuse disorders;
`(3) the definitions for the data elements to be used under the
plan;
`(4) the obstacles to implementation of the plan and the manner in which
such obstacles would be resolved;
`(5) the resources needed to implement the performance partnerships
under the plan; and
`(6) an implementation strategy complete with recommendations for any
necessary legislation.
`(b) SUBMISSION- Not later than 2 years after the date of the enactment of
this Act, the plans developed under subsection (a) shall be submitted to the
Committee on Health, Education, Labor, and Pensions of the Senate and the
Committee on Commerce of the House of Representatives.
`(c) INFORMATION- As the elements of the plans described in subsection (a)
are developed, States are encouraged to provide information to the Secretary
on a voluntary basis.
`(d) PARTICIPANTS- The Secretary shall include among those interested
groups that participate in the development of the plan consumers of mental
health or substance abuse services, providers, representatives of political
divisions of States, and representatives of racial and ethnic groups including
Native Americans.'.
(b) AVAILABILITY TO STATES OF GRANT PROGRAMS- Section 1952 of the Public
Health Service Act (42 U.S.C. 300x-62) is amended as follows:
`SEC. 1952. AVAILABILITY TO STATES OF GRANT PAYMENTS.
`Any amounts paid to a State for a fiscal year under section 1911 or 1921
shall be available for obligation and expenditure until the end of the fiscal
year following the fiscal year for which the amounts were paid.'.
SEC. 3404. DATA INFRASTRUCTURE PROJECTS.
Part C of title XIX of the Public Health Service Act (42 U.S.C. 300y et
seq.) is amended--
(1) by striking the headings for part C and subpart I and inserting the
following:
`PART C--CERTAIN PROGRAMS REGARDING MENTAL HEALTH AND SUBSTANCE
ABUSE
`Subpart I--Data Infrastructure Development';
(2) by striking section 1971 (42 U.S.C. 300y) and inserting the
following:
`SEC. 1971. DATA INFRASTRUCTURE DEVELOPMENT.
`(a) IN GENERAL- The Secretary may make grants to, and enter into
contracts or cooperative agreements with States for the purpose of developing
and operating mental health or substance abuse data collection, analysis, and
reporting systems with regard to performance measures including capacity,
process, and outcomes measures.
`(b) PROJECTS- The Secretary shall establish criteria to ensure that
services will be available under this section to States that have a
fundamental basis for the collection, analysis, and reporting of mental health
and substance abuse performance measures and States that do not have such
basis. The Secretary will establish criteria for determining whether a State
has a fundamental basis for the collection, analysis, and reporting of
data.
`(c) CONDITION OF RECEIPT OF FUNDS- As a condition of the receipt of an
award under this section a State shall agree to collect, analyze, and report
to the Secretary within 2 years of the date of the award on a core set of
performance measures to be determined by the Secretary in conjunction with the
States.
`(d) MATCHING REQUIREMENT-
`(1) IN GENERAL- With respect to the costs of the program to be carried
out under subsection (a) by a State, the Secretary may make an award under
such subsection 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.
`(2) DETERMINATION OF AMOUNT CONTRIBUTED- Non-Federal contributions
under 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
contributions.
`(e) DURATION OF SUPPORT- The period during which payments may be made for
a project under subsection (a) may be not less than 3 years nor more than 5
years.
`(f) AUTHORIZATION OF APPROPRIATION-
`(1) IN GENERAL- For the purpose of carrying out this section, there are
authorized to be appropriated such sums as may be necessary for each of the
fiscal years 2001, 2002 and 2003.
`(2) ALLOCATION- Of the amounts appropriated under paragraph (1) for a
fiscal year, 50 percent shall be expended to support data infrastructure
development for mental health and 50 percent shall be expended to support
data infrastructure development for substance abuse.'.
SEC. 3405. REPEAL OF OBSOLETE ADDICT REFERRAL PROVISIONS.
(a) REPEAL OF OBSOLETE PUBLIC HEALTH SERVICE ACT AUTHORITIES- Part E of
title III (42 U.S.C. 257 et seq.) is repealed.
(b) REPEAL OF OBSOLETE NARA AUTHORITIES- Titles III and IV of the Narcotic
Addict Rehabilitation Act of 1966 (Public Law 89-793) are repealed.
(c) REPEAL OF OBSOLETE TITLE 28 AUTHORITIES-
(1) IN GENERAL- Chapter 175 of title 28, United States Code, is
repealed.
(2) TABLE OF CONTENTS- The table of contents to part VI of title 28,
United States Code, is amended by striking the items relating to chapter
175.
SEC. 3406. INDIVIDUALS WITH CO-OCCURRING DISORDERS.
The Public Health Service Act is amended by inserting after section 503
(42 U.S.C. 290aa-2) the following:
`SEC. 503A. REPORT ON INDIVIDUALS WITH CO-OCCURRING MENTAL ILLNESS AND
SUBSTANCE ABUSE DISORDERS.
`(a) IN GENERAL- Not later than 2 years after the date of the enactment of
this section, the Secretary shall, after consultation with organizations
representing States, mental health and substance abuse treatment providers,
prevention specialists, individuals receiving treatment services, and family
members of such individuals, prepare and submit to the Committee on Health,
Education, Labor, and Pensions of the Senate and the Committee on Commerce of
the House of Representatives, a report on prevention and treatment services
for individuals who have co-occurring mental illness and substance abuse
disorders.
`(b) REPORT CONTENT- The report under subsection (a) shall be based on
data collected from existing Federal and State surveys regarding the treatment
of co-occurring mental illness and substance abuse disorders and shall
include--
`(1) a summary of the manner in which individuals with co-occurring
disorders are receiving treatment, including the most up-to-date information
available regarding the number of children and adults with co-occurring
mental illness and substance abuse disorders and the manner in which funds
provided under sections 1911 and 1921 are being utilized, including the
number of such children and adults served with such funds;
`(2) a summary of improvements necessary to ensure that individuals with
co-occurring mental illness and substance abuse disorders receive the
services they need;
`(3) a summary of practices for preventing substance abuse among
individuals who have a mental illness and are at risk of having or acquiring
a substance abuse disorder; and
`(4) a summary of evidenced-based practices for treating individuals
with co-occurring mental illness and substance abuse disorders and
recommendations for implementing such practices.
`(c) FUNDS FOR REPORT- The Secretary may obligate funds to carry out this
section with such appropriations as are available.'.
SEC. 3407. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.
Subpart III of part B of title XIX of the Public Health Service Act (42
U.S.C. 300x-51 et seq.) (as amended by section 3305) is further amended by
adding at the end the following:
`SEC. 1956. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.
`States may use funds available for treatment under sections 1911 and 1921
to treat persons with co-occurring substance abuse and mental disorders as
long as funds available under such sections are used for the purposes for
which they were authorized by law and can be tracked for accounting
purposes.'.
TITLE XXXV--WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR PRESCRIBE
CERTAIN NARCOTIC DRUGS FOR MAINTENANCE TREATMENT OR DETOXIFICATION
TREATMENT
SEC. 3501. SHORT TITLE.
This title may be cited as the `Drug Addiction Treatment Act of 2000'.
SEC. 3502. AMENDMENT TO CONTROLLED SUBSTANCES ACT.
(a) IN GENERAL- Section 303(g) of the Controlled Substances Act (21 U.S.C.
823(g)) is amended--
(1) in paragraph (2), by striking `(A) security' and inserting `(i)
security', and by striking `(B) the maintenance' and inserting `(ii) the
maintenance';
(2) by redesignating paragraphs (1) through (3) as subparagraphs (A)
through (C), respectively;
(3) by inserting `(1)' after `(g)';
(4) by striking `Practitioners who dispense' and inserting `Except as
provided in paragraph (2), practitioners who dispense'; and
(5) by adding at the end the following paragraph:
`(2)(A) Subject to subparagraphs (D) and (J), the requirements of
paragraph (1) are waived in the case of the dispensing (including the
prescribing), by a practitioner, of narcotic drugs in schedule III, IV, or V
or combinations of such drugs if the practitioner meets the conditions
specified in subparagraph (B) and the narcotic drugs or combinations of such
drugs meet the conditions specified in subparagraph (C).
