[Congressional Record Volume 168, Number 106 (Wednesday, June 22, 2022)]
[House]
[Pages H5752-H5795]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
{time} 1400
RESTORING HOPE FOR MENTAL HEALTH AND WELL-BEING ACT OF 2022
Mr. PALLONE. Mr. Speaker, pursuant to House Resolution 1191, I call
up the bill (H.R. 7666) to amend the Public Health Service Act to
reauthorize certain programs relating to mental health and substance
use disorders, and for other purposes, and ask for its immediate
consideration in the House.
The Clerk read the title of the bill.
The SPEAKER pro tempore (Mr. Cleaver). Pursuant to House Resolution
1191, in lieu of the amendment in the nature of a substitute
recommended by the Committee on Energy and Commerce printed in the
bill, an amendment in the nature of a substitute consisting of the text
of Rules Committee print 117-51, modified by the amendment printed in
part D of House Report 117-381, is adopted and the bill, as amended, is
considered read.
The text of the bill, as amended, is as follows:
H.R. 7666
Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled.
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Restoring
Hope for Mental Health and Well-Being Act of 2022''.
(b) Table of Contents.--The table of contents for this Act
is as follows:
Sec. 1. Short title; table of contents.
TITLE I--MENTAL HEALTH AND CRISIS CARE NEEDS
Subtitle A--Crisis Care Services and 9-8-8 Implementation
Sec. 101. Behavioral Health Crisis Coordinating Office.
================
Subtitle B--Into the Light for Maternal Mental Health and Substance Use
Disorders
Sec. 111. Screening and treatment for maternal mental health and
substance use disorders.
Sec. 112. Maternal mental health hotline.
Sec. 113. Task force on maternal mental health.
Subtitle C--Reaching Improved Mental Health Outcomes for Patients
Sec. 121. Innovation for mental health.
Sec. 122. Crisis care coordination.
Sec. 123. Treatment of serious mental illness.
Subtitle D--Anna Westin Legacy
Sec. 131. Maintaining education and training on eating disorders.
Subtitle E--Community Mental Health Services Block Grant
Reauthorization
Sec. 141. Reauthorization of block grants for community mental health
================
Subtitle F--Peer-Supported Mental Health Services
================
TITLE II--SUBSTANCE USE DISORDER PREVENTION, TREATMENT, AND RECOVERY
SERVICES
================
Subtitle A--Native Behavioral Health Access Improvement
Sec. 201. Behavioral health and substance use disorder services for
Native Americans.
[[Page H5753]]
Subtitle B--Summer Barrow Prevention, Treatment, and Recovery
Sec. 211. Grants for the benefit of homeless individuals.
Sec. 212. Priority substance abuse treatment needs of regional and
national significance.
Sec. 213. Evidence-based prescription opioid and heroin treatment and
interventions demonstration.
Sec. 214. Priority substance use disorder prevention needs of regional
and national significance.
Sec. 215. Sober Truth on Preventing (STOP) Underage Drinking
Reauthorization.
Sec. 216. Grants for jail diversion programs.
Sec. 217. Formula grants to States.
Sec. 218. Projects for Assistance in Transition From Homelessness.
Sec. 219. Grants for reducing overdose deaths.
Sec. 220. Opioid overdose reversal medication access and education
grant programs.
Sec. 221. State demonstration grants for comprehensive opioid abuse
response.
Sec. 222. Emergency department alternatives to opioids.
Subtitle C--Excellence in Recovery Housing
Sec. 231. Clarifying the role of SAMHSA in promoting the availability
of high-quality recovery housing.
Sec. 232. Developing guidelines for States to promote the availability
of high-quality recovery housing.
Sec. 233. Coordination of Federal activities to promote the
availability of recovery housing.
Sec. 234. NAS study and report.
Sec. 235. Grants for States to promote the availability of recovery
housing and services.
Sec. 236. Funding.
================
Subtitle D--Substance Use Prevention, Treatment, and Recovery Services
Block Grant
Sec. 241. Eliminating stigmatizing language relating to substance use.
Sec. 242. Authorized activities.
Sec. 243. Requirements relating to certain infectious diseases and
human immunodeficiency virus.
Sec. 244. State plan requirements.
Sec. 245. Updating certain language relating to Tribes.
Sec. 246. Block grants for substance use prevention, treatment, and
recovery services.
Sec. 247. Requirement of reports and audits by States.
Sec. 248. Study on assessment for use in distribution of limited State
resources.
Subtitle E--Timely Treatment for Opioid Use Disorder
Sec. 251. Study on exemptions for treatment of opioid use disorder
through opioid treatment programs during the COVID-19
public health emergency.
================
Subtitle F--Additional Provisions Relating to Addiction Treatment
Sec. 261. Prohibition.
Sec. 262. Eliminating additional requirements for dispensing narcotic
drugs in schedule III, IV, and V for maintenance or
detoxification treatment.
Sec. 263. Requiring prescribers of controlled substances to complete
training.
TITLE III--ACCESS TO MENTAL HEALTH CARE AND COVERAGE
Subtitle A--Collaborate in an Orderly and Cohesive Manner
Sec. 301. Increasing uptake of the collaborative care model.
Subtitle B--Helping Enable Access to Lifesaving Services
Sec. 311. Reauthorization and provision of certain programs to
strengthen the health care workforce.
Subtitle C--Eliminating the Opt-Out for Nonfederal Governmental Health
Plans
Sec. 321. Eliminating the opt-out for nonfederal governmental health
plans.
Subtitle D--Mental Health and Substance Use Disorder Parity
Implementation
Sec. 331. Grants to support mental health and substance use disorder
parity implementation.
TITLE IV--CHILDREN AND YOUTH
================
Subtitle A--Supporting Children's Mental Health Care Access
Sec. 401. Pediatric mental health care access grants.
Sec. 402. Infant and early childhood mental health promotion,
intervention, and treatment.
Subtitle B--Continuing Systems of Care for Children
Sec. 411. Comprehensive Community Mental Health Services for Children
with Serious Emotional Disturbances.
Sec. 412. Substance Use Disorder Treatment and Early Intervention
Services for Children and Adolescents.
Subtitle C--Garrett Lee Smith Memorial Reauthorization
Sec. 421. Suicide prevention technical assistance center.
Sec. 422. Youth suicide early intervention and prevention strategies.
Sec. 423. Mental health and substance use disorder services for
students in higher education.
Sec. 424. Mental and behavioral health outreach and education at
institutions of higher education.
TITLE I--MENTAL HEALTH AND CRISIS CARE NEEDS
Subtitle A--Crisis Care Services and 9-8-8 Implementation
SEC. 101. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.
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. 506B. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.
``(a) In General.--The Secretary shall establish, within
the Substance Abuse and Mental Health Services
Administration, an office to coordinate work relating to
behavioral health crisis care across the operating divisions
and agencies of the Department of Health and Human Services,
including the Substance Abuse and Mental Health Services
Administration, the Centers for Medicare & Medicaid Services,
and the Health Resources and Services Administration, and
external stakeholders.
``(b) Duty.--The office established under subsection (a)
shall--
``(1) convene Federal, State, Tribal, local, and private
partners;
``(2) launch and manage Federal workgroups charged with
making recommendations regarding behavioral health crisis
issues, including with respect to health care best practices,
workforce development, mental health disparities, data
collection, technology, program oversight, public awareness,
and engagement; and
``(3) support technical assistance, data analysis, and
evaluation functions in order to assist States, localities,
Territories, Tribes, and Tribal communities to develop crisis
care systems and establish nationwide best practices with the
objective of expanding the capacity of, and access to, local
crisis call centers, mobile crisis care, crisis
stabilization, psychiatric emergency services, and rapid
post-crisis follow-up care provided by--
``(A) the National Suicide Prevention and Mental Health
Crisis Hotline and Response System;
``(B) community mental health centers (as defined in
section 1861(ff)(3)(B) of the Social Security Act);
``(C) certified community behavioral health clinics, as
described in section 223 of the Protecting Access to Medicare
Act of 2014; and
``(D) other community mental health and substance use
disorder providers.
``(c) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $5,000,000 for
each of fiscal years 2023 through 2027.''.
SEC. 102. CRISIS RESPONSE CONTINUUM OF CARE.
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 at the
end the following:
``SEC. 520N. CRISIS RESPONSE CONTINUUM OF CARE.
``(a) In General.--The Secretary shall publish best
practices for a crisis response continuum of care for use by
health care providers, crisis services administrators, and
crisis services providers in responding to individuals
(including children and adolescents) experiencing mental
health crises, substance-related crises, and crises arising
from co-occurring disorders.
``(b) Best Practices.--
``(1) Scope of best practices.--The best practices
published under subsection (a) shall define--
``(A) a minimum set of core crisis response services, as
determined by the Secretary, for each entity that furnishes
such services, that--
``(i) do not require prior authorization from an insurance
provider or group health plan nor a referral from a health
care provider prior to the delivery of services;
``(ii) provide for serving all individuals regardless of
age or ability to pay;
``(iii) provide for operating 24 hours a day, 7 days a
week; and
``(iv) provide for care and support through resources
described in paragraph (2)(A) until the individual has been
stabilized or transferred to the next level of crisis care;
and
``(B) psychiatric stabilization, including the point at
which a case may be closed for--
``(i) individuals screened over the phone; and
``(ii) individuals stabilized on the scene by mobile teams.
``(2) Identification of essential functions.--The best
practices published under subsection (a) shall identify the
essential functions of each service in the crisis response
continuum, which shall include at least the following:
``(A) Identification of resources for referral and
enrollment in continuing mental health, substance use, or
other human services relevant for the individual in crisis
where necessary.
``(B) Delineation of access and entry points to services
within the crisis response continuum.
``(C) Development of protocols and agreements for the
transfer and receipt of individuals to and from other
segments of the crisis response continuum segments as needed,
and from outside referrals including health care providers,
first responders including law enforcement, paramedics, and
firefighters, education institutions, and community-based
organizations.
``(D) Description of the qualifications of crisis services
staff, including roles for physicians, licensed clinicians,
case managers, and peers (in accordance with State licensing
requirements or
[[Page H5754]]
requirements applicable to Tribal health professionals).
``(E) The convening of collaborative meetings of crisis
response service providers, first responders including law
enforcement, paramedics, and firefighters, and community
partners (including National Suicide Prevention Lifeline or
9-8-8 call centers, 9-1-1 public service answering points,
and local mental health and substance use disorder treatment
providers) operating in a common region for the discussion of
case management, best practices, and general performance
improvement.
``(3) Service capacity and quality best practices.--The
best practices under subsection (a) shall include
recommendations on--
``(A) adequate volume of services to meet population need;
``(B) appropriate timely response; and
``(C) capacity to meet the needs of different patient
populations that may experience a mental health or substance
use crisis, including children, families, and all age groups,
cultural and linguistic minorities, individuals with co-
occurring mental health and substance use disorders,
individuals with cognitive disabilities, individuals with
developmental delays, and individuals with chronic medical
conditions and physical disabilities.
``(4) Implementation timeframe.--The Secretary shall--
``(A) not later than 1 year after the date of enactment of
this section, publish and maintain the best practices
required by subsection (a); and
``(B) every two years thereafter, publish updates.
``(5) Data collection and evaluations.--The Secretary,
directly or through grants, contracts, or interagency
agreements, shall collect data and conduct evaluations with
respect to the provision of services and programs offered on
the crisis response continuum for purposes of assessing the
extent to which the provision of such services and programs
meet certain objectives and outcomes measures as determined
by the Secretary. Such objectives shall include--
``(A) a reduction in reliance on law enforcement response,
as appropriate, to individuals in crisis who would be more
appropriately served by a mobile crisis team capable of
responding to mental health and substance-related crises;
``(B) a reduction in boarding or extended holding of
patients in emergency room facilities who require further
psychiatric care, including care for substance use disorders;
``(C) evidence of adequate access to crisis care centers
and crisis bed services; and
``(D) evidence of adequate linkage to appropriate post-
crisis care and longitudinal treatment for mental health or
substance use disorder when relevant.''.
Subtitle B--Into the Light for Maternal Mental Health and Substance Use
Disorders
SEC. 111. SCREENING AND TREATMENT FOR MATERNAL MENTAL HEALTH
AND SUBSTANCE USE DISORDERS.
(a) In General.--Section 317L-1 of the Public Health
Service Act (42 U.S.C. 247b-13a) is amended--
(1) in the section heading, by striking ``maternal
depression'' and inserting ``maternal mental health and
substance use disorders''; and
(2) in subsection (a)--
(A) by inserting ``, Indian Tribes and Tribal organizations
(as such terms are defined in section 4 of the Indian Self-
Determination and Education Assistance Act), and Urban Indian
organizations (as such term is defined under the Federally
Recognized Indian Tribe List Act of 1994)'' after ``States'';
and
(B) by striking ``for women who are pregnant, or who have
given birth within the preceding 12 months, for maternal
depression'' and inserting ``for women who are postpartum,
pregnant, or have given birth within the preceding 12 months,
for maternal mental health and substance use disorders''.
(b) Application.--Subsection (b) of section 317L-1 of the
Public Health Service Act (42 U.S.C. 247b-13a) is amended--
(1) by striking ``a State shall submit'' and inserting ``an
entity listed in subsection (a) shall submit''; and
(2) in paragraphs (1) and (2), by striking ``maternal
depression'' each place it appears and inserting ``maternal
mental health and substance use disorders''.
(c) Priority.--Subsection (c) of section 317L-1 of the
Public Health Service Act (42 U.S.C. 247b-13a) is amended--
(1) by striking ``may give priority to States proposing to
improve or enhance access to screening'' and inserting the
following: ``shall give priority to entities listed in
subsection (a) that--
``(1) are proposing to create, improve, or enhance
screening, prevention, and treatment'';
(2) by striking ``maternal depression'' and inserting
``maternal mental health and substance use disorders'';
(3) by striking the period at the end of paragraph (1), as
so designated, and inserting a semicolon; and
(4) by inserting after such paragraph (1) the following:
``(2) are currently partnered with, or will partner with, a
community-based organization to address maternal mental
health and substance use disorders;
``(3) are located in an area with high rates of adverse
maternal health outcomes or significant health, economic,
racial, or ethnic disparities in maternal health and
substance use disorder outcomes; and
``(4) operate in a health professional shortage area
designated under section 332.''.
(d) Use of Funds.--Subsection (d) of section 317L-1 of the
Public Health Service Act (42 U.S.C. 247b-13a) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A), by striking ``to health care
providers; and'' and inserting ``on maternal mental health
and substance use disorder screening, brief intervention,
treatment (as applicable for health care providers), and
referrals for treatment to health care providers in the
primary care setting and nonclinical perinatal support
workers;'';
(B) in subparagraph (B), by striking ``to health care
providers, including information on maternal depression
screening, treatment, and followup support services, and
linkages to community-based resources; and'' and inserting
``on maternal mental health and substance use disorder
screening, brief intervention, treatment (as applicable for
health care providers) and referrals for treatment, follow-up
support services, and linkages to community-based resources
to health care providers in the primary care setting and
clinical perinatal support workers; and''; and
(C) by adding at the end the following:
``(C) enabling health care providers (such as obstetrician-
gynecologists, nurse practitioners, nurse midwives,
pediatricians, psychiatrists, mental and other behavioral
health care providers, and adult primary care clinicians) to
provide or receive real-time psychiatric consultation (in-
person or remotely), including through the use of technology-
enabled collaborative learning and capacity building models
(as defined in section 330N), to aid in the treatment of
pregnant and postpartum women; and''; and
(2) in paragraph (2)--
(A) by striking subparagraph (A) and redesignating
subparagraphs (B) and (C) as subparagraphs (A) and (B),
respectively;
(B) in subparagraph (A), as redesignated, by striking
``and'' at the end;
(C) in subparagraph (B), as redesignated--
(i) by inserting ``, including'' before ``for rural
areas''; and
(ii) by striking the period at the end and inserting a
semicolon; and
(D) by inserting after subparagraph (B), as redesignated,
the following:
``(C) providing assistance to pregnant and postpartum women
to receive maternal mental health and substance use disorder
treatment, including patient consultation, care coordination,
and navigation for such treatment;
``(D) coordinating with maternal and child health programs
of the Federal Government and State, local, and Tribal
governments, including child psychiatric access programs;
``(E) conducting public outreach and awareness regarding
grants under subsection (a);
``(F) creating multistate consortia to carry out the
activities required or authorized under this subsection; and
``(G) training health care providers in the primary care
setting and nonclinical perinatal support workers on trauma-
informed care, culturally and linguistically appropriate
services, and best practices related to training to improve
the provision of maternal mental health and substance use
disorder care for racial and ethnic minority populations,
including with respect to perceptions and biases that may
affect the approach to, and provision of, care.''.
(e) Additional Provisions.--Section 317L-1 of the Public
Health Service Act (42 U.S.C. 247b-13a) is amended--
(1) by redesignating subsection (e) as subsection (h); and
(2) by inserting after subsection (d) the following:
``(e) Technical Assistance.--The Secretary shall provide
technical assistance to grantees and entities listed in
subsection (a) for carrying out activities pursuant to this
section.
``(f) Dissemination of Best Practices.--The Secretary,
based on evaluation of the activities funded pursuant to this
section, shall identify and disseminate evidence-based or
evidence-informed best practices for screening, assessment,
and treatment services for maternal mental health and
substance use disorders, including culturally and
linguistically appropriate services, for women during
pregnancy and 12 months following pregnancy.
``(g) Matching Requirement.--The Federal share of the cost
of the activities for which a grant is made to an entity
under subsection (a) shall not exceed 90 percent of the total
cost of such activities.''.
(f) Authorization of Appropriations.--Subsection (h) of
section 317L-1 (42 U.S.C. 247b-13a) of the Public Health
Service Act, as redesignated, is further amended--
(1) by striking ``$5,000,000'' and inserting
``$24,000,000''; and
(2) by striking ``2018 through 2022'' and inserting ``2023
through 2027''.
SEC. 112. MATERNAL MENTAL HEALTH HOTLINE.
Part P of title III of the Public Health Service Act (42
U.S.C. 280g et seq.) is amended by adding at the end the
following:
``SEC. 399V-7. MATERNAL MENTAL HEALTH HOTLINE.
``(a) In General.--The Secretary shall maintain, directly
or by grant or contract, a national hotline to provide
emotional support, information, brief intervention, and
mental health and substance use disorder resources to
pregnant and postpartum women at risk of, or affected by,
maternal mental health and substance use disorders, and to
their families or household members.
``(b) Requirements for Hotline.--The hotline under
subsection (a) shall--
``(1) be a 24/7 real-time hotline;
``(2) provide voice and text support;
``(3) be staffed by certified peer specialists, licensed
health care professionals, or licensed mental health
professionals who are trained on--
``(A) maternal mental health and substance use disorder
prevention, identification, and intervention; and
``(B) providing culturally and linguistically appropriate
support; and
[[Page H5755]]
``(4) provide maternal mental health and substance use
disorder assistance and referral services to meet the needs
of underserved populations, individuals with disabilities,
and family and household members of pregnant or postpartum
women at risk of experiencing maternal mental health and
substance use disorders.
``(c) Additional Requirements.--In maintaining the hotline
under subsection (a), the Secretary shall--
``(1) consult with the Domestic Violence Hotline, National
Suicide Prevention Lifeline, and Veterans Crisis Line to
ensure that pregnant and postpartum women are connected in
real-time to the appropriate specialized hotline service,
when applicable;
``(2) conduct a public awareness campaign for the hotline;
and
``(3) consult with Federal departments and agencies,
including the Centers of Excellence of the Substance Abuse
and Mental Health Services Administration and the Department
of Veterans Affairs, to increase awareness regarding the
hotline.
``(d) Annual Report.--The Secretary shall submit an annual
report to the Congress on the hotline under subsection (a)
and implementation of this section, including--
``(1) an evaluation of the effectiveness of activities
conducted or supported under subsection (a);
``(2) a directory of entities or organizations to which
staff maintaining the hotline funded under this section may
make referrals; and
``(3) such additional information as the Secretary
determines appropriate.
``(e) Authorization of Appropriations.--To carry out this
section, there are authorized to be appropriated $10,000,000
for each of fiscal years 2023 through 2027.''.
SEC. 113. TASK FORCE ON MATERNAL MENTAL HEALTH.
Part B of title III of the Public Health Service Act (42
U.S.C. 243 et seq.) is amended by inserting after section
317L-1 (42 U.S.C. 247b-13a) the following:
``SEC. 317L-2. TASK FORCE ON MATERNAL MENTAL HEALTH.
``(a) Establishment.--Not later than 180 days after the
date of enactment of the Restoring Hope for the Mental Health
and Well-Being Act of 2022, the Secretary, for purposes of
identifying, evaluating, and making recommendations to
coordinate and improve Federal responses to maternal mental
health conditions, shall--
``(1) establish a task force to be known as the Task Force
on Maternal Mental Health (in this section referred to as the
`Task Force'); or
``(2) incorporate the duties, public meetings, and reports
specified in subsections (c) through (f) into existing
Federal policy forums, including the Maternal Health
Interagency Policy Committee and the Maternal Health Working
Group, as appropriate.
``(b) Membership.--
``(1) Composition.--The Task Force shall be composed of--
``(A) the Federal members under paragraph (2); and
``(B) the non-Federal members under paragraph (3).
``(2) Federal members.--The Federal members of the Task
Force shall consist of the following heads of Federal
departments and agencies (or their designees):
``(A) The Assistant Secretary for Health of the Department
of Health and Human Services, who shall serve as Chair.
``(B) The Assistant Secretary for Planning and Evaluation
of the Department of Health and Human Services.
``(C) The Assistant Secretary of the Administration for
Children and Families.
``(D) The Director of the Centers for Disease Control and
Prevention.
``(E) The Administrator of the Centers for Medicare &
Medicaid Services.
``(F) The Administrator of the Health Resources and
Services Administration.
``(G) The Director of the Indian Health Service.
``(H) The Assistant Secretary for Mental Health and
Substance Use.
``(I) Such other Federal departments and agencies as the
Secretary determines appropriate that serve individuals with
maternal mental health conditions.
``(3) Non-federal members.--The non-Federal members of the
Task Force shall--
``(A) compose not more than one-half, and not less than
one-third, of the total membership of the Task Force;
``(B) be appointed by the Secretary; and
``(C) include--
``(i) representatives of medical societies with expertise
in maternal or mental health;
``(ii) representatives of nonprofit organizations with
expertise in maternal or mental health;
``(iii) relevant industry representatives; and
``(iv) other representatives, as appropriate.
``(4) Deadline for designating designees.--If the Assistant
Secretary for Health, or the head of a Federal department or
agency serving as a member of the Task Force under paragraph
(2), chooses to be represented on the Task Force by a
designee, the Assistant Secretary or department or agency
head shall designate such designee not later than 90 days
after the date of the enactment of this section.
``(c) Duties.--The Task Force shall--
``(1) prepare and regularly update a report that analyzes
and evaluates the state of national maternal mental health
policy and programs at the Federal, State, and local levels,
and identifies best practices with respect to maternal mental
health policy, including--
``(A) a set of evidence-based, evidence-informed, and
promising practices with respect to--
``(i) prevention strategies for individuals at risk of
experiencing a maternal mental health condition, including
strategies and recommendations to address health inequities;
``(ii) the identification, screening, diagnosis,
intervention, and treatment of individuals and families
affected by a maternal mental health condition;
``(iii) the expeditious referral to, and implementation of,
practices and supports that prevent and mitigate the effects
of a maternal mental health condition, including strategies
and recommendations to eliminate the racial and ethnic
disparities that exist in maternal mental health; and
``(iv) community-based or multigenerational practices that
support individuals and families affected by a maternal
mental health condition; and
``(B) Federal and State programs and activities to prevent,
screen, diagnose, intervene, and treat maternal mental health
conditions;
``(2) develop and regularly update a national strategy for
maternal mental health, taking into consideration the
findings of the report under paragraph (1), on how the Task
Force and Federal departments and agencies represented on the
Task Force may prioritize options for, and may implement a
coordinated approach to, addressing maternal mental health
conditions, including by--
``(A) increasing prevention, screening, diagnosis,
intervention, treatment, and access to care, including
clinical and nonclinical care such as peer-support and
community health workers, through the public and private
sectors;
``(B) providing support for pregnant or postpartum
individuals who are at risk for or experiencing a maternal
mental health condition, and their families, as appropriate;
``(C) reducing racial, ethnic, geographic, and other health
disparities for prevention, diagnosis, intervention,
treatment, and access to care;
``(D) identifying options for modifying, strengthening, and
coordinating Federal programs and activities, such as the
Medicaid program under title XIX of the Social Security Act
and the State Children's Health Insurance Program under title
XXI of such Act, including existing infant and maternity
programs, in order to increase research, prevention,
identification, intervention, and treatment with respect to
maternal mental health; and
``(E) planning, data sharing, and communication within and
across Federal departments, agencies, offices, and programs;
``(3) solicit public comments from stakeholders for the
report under paragraph (1) and the national strategy under
paragraph (2), including comments from frontline service
providers, mental health professionals, researchers, experts
in maternal mental health, institutions of higher education,
public health agencies (including maternal and child health
programs), and industry representatives, in order to inform
the activities and reports of the Task Force; and
``(4) disaggregate any data collected under this section by
race, ethnicity, geographical location, age, marital status,
socioeconomic level, and other factors, as the Secretary
determines appropriate.
``(d) Meetings.--The Task Force shall--
``(1) meet not less than two times each year; and
``(2) convene public meetings, as appropriate, to fulfill
its duties under this section.
``(e) Reports to Public and Federal Leaders.--The Task
Force shall make publicly available and submit to the heads
of relevant Federal departments and agencies, the Committee
on Energy and Commerce of the House of Representatives, the
Committee on Health, Education, Labor, and Pensions of the
Senate, and other relevant congressional committees, the
following:
``(1) Not later than 1 year after the first meeting of the
Task Force, an initial report under subsection (c)(1).
``(2) Not later than 2 years after the first meeting of the
Task Force, an initial national strategy under subsection
(c)(2).
``(3) Each year thereafter--
``(A) an updated report under subsection (c)(1);
``(B) an updated national strategy under subsection (c)(2);
or
``(C) if no update is made under subsection (c)(1) or
(c)(2), a report summarizing the activities of the Task
Force.
``(f) Reports to Governors.--Upon finalizing the initial
national strategy under subsection (c)(2), and upon making
relevant updates to such strategy, the Task Force shall
submit a report to the Governors of all States describing
opportunities for local- and State-level partnerships
identified under subsection (c)(2)(D).