`(B) For purposes of subparagraph (A), the conditions specified in this
subparagraph with respect to a practitioner are that, before the initial
dispensing of narcotic drugs in schedule III, IV, or V or combinations of such
drugs to patients for maintenance or detoxification treatment, the
practitioner submit to the Secretary a notification of the intent of the
practitioner to begin dispensing the drugs or combinations for such purpose,
and that the notification contain the following certifications by the
practitioner:
`(i) The practitioner is a qualifying physician (as defined in
subparagraph (G)).
`(ii) With respect to patients to whom the practitioner will provide
such drugs or combinations of drugs, the practitioner has the capacity to
refer the patients for appropriate counseling and other appropriate
ancillary services.
`(iii) In any case in which the practitioner is not in a group practice,
the total number of such patients of the practitioner at any one time will
not exceed the applicable number. For purposes of this clause, the
applicable number is 30, except that the Secretary may by regulation change
such total number.
`(iv) In any case in which the practitioner is in a group practice, the
total number of such patients of the group practice at any one time will not
exceed the applicable number. For purposes of this clause, the applicable
number is 30, except that the Secretary may by regulation change such total
number, and the Secretary for such purposes may by regulation establish
different categories on the basis of the number of practitioners in a group
practice and establish for the various categories different numerical
limitations on the number of such patients that the group practice may
have.
`(C) For purposes of subparagraph (A), the conditions specified in this
subparagraph with respect to narcotic drugs in schedule III, IV, or V or
combinations of such drugs are as follows:
`(i) The drugs or combinations of drugs have, under the Federal Food,
Drug, and Cosmetic Act or section 351 of the Public Health Service Act, been
approved for use in maintenance or detoxification treatment.
`(ii) The drugs or combinations of drugs have not been the subject of an
adverse determination. For purposes of this clause, an adverse determination
is a determination published in the Federal Register and made by the
Secretary, after consultation with the Attorney General, that the use of the
drugs or combinations of drugs for maintenance or detoxification treatment
requires additional standards respecting the qualifications of practitioners
to provide such treatment, or requires standards respecting the quantities
of the drugs that may be provided for unsupervised use.
`(D)(i) A waiver under subparagraph (A) with respect to a practitioner is
not in effect unless (in addition to conditions under subparagraphs (B) and
(C)) the following conditions are met:
`(I) The notification under subparagraph (B) is in writing and states
the name of the practitioner.
`(II) The notification identifies the registration issued for the
practitioner pursuant to subsection (f).
`(III) If the practitioner is a member of a group practice, the
notification states the names of the other practitioners in the practice and
identifies the registrations issued for the other practitioners pursuant to
subsection (f).
`(ii) Upon receiving a notification under subparagraph (B), the Attorney
General shall assign the practitioner involved an identification number under
this paragraph for inclusion with the registration issued for the practitioner
pursuant to subsection (f). The identification number so assigned shall be
appropriate to preserve the confidentiality of patients for whom the
practitioner has dispensed narcotic drugs under a waiver under subparagraph
(A).
`(iii) Not later than 45 days after the date on which the Secretary
receives a notification under subparagraph (B), the Secretary shall make a
determination of whether the practitioner involved meets all requirements for
a waiver under subparagraph (B). If the Secretary fails to make such
determination by the end of the such 45-day period, the Attorney General shall
assign the physician an identification number described in clause (ii) at the
end of such period.
`(E)(i) If a practitioner is not registered under paragraph (1) and, in
violation of the conditions specified in subparagraphs (B) through (D),
dispenses narcotic drugs in schedule III, IV, or V or combinations of such
drugs for maintenance treatment or detoxification treatment, the Attorney
General may, for purposes of section 304(a)(4), consider the practitioner to
have committed an act that renders the registration of the practitioner
pursuant to subsection (f) to be inconsistent with the public interest.
`(ii)(I) Upon the expiration of 45 days from the date on which the
Secretary receives a notification under subparagraph (B), a practitioner who
in good faith submits a notification under subparagraph (B) and reasonably
believes that the conditions specified in subparagraphs (B) through (D) have
been met shall, in dispensing narcotic drugs in schedule III, IV, or V or
combinations of such drugs for maintenance treatment or detoxification
treatment, be considered to have a waiver under subparagraph (A) until
notified otherwise by the Secretary, except that such a practitioner may
commence to prescribe or dispense such narcotic drugs for such purposes prior
to the expiration of such 45-day period if it facilitates the treatment of an
individual patient and both the Secretary and the Attorney General are
notified by the practitioner of the intent to commence prescribing or
dispensing such narcotic drugs.
`(II) For purposes of subclause (I), the publication in the Federal
Register of an adverse determination by the Secretary pursuant to subparagraph
(C)(ii) shall (with respect to the narcotic drug or combination involved) be
considered to be a notification provided by the Secretary to practitioners,
effective upon the expiration of the 30-day period beginning on the date on
which the adverse determination is so published.
`(F)(i) With respect to the dispensing of narcotic drugs in schedule III,
IV, or V or combinations of such drugs to patients for maintenance or
detoxification treatment, a practitioner may, in his or her discretion,
dispense such drugs or combinations for such treatment under a registration
under paragraph (1) or a waiver under subparagraph (A) (subject to meeting the
applicable conditions).
`(ii) This paragraph may not be construed as having any legal effect on
the conditions for obtaining a registration under paragraph (1), including
with respect to the number of patients who may be served under such a
registration.
`(G) For purposes of this paragraph:
`(i) The term `group practice' has the meaning given such term in
section 1877(h)(4) of the Social Security Act.
`(ii) The term `qualifying physician' means a physician who is licensed
under State law and who meets one or more of the following conditions:
`(I) The physician holds a subspecialty board certification in
addiction psychiatry from the American Board of Medical
Specialties.
`(II) The physician holds an addiction certification from the American
Society of Addiction Medicine.
`(III) The physician holds a subspecialty board certification in
addiction medicine from the American Osteopathic Association.
`(IV) The physician has, with respect to the treatment and management
of opiate-dependent patients, completed not less than eight hours of
training (through classroom situations, seminars at professional society
meetings, electronic communications, or otherwise) that is provided by the
American Society of Addiction Medicine, the American Academy of Addiction
Psychiatry, the American Medical Association, the American Osteopathic
Association, the American Psychiatric Association, or any other
organization that the Secretary determines is appropriate for purposes of
this subclause.
`(V) The physician has participated as an investigator in one or more
clinical trials leading to the approval of a narcotic drug in schedule
III, IV, or V for maintenance or detoxification treatment, as demonstrated
by a statement submitted to the Secretary by the sponsor of such approved
drug.
`(VI) The physician has such other training or experience as the State
medical licensing board (of the State in which the physician will provide
maintenance or detoxification treatment) considers to demonstrate the
ability of the physician to treat and manage opiate-dependent
patients.
`(VII) The physician has such other training or experience as the
Secretary considers to demonstrate the ability of the physician to treat
and manage opiate-dependent patients. Any criteria of the Secretary under
this subclause shall be established by regulation. Any such criteria are
effective only for 3 years after the date on which the criteria are
promulgated, but may be extended for such additional discrete 3-year
periods as the Secretary considers appropriate for purposes of this
subclause. Such an extension of criteria may only be effectuated through a
statement published in the Federal Register by the Secretary during the
30-day period preceding the end of the 3-year period involved.
`(H)(i) In consultation with the Administrator of the Drug Enforcement
Administration, the Administrator of the Substance Abuse and Mental Health
Services Administration, the Director of the National Institute on Drug Abuse,
and the Commissioner of Food and Drugs, the Secretary shall issue regulations
(through notice and comment rulemaking) or issue practice guidelines to
address the following:
`(I) Approval of additional credentialing bodies and the
responsibilities of additional credentialing bodies.
`(II) Additional exemptions from the requirements of this paragraph and
any regulations under this paragraph.
Nothing in such regulations or practice guidelines may authorize any
Federal official or employee to exercise supervision or control over the
practice of medicine or the manner in which medical services are provided.
`(ii) Not later than 120 days after the date of the enactment of the Drug
Addiction Treatment Act of 2000, the Secretary shall issue a treatment
improvement protocol containing best practice guidelines for the treatment and
maintenance of opiate-dependent patients. The Secretary shall develop the
protocol in consultation with the Director of the National Institute on Drug
Abuse, the Administrator of the Drug Enforcement Administration, the
Commissioner of Food and Drugs, the Administrator of the Substance Abuse and
Mental Health Services Administration and other substance abuse disorder
professionals. The protocol shall be guided by science.