``(g) Sunset.--The Task Force shall terminate on September
30, 2027.
``(h) Nonduplication of Federal Efforts.--The Secretary may
relieve the Task Force, in carrying out subsections (c)
through (f), from responsibility for carrying out such
activities as may be specified by the Secretary as
duplicative with other activities carried out by the
Department of Health and Human Services.''.
Subtitle C--Reaching Improved Mental Health Outcomes for Patients
SEC. 121. INNOVATION FOR MENTAL HEALTH.
(a) National Mental Health and Substance Use Policy
Laboratory.--Section 501A of the Public Health Service Act
(42 U.S.C. 290aa-0) is amended--
(1) in subsection (e)(1), by striking ``Indian tribes or
tribal organizations'' and inserting ``Indian Tribes or
Tribal organizations'';
(2) by striking subsection (e)(3); and
(3) by adding at the end the following:
``(f) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $10,000,000
for each of fiscal years 2023 through 2027.''.
[[Page H5756]]
(b) Interdepartmental Serious Mental Illness Coordinating
Committee.--
(1) In general.--Part A of title V of the Public Health
Service Act (42 U.S.C. 290aa et seq.) is amended by inserting
after section 501A (42 U.S.C. 290aa-0) the following:
``SEC. 501B. INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS
COORDINATING COMMITTEE.
``(a) Establishment.--
``(1) In general.--The Secretary of Health and Human
Services, or the designee of the Secretary, shall establish a
committee to be known as the Interdepartmental Serious Mental
Illness Coordinating Committee (in this section referred to
as the `Committee').
``(2) Federal advisory committee act.--Except as provided
in this section, the provisions of the Federal Advisory
Committee Act (5 U.S.C. App.) shall apply to the Committee.
``(b) Meetings.--The Committee shall meet not fewer than 2
times each year.
``(c) Responsibilities.--The Committee shall submit, on a
biannual basis, to Congress and any other relevant Federal
department or agency a report including--
``(1) a summary of advances in serious mental illness and
serious emotional disturbance research related to the
prevention of, diagnosis of, intervention in, and treatment
and recovery of serious mental illnesses, serious emotional
disturbances, and advances in access to services and support
for adults with a serious mental illness or children with a
serious emotional disturbance;
``(2) an evaluation of the effect Federal programs related
to serious mental illness have on public health, including
public health outcomes such as--
``(A) rates of suicide, suicide attempts, incidence and
prevalence of serious mental illnesses, serious emotional
disturbances, and substance use disorders, overdose, overdose
deaths, emergency hospitalizations, emergency room boarding,
preventable emergency room visits, interaction with the
criminal justice system, homelessness, and unemployment;
``(B) increased rates of employment and enrollment in
educational and vocational programs;
``(C) quality of mental and substance use disorders
treatment services; or
``(D) any other criteria as may be determined by the
Secretary; and
``(3) specific recommendations for actions that agencies
can take to better coordinate the administration of mental
health services for adults with a serious mental illness or
children with a serious emotional disturbance.
``(d) Membership.--
``(1) Federal members.--The Committee shall be composed of
the following Federal representatives, or the designees of
such representatives--
``(A) the Secretary of Health and Human Services, who shall
serve as the Chair of the Committee;
``(B) the Assistant Secretary for Mental Health and
Substance Use;
``(C) the Attorney General;
``(D) the Secretary of Veterans Affairs;
``(E) the Secretary of Defense;
``(F) the Secretary of Housing and Urban Development;
``(G) the Secretary of Education;
``(H) the Secretary of Labor;
``(I) the Administrator of the Centers for Medicare &
Medicaid Services; and
``(J) the Commissioner of Social Security.
``(2) Non-federal members.--The Committee shall also
include not less than 14 non-Federal public members appointed
by the Secretary of Health and Human Services, of which--
``(A) at least 2 members shall be an individual who has
received treatment for a diagnosis of a serious mental
illness;
``(B) at least 1 member shall be a parent or legal guardian
of an adult with a history of a serious mental illness or a
child with a history of a serious emotional disturbance;
``(C) at least 1 member shall be a representative of a
leading research, advocacy, or service organization for
adults with a serious mental illness;
``(D) at least 2 members shall be--
``(i) a licensed psychiatrist with experience in treating
serious mental illnesses;
``(ii) a licensed psychologist with experience in treating
serious mental illnesses or serious emotional disturbances;
``(iii) a licensed clinical social worker with experience
treating serious mental illnesses or serious emotional
disturbances; or
``(iv) a licensed psychiatric nurse, nurse practitioner, or
physician assistant with experience in treating serious
mental illnesses or serious emotional disturbances;
``(E) at least 1 member shall be a licensed mental health
professional with a specialty in treating children and
adolescents with a serious emotional disturbance;
``(F) at least 1 member shall be a mental health
professional who has research or clinical mental health
experience in working with minorities;
``(G) at least 1 member shall be a mental health
professional who has research or clinical mental health
experience in working with medically underserved populations;
``(H) at least 1 member shall be a State certified mental
health peer support specialist;
``(I) at least 1 member shall be a judge with experience in
adjudicating cases related to criminal justice or serious
mental illness;
``(J) at least 1 member shall be a law enforcement officer
or corrections officer with extensive experience in
interfacing with adults with a serious mental illness,
children with a serious emotional disturbance, or individuals
in a mental health crisis; and
``(K) at least 1 member shall have experience providing
services for homeless individuals and working with adults
with a serious mental illness, children with a serious
emotional disturbance, or individuals in a mental health
crisis.
``(3) Terms.--A member of the Committee appointed under
paragraph (2) shall serve for a term of 3 years, and may be
reappointed for 1 or more additional 3-year terms. Any member
appointed to fill a vacancy for an unexpired term shall be
appointed for the remainder of such term. A member may serve
after the expiration of the member's term until a successor
has been appointed.
``(e) Working Groups.--In carrying out its functions, the
Committee may establish working groups. Such working groups
shall be composed of Committee members, or their designees,
and may hold such meetings as are necessary.
``(f) Sunset.--The Committee shall terminate on September
30, 2027.''.
(2) Conforming amendments.--
(A) Section 501(l)(2) of the Public Health Service Act (42
U.S.C. 290aa(l)(2)) is amended by striking ``section 6031 of
such Act'' and inserting ``section 501B of this Act''.
(B) Section 6031 of the Helping Families in Mental Health
Crisis Reform Act of 2016 (Division B of Public Law 114-255)
is repealed (and by conforming the item relating to such
section in the table of contents in section 1(b)).
(c) Priority Mental Health Needs of Regional and National
Significance.--Section 520A of the Public Health Service Act
(42 U.S.C. 290bb-32) is amended--
(1) in subsection (a), by striking ``Indian tribes or
tribal organizations'' and inserting ``Indian Tribes or
Tribal organizations''; and
(2) in subsection (f), by striking ``$394,550,000 for each
of fiscal years 2018 through 2022'' and inserting
``$599,036,000 for each of fiscal years 2023 through 2027''.
SEC. 122. CRISIS CARE COORDINATION.
(a) Strengthening Community Crisis Response Systems.--
Section 520F of the Public Health Service Act (42 U.S.C.
290bb-37) is amended to read as follows:
``SEC. 520F. MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT
PROGRAM.
``(a) In General.--The Secretary shall establish a pilot
program under which the Secretary will award competitive
grants to States, localities, territories, Indian Tribes, and
Tribal organizations to establish new, or enhance existing,
mobile crisis response teams that divert the response for
mental health and substance use crises from law enforcement
to mobile crisis teams, as described in subsection (b).
``(b) Mobile Crisis Teams Described.--A mobile crisis team
described in this subsection is a team of individuals--
``(1) that is available to respond to individuals in crisis
and provide immediate stabilization, referrals to community-
based mental health and substance use disorder services and
supports, and triage to a higher level of care if medically
necessary;
``(2) which may include licensed counselors, clinical
social workers, physicians, paramedics, crisis workers, peer
support specialists, or other qualified individuals; and
``(3) which may provide support to divert behavioral health
crisis calls from the 9-1-1 system to the 9-8-8 system.
``(c) Priority.--In awarding grants under this section, the
Secretary shall prioritize applications which account for the
specific needs of the communities to be served, including
children and families, veterans, rural and underserved
populations, and other groups at increased risk of death from
suicide or overdose.
``(d) Report.--
``(1) Initial report.--Not later than September 30, 2024,
the Secretary shall submit to Congress a report on steps
taken by the entities specified in subsection (a) as of such
date of enactment to strengthen the partnerships among mental
health providers, substance use disorder treatment providers,
primary care physicians, mental health and substance use
crisis teams, paramedics, law enforcement officers, and other
first responders.
``(2) Progress reports.--Not later than one year after the
date on which the first grant is awarded to carry out this
section, and for each year thereafter, the Secretary shall
submit to Congress a report on the grants made during the
year covered by the report, which shall include--
``(A) impact data on the teams and people served by such
programs, including demographic information of individuals
served, volume, and types of service utilization;
``(B) outcomes of the number of linkages to community-based
resources, short-term crisis receiving and stabilization
facilities, and diversion from law enforcement or hospital
emergency department settings;
``(C) data consistent with the State block grant
requirements for continuous evaluation and quality
improvement, and other relevant data as determined by the
Secretary; and
``(D) the Secretary's recommendations and best practices
for--
``(i) States and localities providing mobile crisis
response and stabilization services for youth and adults; and
``(ii) improvements to the program established under this
section.
``(e) Authorization of Appropriations.--There are
authorized to be appropriated to carry out this section,
$10,000,000 for each of fiscal years 2023 through 2027.''.
(b) Mental Health Awareness Training Grants.--
(1) In general.--Section 520J(b) of the Public Health
Service Act (42 U.S.C. 290bb-41(b)) is amended--
(A) in paragraph (1), by striking ``Indian tribes, tribal
organizations'' and inserting ``Indian Tribes, Tribal
organizations'';
(B) in paragraph (4), by striking ``Indian tribe, tribal
organization'' and inserting ``Indian Tribe, Tribal
organization'';
(C) in paragraph (5)--
[[Page H5757]]
(i) by striking ``Indian tribe, tribal organization'' and
inserting ``Indian Tribe, Tribal organization'';
(ii) in subparagraph (A), by striking ``and'' at the end;
(iii) in subparagraph (B)(ii), by striking the period at
the end and inserting ``; and''; and
(iv) by adding at the end the following:
``(C) suicide intervention and prevention, including
recognizing warning signs and how to refer someone for
help.'';
(D) in paragraph (6), by striking ``Indian tribe, tribal
organization'' and inserting ``Indian Tribe, Tribal
organization''; and
(E) in paragraph (7), by striking ``$14,693,000 for each of
fiscal years 2018 through 2022'' and inserting ``$24,963,000
for each of fiscal years 2023 through 2027''.
(2) Technical corrections.--Section 520J(b) of the Public
Health Service Act (42 U.S.C. 290bb-41(b)) is amended--
(A) in the heading of paragraph (2), by striking
``Emergency Services Personnel'' and inserting ``Emergency
services personnel''; and
(B) in the heading of paragraph (3), by striking
``Distribution of Awards'' and inserting ``Distribution of
awards''.
(c) Adult Suicide Prevention.--Section 520L of the Public
Health Service Act (42 U.S.C. 290bb-43) is amended--
(1) in subsection (a)--
(A) in paragraph (2)--
(i) by striking ``Indian tribe'' each place it appears and
inserting ``Indian Tribe''; and
(ii) by striking ``tribal organization'' each place it
appears and inserting ``Tribal organization''; and
(B) by amending paragraph (3)(C) to read as follows:
``(C) Raising awareness of suicide prevention resources,
promoting help seeking among those at risk for suicide.'';
and
(2) in subsection (d), by striking ``$30,000,000 for the
period of fiscal years 2018 through 2022'' and inserting
``$30,000,000 for each of fiscal years 2023 through 2027''.
SEC. 123. TREATMENT OF SERIOUS MENTAL ILLNESS.
(a) Assertive Community Treatment Grant Program.--
(1) Technical amendment.--Section 520M(b) of the Public
Health Service Act (42 U.S.C. 290bb-44(b)) is amended by
striking ``Indian tribe or tribal organization'' and
inserting ``Indian Tribe or Tribal organization''.
(2) Report to congress.--Section 520M(d)(1) of the Public
Health Service Act (42 U.S.C. 290bb-44(d)(1)) is amended by
striking ``not later than the end of fiscal year 2021'' and
inserting ``not later than the end of fiscal year 2026''.
(3) Authorization of appropriations.--Section 520M(e)(1) of
the Public Health Service Act (42 U.S.C. 290bb-44(d)(1)) is
amended by striking ``$5,000,000 for the period of fiscal
years 2018 through 2022'' and inserting ``$9,000,000 for each
of fiscal years 2023 through 2027''.
(b) Assisted Outpatient Treatment.--Section 224 of the
Protecting Access to Medicare Act of 2014 (42 U.S.C. 290aa
note) is amended to read as follows:
``SEC. 224. ASSISTED OUTPATIENT TREATMENT GRANT PROGRAM FOR
INDIVIDUALS WITH SERIOUS MENTAL ILLNESS.
``(a) In General.--The Secretary shall carry out a program
to award grants to eligible entities for assisted outpatient
treatment programs for individuals with serious mental
illness.
``(b) Consultation.--The Secretary shall carry out this
section in consultation with the Director of the National
Institute of Mental Health, the Attorney General of the
United States, the Administrator of the Administration for
Community Living, and the Assistant Secretary for Mental
Health and Substance Use.
``(c) Selecting Among Applicants.--In awarding grants under
this section, the Secretary--
``(1) may give preference to applicants that have not
previously implemented an assisted outpatient treatment
program; and
``(2) shall evaluate applicants based on their potential to
reduce hospitalization, homelessness, incarceration, and
interaction with the criminal justice system while improving
the health and social outcomes of the patient.
``(d) Program Requirements.--An assisted outpatient
treatment program funded with a grant awarded under this
section shall include--
``(1) evaluating the medical and social needs of the
patients who are participating in the program;
``(2) preparing and executing treatment plans for such
patients that--
``(A) include criteria for completion of court-ordered
treatment if applicable; and
``(B) provide for monitoring of the patient's compliance
with the treatment plan, including compliance with medication
and other treatment regimens;
``(3) providing for case management services that support
the treatment plan;
``(4) ensuring appropriate referrals to medical and social
services providers;
``(5) evaluating the process for implementing the program
to ensure consistency with the patient's needs and State law;
and
``(6) measuring treatment outcomes, including health and
social outcomes such as rates of incarceration, health care
utilization, and homelessness.
``(e) Report.--Not later than the end of fiscal year 2027,
the Secretary shall submit a report to the appropriate
congressional committees on the grant program under this
section. Such report shall include an evaluation of the
following:
``(1) Cost savings and public health outcomes such as
mortality, suicide, substance abuse, hospitalization, and use
of services.
``(2) Rates of incarceration of patients.
``(3) Rates of homelessness of patients.
``(4) Patient and family satisfaction with program
participation.
``(5) Demographic information regarding participation of
those served by the grant compared to demographic information
in the population of the grant recipient.
``(f) Definitions.--In this section:
``(1) The term `assisted outpatient treatment' means
medically prescribed mental health treatment that a patient
receives while living in a community under the terms of a law
authorizing a State or local civil court to order such
treatment.
``(2) The term `eligible entity' means a county, city,
mental health system, mental health court, or any other
entity with authority under the law of the State in which the
entity is located to implement, monitor, and oversee an
assisted outpatient treatment program.
``(g) Funding.--
``(1) Amount of grants.--
``(A) Maximum amount.--The amount of a grant under this
section shall not exceed $1,000,000 for any fiscal year.
``(B) Determination.--Subject to subparagraph (A), the
Secretary shall determine the amount of each grant under this
section based on the population of the area to be served
through the grant and an estimate of the number of patients
to be served.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section $22,000,000 for
each of fiscal years 2023 through 2027.''.
Subtitle D--Anna Westin Legacy
SEC. 131. MAINTAINING EDUCATION AND TRAINING ON EATING
DISORDERS.
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 102, is further amended by adding at the end the
following:
``SEC. 520O. CENTER OF EXCELLENCE FOR EATING DISORDERS FOR
EDUCATION AND TRAINING ON EATING DISORDERS.
``(a) In General.--The Secretary, acting through the
Assistant Secretary, shall maintain, by competitive grant or
contract, a Center of Excellence for Eating Disorders
(referred to in this section as the `Center') to improve the
identification of, interventions for, and treatment of eating
disorders in a manner that is developmentally, culturally,
and linguistically appropriate.
``(b) Subgrants and Subcontracts.--The Center shall
coordinate and implement the activities under subsection (c),
in whole or in part, by awarding competitive subgrants or
subcontracts--
``(1) across geographical regions; and
``(2) in a manner that is not duplicative.
``(c) Activities.--The Center--
``(1) shall--
``(A) provide training and technical assistance for--
``(i) primary care and behavioral health care providers to
carry out screening, brief intervention, and referral to
treatment for individuals experiencing, or at risk for,
eating disorders; and
``(ii) nonclinical community support workers to identify
and support individuals with, or at disproportionate risk
for, eating disorders;
``(B) develop and provide training materials to health care
providers, including primary care and behavioral health care
providers, in the effective treatment and ongoing support of
individuals with eating disorders, including children and
marginalized populations at disproportionate risk for eating
disorders;
``(C) provide collaboration and coordination to other
centers of excellence, technical assistance centers, and
psychiatric consultation lines of the Substance Abuse and
Mental Health Services Administration and the Health
Resources and Services Administration on the identification,
effective treatment, and ongoing support of individuals with
eating disorders; and
``(D) coordinate with the Director of the Centers for
Disease Control and Prevention and the Administrator of the
Health Resources and Services Administration to disseminate
training to primary care and behavioral health care
providers; and
``(2) may--
``(A) coordinate with electronic health record systems for
the integration of protocols pertaining to screening, brief
intervention, and referral to treatment for individuals
experiencing, or at risk for, eating disorders;
``(B) develop and provide training materials to health care
providers, including primary care and behavioral health care
providers, in the effective treatment and ongoing support for
members of the Armed Forces and veterans experiencing, or at
risk for, eating disorders; and
``(C) consult with the Secretary of Defense and the
Secretary of Veterans Affairs on prevention, identification,
intervention for, and treatment of eating disorders.
``(d) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $1,000,000
for each of fiscal years 2023 through 2027.''.
Subtitle E--Community Mental Health Services Block Grant
Reauthorization
SEC. 141. REAUTHORIZATION OF BLOCK GRANTS FOR COMMUNITY
MENTAL HEALTH SERVICES.
(a) Funding.--Section 1920(a) of the Public Health Service
Act (42 U.S.C. 300x-9(a)) is amended by striking
``$532,571,000 for each of fiscal years 2018 through 2022''
and inserting ``$857,571,000 for each of fiscal years 2023
through 2027''.
(b) Set-Aside for Evidence-based Crisis Care Services.--
Section 1920 of the Public Health Service Act (42 U.S.C.
300x-9) is amended by adding at the end the following:
``(d) Crisis Care.--
``(1) In general.--Except as provided in paragraph (3), a
State shall expend at least 5 percent of the amount the State
receives pursuant to
[[Page H5758]]
section 1911 for each fiscal year to support evidenced-based
programs that address the crisis care needs of--
``(A) individuals, including children and adolescents,
experiencing mental health crises, substance-related crises,
or crises arising from co-occurring disorders; and
``(B) persons with intellectual and developmental
disabilities.
``(2) Core elements.--At the discretion of the single State
agency responsible for the administration of the program of
the State under a grant under section 1911, funds expended
pursuant to paragraph (1) may be used to fund some or all of
the core crisis care service components, delivered according
to evidence-based principles, including the following:
``(A) Crisis call centers.
``(B) 24/7 mobile crisis services.
``(C) Crisis stabilization programs offering acute care or
subacute care in a hospital or appropriately licensed
facility, as determined by the Substance Abuse and Mental
Health Services Administration, with referrals to inpatient
or outpatient care.
``(3) State flexibility.--In lieu of expending 5 percent of
the amount the State receives pursuant to section 1911 for a
fiscal year to support evidence-based programs as required by
paragraph (1), a State may elect to expend not less than 10
percent of such amount to support such programs by the end of
two consecutive fiscal years.
``(4) Rule of construction.--With respect to funds expended
pursuant to the set-aside in paragraph (1), section
1912(b)(1)(A)(vi) shall not apply.''.
(c) Early Intervention.--
(1) State plan option.--Section 1912(b)(1)(A)(vii) of the
Public Health Service Act (42 U.S.C. 300x-1(b)(1)(A)(vii)) is
amended--
(A) in subclause (III), by striking ``and'' at the end;
(B) in subclause (IV), by striking the period at the end
and inserting ``; and''; and
(C) by adding at the end the following:
``(V) a description of any evidence-based early
intervention strategies and programs the State provides to
prevent, delay, or reduce the severity and onset of mental
illness and behavioral problems, including for children and
adolescents, irrespective of experiencing a serious mental
illness or serious emotional disturbance, as defined under
subsection (c)(1).''.
(2) Allocation allowance; reports.--Section 1920 of the
Public Health Service Act (42 U.S.C. 300x-9), as amended by
subsection (c), is further amended by adding at the end the
following:
``(e) Early Intervention Services.--In the case of a State
with a State plan that provides for strategies and programs
specified in section 1912(b)(1)(A)(vii)(VI), such State may
expend not more than 5 percent of the amount of the allotment
of the State pursuant to a funding agreement under section
1911 for each fiscal year to support such strategies and
programs.
``(f) Reports to Congress.--Not later than September 30,
2025, and biennially thereafter, the Secretary shall provide
a report to the Congress on the crisis care and early
intervention strategies and programs pursued by States
pursuant to subsections (d) and (e). Each such report shall
include--
``(1) a description of the each State's crisis care and
early intervention activities;
``(2) the population served, including information on
demographics, including age;
``(3) the outcomes of such activities, including--
``(A) how such activities reduced hospitalizations and
hospital stays;
``(B) how such activities reduced incidents of suicidal
ideation and behaviors; and
``(C) how such activities reduced the severity of onset of
serious mental illness and serious emotional disturbance; and
``(4) any other relevant information the Secretary deems
necessary.''.
Subtitle F--Peer-Supported Mental Health Services
SEC. 151. PEER-SUPPORTED 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.) is amended by inserting
after section 520G (42 U.S.C. 290bb--38) the following:
``SEC. 520H. PEER-SUPPORTED MENTAL HEALTH SERVICES.
``(a) Grants Authorized.--The Secretary, acting through the
Director of the Center for Mental Health Services, shall
award grants to eligible entities to enable such entities to
develop, expand, and enhance access to mental health peer-
delivered services.
``(b) Use of Funds.--Grants awarded under subsection (a)
shall be used to develop, expand, and enhance national,
statewide, or community-focused programs, including virtual
peer-support services and infrastructure, including by--
``(1) carrying out workforce development, recruitment, and
retention activities, to train, recruit, and retain peer-
support providers;
``(2) building connections between mental health treatment
programs, including between community organizations and peer-
support networks, including virtual peer-support networks,
and with other mental health support services;
``(3) reducing stigma associated with mental health
disorders;
``(4) expanding and improving virtual peer mental health
support services, including adoption of technologies to
expand access to virtual peer mental health support services,
including by acquiring--
``(A) appropriate physical hardware for such virtual
services;
``(B) software and programs to efficiently run peer-support
services virtually; and
``(C) other technology for establishing virtual waiting
rooms and virtual video platforms for meetings; and
``(5) conducting research on issues relating to mental
illness and the impact peer-support has on resiliency,
including identifying--
``(A) the signs of mental illness;
``(B) the resources available to individuals with mental
illness and to their families; and
``(C) the resources available to help support individuals
living with mental illness.
``(c) Special Consideration.--In carrying out this section,
the Secretary shall give special consideration to the unique
needs of rural areas.
``(d) Definition.--In this section, the term `eligible
entity' means--
``(1) a nonprofit consumer-run organization that--
``(A) is principally governed by people living with a
mental health condition; and
``(B) mobilizes resources within and outside of the mental
health community, which may include through peer-support
networks, to increase the prevalence and quality of long-term
wellness of individuals living with a mental health
condition, including those with a co-occurring substance use
disorder; or
``(2) a Federally recognized Tribe, Tribal organization,
Urban Indian organization, or consortium of Tribes or Tribal
organizations.
``(e) Authorization of Appropriations.--There is authorized
to be appropriated to carry out this section $13,000,000 for
each of fiscal years 2023 through 2027.''.
TITLE II--SUBSTANCE USE DISORDER PREVENTION, TREATMENT, AND RECOVERY
SERVICES
Subtitle A--Native Behavioral Health Access Improvement
SEC. 201. BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER
SERVICES FOR NATIVE AMERICANS.
Section 506A of the Public Health Service Act (42 U.S.C.
290aa-5a) is amended to read as follows:
``SEC. 506A. BEHAVIORAL HEALTH AND SUBSTANCE USE DISORDER
SERVICES FOR NATIVE AMERICANS.
``(a) Definitions.--In this section:
``(1) The term `eligible entity' means an Indian Tribe, a
Tribal organization, an Urban Indian organization, and a
Native Hawaiian health organization.
``(2) The terms `Indian Tribe', `Tribal organization', and
`Urban Indian organization' have the meanings given to the
terms `Indian tribe', `tribal organization', and `Urban
Indian organization' in section 4 of the Indian Health Care
Improvement Act.
``(3) The term `Native Hawaiian health organization' means
`Papa Ola Lokahi' as defined in section 12 of the Native
Hawaiian Health Care Improvement Act.
``(b) Formula Funds.--
``(1) In general.--The Secretary, in consultation with the
Director of the Indian Health Service, as appropriate, shall
award funds to eligible entities, in amounts determined
pursuant to the formula described in paragraph (2), to be
used by the eligible entity to provide culturally appropriate
mental health and substance use disorder prevention,
treatment, and recovery services to American Indians, Alaska
Natives, and Native Hawaiians.
``(2) Formula.--The Secretary, using the process described
in subsection (d), shall develop a formula to determine the
amount of an award under paragraph (1). Such formula shall
take into account the populations of eligible entities whose
rates of overdose deaths or suicide are substantially higher
relative to the populations of other Indian Tribes, Tribal
organizations, Urban Indian organizations, or Native Hawaiian
health organizations, as applicable.
``(c) Technical Assistance and Program Evaluation.--
``(1) In general.--The Secretary shall--
``(A) provide technical assistance to applicants and
awardees under this section; and
``(B) collect and evaluate information on the program
carried out under this section.
``(2) Consultation on evaluation measures, and data
submission and reporting requirements.--The Secretary shall,
using the process described in subsection (d), develop
evaluation measures and data submission and reporting
requirements for purposes of the collection and evaluation of
information.
``(3) Data submission and reporting.--As a condition on
receipt of funds under this section, an applicant shall agree
to submit data and reports in a timely manner consistent with
the evaluation measures and data submission and reporting
requirements developed under subsection (d).
``(d) Regulations.--
``(1) Promulgation.--Not later than 180 days after the date
of enactment of the Restoring Hope for Mental Health and
Well-Being Act of 2022, the Secretary shall initiate
procedures under subchapter III of chapter 5 of title 5,
United States Code, to negotiate and promulgate such
regulations as are necessary to carry out this section,
including development of the funding formula described in
subsection (b) and the program evaluation and reporting
requirements under subsection (c).
``(2) Publication.--Not later than 18 months after the date
of enactment of the Restoring Hope for Mental Health and
Well-Being Act of 2022, the Secretary shall publish in the
Federal Register proposed regulations to implement this
section.
``(3) Committee.--A negotiated rulemaking committee
established pursuant to section 565 of title 5, United States
Code, to carry out this subsection shall have as its members
only representatives of the Federal Government, Tribal
Governments, and Urban Indian organizations. For purposes of
such rulemaking, the Indian Health Service shall be the lead
agency for the Department.
``(4) Adaptation of procedures.--In carrying out this
subsection, the Secretary shall
[[Page H5759]]
adapt any negotiated rulemaking procedures to the unique
context of the government-to-government relationship between
the United States and Indian Tribes.
``(5) Effect.--The lack of promulgated regulations under
this subsection shall not limit the effect or implementation
of this section.
``(e) Application.--An entity desiring an award under
subsection (b) shall submit an application to the Secretary
at such time, in such manner, and accompanied by such
information as the Secretary may reasonably require.
``(f) Report.--Not later than 3 years after the date of the
enactment of the Restoring Hope for Mental Health and Well-
Being Act of 2022, 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 Energy and Commerce of the House of
Representatives, 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,
$40,000,000 for each of fiscal years 2023 through 2027.''.
Subtitle B--Summer Barrow Prevention, Treatment, and Recovery
SEC. 211. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.
Section 506(e) of the Public Health Service Act (42 U.S.C.
290aa-5(e)) is amended by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.
SEC. 212. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
Section 509 of the Public Health Service Act (42 U.S.C.
290bb-2) is amended--
(1) in the section heading, by striking ``abuse'' and
inserting ``use disorder'';
(2) in subsection (a)--
(A) by striking ``tribes and tribal organizations (as the
terms `Indian tribes' and `tribal organizations' are
defined'' and inserting ``Tribes and Tribal organizations (as
such terms are defined''; and
(B) in paragraph (3), by striking ``in substance abuse'';
(3) in subsection (b), in the subsection heading, by
striking ``Abuse'' and inserting ``Use Disorder''; and
(4) in subsection (f), by striking ``$333,806,000 for each
of fiscal years 2018 through 2022'' and inserting
``$521,517,000 for each of fiscal years 2023 through 2027''.
SEC. 213. EVIDENCE-BASED PRESCRIPTION OPIOID AND HEROIN
TREATMENT AND INTERVENTIONS DEMONSTRATION.
Section 514B of the Public Health Service Act (42 U.S.C.
290bb-10) is amended--
(1) in subsection (a)(1)--
(A) by striking ``substance abuse'' and inserting
``substance use disorder'';
(B) by striking ``tribes and tribal organizations'' and
inserting ``Tribes and Tribal organizations''; and
(C) by striking ``addiction'' and inserting ``substance use
disorders'';
(2) in subsection (e)(3), by striking ``tribes and tribal
organizations'' and inserting ``Tribes and Tribal
organizations''; and
(3) in subsection (f), by striking ``2017 through 2021''
and inserting ``2023 through 2027''.
SEC. 214. PRIORITY SUBSTANCE USE DISORDER PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.
Section 516 of the Public Health Service Act (42 U.S.C.
290bb-22) is amended--
(1) in subsection (a)--
(A) in paragraph (3), by striking ``abuse'' and inserting
``use''; and
(B) in the matter following paragraph (3), by striking
``tribes or tribal organizations'' and inserting ``Tribes or
Tribal organizations'';
(2) in subsection (b), in the subsection heading, by
striking ``Abuse'' and inserting ``Use Disorder''; and
(3) in subsection (f), by striking ``$211,148,000 for each
of fiscal years 2018 through 2022'' and inserting
``$218,219,000 for each of fiscal years 2023 through 2027''.
SEC. 215. SOBER TRUTH ON PREVENTING (STOP) UNDERAGE DRINKING
REAUTHORIZATION.
Section 519B of the Public Health Service Act (42 U.S.C.
290bb-25b) is amended--
(1) by amending subsection (a) to read as follows:
``(a) Definitions.--For purposes of this section:
``(1) The term `alcohol beverage industry' means the
brewers, vintners, distillers, importers, distributors, and
retail or online outlets that sell or serve beer, wine, and
distilled spirits.
``(2) The term `school-based prevention' means programs,
which are institutionalized, and run by staff members or
school-designated persons or organizations in any grade of
school, kindergarten through 12th grade.
``(3) The term `youth' means persons under the age of
21.''; and
(2) by striking subsections (c) through (g) and inserting
the following:
``(c) Interagency Coordinating Committee; Annual Report on
State Underage Drinking Prevention and Enforcement
Activities.--
``(1) Interagency coordinating committee on the prevention
of underage drinking.--
``(A) In general.--The Secretary, in collaboration with the
Federal officials specified in subparagraph (B), shall
continue to support and enhance the efforts of the
interagency coordinating committee, that began operating in
2004, focusing on underage drinking (referred to in this
subsection as the `Committee').
``(B) Other agencies.--The officials referred to in
subparagraph (A) are the Secretary of Education, the Attorney
General, the Secretary of Transportation, the Secretary of
the Treasury, the Secretary of Defense, the Surgeon General,
the Director of the Centers for Disease Control and
Prevention, the Director of the National Institute on Alcohol
Abuse and Alcoholism, the Assistant Secretary for Mental
Health and Substance Use, the Director of the National
Institute on Drug Abuse, the Assistant Secretary for Children
and Families, the Director of the Office of National Drug
Control Policy, the Administrator of the National Highway
Traffic Safety Administration, the Administrator of the
Office of Juvenile Justice and Delinquency Prevention, the
Chairman of the Federal Trade Commission, and such other
Federal officials as the Secretary of Health and Human
Services determines to be appropriate.
``(C) Chair.--The Secretary of Health and Human Services
shall serve as the chair of the Committee.
``(D) Duties.--The Committee shall guide policy and program
development across the Federal Government with respect to
underage drinking, provided, however, that nothing in this
section shall be construed as transferring regulatory or
program authority from an Agency to the Coordinating
Committee.
``(E) Consultations.--The Committee shall actively seek the
input of and shall consult with all appropriate and
interested parties, including States, public health research
and interest groups, foundations, and alcohol beverage
industry trade associations and companies.
``(F) Annual report.--
``(i) In general.--The Secretary, on behalf of the
Committee, shall annually submit to the Congress a report
that summarizes--
``(I) all programs and policies of Federal agencies
designed to prevent and reduce underage drinking, focusing
particularly on programs and policies that support the
adoption and enforcement of State policies designed to
prevent and reduce underage drinking as specified in
paragraph (2);
``(II) the extent of progress in preventing and reducing
underage drinking at State and national levels;
``(III) data that the Secretary shall collect with respect
to the information specified in clause (ii); and
``(IV) such other information regarding underage drinking
as the Secretary determines to be appropriate.
``(ii) Certain information.--The report under clause (i)
shall include information on the following:
``(I) Patterns and consequences of underage drinking as
reported in research and surveys such as, but not limited to,
Monitoring the Future, Youth Risk Behavior Surveillance
System, the National Survey on Drug Use and Health, and the
Fatality Analysis Reporting System.
``(II) Measures of the availability of alcohol from
commercial and non-commercial sources to underage
populations.
``(III) Measures of the exposure of underage populations to
messages regarding alcohol in advertising, social media, and
the entertainment media.
``(IV) Surveillance data, including information on the
onset and prevalence of underage drinking, consumption
patterns, beverage preferences, prevalence of drinking among
students at institutions of higher education, correlations
between adult and youth drinking, and the means of underage
access, including trends over time for these surveillance
data. The Secretary shall develop a plan to improve the
collection, measurement, and consistency of reporting Federal
underage alcohol data.
``(V) Any additional findings resulting from research
conducted or supported under subsection (f).
``(VI) Evidence-based best practices to prevent and reduce
underage drinking including a review of the research
literature related to State laws, regulations, and policies
designed to prevent and reduce underage drinking, as
described in paragraph (2)(B)(i).
``(2) Annual report on state underage drinking prevention
and enforcement activities.--
``(A) In general.--The Secretary shall, with input and
collaboration from other appropriate Federal agencies,
States, Indian Tribes, territories, and public health,
consumer, and alcohol beverage industry groups, annually
issue a report on each State's performance in enacting,
enforcing, and creating laws, regulations, and policies to
prevent or reduce underage drinking based on an assessment of
best practices developed pursuant to paragraph (1)(F)(ii)(VI)
and subparagraph (B)(i). For purposes of this paragraph, each
such report, with respect to a year, shall be referred to as
the `State Report'. Each State Report shall be designed as a
resource tool for Federal agencies assisting States in the
their underage drinking prevention efforts, State public
health and law enforcement agencies, State and local
policymakers, and underage drinking prevention coalitions
including those receiving grants pursuant to subsection (e).
``(B) State performance measures.--
``(i) In general.--The Secretary shall develop, in
consultation with the Committee, a set of measures to be used
in preparing the State Report on best practices as they
relate to State laws, regulations, policies, and enforcement
practices.
``(ii) State report content.--The State Report shall
include updates on State laws, regulations, and policies
included in previous reports to Congress, including with
respect to the following:
``(I) Whether or not the State has comprehensive anti-
underage drinking laws such as for the illegal sale,
purchase, attempt to purchase, consumption, or possession of
alcohol; illegal use of fraudulent ID; illegal furnishing or
obtaining of alcohol for an individual under 21 years; the
degree of strictness of the penalties for such offenses; and
the prevalence of the enforcement of each of these
infractions.
``(II) Whether or not the State has comprehensive liability
statutes pertaining to underage access to alcohol such as
dram shop, social host,
[[Page H5760]]
and house party laws, and the prevalence of enforcement of
each of these laws.
``(III) Whether or not the State encourages and conducts
comprehensive enforcement efforts to prevent underage access
to alcohol at retail outlets, such as random compliance
checks and shoulder tap programs, and the number of
compliance checks within alcohol retail outlets measured
against the number of total alcohol retail outlets in each
State, and the result of such checks.
``(IV) Whether or not the State encourages training on the
proper selling and serving of alcohol for all sellers and
servers of alcohol as a condition of employment.
``(V) Whether or not the State has policies and regulations
with regard to direct sales to consumers and home delivery of
alcoholic beverages.
``(VI) Whether or not the State has programs or laws to
deter adults from purchasing alcohol for minors; and the
number of adults targeted by these programs.
``(VII) Whether or not the State has enacted graduated
drivers licenses and the extent of those provisions.
``(iii) Additional categories.--In addition to the updates
on State laws, regulations, and policies listed in clause
(ii), the Secretary shall consider the following:
``(I) Whether or not States have adopted laws, regulations,
and policies that deter underage alcohol use, as described in
`The Surgeon General's Call to Action to Prevent and Reduce
Underage Drinking' issued in 2007 and `Facing Addiction in
America: The Surgeon General's Report on Alcohol, Drugs and
Health' issued in 2016, including restrictions on low-price,
high-volume drink specials, and wholesaler pricing
provisions.
``(II) Whether or not States have adopted laws,
regulations, and policies designed to reduce alcohol
advertising messages attractive to youth and youth exposure
to alcohol advertising and marketing in measured and
unmeasured media and digital and social media.
``(III) Whether or not States have laws and policies that
promote underage drinking prevention policy development by
local jurisdictions.
``(IV) Whether or not States have adopted laws,
regulations, and policies to restrict youth access to
alcoholic beverages that may pose special risks to youth,
including but not limited to alcoholic mists, gelatins,
freezer pops, premixed caffeinated alcoholic beverages, and
flavored malt beverages.
``(V) Whether or not States have adopted uniform best
practices protocols for conducting compliance checks and
shoulder tap programs.
``(VI) Whether or not States have adopted uniform best
practices penalty protocols for violations of laws
prohibiting retail licensees from selling or furnishing of
alcohol to minors.
``(iv) Uniform data system.--For performance measures
related to enforcement of underage drinking laws as specified
in clauses (ii) and (iii), the Secretary shall develop and
test a uniform data system for reporting State enforcement
data, including the development of a pilot program for this
purpose. The pilot program shall include procedures for
collecting enforcement data from both State and local law
enforcement jurisdictions.
``(3) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection $1,000,000
for each of fiscal years 2023 through 2027.
``(d) National Media Campaign To Prevent Underage
Drinking.--
``(1) In general.--The Secretary, in consultation with the
National Highway Traffic Safety Administration, shall develop
an intensive, multifaceted, adult-oriented national media
campaign to reduce underage drinking by influencing attitudes
regarding underage drinking, increasing the willingness of
adults to take actions to reduce underage drinking, and
encouraging public policy changes known to decrease underage
drinking rates.
``(2) Purpose.--The purpose of the national media campaign
described in this section shall be to achieve the following
objectives:
``(A) Instill a broad societal commitment to reduce
underage drinking.
``(B) Increase specific actions by adults that are meant to
discourage or inhibit underage drinking.
``(C) Decrease adult conduct that tends to facilitate or
condone underage drinking.
``(3) Components.--When implementing the national media
campaign described in this section, the Secretary shall--
``(A) educate the public about the public health and safety
benefits of evidence-based policies to reduce underage
drinking, including minimum legal drinking age laws, and
build public and parental support for and cooperation with
enforcement of such policies;
``(B) educate the public about the negative consequences of
underage drinking;
``(C) promote specific actions by adults that are meant to
discourage or inhibit underage drinking, including positive
behavior modeling, general parental monitoring, and
consistent and appropriate discipline;
``(D) discourage adult conduct that tends to facilitate
underage drinking, including the hosting of underage parties
with alcohol and the purchasing of alcoholic beverages on
behalf of underage youth;
``(E) establish collaborative relationships with local and
national organizations and institutions to further the goals
of the campaign and assure that the messages of the campaign
are disseminated from a variety of sources;
``(F) conduct the campaign through multi-media sources; and
``(G) conduct the campaign with regard to changing
demographics and cultural and linguistic factors.
``(4) Consultation requirement.--In developing and
implementing the national media campaign described in this
section, the Secretary shall consult recommendations for
reducing underage drinking published by the National Academy
of Sciences and the Surgeon General. The Secretary shall also
consult with interested parties including medical, public
health, and consumer and parent groups, law enforcement,
institutions of higher education, community organizations and
coalitions, and other stakeholders supportive of the goals of
the campaign.
``(5) Annual report.--The Secretary shall produce an annual
report on the progress of the development or implementation
of the media campaign described in this subsection, including
expenses and projected costs, and, as such information is
available, report on the effectiveness of such campaign in
affecting adult attitudes toward underage drinking and adult
willingness to take actions to decrease underage drinking.
``(6) Research on youth-oriented campaign.--The Secretary
may, based on the availability of funds, conduct research on
the potential success of a youth-oriented national media
campaign to reduce underage drinking. The Secretary shall
report any such results to Congress with policy
recommendations on establishing such a campaign.
``(7) Administration.--The Secretary may enter into a
subcontract with another Federal agency to delegate the
authority for execution and administration of the adult-
oriented national media campaign.
``(8) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section $2,500,000 for
each of fiscal years 2023 through 2027.
``(e) Community-Based Coalition Enhancement Grants To
Prevent Underage Drinking.--
``(1) Authorization of program.--The Assistant Secretary
for Mental Health and Substance Use, in consultation with the
Director of the Office of National Drug Control Policy, shall
award enhancement grants to eligible entities to design,
implement, evaluate, and disseminate comprehensive strategies
to maximize the effectiveness of community-wide approaches to
preventing and reducing underage drinking. This subsection is
subject to the availability of appropriations.
``(2) Purposes.--The purposes of this subsection are to--
``(A) prevent and reduce alcohol use among youth in
communities throughout the United States;
``(B) strengthen collaboration among communities, the
Federal Government, Tribal Governments, and State and local
governments;
``(C) enhance intergovernmental cooperation and
coordination on the issue of alcohol use among youth;
``(D) serve as a catalyst for increased citizen
participation and greater collaboration among all sectors and
organizations of a community that first demonstrates a long-
term commitment to reducing alcohol use among youth;
``(E) implement state-of-the-art science-based strategies
to prevent and reduce underage drinking by changing local
conditions in communities; and
``(F) enhance, not supplant, effective local community
initiatives for preventing and reducing alcohol use among
youth.
``(3) Application.--An eligible entity desiring an
enhancement grant under this subsection shall submit an
application to the Assistant Secretary at such time, and in
such manner, and accompanied by such information and
assurances, as the Assistant Secretary may require. Each
application shall include--
``(A) a complete description of the entity's current
underage alcohol use prevention initiatives and how the grant
will appropriately enhance the focus on underage drinking
issues; or
``(B) a complete description of the entity's current
initiatives, and how it will use this grant to enhance those
initiatives by adding a focus on underage drinking
prevention.
``(4) Uses of funds.--Each eligible entity that receives a
grant under this subsection shall use the grant funds to
carry out the activities described in such entity's
application submitted pursuant to paragraph (3) and obtain
specialized training and technical assistance by the entity
funded under section 4 of Public Law 107-82, as amended (21
U.S.C. 1521 note). Grants under this subsection shall not
exceed $60,000 per year and may not exceed four years.
``(5) Supplement not supplant.--Grant funds provided under
this subsection shall be used to supplement, not supplant,
Federal and non-Federal funds available for carrying out the
activities described in this subsection.
``(6) Evaluation.--Grants under this subsection shall be
subject to the same evaluation requirements and procedures as
the evaluation requirements and procedures imposed on
recipients of drug-free community grants.
``(7) Definitions.--For purposes of this subsection, the
term `eligible entity' means an organization that is
currently receiving or has received grant funds under the
Drug-Free Communities Act of 1997.
``(8) Administrative expenses.--Not more than 6 percent of
a grant under this subsection may be expended for
administrative expenses.
``(9) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection $11,500,000
for each of fiscal years 2023 through 2027.
``(f) Grants to Professional Pediatric Provider
Organizations To Reduce Underage Drinking Through Screening
and Brief Interventions.--
``(1) In general.--The Secretary, acting through the
Assistant Secretary for Mental Health and Substance Use,
shall make one or more grants to professional pediatric
provider organizations to increase among the members of such
organizations effective practices to reduce the prevalence of
alcohol use among individuals under the age of 21, including
college students.
[[Page H5761]]
``(2) Purposes.--Grants under this subsection shall be made
to promote the practices of--
``(A) screening adolescents for alcohol use;
``(B) offering brief interventions to adolescents to
discourage such use;
``(C) educating parents about the dangers of and methods of
discouraging such use;
``(D) diagnosing and treating alcohol use disorders; and
``(E) referring patients, when necessary, to other
appropriate care.
``(3) Use of funds.--A professional pediatric provider
organization receiving a grant under this section may use the
grant funding to promote the practices specified in paragraph
(2) among its members by--
``(A) providing training to health care providers;
``(B) disseminating best practices, including culturally
and linguistically appropriate best practices, and
developing, printing, and distributing materials; and
``(C) supporting other activities approved by the Assistant
Secretary.
``(4) Application.--To be eligible to receive a grant under
this subsection, a professional pediatric provider
organization shall submit an application to the Assistant
Secretary at such time, and in such manner, and accompanied
by such information and assurances as the Secretary may
require. Each application shall include--
``(A) a description of the pediatric provider organization;
``(B) a description of the activities to be completed that
will promote the practices specified in paragraph (2);
``(C) a description of the organization's qualifications
for performing such practices; and
``(D) a timeline for the completion of such activities.
``(5) Definitions.--For the purpose of this subsection:
``(A) Brief intervention.--The term `brief intervention'
means, after screening a patient, providing the patient with
brief advice and other brief motivational enhancement
techniques designed to increase the insight of the patient
regarding the patient's alcohol use, and any realized or
potential consequences of such use to effect the desired
related behavioral change.
``(B) Adolescents.--The term `adolescents' means
individuals under 21 years of age.
``(C) Professional pediatric provider organization.--The
term `professional pediatric provider organization' means an
organization or association that--
``(i) consists of or represents pediatric health care
providers; and
``(ii) is qualified to promote the practices specified in
paragraph (2).
``(D) Screening.--The term `screening' means using
validated patient interview techniques to identify and assess
the existence and extent of alcohol use in a patient.
``(6) Authorization of appropriations.--There is authorized
to be appropriated to carry out this subsection $3,000,000
for each of fiscal years 2023 through 2027.
``(g) Data Collection and Research.--
``(1) Additional research on underage drinking.--
``(A) In general.--The Secretary shall, subject to the
availability of appropriations, collect data, and conduct or
support research that is not duplicative of research
currently being conducted or supported by the Department of
Health and Human Services, on underage drinking, with respect
to the following:
``(i) Improve data collection in support of evaluation of
the effectiveness of comprehensive community-based programs
or strategies and statewide systems to prevent and reduce
underage drinking, across the underage years from early
childhood to age 21, such as programs funded and implemented
by governmental entities, public health interest groups and
foundations, and alcohol beverage companies and trade
associations, through the development of models of State-
level epidemiological surveillance of underage drinking by
funding in States or large metropolitan areas new
epidemiologists focused on excessive drinking including
underage alcohol use.
``(ii) Obtain and report more precise information than is
currently collected on the scope of the underage drinking
problem and patterns of underage alcohol consumption,
including improved knowledge about the problem and progress
in preventing, reducing, and treating underage drinking, as
well as information on the rate of exposure of youth to
advertising and other media messages encouraging and
discouraging alcohol consumption.
``(iii) Synthesize, expand on, and widely disseminate
existing research on effective strategies for reducing
underage drinking, including translational research, and make
this research easily accessible to the general public.
``(iv) Improve and conduct public health surveillance on
alcohol use and alcohol-related conditions in States by
increasing the use of surveys, such as the Behavioral Risk
Factor Surveillance System, to monitor binge and excessive
drinking and related harms among individuals who are at least
18 years of age, but not more than 20 years of age, including
harm caused to self or others as a result of alcohol use that
is not duplicative of research currently being conducted or
supported by the Department of Health and Human Services.
``(B) Authorization of appropriations.--There is authorized
to be appropriated to carry out this paragraph $5,000,000 for
each of fiscal years 2023 through 2027.
``(2) National academy of sciences study.--
``(A) In general.--Not later than 12 months after the
enactment of the Restoring Hope for Mental Health and Well-
Being Act of 2022, the Secretary shall--
``(i) contract with the National Academy of Sciences to
study developments in research on underage drinking and the
public policy implications of these developments; and
``(ii) report to the Congress on the results of such
review.
``(B) Authorization of appropriations.--There is authorized
to be appropriated to carry out this paragraph $500,000 for
fiscal year 2023.''.
SEC. 216. GRANTS FOR JAIL DIVERSION PROGRAMS.
Section 520G of the Public Health Service Act (42 U.S.C.
290bb-38) is amended--
(1) in subsection (a)--
(A) by striking ``up to 125''; and
(B) by striking ``tribes and tribal organizations'' and
inserting ``Tribes and Tribal organizations'';
(2) in subsection (b)(2), by striking ``tribes, and tribal
organizations'' and inserting ``Tribes, and Tribal
organizations'';
(3) in subsection (c)--
(A) in paragraph (1), by striking ``tribe or tribal
organization'' and inserting ``Tribe or Tribal organization,
health facility or program described in subsection (a), or
public or nonprofit entity referred to in subsection (a)'';
and
(B) in paragraph (2)(A)(iii), by striking ``tribe, or
tribal organization'' and inserting ``Tribe, or Tribal
organization'';
(4) in subsection (e)--
(A) in the matter preceding paragraph (1), by striking
``tribe, or tribal organization'' and inserting ``Tribe, or
Tribal organization''; and
(B) in paragraph (5), by striking ``or arrest'' and
inserting ``, arrest, or release'';
(5) in subsection (f), by striking ``tribe, or tribal
organization'' each place it appears and inserting ``Tribe,
or Tribal organization'';
(6) in subsection (h), by striking ``tribe, or tribal
organization'' and inserting ``Tribe, or Tribal
organization''; and
(7) in subsection (j), by striking ``$4,269,000 for each of
fiscal years 2018 through 2022'' and inserting ``$14,000,000
for each of fiscal years 2023 through 2027''.
SEC. 217. FORMULA GRANTS TO STATES.
Section 521 of the Public Health Service Act (42 U.S.C.
290cc-21) is amended by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.
SEC. 218. PROJECTS FOR ASSISTANCE IN TRANSITION FROM
HOMELESSNESS.
Section 535(a) of the Public Health Service Act (42 U.S.C.
290cc-35(a)) is amended by striking ``2018 through 2022'' and
inserting ``2023 through 2027''.
SEC. 219. GRANTS FOR REDUCING OVERDOSE DEATHS.
(a) Grants.--
(1) Repeal of maximum grant amount.--Paragraph (2) of
section 544(a) of the Public Health Service Act (42 U.S.C.
290dd-3(a)) is hereby repealed.
(2) Eligible entity; subgrants.--Section 544(a) of the
Public Health Service Act (42 U.S.C. 290dd-3(a)) is amended
by striking paragraph (3) and inserting the following:
``(2) Eligible entity.--For purposes of this section, the
term `eligible entity' means a State, Territory, locality,
Indian Tribe (as defined in the Federally Recognized Indian
Tribe List Act of 1994), Tribal organization, or Urban Indian
organization (as those terms are defined in section 4 of the
Indian Health Care Improvement Act).
``(3) Subgrants.--For the purposes for which a grant is
awarded under this section, the eligible entity receiving the
grant may award subgrants to a Federally qualified health
center (as defined in section 1861(aa) of the Social Security
Act), an opioid treatment program (as defined in section 8.2
of title 42, Code of Federal Regulations (or any successor
regulations)), any practitioner dispensing narcotic drugs
pursuant to section 303(g) of the Controlled Substances Act,
or any nonprofit organization that the Secretary deems
appropriate.''.