`(I) During the 3-year period beginning on the date of the enactment of
the Drug Addiction Treatment Act of 2000, a State may not preclude a
practitioner from dispensing or prescribing drugs in schedule III, IV, or V,
or combinations of such drugs, to patients for maintenance or detoxification
treatment in accordance with this paragraph unless, before the expiration of
that 3-year period, the State enacts a law prohibiting a practitioner from
dispensing such drugs or combinations of drug.
`(J)(i) This paragraph takes effect on the date of the enactment of the
Drug Addiction Treatment Act of 2000, and remains in effect thereafter except
as provided in clause (iii) (relating to a decision by the Secretary or the
Attorney General that this paragraph should not remain in effect).
`(ii) For purposes relating to clause (iii), the Secretary and the
Attorney General may, during the 3-year period beginning on the date of the
enactment of the Drug Addiction Treatment Act of 2000, make determinations in
accordance with the following:
`(I) The Secretary may make a determination of whether treatments
provided under waivers under subparagraph (A) have been effective forms of
maintenance treatment and detoxification treatment in clinical settings; may
make a determination of whether such waivers have significantly increased
(relative to the beginning of such period) the availability of maintenance
treatment and detoxification treatment; and may make a determination of
whether such waivers have adverse consequences for the public health.
`(II) The Attorney General may make a determination of the extent to
which there have been violations of the numerical limitations established
under subparagraph (B) for the number of individuals to whom a practitioner
may provide treatment; may make a determination of whether waivers under
subparagraph (A) have increased (relative to the beginning of such period)
the extent to which narcotic drugs in schedule III, IV, or V or combinations
of such drugs are being dispensed or possessed in violation of this Act; and
may make a determination of whether such waivers have adverse consequences
for the public health.
`(iii) If, before the expiration of the period specified in clause (ii),
the Secretary or the Attorney General publishes in the Federal Register a
decision, made on the basis of determinations under such clause, that this
paragraph should not remain in effect, this paragraph ceases to be in effect
60 days after the date on which the decision is so published. The Secretary
shall in making any such decision consult with the Attorney General, and shall
in publishing the decision in the Federal Register include any comments
received from the Attorney General for inclusion in the publication. The
Attorney General shall in making any such decision consult with the Secretary,
and shall in publishing the decision in the Federal Register include any
comments received from the Secretary for inclusion in the publication.'.
(b) CONFORMING AMENDMENTS- Section 304 of the Controlled Substances Act
(21 U.S.C. 824) is amended--
(1) in subsection (a), in the matter after and below paragraph (5), by
striking `section 303(g)' each place such term appears and inserting
`section 303(g)(1)'; and
(2) in subsection (d), by striking `section 303(g)' and inserting
`section 303(g)(1)'.
(c) ADDITIONAL AUTHORIZATION OF APPROPRIATIONS- For the purpose of
assisting the Secretary of Health and Human Services with the additional
duties established for the Secretary pursuant to the amendments made by this
section, there are authorized to be appropriated, in addition to other
authorizations of appropriations that are available for such purpose, such
sums as may be necessary for each of fiscal years 2001 through 2003.
TITLE XXXVI--METHAMPHETAMINE AND OTHER CONTROLLED
SUBSTANCES
SEC. 3601. SHORT TITLE.
This title may be cited as the `Methamphetamine Anti-Proliferation Act of
2000'.
Subtitle A--Methamphetamine Production, Trafficking, and
Abuse
PART I--CRIMINAL PENALTIES
SEC. 3611. ENHANCED PUNISHMENT OF AMPHETAMINE LABORATORY OPERATORS.
(a) AMENDMENT TO FEDERAL SENTENCING GUIDELINES- Pursuant to its authority
under section 994(p) of title 28, United States Code, the United States
Sentencing Commission shall amend the Federal sentencing guidelines in
accordance with this section with respect to any offense relating to the
manufacture, importation, exportation, or trafficking in amphetamine
(including an attempt or conspiracy to do any of the foregoing) in violation
of--
(1) the Controlled Substances Act (21 U.S.C. 801 et seq.);
(2) the Controlled Substances Import and Export Act (21 U.S.C. 951 et
seq.); or
(3) the Maritime Drug Law Enforcement Act (46 U.S.C. App. 1901 et
seq.).
(b) GENERAL REQUIREMENT- In carrying out this section, the United States
Sentencing Commission shall, with respect to each offense described in
subsection (a) relating to amphetamine--
(1) review and amend its guidelines to provide for increased penalties
such that those penalties are comparable to the base offense level for
methamphetamine; and
(2) take any other action the Commission considers necessary to carry
out this subsection.
(c) ADDITIONAL REQUIREMENTS- In carrying out this section, the United
States Sentencing Commission shall ensure that the sentencing guidelines for
offenders convicted of offenses described in subsection (a) reflect the
heinous nature of such offenses, the need for aggressive law enforcement
action to fight such offenses, and the extreme dangers associated with
unlawful activity involving amphetamines, including--
(1) the rapidly growing incidence of amphetamine abuse and the threat to
public safety that such abuse poses;
(2) the high risk of amphetamine addiction;
(3) the increased risk of violence associated with amphetamine
trafficking and abuse; and
(4) the recent increase in the illegal importation of amphetamine and
precursor chemicals.
(d) EMERGENCY AUTHORITY TO SENTENCING COMMISSION- The United States
Sentencing Commission shall promulgate amendments pursuant to this section as
soon as practicable after the date of the enactment of this Act in accordance
with the procedure set forth in section 21(a) of the Sentencing Act of 1987
(Public Law 100-182), as though the authority under that Act had not
expired.
SEC. 3612. ENHANCED PUNISHMENT OF AMPHETAMINE OR METHAMPHETAMINE LABORATORY
OPERATORS.
(a) FEDERAL SENTENCING GUIDELINES-
(1) IN GENERAL- Pursuant to its authority under section 994(p) of title
28, United States Code, the United States Sentencing Commission shall amend
the Federal sentencing guidelines in accordance with paragraph (2) with
respect to any offense relating to the manufacture, attempt to manufacture,
or conspiracy to manufacture amphetamine or methamphetamine in violation
of--
(A) the Controlled Substances Act (21 U.S.C. 801 et seq.);
(B) the Controlled Substances Import and Export Act (21 U.S.C. 951 et
seq.); or
(C) the Maritime Drug Law Enforcement Act (46 U.S.C. App. 1901 et
seq.).
(2) REQUIREMENTS- In carrying out this paragraph, the United States
Sentencing Commission shall--
(A) if the offense created a substantial risk of harm to human life
(other than a life described in subparagraph (B)) or the environment,
increase the base offense level for the offense--
(i) by not less than 3 offense levels above the applicable level in
effect on the date of the enactment of this Act; or
(ii) if the resulting base offense level after an increase under
clause (i) would be less than level 27, to not less than level 27;
or
(B) if the offense created a substantial risk of harm to the life of a
minor or incompetent, increase the base offense level for the
offense--
(i) by not less than 6 offense levels above the applicable level in
effect on the date of the enactment of this Act; or
(ii) if the resulting base offense level after an increase under
clause (i) would be less than level 30, to not less than level
30.
(3) EMERGENCY AUTHORITY TO SENTENCING COMMISSION- The United States
Sentencing Commission shall promulgate amendments pursuant to this
subsection as soon as practicable after the date of the enactment of this
Act in accordance with the procedure set forth in section 21(a) of the
Sentencing Act of 1987 (Public Law 100-182), as though the authority under
that Act had not expired.
(b) EFFECTIVE DATE- The amendments made pursuant to this section shall
apply with respect to any offense occurring on or after the date that is 60
days after the date of the enactment of this Act.
SEC. 3613. MANDATORY RESTITUTION FOR VIOLATIONS OF CONTROLLED SUBSTANCES ACT
AND CONTROLLED SUBSTANCES IMPORT AND EXPORT ACT RELATING TO AMPHETAMINE AND
METHAMPHETAMINE.