(3) Prescribing.--Section 544(a)(4) of the Public Health
Service Act (42 U.S.C. 290dd-3(a)(4)) is amended--
(A) in subparagraph (A), by inserting ``, including
patients prescribed with both an opioid and a
benzodiazepine'' before the semicolon at the end; and
(B) in subparagraph (D), by striking ``drug overdose'' and
inserting ``substance overdose''.
(4) Use of funds.--Paragraph (5) of section 544(c) of the
Public Health Service Act (42 U.S.C. 290dd-3(c)) is amended
to read as follows:
``(5) To establish protocols to connect patients who have
experienced an overdose with appropriate treatment, including
overdose reversal medications, medication assisted treatment,
and appropriate counseling and behavioral therapies.''.
(5) Improving access to overdose treatment.--Section 544 of
the Public Health Service Act (42 U.S.C. 290dd-3) is
amended--
(A) by redesignating subsections (d) through (f) as
subsections (e) through (g), respectively;
(B) in subsection (f), as so redesignated, by striking
``subsection (d)'' and inserting ``subsection (e)''; and
(C) by inserting after subsection (c) the following:
``(d) Improving Access to Overdose Treatment.--
``(1) Information on best practices.--
``(A) Health and human services.--The Secretary of Health
and Human Services may provide information to States,
localities, Indian Tribes, Tribal organizations, and Urban
Indian organizations on best practices for prescribing or co-
prescribing a drug or device approved, cleared, or otherwise
authorized under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose,
including for patients receiving chronic opioid therapy and
patients being treated for opioid use disorders.
[[Page H5762]]
``(B) Defense.--The Secretary of Defense may provide
information to prescribers within Department of Defense
medical facilities on best practices for prescribing or co-
prescribing a drug or device approved, cleared, or otherwise
authorized under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose,
including for patients receiving chronic opioid therapy and
patients being treated for opioid use disorders.
``(C) Veterans affairs.--The Secretary of Veterans Affairs
may provide information to prescribers within Department of
Veterans Affairs medical facilities on best practices for
prescribing or co-prescribing a drug or device approved,
cleared, or otherwise authorized under the Federal Food,
Drug, and Cosmetic Act for emergency treatment of known or
suspected opioid overdose, including for patients receiving
chronic opioid therapy and patients being treated for opioid
use disorders.
``(2) Rule of construction.--Nothing in this subsection
shall be construed as establishing or contributing to a
medical standard of care.''.
(6) Authorization of appropriations.--Section 544(g) of the
Public Health Service Act (42 U.S.C. 290dd-3), as
redesignated, is amended by striking ``fiscal years 2017
through 2021'' and inserting ``fiscal years 2023 through
2027''.
(7) Technical amendments.--
(A) Section 544 of the Public Health Service Act (42 U.S.C.
290dd-3), as amended, is further amended by striking
``approved or cleared'' each place it appears and inserting
``approved, cleared, or otherwise authorized''.
(B) Section 107 of the Comprehensive Addiction and Recovery
Act of 2016 (Public Law 114-198) is amended by striking
subsection (b).
SEC. 220. OPIOID OVERDOSE REVERSAL MEDICATION ACCESS AND
EDUCATION GRANT PROGRAMS.
(a) Grants.--Section 545 of the Public Health Service Act
(42 U.S.C. 290ee) is amended--
(1) in the section heading, by striking ``access and
education grant programs'' and inserting ``access, education,
and co-prescribing grant programs'';
(2) in the heading of subsection (a), by striking ``Grants
to States'' and inserting ``Grants'';
(3) in subsection (a), by striking ``shall make grants to
States'' and inserting ``shall make grants to States,
localities, Indian Tribes (as defined by the Federally
Recognized Indian Tribe List Act of 1994), Tribal
organizations, and Urban Indian organizations (as those terms
are defined in section 4 of the Indian Health Care
Improvement Act)'';
(4) in subsection (a)(1), by striking ``implement
strategies for pharmacists to dispense a drug or device'' and
inserting ``implement strategies that increase access to
drugs or devices'';
(5) by redesignating paragraphs (3) and (4) as paragraphs
(4) and (5), respectively; and
(6) by inserting after paragraph (2) the following:
``(3) encourage health care providers to co-prescribe, as
appropriate, drugs or devices approved, cleared, or otherwise
authorized under the Federal Food, Drug, and Cosmetic Act for
emergency treatment of known or suspected opioid overdose;''.
(b) Grant Period.--Section 545(d)(2) of the Public Health
Service Act (42 U.S.C. 290ee(d)(2)) is amended by striking
``3 years'' and inserting ``5 years''.
(c) Limitation.--Paragraph (3) of section 545(d) of the
Public Health Service Act (42 U.S.C. 290ee(d)) is amended to
read as follows:
``(3) Limitations.--A State may--
``(A) use not more than 10 percent of a grant under this
section for educating the public pursuant to subsection
(a)(5); and
``(B) use not less than 20 percent of a grant under this
section to offset cost-sharing for distribution and
dispensing of drugs or devices approved, cleared, or
otherwise authorized under the Federal Food, Drug, and
Cosmetic Act for emergency treatment of known or suspected
opioid overdose.''.
(d) Authorization of Appropriations.--Section 545(h)(1) of
the Public Health Service Act, is amended by striking
``fiscal years 2017 through 2019'' and inserting ``fiscal
years 2023 through 2027''.
(e) Technical Amendment.--Section 545 of the Public Health
Service Act (42 U.S.C. 290ee), as amended, is further amended
by striking ``approved or cleared'' each place it appears and
inserting ``approved, cleared, or otherwise authorized''.
SEC. 221. STATE DEMONSTRATION GRANTS FOR COMPREHENSIVE OPIOID
ABUSE RESPONSE.
Section 548 of the Public Health Service Act (42 U.S.C.
290ee-3) is amended--
(1) in the section heading, by striking ``abuse'' and
inserting ``use disorder'';
(2) in subsection (b)--
(A) in the subsection heading, by striking ``Abuse'' and
inserting ``Use Disorder'';
(B) in paragraph (1), by striking ``abuse'' and inserting
``use disorder'';
(C) in paragraph (2)--
(i) in the matter preceding subparagraph (A), by striking
``abuse'' and inserting ``use disorder'';
(ii) in subparagraph (A), by striking ``opioid use,
treatment, and addiction recovery'' and inserting ``opioid
use disorders, and treatment for, and recovery from opioid
use disorders'';
(iii) in subparagraph (C), by striking ``addiction'' each
place it appears and inserting ``use disorder'';
(iv) by amending subparagraph (D) to read as follows:
``(D) developing, implementing, and expanding efforts to
prevent overdose death from opioid or other prescription
medication use disorders; and''; and
(v) in subparagraph (E), by striking ``abuse'' and
inserting ``use disorders''; and
(D) in paragraph (4), by striking ``abuse'' each place it
appears and inserting ``use disorders''; and
(3) by striking ``2017 through 2021'' and inserting ``2023
through 2027''.
SEC. 222. EMERGENCY DEPARTMENT ALTERNATIVES TO OPIOIDS.
Section 7091 of the SUPPORT for Patients and Communities
Act (Public Law 115-271) is amended--
(1) in the section heading, by striking ``demonstration''
(and by conforming the item relating to such section in the
table of contents in section 1(b));
(2) in subsection (a)--
(A) by amending the subsection heading to read as follows:
``Grant Program''; and
(B) in paragraph (1), by striking ``demonstration'';
(3) in subsection (b), in the subsection heading, by
striking ``Demonstration'';
(4) in subsection (d)(4), by striking ``tribal'' and
inserting ``Tribal'';
(5) in subsection (f), by striking ``Not later than 1 year
after completion of the demonstration program under this
section, the Secretary shall submit a report to the Congress
on the results of the demonstration program'' and inserting
``Not later than the end of each of fiscal years 2024 and
2027, the Secretary shall submit to the Congress a report on
the results of the program''; and
(6) in subsection (g), by striking ``2019 through 2021''
and inserting ``2023 through 2027''.
Subtitle C--Excellence in Recovery Housing
SEC. 231. CLARIFYING THE ROLE OF SAMHSA IN PROMOTING THE
AVAILABILITY OF HIGH-QUALITY RECOVERY HOUSING.
Section 501(d) of the Public Health Service Act (42 U.S.C.
290aa) is amended--
(1) in paragraph (24)(E), by striking ``and'' at the end;
(2) in paragraph (25), by striking the period at the end
and inserting ``; and''; and
(3) by adding at the end the following:
``(26) collaborate with national accrediting entities,
reputable providers, organizations or individuals with
established expertise in delivery of recovery housing
services, States, Federal agencies (including the Department
of Health and Human Services, the Department of Housing and
Urban Development, and the agencies listed in section
550(e)(2)(B)), and other relevant stakeholders, to promote
the availability of high-quality recovery housing and
services for individuals with a substance use disorder.''.
SEC. 232. DEVELOPING GUIDELINES FOR STATES TO PROMOTE THE
AVAILABILITY OF HIGH-QUALITY RECOVERY HOUSING.
Section 550(a) of the Public Health Service Act (42 U.S.C.
290ee-5(a)) (relating to national recovery housing best
practices) is amended--
(1) by amending paragraph (1) to read as follows:
``(1) In general.--The Secretary, in consultation with the
individuals and entities specified in paragraph (2), shall
build on existing best practices and previously developed
guidelines to develop and periodically update consensus-based
best practices, which may include model laws for implementing
suggested minimum standards for operating, and promoting the
availability of, high-quality recovery housing.'';
(2) in paragraph (2)--
(A) by striking subparagraphs (A) and (B) and inserting the
following:
``(A) Officials representing the agencies described in
subsection (e)(2).''; and
(B) by redesignating subparagraphs (C) through (G) as
subparagraphs (B) through (F), respectively; and
(3) by adding at the end the following:
``(3) Availability.--The best practices referred to in
paragraph (1) shall be--
``(A) made publicly available; and
``(B) published on the public website of the Substance
Abuse and Mental Health Services Administration.
``(4) Exclusion of guideline on treatment services.--In
developing the guidelines under paragraph (1), the Secretary
may not include any guidelines with respect to substance use
disorder treatment services.''.
SEC. 233. COORDINATION OF FEDERAL ACTIVITIES TO PROMOTE THE
AVAILABILITY OF RECOVERY HOUSING.
Section 550 of the Public Health Service Act (42 U.S.C.
290ee-5) (relating to national recovery housing best
practices) is amended--
(1) by redesignating subsections (e), (f), and (g) as
subsections (g), (h), and (i), respectively; and
(2) by inserting after subsection (d) the following:
``(e) Coordination of Federal Activities To Promote the
Availability of Housing for Individuals Experiencing
Homelessness, Individuals With a Mental Illness, and
Individuals With a Substance Use Disorder.--
``(1) In general.--The Secretary, acting through the
Assistant Secretary, and the Secretary of Housing and Urban
Development shall convene an interagency working group for
the following purposes:
``(A) To increase collaboration, cooperation, and
consultation among the Department of Health and Human
Services, the Department of Housing and Urban Development,
and the Federal agencies listed in paragraph (2)(B), with
respect to promoting the availability of housing, including
recovery housing, for individuals experiencing homelessness,
individuals with mental illnesses, and individuals with
substance use disorder.
``(B) To align the efforts of such agencies and avoid
duplication of such efforts by such agencies.
``(C) To develop objectives, priorities, and a long-term
plan for supporting State, Tribal, and local efforts with
respect to the operation of recovery housing that is
consistent with the best practices developed under this
section.
[[Page H5763]]
``(D) To coordinate enforcement of fair housing practices,
as appropriate, among Federal and State agencies.
``(E) To coordinate data collection on the quality of
recovery housing.
``(2) Composition.--The interagency working group under
paragraph (1) shall be composed of--
``(A) the Secretary, acting through the Assistant
Secretary, and the Secretary of Housing and Urban
Development, who shall serve as the co-chairs; and
``(B) representatives of each of the following Federal
agencies:
``(i) The Centers for Medicare & Medicaid Services.
``(ii) The Substance Abuse and Mental Health Services
Administration.
``(iii) The Health Resources and Services Administration.
``(iv) The Office of Inspector General.
``(v) The Indian Health Service.
``(vi) The Department of Agriculture.
``(vii) The Department of Justice.
``(viii) The Office of National Drug Control Policy.
``(ix) The Bureau of Indian Affairs.
``(x) The Department of Labor.
``(xi) The Department of Veterans Affairs.
``(xii) Any other Federal agency as the co-chairs determine
appropriate.
``(3) Meetings.--The working group shall meet on a
quarterly basis.
``(4) Reports to congress.--Not later than 4 years after
the date of the enactment of this section, the working group
shall submit to the Committee on Energy and Commerce, the
Committee on Ways and Means, the Committee on Agriculture,
and the Committee on Financial Services of the House of
Representatives and the Committee on Health, Education,
Labor, and Pensions, the Committee on Agriculture, Nutrition,
and Forestry, and the Committee on Finance of the Senate a
report describing the work of the working group and any
recommendations of the working group to improve Federal,
State, and local coordination with respect to recovery
housing and other housing resources and operations for
individuals experiencing homelessness, individuals with a
mental illness, and individuals with a substance use
disorder.''.
SEC. 234. NAS STUDY AND REPORT.
(a) In General.--Not later than 60 days after the date of
enactment of this Act, the Secretary of Health and Human
Services, acting through the Assistant Secretary for Mental
Health and Substance Use shall--
(1) contract with the National Academies of Sciences,
Engineering, and Medicine--
(A) to study the quality and effectiveness of recovery
housing in the United States and whether the availability of
such housing meets demand; and
(B) to identify recommendations to promote the availability
of high-quality recovery housing; and
(2) report to the Congress on the results of such review.
(b) Authorization of Appropriations.--To carry out this
section there is authorized to be appropriated $1,500,000 for
fiscal year 2023.
SEC. 235. GRANTS FOR STATES TO PROMOTE THE AVAILABILITY OF
RECOVERY HOUSING AND SERVICES.
Section 550 of the Public Health Service Act (42 U.S.C.
290ee-5) (relating to national recovery housing best
practices), as amended by sections 232 and 233, is further
amended by inserting after subsection (e) (as inserted by
section 233) the following:
``(f) Grants for Implementing National Recovery Housing
Best Practices.--
``(1) In general.--The Secretary shall award grants to
States (and political subdivisions thereof), Tribes, and
territories--
``(A) for the provision of technical assistance to
implement the guidelines and recommendations developed under
subsection (a); and
``(B) to promote--
``(i) the availability of recovery housing for individuals
with a substance use disorder; and
``(ii) the maintenance of recovery housing in accordance
with best practices developed under this section.
``(2) State promotion plans.--Not later than 90 days after
receipt of a grant under paragraph (1), and every 2 years
thereafter, each State (or political subdivisions thereof,)
Tribe, or territory receiving a grant under paragraph (1)
shall submit to the Secretary, and publish on a publicly
accessible internet website of the State (or political
subdivisions thereof), Tribe, or territory--
``(A) the plan of the State (or political subdivisions
thereof), Tribe, or territory, with respect to the promotion
of recovery housing for individuals with a substance use
disorder located within the jurisdiction of such State (or
political subdivisions thereof), Tribe, or territory; and
``(B) a description of how such plan is consistent with the
best practices developed under this section.''.
SEC. 236. FUNDING.
Subsection (i) of section 550 of the Public Health Service
Act (42 U.S.C. 290ee-5) (relating to national recovery
housing best practices), as redesignated by section 233, is
amended by striking ``$3,000,000 for the period of fiscal
years 2019 through 2021'' and inserting ``$5,000,000 for the
period of fiscal years 2023 through 2027''.
SEC. 237. TECHNICAL CORRECTION.
Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended--
(1) by redesignating section 550 (relating to Sobriety
Treatment and Recovery Teams) (42 U.S.C. 290ee-10), as added
by section 8214 of Public Law 115-271, as section 550A; and
(2) by moving such section so it appears after section 550
(relating to national recovery housing best practices).
Subtitle D--Substance Use Prevention, Treatment, and Recovery Services
Block Grant
SEC. 241. ELIMINATING STIGMATIZING LANGUAGE RELATING TO
SUBSTANCE USE.
(a) Block Grants for Prevention and Treatment of Substance
Use.--Part B of title XIX of the Public Health Service Act
(42 U.S.C. 300x et seq.) is amended--
(1) in the part heading, by striking ``substance abuse''
and inserting ``substance use'';
(2) in subpart II, by amending the subpart heading to read
as follows: ``Block Grants for Substance Use Prevention,
Treatment, and Recovery Services'';
(3) in section 1922(a) (42 U.S.C. 300x-22(a))--
(A) in paragraph (1), in the matter preceding subparagraph
(A), by striking ``substance abuse'' and inserting
``substance use disorders''; and
(B) by striking ``such abuse'' each place it appears in
paragraphs (1) and (2) and inserting ``such disorders'';
(4) in section 1923 (42 U.S.C. 300x-23)--
(A) in the section heading, by striking ``substance abuse''
and inserting ``substance use''; and
(B) in subsection (a), by striking ``drug abuse'' and
inserting ``substance use disorders'';
(5) in section 1925(a)(1) (42 U.S.C. 300x-25(a)(1)), by
striking ``alcohol or drug abuse'' and inserting ``alcohol or
other substance use disorders'';
(6) in section 1926(b)(2)(B) (42 U.S.C. 300x-26(b)(2)(B)),
by striking ``substance abuse'';
(7) in section 1931(b)(2) (42 U.S.C. 300x-31(b)(2)), by
striking ``substance abuse'' and inserting ``substance use
disorders'';
(8) in section 1933(d)(1) (42 U.S.C. 300x-33(d)), in the
matter following subparagraph (B), by striking ``abuse of
alcohol and other drugs'' and inserting ``use of
substances'';
(9) by amending paragraph (4) of section 1934 (42 U.S.C.
300x-34) to read as follows:
``(4) The term `substance use disorder' means the recurrent
use of alcohol or other drugs that causes clinically
significant impairment.'';
(10) in section 1935 (42 U.S.C. 300x-35)--
(A) in subsection (a), by striking ``substance abuse'' and
inserting ``substance use disorders''; and
(B) in subsection (b)(1), by striking ``substance abuse''
each place it appears and inserting ``substance use
disorders'';
(11) in section 1949 (42 U.S.C. 300x-59), by striking
``substance abuse'' each place it appears in subsections (a)
and (d) and inserting ``substance use disorders'';
(12) in section 1954(b)(4) (42 U.S.C. 300x-64(b)(4))--
(A) by striking ``substance abuse'' and inserting
``substance use disorders''; and
(B) by striking ``such abuse'' and inserting ``such
disorders'';
(13) in section 1955 (42 U.S.C. 300x-65), by striking
``substance abuse'' each place it appears and inserting
``substance use disorder''; and
(14) in section 1956 (42 U.S.C. 300x-66), by striking
``substance abuse'' and inserting ``substance use
disorders''.
(b) Certain Programs Regarding Mental Health and Substance
Abuse.--Part C of title XIX of the Public Health Service Act
(42 U.S.C. 300y et seq.) is amended--
(1) in the part heading, by striking ``substance abuse''
and inserting ``substance use'';
(2) in section 1971 (42 U.S.C. 300y), by striking
``substance abuse'' each place it appears in subsections (a),
(b), and (f) and inserting ``substance use''; and
(3) in section 1976 (42 U.S.C. 300y-11), by striking
``intravenous abuse'' each place it appears and inserting
``intravenous use''.
SEC. 242. AUTHORIZED ACTIVITIES.
Section 1921(b) of the Public Health Service Act (42 U.S.C.
300x-21(b)) is amended by striking ``prevent and treat
substance use disorders'' and inserting ``prevent, treat, and
provide recovery support services for substance use
disorders''.
SEC. 243. REQUIREMENTS RELATING TO CERTAIN INFECTIOUS
DISEASES AND HUMAN IMMUNODEFICIENCY VIRUS.
Section 1924 of the Public Health Service Act (42 U.S.C.
300x-24) is amended--
(1) in the section heading, by striking ``tuberculosis and
human immunodeficiency virus'' and inserting ``tuberculosis,
viral hepatitis, and human immunodeficiency virus'';
(2) by amending subsection (a)(2) to read as follows:
``(2) Designated states.--
``(A) Fiscal years through fiscal year 2024.--For purposes
of this subsection, through September 30, 2024, a State
described in this paragraph is any State whose rate of cases
of acquired immune deficiency syndrome is 10 or more such
cases per 100,000 individuals (as indicated by the number of
such cases reported to and confirmed by the Director of the
Centers for Disease Control and Prevention for the most
recent calendar year for which such data are available).
``(B) Fiscal year 2025 and succeeding fiscal years.--
``(i) In general.--Beginning with fiscal year 2025, for
purposes of this subsection, a State described in this
paragraph is any State whose rate of cases of human
immunodeficiency virus is 10 or more such cases per 100,000
individuals (as indicated by the number of such cases newly
reported to and confirmed by the Director of the Centers for
Disease Control and Prevention for the most recent calendar
year for which such data are available).
``(ii) Continuation of designated state status.--In the
case of a State whose rate of cases of human immunodeficiency
virus falls below the threshold specified in clause (i) for a
calendar year, such State shall, notwithstanding clause (i),
continue to be described in this paragraph unless the rate of
cases falls below such threshold for three consecutive
calendar years.''.
[[Page H5764]]
(3) by redesignating subsections (c) and (d) as subsections
(d) and (e), respectively; and
(4) by inserting after subsection (b) the following:
``(c) Viral Hepatitis.--
``(1) In general.--A funding agreement for a grant under
section 1921 is that the State involved will require that any
entity receiving amounts from the grant for operating a
program of treatment for substance use disorders--
``(A) will, directly or through arrangements with other
public or nonprofit private entities, routinely make
available viral hepatitis services to each individual
receiving treatment for such disorders; and
``(B) in the case of an individual in need of such
treatment who is denied admission to the program on the basis
of the lack of the capacity of the program to admit the
individual, will refer the individual to another provider of
viral hepatitis services.
``(2) Viral hepatitis services.--For purposes of paragraph
(1), the term `viral hepatitis services', with respect to an
individual, means--
``(A) screening the individual for viral hepatitis; and
``(B) referring the individual to a provider whose practice
includes viral hepatitis vaccination and treatment.''.
SEC. 244. STATE PLAN REQUIREMENTS.
Section 1932(b)(1)(A) of the Public Health Service Act (42
U.S.C. 300x-32(b)(1)(A)) is amended--
(1) by redesignating clauses (vi) through (ix) as clauses
(vii) through (x), respectively; and
(2) by inserting after clause (v) the following:
``(vi) provides a description of--
``(I) the State's comprehensive statewide recovery support
services activities, including the number of individuals
being served, target populations, and priority needs; and
``(II) the amount of funds received under this subpart
expended on recovery support services, disaggregated by the
amount expended for type of service activity;''.
SEC. 245. UPDATING CERTAIN LANGUAGE RELATING TO TRIBES.
Section 1933(d) of the Public Health Service Act (42 U.S.C.
300x-33(d)) is amended--
(1) in paragraph (1)--
(A) in subparagraph (A)--
(i) by striking ``of an Indian tribe or tribal
organization'' and inserting ``of an Indian Tribe or Tribal
organization''; and
(ii) by striking ``such tribe'' and inserting ``such
Tribe'';
(B) in subparagraph (B)--
(i) by striking ``tribe or tribal organization'' and
inserting ``Tribe or Tribal organization''; and
(ii) by striking ``Secretary under this'' and inserting
``Secretary under this subpart''; and
(C) in the matter following subparagraph (B), by striking
``tribe or tribal organization'' and inserting ``Tribe or
Tribal organization'';
(2) by amending paragraph (2) to read as follows:
``(2) Indian tribe or tribal organization as grantee.--The
amount reserved by the Secretary on the basis of a
determination under this subsection shall be granted to the
Indian Tribe or Tribal organization serving the individuals
for whom such a determination has been made.'';
(3) in paragraph (3), by striking ``tribe or tribal
organization'' and inserting ``Tribe or Tribal
organization''; and
(4) in paragraph (4)--
(A) in the paragraph heading, by striking ``Definition''
and inserting ``Definitions''; and
(B) by striking ``The terms'' and all that follows through
``given such terms'' and inserting the following: ``The terms
`Indian Tribe' and `Tribal organization' have the meanings
given the terms `Indian tribe' and `tribal organization' ''.
SEC. 246. BLOCK GRANTS FOR SUBSTANCE USE PREVENTION,
TREATMENT, AND RECOVERY SERVICES.
(a) In General.--Section 1935(a) of the Public Health
Service Act (42 U.S.C. 300x-35(a)), as amended by section
241, is further amended by striking ``appropriated'' and all
that follows through ``2022..'' and inserting the following:
``appropriated $1,908,079,000 for each of fiscal years 2023
through 2027.''.
(b) Technical Corrections.--Section 1935(b)(1)(B) of the
Public Health Service Act (42 U.S.C. 300x-35(b)(1)(B)) is
amended by striking ``the collection of data in this
paragraph is''.
SEC. 247. REQUIREMENT OF REPORTS AND AUDITS BY STATES.
Section 1942(a) of the Public Health Service Act (42 U.S.C.
300x-52(a)) is amended--
(1) in paragraph (1), by striking ``and'' at the end;
(2) in paragraph (2), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following:
``(3) the amount provided to each recipient in the previous
fiscal year.''.
SEC. 248. STUDY ON ASSESSMENT FOR USE IN DISTRIBUTION OF
LIMITED STATE RESOURCES.
(a) In General.--The Secretary of Health and Human
Services, acting through the Assistant Secretary for Mental
Health and Substance Use (in this section referred to as the
``Secretary''), shall, in consultation with States and other
local entities providing prevention, treatment, or recovery
support services related to substance use, conduct a study to
develop a model needs assessment process for States to
consider to help determine how best to allocate block grant
funding received under subpart II of part B of title XIX of
the Public Health Service Act (42 U.S.C. 300x-21) to provide
services to substance use disorder prevention, treatment, and
recovery support. The study shall include cost estimates with
each model needs assessment process.
(b) Report.--Not later than 2 years after the date of the
enactment of this Act, the Secretary shall submit to the
Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education,
Labor, and Pensions of the Senate a report on the results of
the study conducted under paragraph (1).
Subtitle E--Timely Treatment for Opioid Use Disorder
SEC. 251. STUDY ON EXEMPTIONS FOR TREATMENT OF OPIOID USE
DISORDER THROUGH OPIOID TREATMENT PROGRAMS
DURING THE COVID-19 PUBLIC HEALTH EMERGENCY.
(a) Study.--The Assistant Secretary for Mental Health and
Substance Use shall conduct a study, in consultation with
patients and other stakeholders, on activities carried out
pursuant to exemptions granted--
(1) to a State (including the District of Columbia or any
territory of the United States) or an opioid treatment
program;
(2) pursuant to section 8.11(h) of title 42, Code of
Federal Regulations; and
(3) during the period--
(A) beginning on the declaration of the public health
emergency for the COVID-19 pandemic under section 319 of the
Public Health Service Act (42 U.S.C. 247d); and
(B) ending on the earlier of--
(i) the termination of such public health emergency,
including extensions thereof pursuant to such section 319;
and
(ii) the end of calendar year 2022.
(b) Privacy.--The section does not authorize the disclosure
by the Department of Health and Human Services of
individually identifiable information about patients.
(c) Feedback.--In conducting the study under subsection
(a), the Assistant Secretary for Mental Health and Substance
Use shall gather feedback from the States and opioid
treatment programs on their experiences in implementing
exemptions described in subsection (a).
(d) Report.--Not later than 180 days after the end of the
period described in subsection (a)(3)(B), and subject to
subsection (c), the Assistant Secretary for Mental Health and
Substance Use shall publish a report on the results of the
study under this section.
SEC. 252. CHANGES TO FEDERAL OPIOID TREATMENT STANDARDS.
(a) Mobile Medication Units.--Section 302(e) of the
Controlled Substances Act (21 U.S.C. 822(e)) is amended by
adding at the end the following:
``(3) Notwithstanding paragraph (1), a registrant that is
dispensing pursuant to section 303(g) narcotic drugs to
individuals for maintenance treatment or detoxification
treatment shall not be required to have a separate
registration to incorporate one or more mobile medication
units into the registrant's practice to dispense such
narcotics at locations other than the registrant's principal
place of business or professional practice described in
paragraph (1), so long as the registrant meets such standards
for operation of a mobile medication unit as the Attorney
General may establish.''.
(b) Revise Opioid Treatment Program Admission Criteria to
Eliminate Requirement That Patients Have an Opioid Use
Disorder for at Least 1 Year.--Not later than 18 months after
the date of enactment of this Act, the Secretary of Health
and Human Services shall revise section 8.12(e)(1) of title
42, Code of Federal Regulations (or successor regulations),
to eliminate the requirement that an opioid treatment program
only admit an individual for treatment under the program if
the individual has been addicted to opioids for at least 1
year before being so admitted for treatment.
(c) Final Regulation on Periods for Take-Home Supply
Requirements.--
(1) In general.--Not later than 18 months after the date of
enactment of this Act, the Secretary of Health and Human
Services shall promulgate a final regulation amending
paragraphs (i)(3)(i) through (i)(3)(vi) of section 8.12 of
title 42, Code of Federal Regulations, as appropriate based
on the findings of the study under section 251 of this Act.
(2) Criteria.--The regulation under paragraph (1) shall
establish relevant criteria for the medical director or an
appropriately licensed practitioner of an opioid treatment
program, to determine whether a patient is stable and may
qualify for unsupervised use, which criteria may allow for
consideration of each of the following:
(A) Whether the benefits of providing unsupervised doses to
a patient outweigh the risks.
(B) The patient's demonstrated adherence to their treatment
plan.
(C) The patient's history of negative toxicology tests.
(D) Whether there is an absence of serious behavioral
problems.
(E) The patient's stability in living arrangements and
social relationships.
(F) Whether there is an absence of substance misuse-related
behaviors.
(G) Whether there is an absence of recent diversion
activity.
(H) Whether there is an assurance that the medication can
be safely stored by the patient.
(I) Any other criterion the Secretary of Health and Human
Services determines appropriate.
(3) Prohibited sole consideration.--The regulation under
paragraph (1) shall prohibit the medical director of an
opioid treatment program from considering, as the sole
consideration in determining whether a patient is
sufficiently responsible in handling opioid drugs for
unsupervised use, whether the patient has an absence of
recent misuse of drugs (whether narcotic or nonnarcotic),
including alcohol.
Subtitle F--Additional Provisions Relating to Addiction Treatment
SEC. 261. PROHIBITION.
Notwithstanding any provision of this Act and the
amendments made by this Act, no funds
[[Page H5765]]
made available to carry out this Act or any amendment made by
this Act shall be used to purchase, procure, or distribute
pipes or cylindrical objects intended to be used to smoke or
inhale illegal scheduled substances.
SEC. 262. ELIMINATING ADDITIONAL REQUIREMENTS FOR DISPENSING
NARCOTIC DRUGS IN SCHEDULE III, IV, AND V FOR
MAINTENANCE OR DETOXIFICATION TREATMENT.
(a) In General.--Section 303(g) of the Controlled
Substances Act (21 U.S.C. 823(g)) is amended--
(1) by striking paragraph (2);
(2) by striking ``(g)(1) Except as provided in paragraph
(2), practitioners who dispense narcotic drugs to individuals
for maintenance treatment or detoxification treatment'' and
inserting ``(g) Practitioners who dispense narcotic drugs
(other than narcotic drugs in schedule III, IV, or V) to
individuals for maintenance treatment or detoxification
treatment'';
(3) by redesignating subparagraphs (A), (B), and (C) as
paragraphs (1), (2), and (3), respectively; and
(4) in paragraph (2), as so redesignated--
(A) by striking ``(i) security of stocks'' and inserting
``(A) security of stocks''; and
(B) by striking ``(ii) the maintenance of records'' and
inserting ``(B) the maintenance of records''.
(b) Conforming Changes.--
(1) Subsections (a) and (d)(1) of section 304 of the
Controlled Substances Act (21 U.S.C. 824) are each amended by
striking ``303(g)(1)'' each place it appears and inserting
``303(g)''.
(2) Section 309A(a)(2) of the Controlled Substances Act (21
U.S.C. 829a) is amended--
(A) in the matter preceding subparagraph (A), by striking
``the controlled substance is to be administered for the
purpose of maintenance or detoxification treatment under
section 303(g)(2)'' and inserting ``the controlled substance
is a narcotic drug in schedule III, IV, or V to be
administered for the purpose of maintenance or detoxification
treatment''; and
(B) by striking ``and--'' and all that follows through ``is
to be administered by injection or implantation;'' and
inserting ``and is to be administered by injection or
implantation;''.
(3) Section 520E-4(c) of the Public Health Service Act (42
U.S.C. 290bb-36d(c)) is amended by striking ``information on
any qualified practitioner that is certified to prescribe
medication for opioid dependency under section 303(g)(2)(B)
of the Controlled Substances Act'' and inserting
``information on any practitioner who prescribes narcotic
drugs in schedule III, IV, or V of section 202 of the
Controlled Substances Act for the purpose of maintenance or
detoxification treatment''.
(4) Section 544(a)(3) of the Public Health Service Act (42
U.S.C. 290dd-3), as added by section 219(a)(2), is amended by
striking ``any practitioner dispensing narcotic drugs
pursuant to section 303(g) of the Controlled Substances Act''
and inserting ``any practitioner dispensing narcotic drugs
for the purpose of maintenance or detoxification treatment''.
(5) Section 1833(bb)(3)(B) of the Social Security Act (42
U.S.C. 1395l(bb)(3)(B)) is amended by striking ``first
receives a waiver under section 303(g) of the Controlled
Substances Act on or after January 1, 2019'' and inserting
``first begins prescribing narcotic drugs in schedule III,
IV, or V of section 202 of the Controlled Substances Act for
the purpose of maintenance or detoxification treatment on or
after January 1, 2021''.
(6) Section 1834(o)(3)(C)(ii) of the Social Security Act
(42 U.S.C. 1395m(o)(3)(C)(ii)) is amended by striking ``first
receives a waiver under section 303(g) of the Controlled
Substances Act on or after January 1, 2019'' and inserting
``first begins prescribing narcotic drugs in schedule III,
IV, or V of section 202 of the Controlled Substances Act for
the purpose of maintenance or detoxification treatment on or
after January 1, 2021''.
(7) Section 1866F(c)(3) of the Social Security Act (42
U.S.C. 1395cc-6(c)(3)) is amended--
(A) in subparagraph (A), by adding ``and'' at the end;
(B) in subparagraph (B), by striking ``; and'' and
inserting a period; and
(C) by striking subparagraph (C).
(8) Section 1903(aa)(2)(C) of the Social Security Act (42
U.S.C. 1396b(aa)(2)(C)) is amended--
(A) in clause (i), by adding ``and'' at the end;
(B) by striking clause (ii); and
(C) by redesignating clause (iii) as clause (ii).
SEC. 263. REQUIRING PRESCRIBERS OF CONTROLLED SUBSTANCES TO
COMPLETE TRAINING.
Section 303 of the Controlled Substances Act (21 U.S.C.
823) is amended by adding at the end the following:
``(l) Required Training for Prescribers.--
``(1) Training required.--As a condition on registration
under this section to dispense controlled substances in
schedule II, III, IV, or V, the Attorney General shall
require any qualified practitioner, beginning with the first
applicable registration for the practitioner, to meet the
following:
``(A) If the practitioner is a physician is a physician (as
defined under section 1861(r) of the Social Security Act),
the practitioner meets one ore more of the following
conditions:
``(i) The physician holds a board certification in
addiction psychiatry or addiction medicine from the American
Board of Medical Specialties.
``(ii) The physician holds a board certification from the
American Board of Addiction Medicine.
``(iii) The physician holds a board certification in
addiction medicine from the American Osteopathic Association.
``(iv) The physician has, with respect to the treatment and
management of patients with opioid or other substance use
disorders, of the safe pharmacological management of dental
pain and screening, brief intervention, and referral for
appropriate treatment of patients with or at risk of
developing opioid or other substance use disorders, completed
not less than 8 hours of training (through classroom
situations, seminars at professional society meetings,
electronic communications, or otherwise that is provided by--
``(I) the American Society of Addiction Medicine, the
American Academy of Addiction Psychiatry, the American
Medical Association, the American Osteopathic Association,
the American Dental Association, the American Association of
Oral and Maxillofacial Surgeons, the American Psychiatric
Assocation, or any other organization accredited by the
Accreditation Council for Continuing Medical Education
(commonly known as the `ACCME') or the Commission on Dental
Accreditation;
``(II) any organization accredited by a State medical
society accreditor that is recognized by the ACCME or the
Commission on Dental Accreditation;
``(III) any organization accredited by the American
Osteopathic Association to provide continuing medical
education; or
``(IV) any organization approved by the Assistant Secretary
for Mental Health and Substance Abuse or the ACCME, of the
Commission on Dental Accreditation.
``(v) The physician graduated in good standing from an
accredited school of allopathic medicine or osteopathic
medicine, dental surgery, or dental medicine in the United
States during the 5-year period immediately preceding the
date on which the physician first registers or renews under
this section and has successfully completed a comprehensive
allopathic or osteopathic medicine curriculum or accredited
medical residency or dental surgery or dental medicine
curriculum that included not less than 8 hours of training
on--hat included not less than 8 hours of training on
treating and managing patients with opioid and other
substance use disorders, including the appropriate clinical
use of all drugs approved by the Food and Drug Administration
for the treatment of a substance use disorder.
``(I) treating and managing patents with opioid and other
substance use disorders, including the appropriate clinical
use of all drugs approved by the Food and Drug Administration
for the treatment of a substance use disorder; or
``(II) the safe pharmacological management of dental pain
and screening, brief intervention, and referral for
appropriate treatment of patients with or at risk of
developing opioid and other substance us disorders.
``(B) If the practitioner is not a physician (as defined
under section 1861(r) of the Social Security Act), the
practitioner meets one or more of the following conditions:
``(i) The practitioner has completed not fewer than 8 hours
of training with respect to the treatment and management of
patients with opioid or other substance use disorders
(through classroom situations, seminars at professional
society meetings, electronic communications, or otherwise)
provided by the American Society of Addiction Medicine, the
American Academy of Addiction Psychiatry, the American
Medical Association, the American Osteopathic Association,
the American Nurses Credentialing Center, the American
Psychiatric Association, the American Association of Nurse
Practitioners, the American Academy of Physician Associates,
or any other organization approved or accredited by the
Assistant Secretary for Mental Health and Substance Abuse or
the or the Accreditation Council for Continuing Medical
Education.
``(ii) The practitioner has graduated in good standing from
an accredited physician assistant school or accredited school
of advanced practice nursing in the United States during the
5-year period immediately preceding the date on which the
practitioner first registers or renews under this section and
has successfully completed a comprehensive physician
assistant or advanced practice nursing curriculum that
included not fewer than 8 hours of training on treating and
managing patients with opioid and other substance use
disorders, including the appropriate clinical use of all
drugs approved by the Food and Drug Administration for the
treatment of a substance use disorder.
``(2) One-time training.--
``(A) In general.--The Attorney General shall not require
any qualified practitioner to complete the training described
in clause (iv) or (v) of paragraph (1)(A) or clause (i) or
(ii) of paragraph (1)(B) more than once.
``(B) Notification.--Not later than 90 days after the date
of the enactment of the Restoring Hope for mental health and
Well-Being Act of 2022, the Attorney General shall provide to
qualified practitioners a single written, electronic
notification of the training described in clauses (i) and
(ii) of paragraph (1)(B).
``(3) Rule of construction.--Nothing in this subsection
shall be construed to preclude the use, by a qualified
practitioner, of training received pursuant to this
subsection to satisfy registration requirements of a State or
for some other lawful purpose.
``(4) Definitions.--In this section:
``(A) First applicable registration.--The term `first
applicable registration' means the first registration or
renewal of registration by a qualified practitioner under
this section that occurs on or after the date that is 180
days after the date of enactment of the Restoring Hope for
Mental Health and Well-Being Act of 2022.
``(B) Qualified practitioner.--In this subsection, the term
`qualified practitioner' means a practitioner who--
``(i) is licensed under State law to prescribe controlled
substances; and
``(ii) is not solely a veterinarian.''.
[[Page H5766]]
TITLE III--ACCESS TO MENTAL HEALTH CARE AND COVERAGE
Subtitle A--Collaborate in an Orderly and Cohesive Manner
SEC. 301. INCREASING UPTAKE OF THE COLLABORATIVE CARE MODEL.
Section 520K of the Public Health Service Act (42 U.S.C.
290bb-42) is amended to read as follows:
``SEC. 520K. INTEGRATION INCENTIVE GRANTS AND COOPERATIVE
AGREEMENTS.
``(a) Definitions.--In this section:
``(1) Collaborative care model.--The term `collaborative
care model' means the evidence-based, integrated behavioral
health service delivery method that includes--
``(A) care directed by the primary care team;
``(B) structured care management;
``(C) regular assessments of clinical status using
developmentally appropriate, validated tools; and
``(D) modification of treatment as appropriate.
``(2) Eligible entity.--The term `eligible entity' means a
State, or an appropriate State agency, in collaboration
with--
``(A) 1 or more qualified community programs as described
in section 1913(b)(1);
``(B) 1 or more health centers (as defined in section
330(a)), a rural health clinic (as defined in section
1961(aa) of the Social Security Act), or a Federally
qualified health center (as defined in such section); or
``(C) 1 or more primary health care practices.
``(3) Integrated care; bidirectional integrated care.--
``(A) The term `integrated care' means models or practices
for coordinating and jointly delivering behavioral and
physical health services, which may include practices that
share the same space in the same facility.
``(B) The term `bidirectional integrated care' means the
integration of behavioral health care and specialty physical
health care, as well as the integration of primary and
physical health care with specialty behavioral health
settings, including within primary health care settings.
``(4) Primary health care provider.--The term `primary
health care provider' means a provider who--
``(A) provides health services related to family medicine,
internal medicine, pediatrics, obstetrics, gynecology, or
geriatrics; or
``(B) is a doctor of medicine or osteopathy, physician
assistant, or nurse practitioner, who is licensed to practice
medicine by the State in which such physician, assistant, or
practitioner primarily practices, including within primary
health care settings.
``(5) Primary health care practice.--The term `primary
health care practice' means a medical practice of primary
health care providers, including a practice within a larger
health care system.
``(6) Special population.--The term `special population',
for an eligible entity that is collaborating with an entity
described in subparagraph (A) or (B) of paragraph (3),
means--
``(A) adults with a serious mental illness who have a co-
occurring physical health condition or chronic disease;
``(B) children and adolescents with a mental illness who
have a co-occurring physical health condition or chronic
disease;
``(C) individuals with a substance use disorder; or
``(D) individuals with a mental illness who have a co-
occurring substance use disorder.
``(b) Grants and Cooperative Agreements.--
``(1) In general.--The Secretary may award grants and
cooperative agreements to eligible entities to support the
improvement of integrated care for physical and behavioral
health care in accordance with paragraph (2).
``(2) Use of funds.--A grant or cooperative agreement
awarded under this section shall be used--
``(A) in the case of an eligible entity that is
collaborating with an entity described in subparagraph (A) or
(B) of subsection (a)(2)--
``(i) to promote full integration and collaboration in
clinical practices between physical and behavioral health
care for special populations including each population listed
in subsection (a)(7);
``(ii) to support the improvement of integrated care models
for physical and behavioral health care to improve the
overall wellness and physical health status of--
``(I) adults with a serious mental illness or children with
a serious emotional disturbance; and
``(II) individuals with a substance use disorder; and
``(iii) to promote bidirectional integrated care services
including screening, diagnosis, prevention, treatment, and
recovery of mental and substance use disorders, and co-
occurring physical health conditions and chronic diseases;
and
``(B) in the case of an eligible entity that is
collaborating with a primary health care practice, to support
the uptake of the collaborative care model, including by--
``(i) hiring staff;
``(ii) identifying and formalizing contractual
relationships with other health care providers, including
providers who will function as psychiatric consultants and
behavioral health care managers in providing behavioral
health integration services through the collaborative care
model;
``(iii) purchasing or upgrading software and other
resources needed to appropriately provide behavioral health
integration services through the collaborative care model,
including resources needed to establish a patient registry
and implement measurement-based care; and
``(iv) for such other purposes as the Secretary determines
to be necessary.
``(c) Applications.--
``(1) In general.--An eligible entity that is collaborating
with an entity described in subparagraph (A) or (B) of
subsection (a)(2) seeking a grant or cooperative agreement
under subsection (b)(2)(A) shall submit an application to the
Secretary at such time, in such manner, and accompanied by
such information as the Secretary may require, including the
contents described in paragraph (2).
``(2) Contents.--Any such application of an eligible entity
described in subparagraph (A) or (B) of subsection (a)(2)
shall include--
``(A) a description of a plan to achieve fully
collaborative agreements to provide bidirectional integrated
care to special populations;
``(B) a document that summarizes the policies, if any, that
are barriers to the provision of integrated care, and the
specific steps, if applicable, that will be taken to address
such barriers;
``(C) a description of partnerships or other arrangements
with local health care providers to provide services to
special populations;
``(D) an agreement and plan to report to the Secretary
performance measures necessary to evaluate patient outcomes
and facilitate evaluations across participating projects;
``(E) a description of how validated rating scales will be
implemented to support the improvement of patient outcomes
using measurement-based care, including those related to
depression screening, patient follow-up, and symptom
remission; and
``(F) a plan for sustainability beyond the grant or
cooperative agreement period under subsection (e).
``(3) Collaborative care model grants.--An eligible entity
that is collaborating with a primary health care practice
seeking a grant pursuant to subsection (b)(2)(B) shall submit
an application to the Secretary at such time, in such manner,
and accompanied by such information as the Secretary may
require.
``(d) Grant and Cooperative Agreement Amounts.--
``(1) Target amount.--The target amount that an eligible
entity may receive for a year through a grant or cooperative
agreement under this section shall be--
``(A) $2,000,000 for an eligible entity described in
subparagraph (A) or (B) of subsection (a)(2); or
``(B) $100,000 or less for an eligible entity described in
subparagraph (C) of subsection (a)(2).
``(2) Adjustment permitted.--The Secretary, taking into
consideration the quality of an eligible entity's application
and the number of eligible entities that received grants
under this section prior to the date of enactment of the
Restoring Hope for Mental Health and Well-Being Act of 2022,
may adjust the target amount that an eligible entity may
receive for a year through a grant or cooperative agreement
under this section.
``(3) Limitation.--An eligible entity that is collaborating
with an entity described in subparagraph (A) or (B) of
subsection (a)(2) receiving funding under this section--
``(A) may not allocate more than 20 percent of the funds
awarded to such eligible entity under this section to
administrative functions; and
``(B) shall allocate the remainder of such funding to
health facilities that provide integrated care.
``(e) Duration.--A grant or cooperative agreement under
this section shall be for a period not to exceed 5 years.
``(f) Report on Program Outcomes.--An eligible entity
receiving a grant or cooperative agreement under this
section--
``(1) that is collaborating with an entity described in
subparagraph (A) or (B) of subsection (a)(2) shall submit an
annual report to the Secretary that includes--
``(A) the progress made to reduce barriers to integrated
care as described in the entity's application under
subsection (c); and
``(B) a description of outcomes with respect to each
special population listed in subsection (a)(7), including
outcomes related to education, employment, and housing; or
``(2) that is collaborating with a primary health care
practice shall submit an annual report to the Secretary that
includes--
``(A) the progress made to improve access;
``(B) the progress made to improve patient outcomes; and
``(C) the progress made to reduce referrals to specialty
care.
``(g) Technical Assistance for Primary-Behavioral Health
Care Integration.--
``(1) Certain recipients.--The Secretary may provide
appropriate information, training, and technical assistance
to eligible entities that are collaborating with an entity
described in subparagraph (A) or (B) of subsection (a)(2)
that receive a grant or cooperative agreement under this
section, in order to help such entities meet the requirements
of this section, including assistance with--
``(A) development and selection of integrated care models;
``(B) dissemination of evidence-based interventions in
integrated care;
``(C) establishment of organizational practices to support
operational and administrative success; and
``(D) other activities, as the Secretary determines
appropriate.
``(2) Collaborative care model recipients.--The Secretary
shall provide appropriate information, training, and
technical assistance to eligible entities that are
collaborating with primary health care practices that receive
funds under this section to help such entities implement the
collaborative care model, including--
``(A) developing financial models and budgets for
implementing and maintaining a collaborative care model,
based on practice size;
``(B) developing staffing models for essential staff roles;
``(C) providing strategic advice to assist practices
seeking to utilize other clinicians for additional
psychotherapeutic interventions;
``(D) providing information technology expertise to assist
with building the collaborative care
[[Page H5767]]
model into electronic health records, including assistance
with care manager tools, patient registry, ongoing patient
monitoring, and patient records;
``(E) training support for all key staff and operational
consultation to develop practice workflows;
``(F) establishing methods to ensure the sharing of best
practices and operational knowledge among primary health care
physicians and primary health care practices that provide
behavioral health integration services through the
collaborative care model; and
``(G) providing guidance and instruction to primary health
care physicians and primary health care practices on
developing and maintaining relationships with community-based
mental health and substance use disorder facilities for
referral and treatment of patients whose clinical
presentation or diagnosis is best suited for treatment at
such facilities.
``(3) Additional dissemination of technical information.--
In addition to providing the assistance described in
paragraphs (1) and (2) to recipients of a grant or
cooperative agreement under this section, the Secretary may
also provide such assistance to other States and political
subdivisions of States, Indian Tribes and Tribal
organizations (as defined under the Federally Recognized
Indian Tribe List Act of 1994), outpatient mental health and
addiction treatment centers, community mental health centers
that meet the criteria under section 1913(c), certified
community behavioral health clinics described in section 223
of the Protecting Access to Medicare Act of 2014, primary
care organizations such as Federally qualified health centers
or rural health clinics as defined in section 1861(aa) of the
Social Security Act, primary health care practices, other
community-based organizations, and other entities engaging in
integrated care activities, as the Secretary determines
appropriate.
``(h) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $60,000,000
for each of fiscal years 2023 through 2027.''.
Subtitle B--Helping Enable Access to Lifesaving Services
SEC. 311. REAUTHORIZATION AND PROVISION OF CERTAIN PROGRAMS
TO STRENGTHEN THE HEALTH CARE WORKFORCE.
(a) Liability Protections for Health Professional
Volunteers.--Section 224(q)(6) of the Public Health Service
Act (42 U.S.C. 233(q)(6)) is amended by striking ``October 1,
2022'' and inserting ``October 1, 2027''.
(b) Minority Fellowships in Crisis Care Management.--
Section 597(b) of the Public Health Service Act (42 U.S.C.
290ll(b)) is amended by striking ``in the fields of
psychiatry,'' and inserting ``in the fields of crisis care
management, psychiatry,''.
(c) Mental and Behavioral Health Education and Training
Grants.--Section 756 of the Public Health Service Act (42
U.S.C. 294e-1) is amended--
(1) in subsection (a)(1), by inserting ``(which may include
master's and doctoral level programs)'' after ``occupational
therapy''; and
(2) in subsection (f), by striking ``For each of fiscal
years 2019 through 2023'' and inserting ``For each of fiscal
years 2023 through 2027''.
(d) Training Demonstration Program.--Section 760(g) of the
Public Health Service Act (42 U.S.C. 294k(g)) is amended by
inserting ``and $31,700,000 for each of fiscal years 2023
through 2027'' before the period at the end.
SEC. 312. REAUTHORIZATION OF MINORITY FELLOWSHIP PROGRAM.
Section 597(c) of the Public Health Service Act (42 U.S.C.
290ll(c)) is amended by striking ``$12,669,000 for each of
fiscal years 2018 through 2022'' and inserting $25,000,000
for each fiscal years 2023 through 2027''.
Subtitle C--Eliminating the Opt-Out for Nonfederal Governmental Health
Plans
SEC. 321. ELIMINATING THE OPT-OUT FOR NONFEDERAL GOVERNMENTAL
HEALTH PLANS.
Section 2722(a)(2) of the Public Health Service Act (42
U.S.C. 300gg-21(a)(2)) is amended by adding at the end the
following new subparagraph:
``(F) Sunset of election option.--
``(i) In general.--Notwithstanding the preceding provisions
of this paragraph--
``(I) no election described in subparagraph (A) with
respect to section 2726 may be made on or after the date of
the enactment of this subparagraph; and
``(II) except as provided in clause (ii), no such election
with respect to section 2726 expiring on or after the date
that is 180 days after the date of such enactment may be
renewed.