(a) MANDATORY RESTITUTION- Section 413(q) of the Controlled Substances Act
(21 U.S.C. 853(q)) is amended--
(1) in the matter preceding paragraph (1), by striking `may' and
inserting `shall';
(2) by inserting `amphetamine or' before `methamphetamine' each place it
appears;
(A) by inserting `, the State or local government concerned, or both
the United States and the State or local government concerned' after
`United States' the first place it appears; and
(B) by inserting `or the State or local government concerned, as the
case may be,' after `United States' the second place it appears;
and
(4) in paragraph (3), by striking `section 3663 of title 18, United
States Code' and inserting `section 3663A of title 18, United States
Code'.
(b) DEPOSIT OF AMOUNTS IN DEPARTMENT OF JUSTICE ASSETS FORFEITURE FUND-
Section 524(c)(4) of title 28, United States Code, is amended--
(1) by striking `and' at the end of subparagraph (B);
(2) by striking the period at the end of subparagraph (C) and inserting
`; and'; and
(3) by adding at the end the following:
`(D) all amounts collected--
`(i) by the United States pursuant to a reimbursement order under
paragraph (2) of section 413(q) of the Controlled Substances Act (21
U.S.C. 853(q)); and
`(ii) pursuant to a restitution order under paragraph (1) or (3) of
section 413(q) of the Controlled Substances Act for injuries to the United
States.'.
(c) CLARIFICATION OF CERTAIN ORDERS OF RESTITUTION- Section 3663(c)(2)(B)
of title 18, United States Code, is amended by inserting `which may be' after
`the fine'.
(d) EXPANSION OF APPLICABILITY OF MANDATORY RESTITUTION- Section
3663A(c)(1)(A)(ii) of title 18, United States Code, is amended by inserting
`or under section 416(a) of the Controlled Substances Act (21 U.S.C. 856(a)),'
after `under this title,'.
(e) TREATMENT OF ILLICIT SUBSTANCE MANUFACTURING OPERATIONS AS CRIMES
AGAINST PROPERTY- Section 416 of the Controlled Substances Act (21 U.S.C. 856)
is amended by adding at the end the following new subsection:
`(c) A violation of subsection (a) shall be considered an offense against
property for purposes of section 3663A(c)(1)(A)(ii) of title 18, United States
Code.'.
SEC. 3614. METHAMPHETAMINE PARAPHERNALIA.
Section 422(d) of the Controlled Substances Act (21 U.S.C. 863(d)) is
amended in the matter preceding paragraph (1) by inserting `methamphetamine,'
after `PCP,'.
PART II--ENHANCED LAW ENFORCEMENT
SEC. 3621. ENVIRONMENTAL HAZARDS ASSOCIATED WITH ILLEGAL MANUFACTURE OF
AMPHETAMINE AND METHAMPHETAMINE.
(a) USE OF AMOUNTS OR DEPARTMENT OF JUSTICE ASSETS FORFEITURE FUND-
Section 524(c)(1)(E) of title 28, United States Code, is amended--
(1) by inserting `(i) for' before `disbursements';
(2) by inserting `and' after the semicolon; and
(3) by adding at the end the following:
`(I) costs incurred by or on behalf of the Department of Justice in
connection with the removal, for purposes of Federal forfeiture and
disposition, of any hazardous substance or pollutant or contaminant
associated with the illegal manufacture of amphetamine or methamphetamine;
and
`(II) costs incurred by or on behalf of a State or local government in
connection with such removal in any case in which such State or local
government has assisted in a Federal prosecution relating to amphetamine
or methamphetamine, to the extent such costs exceed equitable sharing
payments made to such State or local government in such case;'.
(b) GRANTS UNDER DRUG CONTROL AND SYSTEM IMPROVEMENT GRANT PROGRAM-
Section 501(b)(3) of the Omnibus Crime Control and Safe Streets Act of 1968
(42 U.S.C. 3751(b)(3)) is amended by inserting before the semicolon the
following: `and to remove any hazardous substance or pollutant or contaminant
associated with the illegal manufacture of amphetamine or methamphetamine'.
(c) AMOUNTS SUPPLEMENT AND NOT SUPPLANT-
(1) ASSETS FORFEITURE FUND- Any amounts made available from the
Department of Justice Assets Forfeiture Fund in a fiscal year by reason of
the amendment made by subsection (a) shall supplement, and not supplant, any
other amounts made available to the Department of Justice in such fiscal
year from other sources for payment of costs described in section
524(c)(1)(E)(ii) of title 28, United States Code, as so amended.
(2) GRANT PROGRAM- Any amounts made available in a fiscal year under the
grant program under section 501(b)(3) of the Omnibus Crime Control and Safe
Streets Act of 1968 (42 U.S.C. 3751(b)(3)) for the removal of hazardous
substances or pollutants or contaminants associated with the illegal
manufacture of amphetamine or methamphetamine by reason of the amendment
made by subsection (b) shall supplement, and not supplant, any other amounts
made available in such fiscal year from other sources for such
removal.
SEC. 3622. REDUCTION IN RETAIL SALES TRANSACTION THRESHOLD FOR NON-SAFE
HARBOR PRODUCTS CONTAINING PSEUDOEPHEDRINE OR PHENYLPROPANOLAMINE.
(a) REDUCTION IN TRANSACTION THRESHOLD- Section 102(39)(A)(iv)(II) of the
Controlled Substances Act (21 U.S.C. 802(39)(A)(iv)(II)) is amended--
(1) by striking `24 grams' both places it appears and inserting `9
grams'; and
(2) by inserting before the semicolon at the end the following: `and
sold in package sizes of not more than 3 grams of pseudoephedrine base or 3
grams of phenylpropanolamine base'.
(b) EFFECTIVE DATE- The amendments made by subsection (a) shall take
effect 1 year after the date of the enactment of this Act.
SEC. 3623. TRAINING FOR DRUG ENFORCEMENT ADMINISTRATION AND STATE AND LOCAL
LAW ENFORCEMENT PERSONNEL RELATING TO CLANDESTINE LABORATORIES.
(1) REQUIREMENT- The Administrator of the Drug Enforcement
Administration shall carry out the programs described in subsection (b) with
respect to the law enforcement personnel of States and localities determined
by the Administrator to have significant levels of methamphetamine-related
or amphetamine-related crime or projected by the Administrator to have the
potential for such levels of crime in the future.
(2) DURATION- The duration of any program under that subsection may not
exceed 3 years.
(b) COVERED PROGRAMS- The programs described in this subsection are as
follows:
(1) ADVANCED MOBILE CLANDESTINE LABORATORY TRAINING TEAMS- A program of
advanced mobile clandestine laboratory training teams, which shall provide
information and training to State and local law enforcement personnel in
techniques utilized in conducting undercover investigations and conspiracy
cases, and other information designed to assist in the investigation of the
illegal manufacturing and trafficking of amphetamine and
methamphetamine.
(2) BASIC CLANDESTINE LABORATORY CERTIFICATION TRAINING- A program of
basic clandestine laboratory certification training, which shall provide
information and training--
(A) to Drug Enforcement Administration personnel and State and local
law enforcement personnel for purposes of enabling such personnel to meet
any certification requirements under law with respect to the handling of
wastes created by illegal amphetamine and methamphetamine laboratories;
and
(B) to State and local law enforcement personnel for purposes of
enabling such personnel to provide the information and training covered by
subparagraph (A) to other State and local law enforcement
personnel.
(3) CLANDESTINE LABORATORY RECERTIFICATION AND AWARENESS TRAINING- A
program of clandestine laboratory recertification and awareness training,
which shall provide information and training to State and local law
enforcement personnel for purposes of enabling such personnel to provide
recertification and awareness training relating to clandestine laboratories
to additional State and local law enforcement personnel.
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated for each of fiscal years 2000, 2001, and 2002 amounts as
follows:
(1) $1,500,000 to carry out the program described in subsection
(b)(1).
(2) $3,000,000 to carry out the program described in subsection
(b)(2).
(3) $1,000,000 to carry out the program described in subsection
(b)(3).
SEC. 3624. COMBATING METHAMPHETAMINE AND AMPHETAMINE IN HIGH INTENSITY DRUG
TRAFFICKING AREAS.
(1) IN GENERAL- The Director of National Drug Control Policy shall use
amounts available under this section to combat the trafficking of
methamphetamine and amphetamine in areas designated by the Director as high
intensity drug trafficking areas.
(2) ACTIVITIES- In meeting the requirement in paragraph (1), the
Director shall transfer funds to appropriate Federal, State, and local
governmental agencies for employing additional Federal law enforcement
personnel, or facilitating the employment of additional State and local law
enforcement personnel, including agents, investigators, prosecutors,
laboratory technicians, chemists, investigative assistants, and
drug-prevention specialists.