``(ii) Exception for certain collectively bargained
plans.--Notwithstanding clause (i)(II), a plan described in
subparagraph (B)(ii) that is subject to multiple agreements
described in such subparagraph of varying lengths and that
has an election described in subparagraph (A) with respect to
section 2726 in effect as of the date of the enactment of
this subparagraph that expires on or after the date that is
180 days after the date of such enactment may extend such
election until the date on which the term of the last such
agreement expires.''.
Subtitle D--Mental Health and Substance Use Disorder Parity
Implementation
SEC. 331. GRANTS TO SUPPORT MENTAL HEALTH AND SUBSTANCE USE
DISORDER PARITY IMPLEMENTATION.
(a) In General.--Section 2794(c) of the Public Health
Service Act (42 U.S.C. 300gg-94(c)) (as added by section 1003
of the Patient Protection and Affordable Care Act (Public Law
111-148)) is amended by adding at the end the following:
``(3) Parity implementation.--
``(A) In general.--Beginning during the first fiscal year
that begins after the date of enactment of this paragraph,
the Secretary shall, out of funds made available pursuant to
subparagraph (C), award grants to eligible States to enforce
and ensure compliance with the mental health and substance
use disorder parity provisions of section 2726.
``(B) Eligible state.--A State shall be eligible for a
grant awarded under this paragraph only if such State--
``(i) submits to the Secretary an application for such
grant at such time, in such manner, and containing such
information as specified by the Secretary; and
``(ii) agrees to request and review from health insurance
issuers offering group or individual health insurance
coverage the comparative analyses and other information
required of such health insurance issuers under subsection
(a)(8)(A) of section 2726 relating to the design and
application of nonquantitative treatment limitations imposed
on mental health or substance use disorder benefits.
``(C) Authorization of appropriations.--There are
authorized to be appropriated $10,000,000 for each of the
first five fiscal years beginning after the date of the
enactment of this paragraph, to remain available until
expended, for purposes of awarding grants under subparagraph
(A).''.
(b) Technical Amendment.--Section 2794 of the Public Health
Service Act (42 U.S.C. 300gg-95), as added by section 6603 of
the Patient Protection and Affordable Care Act (Public Law
111-148) is redesignated as section 2795.
TITLE IV--CHILDREN AND YOUTH
Subtitle A--Supporting Children's Mental Health Care Access
SEC. 401. PEDIATRIC MENTAL HEALTH CARE ACCESS GRANTS.
Section 330M of the Public Health Service Act (42 U.S.C.
254c-19) is amended--
(1) in the section enumerator, by striking ``330M'' and
inserting ``330M.'';
(2) in subsection (a)--
(A) by striking ``Indian tribes and tribal organizations''
and inserting ``Indian Tribes and Tribal organizations''; and
(B) by inserting ``or, in the case of a State that does not
submit an application, a nonprofit entity that has the
support of the State'' after ``450b))'';
(3) in subsection (b)--
(A) in paragraph (1)--
(i) in subparagraph (G), by inserting ``developmental-
behavioral pediatricians,'' after ``adolescent
psychiatrists,'';
(ii) in subparagraph (H), by striking ``; and'' at the end
and inserting a semicolon;
(iii) by redesignating subparagraph (I) as subparagraph
(J); and
(iv) by inserting after subparagraph (H) the following:
``(I) maintain an up-to-date list of community-based
supports for children with mental health problems; and'';
(B) by redesignating paragraph (2) as paragraph (4);
(C) by inserting after paragraph (1) the following:
``(2) Support to schools and emergency departments.--In
addition to the activities required by paragraph (1), a
pediatric mental health care telehealth access program
referred to in subsection (a), with respect to which a grant
under such subsection may be used, may provide support to
schools and emergency departments.
``(3) Priority.--In awarding grants under this section, the
Secretary shall give priority to applicants proposing to--
``(A) continue existing programs that meet the requirements
of paragraph (1);
``(B) establish a pediatric mental health care telehealth
access program in the jurisdiction of a State, Territory,
Indian Tribe, or Tribal organization that does not yet have
such a program; or
``(C) expand a pediatric mental health care telehealth
access program to include one or more new sites of care, such
as a school or emergency department.''; and
(D) in paragraph (4), as redesignated by subparagraph (B),
by inserting ``Such a team may include a developmental-
behavioral pediatrician.'' after ``mental health
counselor.'';
(4) in subsections (c), (d), and (f), by striking ``Indian
tribe, or tribal organization'' each place it appears and
inserting ``Indian Tribe, Tribal organization, or nonprofit
entity''; and
(5) by striking subsection (g) and inserting the following:
``(g) Technical Assistance.--The Secretary shall award
grants or contracts to one or more eligible entities (as
defined by the Secretary) for the purposes of providing
technical assistance and evaluation support to grantees under
subsection (a).
``(h) Authorization of Appropriations.--To carry out this
section, there are authorized to be appropriated--
``(1) $14,000,000 for each of fiscal years 2023 through
2025; and
``(2) $30,000,000 for each of fiscal years 2026 through
2027.''.
SEC. 402. INFANT AND EARLY CHILDHOOD MENTAL HEALTH PROMOTION,
INTERVENTION, AND TREATMENT.
Section 399Z-2(f) of the Public Health Service Act (42
U.S.C. 280h-6(f)) is amended by striking ``$20,000,000 for
the period of fiscal years 2018 through 2022'' and inserting
``$50,000,000 for the period of fiscal years 2023 through
2027''.
Subtitle B--Continuing Systems of Care for Children
SEC. 411. COMPREHENSIVE COMMUNITY MENTAL HEALTH SERVICES FOR
CHILDREN WITH SERIOUS EMOTIONAL DISTURBANCES.
(a) Definition of Family.--Section 565(d)(2)(B) of the
Public Health Service Act (42
[[Page H5768]]
U.S.C. 290ff-4(d)(2)(B)) is amended by striking ``as
appropriate regarding mental health services for the child,
the parents of the child (biological or adoptive, as the case
may be) and any foster parents of the child'' and inserting
``as appropriate regarding mental health services for the
child and the parents or kinship caregivers of the child''.
(b) Authorization of Appropriations.--Paragraph (1) of
section 565(f) of the Public Health Service Act (42 U.S.C.
290ff-4(f)) is amended--
(1) by moving the margin of such paragraph 2 ems to the
right; and
(2) by striking ``$119,026,000 for each of fiscal years
2018 through 2022'' and inserting ``$125,000,000 for each of
fiscal years 2023 through 2027''.
SEC. 412. SUBSTANCE USE DISORDER TREATMENT AND EARLY
INTERVENTION SERVICES FOR CHILDREN AND
ADOLESCENTS.
Section 514 of the Public Health Service Act (42 U.S.C.
290bb-7) is amended--
(1) in subsection (a), by striking ``Indian tribes or
tribal organizations'' and inserting ``Indian Tribes or
Tribal organizations''; and
(2) in subsection (f), by striking ``2018 through 2022''
and inserting ``2023 through 2027''.
Subtitle C--Garrett Lee Smith Memorial Reauthorization
SEC. 421. SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.
(a) Technical Amendment.--Section 520C of the Public Health
Service Act (42 U.S.C. 290bb-34) is amended--
(1) by striking ``tribes'' and inserting ``Tribes''; and
(2) by striking ``tribal'' each place it appears and
inserting ``Tribal''.
(b) Authorization of Appropriations.--Section 520C(c) of
the Public Health Service Act (42 U.S.C. 290bb-34(c)) is
amended by striking ``$5,988,000 for each of fiscal years
2018 through 2022'' and inserting ``$9,000,000 for each of
fiscal years 2023 through 2027''.
(c) Annual Report.--Section 520C(d) of the Public Health
Service Act (42 U.S.C. 290bb-34(d)) is amended by striking
``Not later than 2 years after the date of enactment of this
subsection'' and inserting ``Not later than 2 years after the
date of enactment of the Restoring Hope for Mental Health and
Well-Being Act of 2022''.
SEC. 422. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION
STRATEGIES.
Section 520E of the Public Health Service Act (42 U.S.C.
290bb-36) is amended--
(1) by striking ``tribe'' and inserting ``Tribe'';
(2) by striking ``tribal'' each place it appears and
inserting ``Tribal'';
(3) in subsection (a)(1), by inserting ``pediatric health
programs,'' after ``foster care systems,'';
(4) by amending subsection (b)(1)(B) to read as follows:
``(B) a public organization or private nonprofit
organization designated by a State or Indian Tribe (as
defined under the Federally Recognized Indian Tribe List Act
of 1994) to develop or direct the State-sponsored statewide
or Tribal youth suicide early intervention and prevention
strategy; or'';
(5) in subsection (c)--
(A) in paragraph (1), by inserting ``pediatric health
programs,'' after ``foster care systems,'';
(B) in paragraph (7), by inserting ``pediatric health
programs,'' after ``foster care systems,'';
(C) in paragraph (9), by inserting ``pediatric health
programs,'' after ``educational institutions,'';
(D) in paragraph (13), by striking ``and'' at the end;
(E) in paragraph (14), by striking the period at the end
and inserting ``; and''; and
(F) by adding at the end the following:
``(15) provide to parents, legal guardians, and family
members of youth, supplies to securely store means commonly
used in suicide, if applicable, within the household.'';
(6) in subsection (d)--
(A) in the heading, by striking ``Direct Services'' and
inserting ``Suicide Prevention Activities''; and
(B) by striking ``direct services, of which not less than 5
percent shall be used for activities authorized under
subsection (a)(3)'' and inserting ``suicide prevention
activities'';
(7) in subsection (e)(3)(A), by inserting ``and Department
of Education'' after ``Department of Health and Human
Services'';
(8) in subsection (g)--
(A) in paragraph (1), by striking ``18'' and inserting
``24''; and
(B) in paragraph (2), by striking ``2 years after the date
of enactment of Helping Families in Mental Health Crisis
Reform Act of 2016'' and inserting ``3 years after December
31, 2022'';
(9) in subsection (l)(4), by striking ``between 10 and 24
years of age'' and inserting ``up to 24 years of age''; and
(10) in subsection (m), by striking ``$30,000,000 for each
of fiscal years 2018 through 2022'' and inserting
``$40,000,000 for each of fiscal years 2023 through 2027''.
SEC. 423. MENTAL HEALTH AND SUBSTANCE USE DISORDER SERVICES
FOR STUDENTS IN HIGHER EDUCATION.
Section 520E-2 of the Public Health Service Act (42 U.S.C.
290bb-36b) is amended--
(1) in the heading, by striking ``on campus'' and inserting
``for students in higher education''; and
(2) in subsection (i), by striking ``2018 through 2022''
and inserting ``2023 through 2027''.
SEC. 424. MENTAL AND BEHAVIORAL HEALTH OUTREACH AND EDUCATION
AT INSTITUTIONS OF HIGHER EDUCATION.
Section 549 of the Public Health Service Act (42 U.S.C.
290ee-4) is amended--
(1) in the heading, by striking ``on college campuses'' and
inserting ``at institutions of higher education'';
(2) in subsection (c)(2), by inserting ``, including
minority-serving institutions as described in section 371(a)
of the Higher Education Act of 1965 (20 U.S.C. 1067q) and
community colleges'' after ``higher education''; and
(3) in subsection (f), by striking ``2018 through 2022''
and inserting ``2023 through 2027''.
Subtitle D--Media and Mental Health
SEC. 431. STUDY ON THE EFFECTS OF SMARTPHONE AND SOECIAL
MEDIA USE OF ADOLESCENTS.
(a) In general.--Not later than 1 year after the date of
enactment of this Act, the Secretary of Health and Human
Services shall conduct or support research on--
(1) smartphone and social media use by adolescents; and
(2) the effects of such use on--
(A) emotional, behavioral, and physical health and
development; and
(B) any disparities in the mental health outcomes of rural,
minority, and other under-served populations.
(b) Report.--Not later than 5 years after the date of
enactment of this Act, the Secretary of Health and Human
Services shall submit to the Congress, and make publicly
available, a report on the findings of research under this
section.
SEC. 432. RESEARCH ON THE HEALTH AND DEVELOPMENT EFFECTS OF
MEDIA ON INFANTS, CHILDREN, AND ADOLESCENTS.
Subpart 7 of part C of title IV of the Public Health
Service Act (42 U.S.C. 285g et seq.) is amended by adding at
the end the following:
SEC. 452H. RESEARCH ON THE HEALTH AND DEVELOPMENT EFFECTS OF
MEDIA ON INFANTS, CHILDREN, AND ADOLESCENTS.
``(a) In general.--The Director of the National Institutes
of Health, in coordination with or acting through the
Director of the Institute, shall conduct and support research
and related activities concerning the health and
developmental effects of media on infants, children, and
adolescents, which may include the positive and negative
effects of exposure to and use of media, such as social
media, applications, websites, television, motion pictures,
artificial intelligence, mobile devices, computers, video
games, virtual and augmented reality, and other media formats
as they become available. Such research shall attempt to
better understand the relationships between media and
technology use and individual differences and characteristics
of children and shall include longitudinally designed studies
to assess the impact of media on youth over time. Such
research shall include consideration of core areas of child
and adolescent health and development including the
following:
``(1) Cognitive.--The role and impact of media use and
exposure in the development children and adolescents within
such cognitive areas as language development, executive
functioning, attention, creative program solving skills,
visual and spatial skills, literacy, critical thinking, and
other learning abilities, and the impact of early technology
use on developmental trajectories.
``(2) Physical--The role and impact of media use and exposure
on children's and adolescent's physical development and
health behaviors, including diet, exercise, sleeping and
eating routines, and other areas of physical development.
``(3) Socio-Emotional.--The role and impact of media use and
exposure on children's and adolescents' social-emotional
competencies, including self-awareness, self-regulation,
social awareness, relationship skills, empathy, distress
tolerance, perception of social cues, awareness of one's
relationship with the media, and decision-making, as well as
outcomes such as violations of privacy, perpetration of or
exposure to violence, bullying or other forms of aggression,
depression, anxiety, substance use, misuse or disorder, and
suicidal ideation/behavior and self-harm.
``(b) Developing Research Agenda.--The Director of the
National Institutes of Health, in consultation with the
Director of the Institute, other appropriate national
research institutes, academies, and centers, the Trans-NIH
Pediatric Research Consortium, and non-Federal exports as
needed, shall develop a research agenda on the health and
development effects of media on infants, children, and
adolescents to inform research activities under subsection
(a). In developing such research agenda, the Director may use
whatever means necessary (such as scientific workshops and
literature reviews) to assess current knowledge and research
gaps in this area.
``(c) Research Program.--In coordination with the Institute
and other national research institutes and centers, and
utilizing the National Institutes of Health's process of
scientific peer review, the Director of the National
Institutes of Health shall fund an expanded research program
on the health and developmental effects of media on infants,
children, and adolescents.
``(d) Report to Congress.--Not later than 1 year after the
date of enactment o this Act, the Director of the National
Institutes of Health shall submit a report to Congress on the
progress made in gathering data and expanding research on the
health and developmental effects of media on infants,
children, and adolescents in accordance with this section.
Such report shall summarize the grants and research funded,
by year, under this section''.
TITLE V--MEDICAID AND CHIP
SEC. 501. MEDICAID AND CHIP REQUIREMENTS FOR HEALTH
SCREENINGS AND REFERRALS FOR ELIGIBLE JUVENILES
IN PUBLIC INSTITUTIONS.
(a) Medicaid State Plan Requirement.--Section 1902 of the
Social Security Act (42 U.S.C. 1396a) is amended--
[[Page H5769]]
(1) in subsection (a)(84)--
(A) in subparagraph (A), by inserting ``, subject to
subparagraph (D),'' after ``but'';
(B) in subparagraph (B), by striking ``and'' at the end;
(C) in subparagraph (C), by adding ``and'' at the end; and
(D) by adding at the end the following new subparagraph:
``(D) beginning on the first day of the first calendar
quarter that begins two years after the date of enactment of
this subparagraph, in the case of individuals who are
eligible juveniles described in subsection (nn)(2), are
within 30 days of the date on which such eligible juvenile is
scheduled to be released from a public institution following
adjudication, the State shall have in place a plan to ensure,
and in accordance with such plan, provide--
``(i) for, in the 30 days prior to the release of such an
eligible juvenile from such public institution (or not later
than one week after release from the public institution), and
in coordination with such institution--
``(I) any screening or diagnostic service which meets
reasonable standards of medical and dental practice, as
determined by the State, or as indicated as medically
necessary, in accordance with paragraphs (1)(A) and (5) of
section 1905(r); and
``(II) a mental health or other behavioral health screening
that is a screening service described under section
1905(r)(1), or a diagnostic service described under paragraph
(5) of such section, if such screening or diagnostic service
was not otherwise conducted pursuant to this clause;
``(ii) for, not later than one week after release from the
public institution, referrals for such eligible juvenile to
the appropriate care and services available under the State
plan (or waiver of such plan) in the geographic region of the
home or residence of such eligible juvenile, based on such
screenings; and
``(iii) for, following the release of such eligible
juvenile from such institution, not less than 30 days of
targeted case management services furnished by a provider in
the geographic region of the home or residence of such
eligible juvenile.''; and
(2) in subsection (nn)(3), by striking ``(30)'' and
inserting ``(31)''.
(b) Authorization of Federal Financial Participation.--The
subdivision (A) of section 1905(a) of the Social Security Act
(42 U.S.C. 1396d(a)) following paragraph (31) of such section
is amended by inserting ``, or in the case of an eligible
juvenile described in section 1902(a)(84)(D) with respect to
the screenings, diagnostic services, referrals, and case
management required under such subparagraph (D)'' after
``(except as a patient in a medical institution''.
(c) CHIP Conforming Amendments.--
(1) Section 2103(c) of the Social Security Act (42 U.S.C.
1397cc(c)) is amended by adding at the end the following new
paragraph:
``(12) Required coverage of screenings, diagnostic
services, referrals, and case management for certain inmates
pre-release.--With respect to individuals described in
section 2110(b)(7), the State shall provide screenings,
diagnostic services, referrals, and case management otherwise
covered under the State child health plan (or waiver of such
plan) during the period described in such section with
respect to such screenings, services, referrals, and case
management.''.
(2) Section 2110(b) of the Social Security Act (42 U.S.C.
1397jj(b)) is amended--
(A) in paragraph (2)(A), by inserting ``except as provided
in paragraph (7),'' before ``a child who is an inmate of a
public institution''; and
(B) by adding at the end the following new paragraph:
``(7) Exception to exclusion of children who are inmates of
a public institution.--A child shall not be considered to be
described in paragraph (2)(A) if such child is an eligible
juvenile (as described in section 1902(a)(84)(D)) with
respect to the screenings, diagnostic services, referrals,
and case management otherwise covered under the State child
health plan (or waiver of such plan) during the period with
respect to which such screenings, services, referrals, and
case management is respectively required under such
section.''.
SEC. 502. GUIDANCE ON REDUCING ADMINISTRATIVE BARRIERS TO
PROVIDING HEALTH CARE SERVICES IN SCHOOLS.
(a) In General.--Not later than 12 months after the date of
enactment of this Act, the Secretary of Health and Human
Services shall issue guidance to State Medicaid agencies,
elementary and secondary schools, and school-based health
centers on reducing administrative barriers to such schools
and centers furnishing medical assistance and obtaining
payment for such assistance under titles XIX and XXI of the
Social Security Act (42 U.S.C. 1396 et seq., 1397aa et seq.).
(b) Contents of Guidance.--The guidance issued pursuant to
subsection (a) shall--
(1) include revisions to the May 2003 Medicaid School-Based
Administrative Claiming Guide, the 1997 Medicaid and Schools
Technical Assistance Guide, and other relevant guidance in
effect on the date of enactment of this Act;
(2) provide information on payment under titles XIX and XXI
of the Social Security Act (42 U.S.C. 1396 et seq., 1397aa et
seq.) for the provision of medical assistance, including such
assistance provided in accordance with an individualized
education program or under the policy described in the State
Medicaid Director letter on payment for services issued on
December 15, 2014 (#14-006);
(3) take into account reasons why small and rural local
education agencies may not provide medical assistance and
provide information on best practices to encourage such
agencies to provide such assistance; and
(4) include best practices and examples of methods that
State Medicaid agencies and local education agencies have
used to pay for, and increase the availability of, medical
assistance.
(c) Definitions.--In this Act:
(1) Individualized education program.--The term
``individualized education program'' has the meaning given
such term in section 602(14) of the Individuals with
Disabilities Education Act (20 U.S.C. 1401(14)).
(2) School-based health center.--The term ``school-based
health center'' has the meaning given such term in section
2110(c)(9) of the Social Security Act (42 U.S.C.
1397jj(c)(9)), and includes an entity that provides Medicaid-
covered services in school-based settings for which Federal
financial participation is permitted.
SEC. 503. GUIDANCE TO STATES ON SUPPORTING PEDIATRIC
BEHAVIORAL HEALTH SERVICES UNDER MEDICAID AND
CHIP.
Not later than 18 months after the date of enactment of
this Act, the Secretary of Health and Human Services shall
issue guidance to States on how to expand the provision of,
and access to, behavioral health services, including mental
health services, for children covered under State plans (or
waivers of such plans) under title XIX of the Social Security
Act (42 U.S.C. 1396 et seq.), or State child health plans (or
waivers of such plans) under title XXI of such Act (42 U.S.C.
1397aa et seq.), including a description of best practices
for--
(1) expanding access to such services;
(2) expanding access to such services in underserved
communities;
(3) flexibilities that States may offer for pediatric
hospitals and other pediatric behavioral health providers to
expand access to services; and
(4) recruitment and retention of providers of such
services.
SEC. 504. ENSURING CHILDREN RECEIVE TIMELY ACCESS TO CARE.
(a) Guidance to States on Flexibilities to Ensure Provider
Capacity to Provide Pediatric Behavioral Health, Including
Mental Health, Crisis Care.--Not later than 18 months after
the date of enactment of this Act, the Secretary of Health
and Human Services shall provide guidance to States on
existing flexibilities under State plans (or waivers of such
plans) under title XIX of the Social Security Act (42 U.S.C.
1396 et seq.), or State child health plans under title XXI of
such Act (42 U.S.C. 1397aa et seq.), to support children
experiencing a behavioral health crisis or in need of
intensive behavioral health, including mental health,
services.
(b) Ensuring Consistent Review and State Implementation of
Early and Periodic Screening, Diagnostic, and Treatment
Services.--Section 1905(r) of the Social Security Act (42
U.S.C. 1396d(r)) is amended by adding at the end the
following: ``Not later than January 1, 2025, and every 5
years thereafter, the Secretary shall review implementation
of the requirements of this subsection by States, including
such requirements relating to services provided by managed
care organizations, prepaid inpatient health plans, prepaid
ambulatory health plans, and primary care case managers, to
identify and disseminate best practices for ensuring
comprehensive coverage of services, to identify gaps and
deficiencies in meeting Federal requirements, and to provide
guidance to States on addressing identified gaps and
disparities and meeting Federal coverage requirements in
order to ensure children have access to health services.''.
SEC. 505. STRATEGIES TO INCREASE ACCESS TO TELEHEALTH UNDER
MEDICAID AND CHIP.
Not later than 1 year after the date of the enactment of
this Act, and in the event updates are available, once every
five years thereafter, the Secretary of Health and Human
Services shall update guidance issued by the Centers for
Medicare & Medicaid Services to States, the State Medicaid &
CHIP Telehealth Toolkit, or any successor guidance, to
describe strategies States may use to overcome existing
barriers and increase access to telehealth services under the
Medicaid program under title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.) and the Children's Health Insurance
Program under title XXI of such Act (42 U.S.C. 1397aa et
seq.). Such updated guidance shall include examples of and
promising practices regarding--
(1) telehealth delivery of covered services;
(2) recommended voluntary billing codes, modifiers, and
place-of-service designations for telehealth and other
virtual health care services;
(3) strategies States can use for the simplification or
alignment of provider credentialing and enrollment protocols
with respect to telehealth across States, State Medicaid
plans under title XIX, State child health plans under title
XXI, Medicaid managed care organizations, prepaid inpatient
health plans, prepaid ambulatory health plans, and primary
care case managers, including during national public health
emergencies; and
(4) strategies States can use to integrate telehealth and
other virtual health care services into value-based health
care models.
SEC. 506. REMOVAL OF LIMITATIONS ON FEDERAL FINANCIAL
PARTICIPATION FOR INMATES WHO ARE ELIGIBLE
JUVENILES PENDING DISPOSITION OF CHARGES.
(a) Medicaid.--
(1) In general.--The subdivision (A) of section 1905(a) of
the Social Security Act (42 U.S.C. 1396d(a)) following
paragraph (31) of such section, as amended by section 501(b),
is further amended by inserting ``, or, at the option of the
State, for an individual who is an eligible juvenile (as
defined in section 1902(nn)(2)), while such individual is an
inmate of a public institution (as defined in section
1902(nn)(3)) pending disposition of charges'' after ``or in
the case of an eligible juvenile described in section
[[Page H5770]]
1902(a)(84)(D) with respect to the screenings, diagnostic
services, referrals, and case management required under such
subparagraph (D)''.
(2) Conforming.--Section 1902(a)(84)(A) of the Social
Security Act (42 U.S.C. 1396a(a)(84)(A)) is amended by
inserting ``(or in the case of a State electing the option
described in the subdivision (A) following paragraph (31) of
section 1905(a), during such period beginning after the
disposition of charges with respect to such individual)''
after ``is such an inmate''.
(b) CHIP.--Section 2110(b)(7) of the Social Security Act
(42 U.S.C. 13977jj(b)(7)), as added by section 501(c)(2)(B),
is further amended by inserting ``or, at the option of the
State, for an individual who is a juvenile, while such
individual is an inmate of a public institution pending
disposition of charges'' after ``if such child is an eligible
juvenile (as described in section 1902(a)(84)(D)) with
respect to screenings, diagnostic services, referrals, and
case management otherwise covered under the State child
health plan (or waiver of such plan)''.
(c) Effective Date.--The amendments made by this section
shall take effect on the first day of the first calendar
quarter that begins after the date that is 18 months after
the date of enactment of this Act and shall apply to items
and services furnished for periods beginning on or after such
date.
TITLE VI--MISCELLANEOUS PROVISIONS
SEC. 601. DETERMINATION OF BUDGETARY EFFECTS.
The budgetary effects of this Act, for the purpose of
complying with the Statutory Pay-As-You-Go Act of 2010, shall
be determined by reference to the latest statement titled
``Budgetary Effects of PAYGO Legislation'' for this Act,
submitted for printing in the Congressional Record by the
Chairman of the House Budget Committee, provided that such
statement has been submitted prior to the vote on passage.
SEC. 602. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
(a) PHSA.--Title XXVII of the Public Health Service Act (42
U.S.C. 300gg et seq.) is amended--
(1) in part D (42 U.S.C. 300gg-111 et seq.), by adding at
the end the following new section:
``SEC. 2799A-11. OVERSIGHT OF PHARMACY BENEFIT MANAGER
SERVICES.
``(a) In General.--For plan years beginning on or after
January 1, 2024, a group health plan or health insurance
issuer offering group health insurance coverage or an entity
or subsidiary providing pharmacy benefits management services
on behalf of such a plan or issuer shall not enter into a
contract with a drug manufacturer, distributor, wholesaler,
subcontractor, rebate aggregator, or any associated third
party that limits the disclosure of information to plan
sponsors in such a manner that prevents the plan or issuer,
or an entity or subsidiary providing pharmacy benefits
management services on behalf of a plan or issuer, from
making the reports described in subsection (b).
``(b) Reports.--
``(1) In general.--For plan years beginning on or after
January 1, 2024, not less frequently than once every 6
months, a health insurance issuer offering group health
insurance coverage or an entity providing pharmacy benefits
management services on behalf of a group health plan or an
issuer providing group health insurance coverage shall submit
to the plan sponsor (as defined in section 3(16)(B) of the
Employee Retirement Income Security Act of 1974) of such
group health plan or health insurance coverage a report in
accordance with this subsection and make such report
available to the plan sponsor in a machine-readable format.
Each such report shall include, with respect to the
applicable group health plan or health insurance coverage--
``(A) as applicable, information collected from drug
manufacturers by such issuer or entity on the total amount of
copayment assistance dollars paid, or copayment cards
applied, that were funded by the drug manufacturer with
respect to the participants and beneficiaries in such plan or
coverage;
``(B) a list of each drug covered by such plan, issuer, or
entity providing pharmacy benefit management services that
was dispensed during the reporting period, including, with
respect to each such drug during the reporting period--
``(i) the brand name, chemical entity, and National Drug
Code;
``(ii) the number of participants and beneficiaries for
whom the drug was filled during the plan year, the total
number of prescription fills for the drug (including original
prescriptions and refills), and the total number of dosage
units of the drug dispensed across the plan year, including
whether the dispensing channel was by retail, mail order, or
specialty pharmacy;
``(iii) the wholesale acquisition cost, listed as cost per
days supply and cost per pill, or in the case of a drug in
another form, per dose;
``(iv) the total out-of-pocket spending by participants and
beneficiaries on such drug, including participant and
beneficiary spending through copayments, coinsurance, and
deductibles; and
``(v) for any drug for which gross spending of the group
health plan or health insurance coverage exceeded $10,000
during the reporting period--
``(I) a list of all other drugs in the same therapeutic
category or class, including brand name drugs and biological
products and generic drugs or biosimilar biological products
that are in the same therapeutic category or class as such
drug; and
``(II) the rationale for preferred formulary placement of
such drug in that therapeutic category or class, if
applicable;
``(C) a list of each therapeutic category or class of drugs
that were dispensed under the health plan or health insurance
coverage during the reporting period, and, with respect to
each such therapeutic category or class of drugs, during the
reporting period--
``(i) total gross spending by the plan, before manufacturer
rebates, fees, or other manufacturer remuneration;
``(ii) the number of participants and beneficiaries who
filled a prescription for a drug in that category or class;
``(iii) if applicable to that category or class, a
description of the formulary tiers and utilization mechanisms
(such as prior authorization or step therapy) employed for
drugs in that category or class;
``(iv) the total out-of-pocket spending by participants and
beneficiaries, including participant and beneficiary spending
through copayments, coinsurance, and deductibles; and
``(v) for each therapeutic category or class under which 3
or more drugs are included on the formulary of such plan or
coverage--
``(I) the amount received, or expected to be received, from
drug manufacturers in rebates, fees, alternative discounts,
or other remuneration--
``(aa) that has been paid, or is to be paid, by drug
manufacturers for claims incurred during the reporting
period; or
``(bb) that is related to utilization of drugs, in such
therapeutic category or class;
``(II) the total net spending, after deducting rebates,
price concessions, alternative discounts or other
remuneration from drug manufacturers, by the health plan or
health insurance coverage on that category or class of drugs;
and
``(III) the net price per course of treatment or single
fill, such as a 30-day supply or 90-day supply, incurred by
the health plan or health insurance coverage and its
participants and beneficiaries, after manufacturer rebates,
fees, and other remuneration for drugs dispensed within such
therapeutic category or class during the reporting period;
``(D) total gross spending on prescription drugs by the
plan or coverage during the reporting period, before rebates
and other manufacturer fees or remuneration;
``(E) total amount received, or expected to be received, by
the health plan or health insurance coverage in drug
manufacturer rebates, fees, alternative discounts, and all
other remuneration received from the manufacturer or any
third party, other than the plan sponsor, related to
utilization of drug or drug spending under that health plan
or health insurance coverage during the reporting period;
``(F) the total net spending on prescription drugs by the
health plan or health insurance coverage during the reporting
period; and
``(G) amounts paid directly or indirectly in rebates, fees,
or any other type of remuneration to brokers, consultants,
advisors, or any other individual or firm who referred the
group health plan's or health insurance issuer's business to
the pharmacy benefit manager.
``(2) Privacy requirements.--Health insurance issuers
offering group health insurance coverage and entities
providing pharmacy benefits management services on behalf of
a group health plan shall provide information under paragraph
(1) in a manner consistent with the privacy, security, and
breach notification regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability
Act of 1996, and shall restrict the use and disclosure of
such information according to such privacy regulations.
``(3) Disclosure and redisclosure.--
``(A) Limitation to business associates.--A group health
plan receiving a report under paragraph (1) may disclose such
information only to business associates of such plan as
defined in section 160.103 of title 45, Code of Federal
Regulations (or successor regulations).
``(B) Clarification regarding public disclosure of
information.--Nothing in this section prevents a health
insurance issuer offering group health insurance coverage or
an entity providing pharmacy benefits management services on
behalf of a group health plan from placing reasonable
restrictions on the public disclosure of the information
contained in a report described in paragraph (1), except that
such issuer or entity may not restrict disclosure of such
report to the Department of Health and Human Services, the
Department of Labor, the Department of the Treasury, or
applicable State agencies.
``(C) Limited form of report.--The Secretary shall define
through rulemaking a limited form of the report under
paragraph (1) required of plan sponsors who are drug
manufacturers, drug wholesalers, or other direct participants
in the drug supply chain, in order to prevent anti-
competitive behavior.
``(4) Report to gao.--A health insurance issuer offering
group health insurance coverage or an entity providing
pharmacy benefits management services on behalf of a group
health plan shall submit to the Comptroller General of the
United States each of the first 4 reports submitted to a plan
sponsor under paragraph (1) with respect to such coverage or
plan, and other such reports as requested, in accordance with
the privacy requirements under paragraph (2), the disclosure
and redisclosure standards under paragraph (3), the standards
specified pursuant to paragraph (5), and such other
information that the Comptroller General determines necessary
to carry out the study under section 602(d) of the Restoring
Hope for Mental Health and Well-Being Act of 2022.
``(5) Standard format.--Not later than June 1, 2023, the
Secretary shall specify through rulemaking standards for
health insurance issuers and entities required to submit
reports under paragraph (4) to submit such reports in a
standard format.
``(c) Enforcement.--
``(1) In general.--The Secretary, in consultation with the
Secretary of Labor and the Secretary of the Treasury, shall
enforce this section.
[[Page H5771]]
``(2) Failure to provide timely information.--A health
insurance issuer or an entity providing pharmacy benefit
management services that violates subsection (a) or fails to
provide information required under subsection (b), or a drug
manufacturer that fails to provide information under
subsection (b)(1)(A) in a timely manner, shall be subject to
a civil monetary penalty in the amount of $10,000 for each
day during which such violation continues or such information
is not disclosed or reported.
``(3) False information.--A health insurance issuer, entity
providing pharmacy benefit management services, or drug
manufacturer that knowingly provides false information under
this section shall be subject to a civil money penalty in an
amount not to exceed $100,000 for each item of false
information. Such civil money penalty shall be in addition to
other penalties as may be prescribed by law.
``(4) Procedure.--The provisions of section 1128A of the
Social Security Act, other than subsection (a) and (b) and
the first sentence of subsection (c)(1) of such section shall
apply to civil monetary penalties under this subsection in
the same manner as such provisions apply to a penalty or
proceeding under section 1128A of the Social Security Act.
``(5) Waivers.--The Secretary may waive penalties under
paragraph (2), or extend the period of time for compliance
with a requirement of this section, for an entity in
violation of this section that has made a good-faith effort
to comply with this section.
``(d) Rule of Construction.--Nothing in this section shall
be construed to permit a health insurance issuer, group
health plan, or other entity to restrict disclosure to, or
otherwise limit the access of, the Department of Health and
Human Services to a report described in subsection (b)(1) or
information related to compliance with subsection (a) by such
issuer, plan, or entity.
``(e) Definition.--In this section, the term `wholesale
acquisition cost' has the meaning given such term in section
1847A(c)(6)(B) of the Social Security Act.''; and
(2) in section 2723 (42 U.S.C. 300gg-22)--
(A) in subsection (a)--
(i) in paragraph (1), by inserting ``(other than
subsections (a) and (b) of section 2799A-11)'' after ``part
D''; and
(ii) in paragraph (2), by inserting ``(other than
subsections (a) and (b) of section 2799A-11)'' after ``part
D''; and
(B) in subsection (b)--
(i) in paragraph (1), by inserting ``(other than
subsections (a) and (b) of section 2799A-11)'' after ``part
D'';
(ii) in paragraph (2)(A), by inserting ``(other than
subsections (a) and (b) of section 2799A-11)'' after ``part
D''; and
(iii) in paragraph (2)(C)(ii), by inserting ``(other than
subsections (a) and (b) of section 2799A-11)'' after ``part
D''.
(b) ERISA.--
(1) In general.--Subtitle B of title I of the Employee
Retirement Income Security Act of 1974 (29 U.S.C. 1021 et
seq.) is amended--
(A) in subpart B of part 7 (29 U.S.C. 1185 et seq.), by
adding at the end the following:
``SEC. 726. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
``(a) In General.--For plan years beginning on or after
January 1, 2024, a group health plan (or health insurance
issuer offering group health insurance coverage in connection
with such a plan) or an entity or subsidiary providing
pharmacy benefits management services on behalf of such a
plan or issuer shall not enter into a contract with a drug
manufacturer, distributor, wholesaler, subcontractor, rebate
aggregator, or any associated third party that limits the
disclosure of information to plan sponsors in such a manner
that prevents the plan or issuer, or an entity or subsidiary
providing pharmacy benefits management services on behalf of
a plan or issuer, from making the reports described in
subsection (b).
``(b) Reports.--
``(1) In general.--For plan years beginning on or after
January 1, 2024, not less frequently than once every 6
months, a health insurance issuer offering group health
insurance coverage or an entity providing pharmacy benefits
management services on behalf of a group health plan or an
issuer providing group health insurance coverage shall submit
to the plan sponsor (as defined in section 3(16)(B)) of such
group health plan or group health insurance coverage a report
in accordance with this subsection and make such report
available to the plan sponsor in a machine-readable format.
Each such report shall include, with respect to the
applicable group health plan or health insurance coverage--
``(A) as applicable, information collected from drug
manufacturers by such issuer or entity on the total amount of
copayment assistance dollars paid, or copayment cards
applied, that were funded by the drug manufacturer with
respect to the participants and beneficiaries in such plan or
coverage;
``(B) a list of each drug covered by such plan, issuer, or
entity providing pharmacy benefit management services that
was dispensed during the reporting period, including, with
respect to each such drug during the reporting period--
``(i) the brand name, chemical entity, and National Drug
Code;
``(ii) the number of participants and beneficiaries for
whom the drug was filled during the plan year, the total
number of prescription fills for the drug (including original
prescriptions and refills), and the total number of dosage
units of the drug dispensed across the plan year, including
whether the dispensing channel was by retail, mail order, or
specialty pharmacy;
``(iii) the wholesale acquisition cost, listed as cost per
days supply and cost per pill, or in the case of a drug in
another form, per dose;
``(iv) the total out-of-pocket spending by participants and
beneficiaries on such drug, including participant and
beneficiary spending through copayments, coinsurance, and
deductibles; and
``(v) for any drug for which gross spending of the group
health plan or health insurance coverage exceeded $10,000
during the reporting period--
``(I) a list of all other drugs in the same therapeutic
category or class, including brand name drugs and biological
products and generic drugs or biosimilar biological products
that are in the same therapeutic category or class as such
drug; and
``(II) the rationale for preferred formulary placement of
such drug in that therapeutic category or class, if
applicable;
``(C) a list of each therapeutic category or class of drugs
that were dispensed under the health plan or health insurance
coverage during the reporting period, and, with respect to
each such therapeutic category or class of drugs, during the
reporting period--
``(i) total gross spending by the plan, before manufacturer
rebates, fees, or other manufacturer remuneration;
``(ii) the number of participants and beneficiaries who
filled a prescription for a drug in that category or class;
``(iii) if applicable to that category or class, a
description of the formulary tiers and utilization mechanisms
(such as prior authorization or step therapy) employed for
drugs in that category or class;
``(iv) the total out-of-pocket spending by participants and
beneficiaries, including participant and beneficiary spending
through copayments, coinsurance, and deductibles; and
``(v) for each therapeutic category or class under which 3
or more drugs are included on the formulary of such plan or
coverage--
``(I) the amount received, or expected to be received, from
drug manufacturers in rebates, fees, alternative discounts,
or other remuneration--
``(aa) that has been paid, or is to be paid, by drug
manufacturers for claims incurred during the reporting
period; or
``(bb) that is related to utilization of drugs, in such
therapeutic category or class;
``(II) the total net spending, after deducting rebates,
price concessions, alternative discounts or other
remuneration from drug manufacturers, by the health plan or
health insurance coverage on that category or class of drugs;
and
``(III) the net price per course of treatment or single
fill, such as a 30-day supply or 90-day supply, incurred by
the health plan or health insurance coverage and its
participants and beneficiaries, after manufacturer rebates,
fees, and other remuneration for drugs dispensed within such
therapeutic category or class during the reporting period;
``(D) total gross spending on prescription drugs by the
plan or coverage during the reporting period, before rebates
and other manufacturer fees or remuneration;
``(E) total amount received, or expected to be received, by
the health plan or health insurance coverage in drug
manufacturer rebates, fees, alternative discounts, and all
other remuneration received from the manufacturer or any
third party, other than the plan sponsor, related to
utilization of drug or drug spending under that health plan
or health insurance coverage during the reporting period;
``(F) the total net spending on prescription drugs by the
health plan or health insurance coverage during the reporting
period; and
``(G) amounts paid directly or indirectly in rebates, fees,
or any other type of remuneration to brokers, consultants,
advisors, or any other individual or firm who referred the
group health plan's or health insurance issuer's business to
the pharmacy benefit manager.
``(2) Privacy requirements.--Health insurance issuers
offering group health insurance coverage and entities
providing pharmacy benefits management services on behalf of
a group health plan shall provide information under paragraph
(1) in a manner consistent with the privacy, security, and
breach notification regulations promulgated under section
264(c) of the Health Insurance Portability and Accountability
Act of 1996, and shall restrict the use and disclosure of
such information according to such privacy regulations.
``(3) Disclosure and redisclosure.--
``(A) Limitation to business associates.--A group health
plan receiving a report under paragraph (1) may disclose such
information only to business associates of such plan as
defined in section 160.103 of title 45, Code of Federal
Regulations (or successor regulations).
``(B) Clarification regarding public disclosure of
information.--Nothing in this section prevents a health
insurance issuer offering group health insurance coverage or
an entity providing pharmacy benefits management services on
behalf of a group health plan from placing reasonable
restrictions on the public disclosure of the information
contained in a report described in paragraph (1), except that
such issuer or entity may not restrict disclosure of such
report to the Department of Health and Human Services, the
Department of Labor, the Department of the Treasury, or
applicable State agencies.
``(C) Limited form of report.--The Secretary shall define
through rulemaking a limited form of the report under
paragraph (1) required of plan sponsors who are drug
manufacturers, drug wholesalers, or other direct participants
in the drug supply chain, in order to prevent anti-
competitive behavior.
``(4) Report to gao.--A health insurance issuer offering
group health insurance coverage or an entity providing
pharmacy benefits management services on behalf of a group
health plan shall submit to the Comptroller General of the
United States each of the first 4 reports submitted to a plan
sponsor under paragraph (1) with respect to such coverage or
plan, and other
[[Page H5772]]
such reports as requested, in accordance with the privacy
requirements under paragraph (2), the disclosure and
redisclosure standards under paragraph (3), the standards
specified pursuant to paragraph (5), and such other
information that the Comptroller General determines necessary
to carry out the study under section 602(d) of the Restoring
Hope for Mental Health and Well-Being Act of 2022.
``(5) Standard format.--Not later than June 1, 2023, the
Secretary shall specify through rulemaking standards for
health insurance issuers and entities required to submit
reports under paragraph (4) to submit such reports in a
standard format.
``(c) Enforcement.--
``(1) In general.--The Secretary, in consultation with the
Secretary of Health and Human Services and the Secretary of
the Treasury, shall enforce this section.
``(2) Failure to provide timely information.--A health
insurance issuer or an entity providing pharmacy benefit
management services that violates subsection (a) or fails to
provide information required under subsection (b), or a drug
manufacturer that fails to provide information under
subsection (b)(1)(A) in a timely manner, shall be subject to
a civil monetary penalty in the amount of $10,000 for each
day during which such violation continues or such information
is not disclosed or reported.
``(3) False information.--A health insurance issuer, entity
providing pharmacy benefit management services, or drug
manufacturer that knowingly provides false information under
this section shall be subject to a civil money penalty in an
amount not to exceed $100,000 for each item of false
information. Such civil money penalty shall be in addition to
other penalties as may be prescribed by law.
``(4) Procedure.--The provisions of section 1128A of the
Social Security Act, other than subsection (a) and (b) and
the first sentence of subsection (c)(1) of such section shall
apply to civil monetary penalties under this subsection in
the same manner as such provisions apply to a penalty or
proceeding under section 1128A of the Social Security Act.
``(5) Waivers.--The Secretary may waive penalties under
paragraph (2), or extend the period of time for compliance
with a requirement of this section, for an entity in
violation of this section that has made a good-faith effort
to comply with this section.
``(d) Rule of Construction.--Nothing in this section shall
be construed to permit a health insurance issuer, group
health plan, or other entity to restrict disclosure to, or
otherwise limit the access of, the Department of Labor to a
report described in subsection (b)(1) or information related
to compliance with subsection (a) by such issuer, plan, or
entity.
``(e) Definition.--In this section, the term `wholesale
acquisition cost' has the meaning given such term in section
1847A(c)(6)(B) of the Social Security Act.''; and
(B) in section 502(b)(3) (29 U.S.C. 1132(b)(3)), by
inserting ``(other than section 726)'' after ``part 7''.
(2) Clerical amendment.--The table of contents in section 1
of the Employee Retirement Income Security Act of 1974 (29
U.S.C. 1001 et seq.) is amended by inserting after the item
relating to section 725 the following new item:
``Sec. 726. Oversight of pharmacy benefit manager services.''.
(c) IRC.--
(1) In general.--Subchapter B of chapter 100 of the
Internal Revenue Code of 1986 is amended by adding at the end
the following:
``SEC. 9826. OVERSIGHT OF PHARMACY BENEFIT MANAGER SERVICES.
``(a) In General.--For plan years beginning on or after
January 1, 2024, a group health plan or an entity or
subsidiary providing pharmacy benefits management services on
behalf of such a plan shall not enter into a contract with a
drug manufacturer, distributor, wholesaler, subcontractor,
rebate aggregator, or any associated third party that limits
the disclosure of information to plan sponsors in such a
manner that prevents the plan, or an entity or subsidiary
providing pharmacy benefits management services on behalf of
a plan, from making the reports described in subsection (b).
``(b) Reports.--
``(1) In general.--For plan years beginning on or after
January 1, 2024, not less frequently than once every 6
months, an entity providing pharmacy benefits management
services on behalf of a group health plan shall submit to the
plan sponsor (as defined in section 3(16)(B) of the Employee
Retirement Income Security Act of 1974) of such group health
plan a report in accordance with this subsection and make
such report available to the plan sponsor in a machine-
readable format. Each such report shall include, with respect
to the applicable group health plan--
``(A) as applicable, information collected from drug
manufacturers by such entity on the total amount of copayment
assistance dollars paid, or copayment cards applied, that
were funded by the drug manufacturer with respect to the
participants and beneficiaries in such plan;
``(B) a list of each drug covered by such plan or entity
providing pharmacy benefit management services that was
dispensed during the reporting period, including, with
respect to each such drug during the reporting period--
``(i) the brand name, chemical entity, and National Drug
Code;
``(ii) the number of participants and beneficiaries for
whom the drug was filled during the plan year, the total
number of prescription fills for the drug (including original
prescriptions and refills), and the total number of dosage
units of the drug dispensed across the plan year, including
whether the dispensing channel was by retail, mail order, or
specialty pharmacy;
``(iii) the wholesale acquisition cost, listed as cost per
days supply and cost per pill, or in the case of a drug in
another form, per dose;
``(iv) the total out-of-pocket spending by participants and
beneficiaries on such drug, including participant and
beneficiary spending through copayments, coinsurance, and
deductibles; and
``(v) for any drug for which gross spending of the group
health plan exceeded $10,000 during the reporting period--
``(I) a list of all other drugs in the same therapeutic
category or class, including brand name drugs and biological
products and generic drugs or biosimilar biological products
that are in the same therapeutic category or class as such
drug; and
``(II) the rationale for preferred formulary placement of
such drug in that therapeutic category or class, if
applicable;
``(C) a list of each therapeutic category or class of drugs
that were dispensed under the health plan during the
reporting period, and, with respect to each such therapeutic
category or class of drugs, during the reporting period--
``(i) total gross spending by the plan, before manufacturer
rebates, fees, or other manufacturer remuneration;
``(ii) the number of participants and beneficiaries who
filled a prescription for a drug in that category or class;
``(iii) if applicable to that category or class, a
description of the formulary tiers and utilization mechanisms
(such as prior authorization or step therapy) employed for
drugs in that category or class;
``(iv) the total out-of-pocket spending by participants and
beneficiaries, including participant and beneficiary spending
through copayments, coinsurance, and deductibles; and
``(v) for each therapeutic category or class under which 3
or more drugs are included on the formulary of such plan--
``(I) the amount received, or expected to be received, from
drug manufacturers in rebates, fees, alternative discounts,
or other remuneration--
``(aa) that has been paid, or is to be paid, by drug
manufacturers for claims incurred during the reporting
period; or
``(bb) that is related to utilization of drugs, in such
therapeutic category or class;
``(II) the total net spending, after deducting rebates,
price concessions, alternative discounts or other
remuneration from drug manufacturers, by the health plan on
that category or class of drugs; and
``(III) the net price per course of treatment or single
fill, such as a 30-day supply or 90-day supply, incurred by
the health plan and its participants and beneficiaries, after
manufacturer rebates, fees, and other remuneration for drugs
dispensed within such therapeutic category or class during
the reporting period;
``(D) total gross spending on prescription drugs by the
plan during the reporting period, before rebates and other
manufacturer fees or remuneration;
``(E) total amount received, or expected to be received, by
the health plan in drug manufacturer rebates, fees,
alternative discounts, and all other remuneration received
from the manufacturer or any third party, other than the plan
sponsor, related to utilization of drug or drug spending
under that health plan during the reporting period;
``(F) the total net spending on prescription drugs by the
health plan during the reporting period; and
``(G) amounts paid directly or indirectly in rebates, fees,
or any other type of remuneration to brokers, consultants,
advisors, or any other individual or firm who referred the
group health plan's business to the pharmacy benefit manager.
``(2) Privacy requirements.--Entities providing pharmacy
benefits management services on behalf of a group health plan
shall provide information under paragraph (1) in a manner
consistent with the privacy, security, and breach
notification regulations promulgated under section 264(c) of
the Health Insurance Portability and Accountability Act of
1996, and shall restrict the use and disclosure of such
information according to such privacy regulations.
``(3) Disclosure and redisclosure.--
``(A) Limitation to business associates.--A group health
plan receiving a report under paragraph (1) may disclose such
information only to business associates of such plan as
defined in section 160.103 of title 45, Code of Federal
Regulations (or successor regulations).
``(B) Clarification regarding public disclosure of
information.--Nothing in this section prevents an entity
providing pharmacy benefits management services on behalf of
a group health plan from placing reasonable restrictions on
the public disclosure of the information contained in a
report described in paragraph (1), except that such entity
may not restrict disclosure of such report to the Department
of Health and Human Services, the Department of Labor, the
Department of the Treasury, or applicable State agencies.
``(C) Limited form of report.--The Secretary shall define
through rulemaking a limited form of the report under
paragraph (1) required of plan sponsors who are drug
manufacturers, drug wholesalers, or other direct participants
in the drug supply chain, in order to prevent anti-
competitive behavior.
``(4) Report to gao.--An entity providing pharmacy benefits
management services on behalf of a group health plan shall
submit to the Comptroller General of the United States each
of the first 4 reports submitted to a plan sponsor under
paragraph (1) with respect to such plan, and other such
reports as requested, in accordance with the privacy
requirements under paragraph (2), the disclosure and
redisclosure standards under paragraph (3), the standards
specified pursuant to paragraph (5), and such other
[[Page H5773]]
information that the Comptroller General determines necessary
to carry out the study under section 602(d) of the Restoring
Hope for Mental Health and Well-Being Act of 2022.
``(5) Standard format.--Not later than June 1, 2023, the
Secretary shall specify through rulemaking standards for
entities required to submit reports under paragraph (4) to
submit such reports in a standard format.
``(c) Enforcement.--
``(1) In general.--The Secretary, in consultation with the
Secretary of Labor and the Secretary of Health and Human
Services, shall enforce this section.
``(2) Failure to provide timely information.--An entity
providing pharmacy benefit management services that violates
subsection (a) or fails to provide information required under
subsection (b), or a drug manufacturer that fails to provide
information under subsection (b)(1)(A) in a timely manner,
shall be subject to a civil monetary penalty in the amount of
$10,000 for each day during which such violation continues or
such information is not disclosed or reported.