(b) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section--
(1) $15,000,000 for fiscal year 2000; and
(2) such sums as may be necessary for each of fiscal years 2001 through
2004.
(c) APPORTIONMENT OF FUNDS-
(1) FACTORS IN APPORTIONMENT- The Director shall apportion amounts
appropriated for a fiscal year pursuant to the authorization of
appropriations in subsection (b) for activities under subsection (a) among
and within areas designated by the Director as high intensity drug
trafficking areas based on the following factors:
(A) The number of methamphetamine manufacturing facilities and
amphetamine manufacturing facilities discovered by Federal, State, or
local law enforcement officials in the previous fiscal year.
(B) The number of methamphetamine prosecutions and amphetamine
prosecutions in Federal, State, or local courts in the previous fiscal
year.
(C) The number of methamphetamine arrests and amphetamine arrests by
Federal, State, or local law enforcement officials in the previous fiscal
year.
(D) The amounts of methamphetamine, amphetamine, or listed chemicals
(as that term is defined in section 102(33) of the Controlled Substances
Act (21 U.S.C. 802(33)) seized by Federal, State, or local law enforcement
officials in the previous fiscal year.
(E) Intelligence and predictive data from the Drug Enforcement
Administration and the Department of Health and Human Services showing
patterns and trends in abuse, trafficking, and transportation in
methamphetamine, amphetamine, and listed chemicals (as that term is so
defined).
(2) CERTIFICATION- Before the Director apportions any funds under this
subsection to a high intensity drug trafficking area, the Director shall
certify that the law enforcement entities responsible for clandestine
methamphetamine and amphetamine laboratory seizures in that area are
providing laboratory seizure data to the national clandestine laboratory
database at the El Paso Intelligence Center.
(d) LIMITATION ON ADMINISTRATIVE COSTS- Not more than 5 percent of the
amount appropriated in a fiscal year pursuant to the authorization of
appropriations for that fiscal year in subsection (b) may be available in that
fiscal year for administrative costs associated with activities under
subsection (a).
SEC. 3625. COMBATING AMPHETAMINE AND METHAMPHETAMINE MANUFACTURING AND
TRAFFICKING.
(a) ACTIVITIES- In order to combat the illegal manufacturing and
trafficking in amphetamine and methamphetamine, the Administrator of the Drug
Enforcement Administration may--
(1) assist State and local law enforcement in small and mid-sized
communities in all phases of investigations related to such manufacturing
and trafficking, including assistance with foreign-language
interpretation;
(2) staff additional regional enforcement and mobile enforcement teams
related to such manufacturing and trafficking;
(3) establish additional resident offices and posts of duty to assist
State and local law enforcement in rural areas in combating such
manufacturing and trafficking;
(4) provide the Special Operations Division of the Administration with
additional agents and staff to collect, evaluate, interpret, and disseminate
critical intelligence targeting the command and control operations of major
amphetamine and methamphetamine manufacturing and trafficking
organizations;
(5) enhance the investigative and related functions of the Chemical
Control Program of the Administration to implement more fully the provisions
of the Comprehensive Methamphetamine Control Act of 1996 (Public Law
104-237);
(6) design an effective means of requiring an accurate accounting of the
import and export of list I chemicals, and coordinate investigations
relating to the diversion of such chemicals;
(7) develop a computer infrastructure sufficient to receive, process,
analyze, and redistribute time-sensitive enforcement information from
suspicious order reporting to field offices of the Administration and other
law enforcement and regulatory agencies, including the continuing
development of the Suspicious Order Reporting and Tracking System (SORTS)
and the Chemical Transaction Database (CTRANS) of the Administration;
(8) establish an education, training, and communication process in order
to alert the industry to current trends and emerging patterns in the illegal
manufacturing of amphetamine and methamphetamine; and
(9) carry out such other activities as the Administrator considers
appropriate.
(b) ADDITIONAL POSITIONS AND PERSONNEL-
(1) IN GENERAL- In carrying out activities under subsection (a), the
Administrator may establish in the Administration not more than 50 full-time
positions, including not more than 31 special-agent positions, and may
appoint personnel to such positions.
(2) PARTICULAR POSITIONS- In carrying out activities under paragraphs
(5) through (8) of subsection (a), the Administrator may establish in the
Administration not more than 15 full-time positions, including not more than
10 diversion investigator positions, and may appoint personnel to such
positions. Any positions established under this paragraph are in addition to
any positions established under paragraph (1).
(c) AUTHORIZATION OF APPROPRIATIONS- There are authorized to be
appropriated for the Drug Enforcement Administration for each fiscal year
after fiscal year 1999, $9,500,000 for purposes of carrying out the activities
authorized by subsection (a) and employing personnel in positions established
under subsection (b), of which $3,000,000 shall be available for activities
under paragraphs (5) through (8) of subsection (a) and for employing personnel
in positions established under subsection (b)(2).
PART III--ABUSE PREVENTION AND TREATMENT
SEC. 3631. EXPANSION OF METHAMPHETAMINE RESEARCH.
Section 464N of the Public Health Service Act (42 U.S.C. 285o-2) is
amended by adding at the end the following:
`(c) METHAMPHETAMINE RESEARCH-
`(1) GRANTS OR COOPERATIVE AGREEMENTS- The Director of the Institute may
make grants or enter into cooperative agreements to expand the current and
on-going interdisciplinary research and clinical trials with treatment
centers of the National Drug Abuse Treatment Clinical Trials Network
relating to methamphetamine abuse and addiction and other biomedical,
behavioral, and social issues related to methamphetamine abuse and
addiction.
`(2) USE OF FUNDS- Amounts made available under a grant or cooperative
agreement under paragraph (1) for methamphetamine abuse and addiction may be
used for research and clinical trials relating to--
`(A) the effects of methamphetamine abuse on the human body, including
the brain;
`(B) the addictive nature of methamphetamine and how such effects
differ with respect to different individuals;
`(C) the connection between methamphetamine abuse and mental
health;
`(D) the identification and evaluation of the most effective methods
of prevention of methamphetamine abuse and addiction;
`(E) the identification and development of the most effective methods
of treatment of methamphetamine addiction, including pharmacological
treatments;
`(F) risk factors for methamphetamine abuse;
`(G) effects of methamphetamine abuse and addiction on pregnant women
and their fetuses; and
`(H) cultural, social, behavioral, neurological and psychological
reasons that individuals abuse methamphetamine, or refrain from abusing
methamphetamine.
`(3) RESEARCH RESULTS- The Director shall promptly disseminate research
results under this subsection to Federal, State and local entities involved
in combating methamphetamine abuse and addiction.
`(4) AUTHORIZATION OF APPROPRIATIONS-
`(A) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out paragraph (1), such sums as may be necessary for
each fiscal year.
`(B) SUPPLEMENT NOT SUPPLANT- Amounts appropriated pursuant to the
authorization of appropriations in subparagraph (A) for a fiscal year
shall supplement and not supplant any other amounts appropriated in such
fiscal year for research on methamphetamine abuse and
addiction.'.
SEC. 3632. METHAMPHETAMINE AND AMPHETAMINE TREATMENT INITIATIVE BY CENTER
FOR SUBSTANCE ABUSE TREATMENT.
Subpart 1 of part B of title V of the Public Health Service Act (42 U.S.C.
290bb et seq.) is amended by adding at the end the following new section:
`METHAMPHETAMINE AND AMPHETAMINE TREATMENT INITIATIVE
`(1) AUTHORITY TO MAKE GRANTS- The Director of the Center for Substance
Abuse Treatment may make grants to States and Indian tribes recognized by
the United States that have a high rate, or have had a rapid increase, in
methamphetamine or amphetamine abuse or addiction in order to permit such
States and Indian tribes to expand activities in connection with the
treatment of methamphetamine or amphetamine abuser or addiction in the
specific geographical areas of such States or Indian tribes, as the case may
be, where there is such a rate or has been such an increase.
`(2) RECIPIENTS- Any grants under paragraph (1) shall be directed to the
substance abuse directors of the States, and of the appropriate tribal
government authorities of the Indian tribes, selected by the Director to
receive such grants.
`(3) NATURE OF ACTIVITIES- Any activities under a grant under paragraph
(1) shall be based on reliable scientific evidence of their efficacy in the
treatment of methamphetamine or amphetamine abuse or addiction.
`(b) GEOGRAPHIC DISTRIBUTION- The Director shall ensure that grants under
subsection (a) are distributed equitably among the various regions of the
country and among rural, urban, and suburban areas that are affected by
methamphetamine or amphetamine abuse or addiction.
`(c) ADDITIONAL ACTIVITIES- The Director shall--
`(1) evaluate the activities supported by grants under subsection
(a);
`(2) disseminate widely such significant information derived from the
evaluation as the Director considers appropriate to assist States, Indian
tribes, and private providers of treatment services for methamphetamine or
amphetamine abuser or addiction in the treatment of methamphetamine or
amphetamine abuse or addiction; and
`(3) provide States, Indian tribes, and such providers with technical
assistance in connection with the provision of such treatment.
`(d) AUTHORIZATION OF APPROPRIATIONS-
`(1) IN GENERAL- There are authorized to be appropriated to carry out
this section $10,000,000 for fiscal year 2000 and such sums as may be
necessary for each of fiscal years 2001 and 2002.
`(2) USE OF CERTAIN FUNDS- Of the funds appropriated to carry out this
section in any fiscal year, the lesser of 5 percent of such funds or
$1,000,000 shall be available to the Director for purposes of carrying out
subsection (c).'.
SEC. 3633. STUDY OF METHAMPHETAMINE TREATMENT.
(1) REQUIREMENT- The Secretary of Health and Human Services shall, in
consultation with the Institute of Medicine of the National Academy of
Sciences, conduct a study on the development of medications for the
treatment of addiction to amphetamine and methamphetamine.
(2) REPORT- Not later than 9 months after the date of the enactment of
this Act, the Secretary shall submit to the Committees on the Judiciary of
the Senate and House of Representatives a report on the results of the study
conducted under paragraph (1).
(b) AUTHORIZATION OF APPROPRIATIONS- There are hereby authorized to be
appropriated for the Department of Health and Human Services for fiscal year
2000 such sums as may be necessary to meet the requirements of subsection
(a).
PART IV--REPORTS
SEC. 3641. REPORTS ON CONSUMPTION OF METHAMPHETAMINE AND OTHER ILLICIT DRUGS
IN RURAL AREAS, METROPOLITAN AREAS, AND CONSOLIDATED METROPOLITAN AREAS.
The Secretary of Health and Human Services shall include in each National
Household Survey on Drug Abuse appropriate prevalence data and information on
the consumption of methamphetamine and other illicit drugs in rural areas,
metropolitan areas, and consolidated metropolitan areas.
SEC. 3642. REPORT ON DIVERSION OF ORDINARY, OVER-THE-COUNTER PSEUDOEPHEDRINE
AND PHENYLPROPANOLAMINE PRODUCTS.
(a) STUDY- The Attorney General shall conduct a study of the use of
ordinary, over-the-counter pseudoephedrine and phenylpropanolamine products in
the clandestine production of illicit drugs. Sources of data for the study
shall include the following:
(1) Information from Federal, State, and local clandestine laboratory
seizures and related investigations identifying the source, type, or brand
of drug products being utilized and how they were obtained for the illicit
production of methamphetamine and amphetamine.
(2) Information submitted voluntarily from the pharmaceutical and retail
industries involved in the manufacture, distribution, and sale of drug
products containing ephedrine, pseudoephedrine, and phenylpropanolamine,
including information on changes in the pattern, volume, or both, of sales
of ordinary, over-the-counter pseudoephedrine and phenylpropanolamine
products.
(1) REQUIREMENT- Not later than 1 year after the date of the enactment
of this Act, the Attorney General shall submit to Congress a report on the
study conducted under subsection (a).
(2) ELEMENTS- The report shall include--
(A) the findings of the Attorney General as a result of the study;
and
(B) such recommendations on the need to establish additional measures
to prevent diversion of ordinary, over-the-counter pseudoephedrine and
phenylpropanolamine (such as a threshold on ordinary, over-the-counter
pseudoephedrine and phenylpropanolamine products) as the Attorney General
considers appropriate.
(3) MATTERS CONSIDERED- In preparing the report, the Attorney General
shall consider the comments and recommendations including the comments on
the Attorney General's proposed findings and recommendations, of State and
local law enforcement and regulatory officials and of representatives of the
industry described in subsection (a)(2).
(c) REGULATION OF RETAIL SALES-
(1) IN GENERAL- Notwithstanding section 401(d) of the Comprehensive
Methamphetamine Control Act of 1996 (21 U.S.C. 802 note) and subject to
paragraph (2), the Attorney General shall establish by regulation a
single-transaction limit of not less than 24 grams of ordinary,
over-the-counter pseudoephedrine or phenylpropanolamine (as the case may be)
for retail distributors, if the Attorney General finds, in the report under
subsection (b), that--
(A) there is a significant number of instances (as set forth in
paragraph (3)(A) of such section 401(d) for purposes of such section)
where ordinary, over-the-counter pseudoephedrine products,
phenylpropanolamine products, or both such products that were purchased
from retail distributors were widely used in the clandestine production of
illicit drugs; and
(B) the best practical method of preventing such use is the
establishment of single-transaction limits for retail distributors of
either or both of such products.
(2) DUE PROCESS- The Attorney General shall establish the
single-transaction limit under paragraph (1) only after notice, comment, and
an informal hearing.
Subtitle B--Controlled Substances Generally
SEC. 3651. ENHANCED PUNISHMENT FOR TRAFFICKING IN LIST I CHEMICALS.
(a) AMENDMENTS TO FEDERAL SENTENCING GUIDELINES- Pursuant to its authority
under section 994(p) of title 28, United States Code, the United States
Sentencing Commission shall amend the Federal sentencing guidelines in
accordance with this section with respect to any violation of paragraph (1) or
(2) of section 401(d) of the Controlled Substances Act (21 U.S.C. 841(d))
involving a list I chemical and any violation of paragraph (1) or (3) of
section 1010(d) of the Controlled Substance Import and Export Act (21 U.S.C.
960(d)) involving a list I chemical.
(b) EPHEDRINE, PHENYLPROPANOLAMINE, AND PSEUDOEPHEDRINE-
(1) IN GENERAL- In carrying this section, the United States Sentencing
Commission shall, with respect to each offense described in subsection (a)
involving ephedrine, phenylpropanolamine, or pseudoephedrine (including
their salts, optical isomers, and salts of optical isomers), review and
amend its guidelines to provide for increased penalties such that those
penalties corresponded to the quantity of controlled substance that could
reasonably have been manufactured using the quantity of ephedrine,
phenylpropanolamine, or pseudoephedrine possessed or distributed.
(2) CONVERSION RATIOS- For the purposes of the amendments made by this
subsection, the quantity of controlled substance that could reasonably have
been manufactured shall be determined by using a table of manufacturing
conversion ratios for ephedrine, phenylpropanolamine, and pseudoephedrine,
which table shall be established by the Sentencing Commission based on
scientific, law enforcement, and other data the Sentencing Commission
considers appropriate.
(c) OTHER LIST I CHEMICALS- In carrying this section, the United States
Sentencing Commission shall, with respect to each offense described in
subsection (a) involving any list I chemical other than ephedrine,
phenylpropanolamine, or pseudoephedrine, review and amend its guidelines to
provide for increased penalties such that those penalties reflect the
dangerous nature of such offenses, the need for aggressive law enforcement
action to fight such offenses, and the extreme dangers associated with
unlawful activity involving methamphetamine and amphetamine, including--
(1) the rapidly growing incidence of controlled substance
manufacturing;
(2) the extreme danger inherent in manufacturing controlled
substances;
(3) the threat to public safety posed by manufacturing controlled
substances; and
(4) the recent increase in the importation, possession, and distribution
of list I chemicals for the purpose of manufacturing controlled
substances.
(d) EMERGENCY AUTHORITY TO SENTENCING COMMISSION- The United States
Sentencing Commission shall promulgate amendments pursuant to this section as
soon as practicable after the date of the enactment of this Act in accordance
with the procedure set forth in section 21(a) of the Sentencing Act of 1987
(Public Law 100-182), as though the authority under that Act had not
expired.
SEC. 3652. MAIL ORDER REQUIREMENTS.
Section 310(b)(3) of the Controlled Substances Act (21 U.S.C. 830(b)(3))
is amended--
(1) by redesignating subparagraphs (A) and (B) as subparagraphs (B) and
(C), respectively;
(2) by inserting before subparagraph (B), as so redesignated, the
following new subparagraph (A):
`(A) As used in this paragraph:
`(i) The term `drug product' means an active ingredient in dosage
form that has been approved or otherwise may be lawfully marketed under
the Food, Drug, and Cosmetic Act for distribution in the United
States.
`(ii) The term `valid prescription' means a prescription which is
issued for a legitimate medical purpose by an individual practitioner
licensed by law to administer and prescribe the drugs concerned and
acting in the usual course of the practitioner's professional
practice.';
(3) in subparagraph (B), as so redesignated, by inserting `or who
engages in an export transaction' after `nonregulated person'; and
(4) adding at the end the following:
`(D) Except as provided in subparagraph (E), the following
distributions to a nonregulated person, and the following export
transactions, shall not be subject to the reporting requirement in
subparagraph (B):
`(i) Distributions of sample packages of drug products when such
packages contain not more than two solid dosage units or the equivalent
of two dosage units in liquid form, not to exceed 10 milliliters of
liquid per package, and not more than one package is distributed to an
individual or residential address in any 30-day period.
`(ii) Distributions of drug products by retail distributors that may
not include face-to-face transactions to the extent that such
distributions are consistent with the activities authorized for a retail
distributor as specified in section 102(46).
`(iii) Distributions of drug products to a resident of a long term
care facility (as that term is defined in regulations prescribed by the
Attorney General) or distributions of drug products to a long term care
facility for dispensing to or for use by a resident of that
facility.
`(iv) Distributions of drug products pursuant to a valid
prescription.
`(v) Exports which have been reported to the Attorney General
pursuant to section 1004 or 1018 or which are subject to a waiver
granted under section 1018(e)(2).
`(vi) Any quantity, method, or type of distribution or any quantity,
method, or type of distribution of a specific listed chemical (including
specific formulations or drug products) or of a group of listed
chemicals (including specific formulations or drug products) which the
Attorney General has excluded by regulation from such reporting
requirement on the basis that such reporting is not necessary for the
enforcement of this title or title III.
`(E) The Attorney General may revoke any or all of the exemptions
listed in subparagraph (D) for an individual regulated person if he finds
that drug products distributed by the regulated person are being used in
violation of this title or title III. The regulated person shall be
notified of the revocation, which will be effective upon receipt by the
person of such notice, as provided in section 1018(c)(1), and shall have
the right to an expedited hearing as provided in section
1018(c)(2).'.
SEC. 3653. THEFT AND TRANSPORTATION OF ANHYDROUS AMMONIA FOR PURPOSES OF
ILLICIT PRODUCTION OF CONTROLLED SUBSTANCES.
(a) IN GENERAL- Part D of the Controlled Substances Act (21 U.S.C. 841 et
seq.) is amended by adding at the end the following:
`ANHYDROUS AMMONIA
`SEC. 423. (a) It is unlawful for any person--
`(1) to steal anhydrous ammonia, or
`(2) to transport stolen anhydrous ammonia across State lines,
knowing, intending, or having reasonable cause to believe that such
anhydrous ammonia will be used to manufacture a controlled substance in
violation of this part.
`(b) Any person who violates subsection (a) shall be imprisoned or fined,
or both, in accordance with section 403(d) as if such violation were a
violation of a provision of section 403.'.
(b) CLERICAL AMENDMENT- The table of contents for that Act is amended by
inserting after the item relating to section 421 the following new items:
`Sec. 422. Drug paraphernalia.
`Sec. 423. Anhydrous ammonia.'.
(c) ASSISTANCE FOR CERTAIN RESEARCH-
(1) AGREEMENT- The Administrator of the Drug Enforcement Administration
shall seek to enter into an agreement with Iowa State University in order to
permit the University to continue and expand its current research into the
development of inert agents that, when added to anhydrous ammonia, eliminate
the usefulness of anhydrous ammonia as an ingredient in the production of
methamphetamine.
(2) REIMBURSABLE PROVISION OF FUNDS- The agreement under paragraph (1)
may provide for the provision to Iowa State University, on a reimbursable
basis, of $500,000 for purposes the activities specified in that
paragraph.
(3) AUTHORIZATION OF APPROPRIATIONS- There is hereby authorized to be
appropriated for the Drug Enforcement Administration for fiscal year 2000,
$500,000 for purposes of carrying out the agreement under this
subsection.
Subtitle C--Ecstasy Anti-Proliferation Act of 2000
SEC. 3661. SHORT TITLE.
This subtitle may be cited as the `Ecstasy Anti-Proliferation Act of
2000'.
SEC. 3662. FINDINGS.
Congress makes the following findings:
(1) The illegal importation of 3,4-methylenedioxy methamphetamine,
commonly referred to as `MDMA' or `Ecstasy' (referred to in this subtitle as
`Ecstasy'), has increased in recent years, as evidenced by the fact that
Ecstasy seizures by the United States Customs Service have increased from
less than 500,000 tablets during fiscal year 1997 to more than 9,000,000
tablets during the first 9 months of fiscal year 2000.
(2) Use of Ecstasy can cause long-lasting, and perhaps permanent, damage
to the serotonin system of the brain, which is fundamental to the
integration of information and emotion, and this damage can cause long-term
problems with learning and memory.
(3) Due to the popularity and marketability of Ecstasy, there are
numerous Internet websites with information on the effects of Ecstasy, the
production of Ecstasy, and the locations of Ecstasy use (often referred to
as `raves'). The availability of this information targets the primary users
of Ecstasy, who are most often college students, young professionals, and
other young people from middle- to high-income families.
(4) Greater emphasis needs to be placed on--
(A) penalties associated with the manufacture, distribution, and use
of Ecstasy;
(B) the education of young people on the negative health effects of
Ecstasy, since the reputation of Ecstasy as a `safe' drug is the most
dangerous component of Ecstasy;
(C) the education of State and local law enforcement agencies
regarding the growing problem of Ecstasy trafficking across the United
States;
(D) reducing the number of deaths caused by Ecstasy use and the
combined use of Ecstasy with other `club' drugs and alcohol; and
(E) adequate funding for research by the National Institute on Drug
Abuse to--
(i) identify those most vulnerable to using Ecstasy and develop
science-based prevention approaches tailored to the specific needs of
individuals at high risk;
(ii) understand how Ecstasy produces its toxic effects and how to
reverse neurotoxic damage;
(iii) develop treatments, including new medications and behavioral
treatment approaches;
(iv) better understand the effects that Ecstasy has on the
developing children and adolescents; and
(v) translate research findings into useful tools and ensure their
effective dissemination.
SEC. 3663. ENHANCED PUNISHMENT OF ECSTASY TRAFFICKERS.
(a) AMENDMENT TO FEDERAL SENTENCING GUIDELINES- Pursuant to its authority
under section 994(p) of title 28, United States Code, the United States
Sentencing Commission (referred to in this section as the `Commission') shall
amend the Federal sentencing guidelines regarding any offense relating to the
manufacture, importation, or exportation of, or trafficking in--
(1) 3,4-methylenedioxy methamphetamine;
(2) 3,4-methylenedioxy amphetamine;
(3) 3,4-methylenedioxy-N-ethylamphetamine;
(4) paramethoxymethamphetamine (PMA); or
(5) any other controlled substance, as determined by the Commission in
consultation with the Attorney General, that is marketed as Ecstasy and that
has either a chemical structure substantially similar to that of
3,4-methylenedioxy methamphetamine or an effect on the central nervous
system substantially similar to or greater than that of 3,4-methylenedioxy
methamphetamine,
including an attempt or conspiracy to commit an offense described in
paragraph (1), (2), (3), (4), or (5) in violation of the Controlled Substances
Act (21 U.S.C. 801 et seq.), the Controlled Substances Import and Export Act
(21 U.S.C. 951 et seq.), or the Maritime Drug Law Enforcement Act (46 U.S.C.
1901 et seq.).
(b) GENERAL REQUIREMENTS- In carrying out this section, the Commission
shall, with respect to each offense described in subsection (a)--
(1) review and amend the Federal sentencing guidelines to provide for
increased penalties such that those penalties reflect the seriousness of
these offenses and the need to deter them; and
(2) take any other action the Commission considers to be necessary to
carry out this section.
(c) ADDITIONAL REQUIREMENTS- In carrying out this section, the Commission
shall ensure that the Federal sentencing guidelines for offenders convicted of
offenses described in subsection (a) reflect--
(1) the need for aggressive law enforcement action with respect to
offenses involving the controlled substances described in subsection (a);
and
(2) the dangers associated with unlawful activity involving such
substances, including--
(A) the rapidly growing incidence of abuse of the controlled
substances described in subsection (a) and the threat to public safety
that such abuse poses;
(B) the recent increase in the illegal importation of the controlled
substances described in subsection (a);
(C) the young age at which children are beginning to use the
controlled substances described in subsection (a);
(D) the fact that the controlled substances described in subsection
(a) are frequently marketed to youth;
(E) the large number of doses per gram of the controlled substances
described in subsection (a); and
(F) any other factor that the Commission determines to be
appropriate.
(d) SENSE OF THE CONGRESS- It is the sense of the Congress that--
(1) the base offense levels for Ecstasy are too low, particularly for
high-level traffickers, and should be increased, such that they are
comparable to penalties for other drugs of abuse; and
(2) based on the fact that importation of Ecstasy has surged in the past
few years, the traffickers are targeting the Nation's youth, and the use of
Ecstasy among youth in the United States is increasing even as other drug
use among this population appears to be leveling off, the base offense
levels for importing and trafficking the controlled substances described in
subsection (a) should be increased.
(e) REPORT- Not later than 60 days after the amendments pursuant to this
section have been promulgated, the Commission shall--
(1) prepare a report describing the factors and information considered
by the Commission in promulgating amendments pursuant to this section;
and
(2) submit the report to--
(A) the Committee on the Judiciary, the Committee on Health,
Education, Labor, and Pensions, and the Committee on Appropriations of the
Senate; and
(B) the Committee on the Judiciary, the Committee on Commerce, and the
Committee on Appropriations of the House of Representatives.
SEC. 3664. EMERGENCY AUTHORITY TO UNITED STATES SENTENCING COMMISSION.
The United States Sentencing Commission shall promulgate amendments under
this subtitle as soon as practicable after the date of the enactment of this
Act in accordance with the procedure set forth in section 21(a) of the
Sentencing Act of 1987 (Public Law 100-182), as though the authority under
that Act had not expired.
SEC. 3665. EXPANSION OF ECSTASY AND CLUB DRUGS ABUSE PREVENTION
EFFORTS.
(a) PUBLIC HEALTH SERVICE ACT- Part A of title V of the Public Health
Service Act (42 U.S.C. 290aa et seq.), as amended by section 3306, is further
amended by adding at the end the following:
`SEC. 506B. GRANTS FOR ECSTASY AND OTHER CLUB DRUGS ABUSE PREVENTION.
`(a) AUTHORITY- The Administrator may make grants to, and enter into
contracts and cooperative agreements with, public and nonprofit private
entities to enable such entities--
`(1) to carry out school-based programs concerning the dangers of the
abuse of and addiction to 3,4-methylenedioxy methamphetamine, related drugs,
and other drugs commonly referred to as `club drugs' using methods that are
effective and science-based, including initiatives that give students the
responsibility to create their own anti-drug abuse education programs for
their schools; and
`(2) to carry out community-based abuse and addiction prevention
programs relating to 3,4-methylenedioxy methamphetamine, related drugs, and
other club drugs that are effective and science-based.
`(b) USE OF FUNDS- Amounts made available under a grant, contract or
cooperative agreement under subsection (a) shall be used for planning,
establishing, or administering prevention programs relating to
3,4-methylenedioxy methamphetamine, related drugs, and other club drugs.
`(1) DISCRETIONARY FUNCTIONS- Amounts provided to an entity under this
section may be used--
`(A) to carry out school-based programs that are focused on those
districts with high or increasing rates of abuse and addiction to
3,4-methylenedioxy methamphetamine, related drugs, and other club drugs
and targeted at populations that are most at risk to start abusing these
drugs;
`(B) to carry out community-based prevention programs that are focused
on those populations within the community that are most at-risk for abuse
of and addiction to 3,4-methylenedioxy methamphetamine, related drugs, and
other club drugs;
`(C) to assist local government entities to conduct appropriate
prevention activities relating to 3,4-methylenedioxy methamphetamine,
related drugs, and other club drugs;
`(D) to train and educate State and local law enforcement officials,
prevention and education officials, health professionals, members of
community anti-drug coalitions and parents on the signs of abuse of and
addiction to 3,4-methylenedioxy methamphetamine, related drugs, and other
club drugs and the options for treatment and prevention;
`(E) for planning, administration, and educational activities related
to the prevention of abuse of and addiction to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs;
`(F) for the monitoring and evaluation of prevention activities
relating to 3,4-methylenedioxy methamphetamine, related drugs, and other
club drugs and reporting and disseminating resulting information to the
public; and
`(G) for targeted pilot programs with evaluation components to
encourage innovation and experimentation with new methodologies.
`(2) PRIORITY- The Administrator shall give priority in awarding grants
under this section to rural and urban areas that are experiencing a high
rate or rapid increases in abuse and addiction to 3,4-methylenedioxy
methamphetamine, related drugs, and other club drugs.
`(d) ALLOCATION AND REPORT-
`(1) PREVENTION PROGRAM ALLOCATION- Not less than $500,000 of the amount
appropriated in each fiscal year to carry out this section shall be made
available to the Administrator, acting in consultation with other Federal
agencies, to support and conduct periodic analyses and evaluations of
effective prevention programs for abuse of and addiction to
3,4-methylenedioxy methamphetamine, related drugs, and other club drugs and
the development of appropriate strategies for disseminating information
about and implementing such programs.
`(2) REPORT- The Administrator shall annually prepare and submit to the
Committee on Health, Education, Labor, and Pensions, the Committee on the
Judiciary, and the Committee on Appropriations of the Senate, and the
Committee on Commerce, the Committee on the Judiciary, and the Committee on
Appropriations of the House of Representatives, a report containing the
results of the analyses and evaluations conducted under paragraph (1).
`(e) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to carry out this section--
`(1) $10,000,000 for fiscal year 2001; and
`(2) such sums as may be necessary for each succeeding fiscal
year.'.
Subtitle D--Miscellaneous
SEC. 3671. ANTIDRUG MESSAGES ON FEDERAL GOVERNMENT INTERNET WEBSITES.
Not later than 90 days after the date of the enactment of this Act, the
head of each department, agency, and establishment of the Federal Government
shall, in consultation with the Director of the Office of National Drug
Control Policy, place antidrug messages on appropriate Internet websites
controlled by such department, agency, or establishment which messages shall,
where appropriate, contain an electronic hyperlink to the Internet website, if
any, of the Office.
SEC. 3672. REIMBURSEMENT BY DRUG ENFORCEMENT ADMINISTRATION OF EXPENSES
INCURRED TO REMEDIATE METHAMPHETAMINE LABORATORIES.
(a) REIMBURSEMENT AUTHORIZED- The Attorney General, acting through the
Administrator of the Drug Enforcement Administration, may reimburse States,
units of local government, Indian tribal governments, other public entities,
and multi-jurisdictional or regional consortia thereof for expenses incurred
to clean up and safely dispose of substances associated with clandestine
methamphetamine laboratories which may present a danger to public health or
the environment.
(b) ADDITIONAL DEA PERSONNEL- From amounts appropriated or otherwise made
available to carry out this section, the Attorney General may hire not more
than five additional Drug Enforcement Administration personnel to administer
this section.
(c) AUTHORIZATION OF APPROPRIATIONS- There is authorized to be
appropriated to the Attorney General to carry out this section $20,000,000 for
fiscal year 2001.
SEC. 3673. SEVERABILITY.
Any provision of this title held to be invalid or unenforceable by its
terms, or as applied to any person or circumstance, shall be construed as to
give the maximum effect permitted by law, unless such provision is held to be
utterly invalid or unenforceable, in which event such provision shall be
severed from this title and shall not affect the applicability of the
remainder of this title, or of such provision, to other persons not similarly
situated or to other, dissimilar circumstances.
Speaker of the House of Representatives.
Vice President of the United States and
President of the Senate.
END