``(3) False information.--An entity providing pharmacy
benefit management services, or drug manufacturer that
knowingly provides false information under this section shall
be subject to a civil money penalty in an amount not to
exceed $100,000 for each item of false information. Such
civil money penalty shall be in addition to other penalties
as may be prescribed by law.
``(4) Procedure.--The provisions of section 1128A of the
Social Security Act, other than subsection (a) and (b) and
the first sentence of subsection (c)(1) of such section shall
apply to civil monetary penalties under this subsection in
the same manner as such provisions apply to a penalty or
proceeding under section 1128A of the Social Security Act.
``(5) Waivers.--The Secretary may waive penalties under
paragraph (2), or extend the period of time for compliance
with a requirement of this section, for an entity in
violation of this section that has made a good-faith effort
to comply with this section.
``(d) Rule of Construction.--Nothing in this section shall
be construed to permit a group health plan or other entity to
restrict disclosure to, or otherwise limit the access of, the
Department of the Treasury to a report described in
subsection (b)(1) or information related to compliance with
subsection (a) by such plan or entity.
``(e) Definition.--In this section, the term `wholesale
acquisition cost' has the meaning given such term in section
1847A(c)(6)(B) of the Social Security Act.''.
(2) Clerical amendment.--The table of sections for
subchapter B of chapter 100 of the Internal Revenue Code of
1986 is amended by adding at the end the following new item:
``Sec. 9826. Oversight of pharmacy benefit manager services.''.
(d) GAO Study.--
(1) In general.--Not later than 3 years after the date of
enactment of this Act, the Comptroller General of the United
States shall submit to Congress a report on--
(A) pharmacy networks of group health plans, health
insurance issuers, and entities providing pharmacy benefit
management services under such group health plan or group or
individual health insurance coverage, including networks that
have pharmacies that are under common ownership (in whole or
part) with group health plans, health insurance issuers, or
entities providing pharmacy benefit management services or
pharmacy benefit administrative services under group health
plan or group or individual health insurance coverage;
(B) as it relates to pharmacy networks that include
pharmacies under common ownership described in subparagraph
(A)--
(i) whether such networks are designed to encourage
enrollees of a plan or coverage to use such pharmacies over
other network pharmacies for specific services or drugs, and
if so, the reasons the networks give for encouraging use of
such pharmacies; and
(ii) whether such pharmacies are used by enrollees
disproportionately more in the aggregate or for specific
services or drugs compared to other network pharmacies;
(C) whether group health plans and health insurance issuers
offering group or individual health insurance coverage have
options to elect different network pricing arrangements in
the marketplace with entities that provide pharmacy benefit
management services, the prevalence of electing such
different network pricing arrangements;
(D) pharmacy network design parameters that encourage
enrollees in the plan or coverage to fill prescriptions at
mail order, specialty, or retail pharmacies that are wholly
or partially-owned by that issuer or entity; and
(E) the degree to which mail order, specialty, or retail
pharmacies that dispense prescription drugs to an enrollee in
a group health plan or health insurance coverage that are
under common ownership (in whole or part) with group health
plans, health insurance issuers, or entities providing
pharmacy benefit management services or pharmacy benefit
administrative services under group health plan or group or
individual health insurance coverage receive reimbursement
that is greater than the median price charged to the group
health plan or health insurance issuer when the same drug is
dispensed to enrollees in the plan or coverage by other
pharmacies included in the pharmacy network of that plan,
issuer, or entity that are not wholly or partially owned by
the health insurance issuer or entity providing pharmacy
benefit management services.
(2) Requirement.--The Comptroller General of the United
States shall ensure that the report under paragraph (1) does
not contain information that would allow a reader to identify
a specific plan or entity providing pharmacy benefits
management services or otherwise contain commercial or
financial information that is privileged or confidential.
(3) Definitions.--In this subsection, the terms ``group
health plan'', ``health insurance coverage'', and ``health
insurance issuer'' have the meanings given such terms in
section 2791 of the Public Health Service Act (42 U.S.C.
300gg-91).
SEC. 603. MEDICARE IMPROVEMENT FUND.
Section 1898(b)(1) of the Social Security Act (42 U.S.C.
1395iii(b)(1)) is amended by striking ``$5,000,000'' and
inserting ``$1,029,000,000''.
SEC. 604. LIMITATIONS ON AUTHORITY.
In carrying out any program of the Substance Abuse and
Mental Health Services Administration whose statutory
authorization is enacted or amended by this Act, the
Secretary of Health and Human Services shall not allocate
funding, or require award recipients to prioritize, dedicate,
or allocate funding, without consideration of the incidence,
prevalence, or determinants of mental health or substance use
issues, unless such allocation or requirement is consistent
with statute, regulation, or other Federal law.
The SPEAKER pro tempore. The bill, as amended, shall be debatable for
1 hour equally divided and controlled by the chair and ranking minority
member of the Committee on Energy and Commerce or their respective
designees.
The gentleman from New Jersey (Mr. Pallone) and the gentlewoman from
Washington (Mrs. Rodgers) each will control 30 minutes.
The Chair recognizes the gentleman from New Jersey.
General Leave
Mr. PALLONE. Mr. Speaker, I ask unanimous consent that all Members
may have 5 legislative days in which to revise and extend their remarks
and add extraneous material on H.R. 7666.
The SPEAKER pro tempore. Is there objection to the request of the
gentleman from New Jersey?
There was no objection.
Mr. PALLONE. Mr. Speaker, I yield myself such time as I may consume.
Mr. Speaker, I rise today in support of H.R. 7666, the Restoring Hope
for Mental Health and Well-Being Act of 2022, and I thank Ranking
Member Rodgers for working with me these past few months to develop
this comprehensive legislation that will help address the mental health
and substance use disorder crisis facing millions of Americans.
This bill is needed today more than ever. Americans report rising
anxiety and depression and increased use of alcohol, opiates, and other
substances. One in five adults are battling a mental illness. Suicide
is now the second leading cause of death for children ages 10 to 14,
and earlier this year the Centers for Disease Control and Prevention
released a report finding that 4 in 10 high school students said they
felt persistently sad or hopeless during the COVID-19 pandemic. The
opioid crisis also continues to devastate families and communities all
around the Nation. 108,000 people lost their lives due to drug
overdoses just last year alone.
The Restoring Hope for Mental Health and Well-Being Act will help
restore hope for millions of Americans. The bill strengthens and
expands more than 30 critical programs that collectively support mental
health care and substance use disorder prevention, care, treatment, and
recovery support services in communities across the Nation.
As the Nation prepares for the launch of the 988 National Suicide
Prevention Lifeline dialing code next month, H.R. 7666 provides key
crisis response efforts, establishing the Substance Abuse and Mental
Health Services Behavioral Health Crisis Coordination Office and
requiring the development of crisis response best practices. The
legislation also continues investments in critical mental health and
substance use services block grant funding to States, territories, and
Tribes.
The Restoring Hope Act includes crucial provisions to meet the
challenges of the Nation's opioid epidemic, expanding and ensuring
timely patient access to lifesaving treatment for opioid use disorders
through the elimination of barriers to treatment. It includes
Representative Tonko's MAT Act, which eliminates the X-waiver, a
burdensome registration requirement that establishes arbitrary caps on
the number of patients a provider can treat for opioid use disorder
using buprenorphine.
This bill also establishes a one-time, 8-hour training requirement on
treating and identifying substance use disorders that providers must
complete
[[Page H5774]]
before their first registration or renewal of a license to dispense
controlled substances.
H.R. 7666 also helps bolster the behavioral health workforce capacity
and training. It also increases access to mental health and substance
use disorder care and coverage by applying the mental health parity law
to State and local government workers, such as teachers and frontline
workers.
The legislation also supports the mental health of children and young
people. It continues investment in the integration of behavioral health
into pediatric primary care through Pediatric Mental Health Access
Grants and enhances research at the National Institutes of Health on
the cognitive, physical, and socioemotional impacts of modern
technology and multimedia on infants, children, and adolescents.
I can't stress enough that this is an epidemic that focuses a lot on
children and adolescents. Older youth need help with suicide prevention
and other mental health support and substance use disorder services.
Students in higher education need that help, and they get it through a
program called the Garrett Lee Smith Memorial Act.
The bill also ensures that State Medicaid programs have resources to
implement and strengthen school-based mental health services while
preserving the continuity of coverage for justice-involved youth. These
important provisions will increase children's access to care.
Mr. Speaker, the scope and reach of this bipartisan legislation--and
I stress that. This was reported out of the Energy and Commerce
Committee unanimously, Mr. Speaker. It is truly bipartisan. It is going
to help to support the mental health and well-being of millions of
Americans, their families, and communities for years to come.
I thank Members on both sides of the aisle, not only Ranking Member
Rodgers, but the subcommittee leadership as well, both Democrat and
Republican.
The reason that we try to do this on a bipartisan level and get
everybody's support is because we have a good chance of passing this in
the Senate, which is also acting on similar legislation. We are hopeful
that as a result of a large vote today, that will spur the Senate into
action, and we can actually get this bill signed into law.
Mr. Speaker, I urge my colleagues to support the bill, and I reserve
the balance of my time.
House of Representatives,
Committee on the Judiciary,
Washington, DC, June 10, 2022.
Hon. Frank Pallone, Jr.,
Chairman, Committee on Energy and Commerce, House of
Representatives, Washington, DC.
Dear Chairman Pallone: This letter is to advise you that
the Committee on the Judiciary has now had an opportunity to
review the provisions in H.R. 7666, the ``Restoring Hope for
Mental Health and Well-Being Act of 2022,'' that fall within
our Rule X jurisdiction. I appreciate your consulting with us
on those provisions. The Judiciary Committee has no objection
to your including them in the bill for consideration on the
House floor, and to expedite that consideration is willing to
forgo action on H.R. 7666, with the understanding that we do
not thereby waive any future jurisdictional claim over those
provisions or their subject matters.
In the event a House-Senate conference on this or similar
legislation is convened, the Judiciary Committee reserves the
right to request an appropriate number of conferees to
address any concerns with these or similar provisions that
may arise in conference.
Please place this letter into the Congressional Record
during consideration of the measure on the House floor. Thank
you for the cooperative spirit in which you have worked
regarding this matter and others between our committees.
Sincerely,
Jerrold Nadler,
Chairman.
____
House of Representatives,
Committee on Energy and Commerce,
Washington, DC, June 13, 2022.
Hon. Jerrold Nadler,
Chairman, Committee on Judiciary,
Washington, DC.
Dear Chairman Nadler: Thank you for consulting with the
Committee on Energy and Commerce and agreeing to be
discharged from further consideration of H.R. 7666, the
``Restoring Hope for Mental Health and Well-Being Act of
2022,'' so that the bill may proceed expeditiously to the
House floor.
I agree that your forgoing further action on this measure
does not in any way diminish or alter the jurisdiction of
your committee or prejudice its jurisdictional prerogatives
on this measure or similar legislation in the future. I would
support your effort to seek appointment of an appropriate
number of conferees from your committee to any House-Senate
conference on this legislation.
I will ensure our letters on H.R. 7666 are included in the
report for this bill and entered into the Congressional
Record during floor consideration of the bill. I appreciate
your cooperation regarding this legislation and look forward
to continuing to work together as this measure moves through
the legislative process.
Sincerely,
Frank Pallone, Jr.,
Chairman.
Mrs. RODGERS of Washington. Mr. Speaker, I yield myself such time as
I may consume.
Mr. Speaker, I rise today in support of H.R. 7666, the Restoring Hope
for Mental Health and Well-Being Act.
We are taking urgent action to help States and communities provide
lifesaving mental health care to people in need, especially for our
children and those suffering from severe mental illness.
I think about Austin, a 9-year-old boy who struggled to cope when his
school was shut down, and his parents were going through a divorce. He
was socially isolated and didn't know where to turn. When he confessed
suicidal thoughts to his mom, they faced long waiting lists and no beds
for the care that he needed.
Cases like Austin's can't be ignored. Parents, teachers, and medical
professionals are talking about this everywhere I go.
In Spokane, Washington, we are seeing more violence in our schools
and rising crime. Drug overdose deaths and fentanyl poisoning were up
300 percent last year. There is an overwhelming sense of despair,
anxiety, fear, and isolation. This has been heightened by the horrific
shootings in Uvalde and Buffalo. Especially for our children, we need
to deliver hope and healing in every community in our country.
This bill will help children in crisis and improve school safety. For
example, Congresswoman Ashley Hinson is leading with Richard Hudson on
a provision that will expand access to behavioral and mental health
services to kids in schools.
It also includes a solution I led on with Congresswoman Young Kim to
reauthorize the Garrett Lee Smith Memorial Act, which supports
community-based youth and young adult suicide prevention programs.
Like with Representative French Hill's solution in this, we are
removing red tape, boosting treatment access, and making sure
communities have resources to combat the substance use disorder
epidemic in America.
More than 100,000 people are dying a year, and our communities are in
desperate need of help to prevent, treat, and rescue people from
overdoses and despair.
The priorities in this bill are targeted to responsibly address our
most urgent needs so we can build stronger families, communities, and a
brighter future. We are accomplishing this by stopping duplicative
programs and cutting the deficit by $200 million. The bulk of the
programs in this bill are block grants that have been successful in
providing our States and communities with the resources and
flexibilities to meet the specific and unique needs in combating mental
illness and addiction while keeping the Federal Government out of the
decisionmaking process for treatments and care.
By protecting charitable choice, we are also making sure faith-based
and religious organizations are competing on an equal footing. This is
a victory for conscience protections.
The provisions in this bill also support care for maternal mental
health and substance use disorders, which are among the leading causes
of death for pregnant and postpartum women. We are saving lives and
caring for women at every stage of pregnancy and beyond.
Mr. Speaker, I again urge support for this legislation. I thank
Chairman Pallone for his leadership and for working with us on
solutions from our colleagues on both sides of the aisle.
While families and communities will lead the way to address the root
causes of despair, isolation, violence, and overdose deaths that are
tearing nearly every community apart and destroying people's lives,
this bill takes an important step forward to help them in these
efforts.
We are taking action to turn this despair into hope. Children like
Austin in communities like mine in eastern Washington are counting on
it. Let's
[[Page H5775]]
deliver today and keep building on this work.
Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Illinois (Ms. Schakowsky), who chairs our Subcommittee on Consumer
Protection and Commerce.
Ms. SCHAKOWSKY. Mr. Speaker, I am so happy about this bipartisan
legislation and really excited about the changes that are going to be
made, because for all 24 years that I have been in Congress, I have not
had a townhall meeting or a meeting with my constituents where the
issue of access and affordability of mental health services has not
come up.
Right now, our country is facing a mental health crisis like we have
not seen before. We are seeing that families are losing loved ones to
COVID, to suicide, and to overdoses.
This bill will provide vital services in substance abuse and mental
health, four things mainly. We will see a strengthening of parity. We
voted for parity a long time ago, and now we are going to make sure
that mental health and physical health are on the same page.
We are going to have 30 programs that are going to strengthen and
reauthorize mental health services. We are going to have more education
for doctors. We are going to have doctors be able to have more patients
for certain mental assistance treatment.
This is a great bill. We should all be proud to vote for it.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 2 minutes to the
gentleman from Minnesota (Mr. Emmer), who has led on important
provisions for children in this bill.
Mr. EMMER. Mr. Speaker, I thank the ranking member, soon to be chair,
for yielding.
I rise in support of H.R. 7666, the Restoring Hope for Mental Health
and Well-Being Act.
After years of lockdowns and social isolation, the mental health of
our Nation's citizens, and especially our youth, is at an all-time low.
But H.R. 7666 begins to return us to a better path, so I thank the
chairman and ranking member for all their hard work to make this a
reality.
I am especially pleased that portions of two bills that I had the
pleasure of working on with my colleague from Maryland were included in
this legislation. One such provision would amend the Medicaid Inmate
Exclusion Policy to allow incarcerated juveniles who have been detained
pending trial to continue to receive Medicaid coverage. Pretrial
detainees are, by definition, presumed innocent. As a matter of due
process, we should not be denying critical health benefits to anyone
who has not been convicted of a crime.
From a practical standpoint, reforms to the Medicaid Inmates
Exclusion Policy will help our local law enforcement better manage the
shockingly high percentage of inmates who suffer from mental illness.
H.R. 7666 also includes language to create a behavioral health
coordinating office, another issue that I have had the pleasure of
working on. Many Federal programs to address the mental health crisis
currently lack clear, unified direction and coordination, which is a
recipe for redundancy and waste.
{time} 1415
The reforms in today's bill will bring all the major agencies into
the room, including the Secretary of Education, the Secretary of Health
and Human Services, and the Director of National Drug Control Policy to
develop a unified approach to addressing topics ranging from substance
abuse care to delivery of better telehealth.
There is always more work to be done to improve the mental health of
our Nation, but H.R. 7666 is an important step, and one we need now
more than ever.
Madam Speaker, I once again urge my colleagues to support this
critical legislation.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Maryland (Mr. Sarbanes), who has been involved with these health and
behavioral issues for a long time.
Mr. SARBANES. Mr. Speaker, I thank the gentleman for yielding.
Mr. Speaker, I, too, rise today in support of H.R. 7666, the
Restoring Hope for Mental Health and Well-Being Act of 2022.
Our Nation, as you know, is facing a continuing mental health and
substance use crisis that has only been exacerbated by the COVID-19
pandemic. This crisis touches the lives of individuals in each and
every corner of our country and has a particularly acute impact on
children and teens.
Recognizing this, last October, the American Academy of Pediatrics,
the American Academy of Child and Adolescent Psychiatry, and the
Children's Hospital Association declared a national emergency in child
and adolescent mental health.
To wrap our arms as a society around children facing mental and
behavioral health challenges, I recently joined in introducing H.R.
7248, the Continuing Systems of Care for Children Act, with my
colleagues Representatives Joyce, Underwood, and Gimenez, a bipartisan
bill that I am proud is included in H.R. 7666 today.
This legislation would reauthorize for 5 years two important grant
programs; one that provides comprehensive community mental health
services for children with serious emotional disturbances, as well as
the Youth and Family TREE Program.
These programs connect children and teenagers to services that meet
their individual needs and have a sustained positive impact on their
well-being.
As we confront the compounding challenges posed by our mental health
and behavioral health crisis and our national gun violence crisis,
Congress must provide our children every resource they need to lead
safe and healthy lives.
That is why it is so important that we pass the Restoring Hope for
Mental Health and Well-Being Act today to bolster mental health
services and better support our communities now and into the future.
Mr. Speaker, I urge my colleagues to vote ``yes'' on this
legislation.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 3 minutes to the
gentleman from Kentucky (Mr. Guthrie), our lead on the Subcommittee on
Health.
Mr. GUTHRIE. Mr. Speaker, I thank the gentlewoman for yielding.
Mr. Speaker, H.R. 7666 the Restoring Hope for Mental Health and Well-
Being Act is a significant bill that will help support our mental
health workforce, increase access to pediatric mental health treatment,
and help make schools safer.
This bill will bolster substance use disorder prevention, treatment,
and recovery resources. The Committee on Energy and Commerce has worked
on this for many months, held hearings, and reported it out by a voice
vote in May.
Recognizing children's mental health has been negatively impacted by
school closures, ineffective lockdowns, and increased violence. This
bill provides specific resources to help communities respond to the
children's mental health crisis. This legislation also supports
community mental health services for children with serious emotional
disturbances through crisis-care service and early intervention
activities.
The need to strengthen resources for children's mental health has
been further heightened after the horrific school violence we have seen
in Uvalde.
This bill also works to reauthorize the Garrett Lee Smith Suicide
Prevention Program, provide funding for a suicide prevention lifeline,
and update a major block grant that States use to provide support to
those with serious mental illness.
In addition to supporting those with mental illness, the legislation
helps those with substance use disorders. Kentucky has seen a drastic
rise in overdoses throughout the pandemic and, nationally, the CDC
estimates that drug overdoses exceeded 107,000 between November 2020
and November 2021.
Many of these drug overdoses have been caused by synthetic opioids,
like illicit fentanyl poisoning, which were involved in about 70
percent of all Kentucky overdoses in 2021.
Ultimately, fighting the drug overdose epidemic will require a two-
pronged approach: Equipping our law enforcement with the tools they
need to keep these deadly poisons off our streets and providing
recovery and treatment resources.
Through the passage of this bill, we are advancing the second part of
this
[[Page H5776]]
approach by increasing access to critical treatment and recovery
resources for people from all walks of life and every stage of life.
This includes resources for moms and pregnant women by supporting care
for maternal health and substance use disorders, which are among the
leading cause of death for pregnant and postpartum women.
In addition, this legislation also has a provision led by
Representative Bucshon, alongside Representatives Miller-Meeks, Axne,
and Pappas, to remove unnecessary regulatory barriers to help those
with opioid use disorder seek the care that they need as quickly as
possible.
The Timely Treatment for Opioid Use Disorder Act removes a Federal
requirement of having to live with opioid disorder for more than 1 year
to be admitted for in-person treatment. I am proud that my bill, the
Substance Use Prevention, Treatment, and Recovery Services Block Grant
Act of 2022, which I have worked together with my colleagues, Messrs.
Tonko, McKinley, and Ms. Wild, is also included in this bill.
The legislation would deliver more coordinated substance use disorder
care as well as explicitly reauthorizing funding for recovery support
services, which include workforce training and others.
Mr. Speaker, I encourage my colleagues to vote for this bill.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from New
York (Mr. Tonko), who chairs our Environment and Climate Change
Subcommittee.
Mr. TONKO. Mr. Speaker, I rise in strong support of the Restoring
Hope for Mental Health and Well-Being Act.
I offer my thanks to Chairman Pallone and Ranking Member Rodgers and
their staffs for their tireless work on this bill. It is yet another
example of the profound good our committee can produce when we work
together in a collaborative and bipartisan fashion.
This strongly bipartisan legislation will take several steps to
improve mental health and substance use care.
Importantly, H.R. 7666 includes my Mainstreaming Addiction Treatment
Act, which will eliminate outdated barriers that prevent more people in
need from having access to buprenorphine, a lifesaving drug. I have
worked on this legislation for years and was pleased to see it advance
out of committee with a strong bipartisan majority.
By passing this legislation, we will vastly expand access to
addiction medicine and move us toward a system of treatment on demand
for those struggling with addiction.
It is not hyperbole to say this is one of the most meaningful steps
that Congress has taken to date to address the opioid epidemic. It will
save countless lives, and I am indeed grateful for the bipartisan push
here to get it over the finish line.
H.R. 7666 also includes a bill that I authored to reauthorize and
strengthen the Substance Use Prevention and Treatment Block Grant,
which serves as the foundation for State's substance use prevention and
treatment programs.
We made important improvements to the block grant, including
clarifying that recovery support services are eligible for funding
through this program.
We are going to keep working to increase funding levels and hopefully
implement a recovery set-aside, ensuring that all States invest in
critical recovery services.
Taken together, the pieces of the Restoring Hope for Mental Health
and Well-Being Act will truly make a difference to families and
communities struggling with mental health and substance use challenges.
Mr. Speaker, I urge all my colleagues to support this critically
important legislation that delivers hope to our communities, delivers
hope to the doorstep of our families.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 2 minutes to the
gentleman from Arkansas (Mr. Hill), a leader on this issue, who
sponsored the underlying bill that is incorporated in this package.
Mr. HILL of Arkansas. Mr. Speaker, I thank Mr. Pallone and Mrs.
McMorris Rodgers for their excellent bipartisan leadership in bringing
these bills to the floor. It is the way Congress is supposed to work.
Mr. Speaker, I didn't know anyone who died of a drug overdose when I
was in high school or college. But my two sweet kids can count five or
six of their peers who have been lost to suicide, drug overdose-
related. It is heartbreaking. Everybody in this House knows the
horrifying 107,000 losses we have seen from opioid deaths last year.
So I do, in fact, rise in support of H.R. 7666, and to discuss my co-
prescribing legislation that was included in this mental health
package. My bill seeks to prevent opioid overdoses through co-
prescription. This effort was inspired by my home State of Arkansas,
which is one of 14 States that has co-prescribing now.
Co-prescribing is when a doctor prescribes an opioid overdose
reversal drug like naloxone along with the prescription. My legislation
encourages co-prescribing when medically appropriate. It also supports
existing standing orders to increase laypersons' access to opioid
overdose reversal drugs like naloxone.
Statistical modeling reported to the International Journal of Drug
Policy suggests that high rates of naloxone distribution among
laypersons and emergency personnel could avert 21 percent of opioid
overdose deaths. The majority of overdose death reduction would be as a
result of that increased naloxone distribution to patients.
Mr. Speaker, in 2021, 551 of our citizens of Arkansas are alive today
because of a co-prescription legislation.
Mr. Speaker, the data is clear. Co-prescribing saves lives, and that
is why I urge my colleagues to support H.R. 7666.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentleman from
Arizona (Mr. O'Halleran), a member of the Committee on Energy and
Commerce.
Mr. O'HALLERAN. Mr. Speaker, I thank the chairman for yielding.
Mr. Speaker, I rise in support of H.R. 7666, the Restoring Hope for
Mental Health and Well-Being Act, legislation that works to increase
the accessibility of our mental health care system and breaks down the
unique barriers to care for rural communities that are facing it.
Each year, hundreds of thousands of Arizonians do not receive the
mental health care they need. Without access to this essential care,
our families and our communities suffer.
In recent years, we have lost too many loved ones to opioid abuse,
suicide, and senseless violence in our communities. It has gone on far
too long. As a homicide investigator in Chicago, I can tell you of the
hundreds and hundreds of these types of cases I saw day in and day out.
Affordable, accessible mental health care plays an important role in
holistically addressing each one of these issues. That is why I worked
with my colleagues on the Committee on Energy and Commerce, a
bipartisan effort, to bring this urgently needed legislation to the
House floor for a vote.
By investing in workforce education and training, and supporting
critical mental health programs, the Restoring Hope for Mental Health
and Well-Being Act works to address the provider shortage millions of
Americans are experiencing and expands access to the care our
vulnerable and underserved communities need.
I am pleased to see the initiative to reauthorize and improve
critical SAMHSA programs included in this bill. In Arizona, more than
five people die every day from overdoses. This crisis is tearing entire
families and communities apart.
Our legislation would assist in developing coordinated local opioid
response plans, expand access to medications that reverse an opioid
overdose, and improve substance use disorder and mental health
treatment for homeless individuals.
Our bill also invests in mental health care for our children through
programs that serve a wide range of ages and mental health needs,
including suicide prevention for students.
Mr. Speaker, it is time we fill those gaps, and I urge my colleagues
to vote for this bill.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 2 minutes to the
gentleman from Texas (Mr. Tony Gonzales), whose community understands
the importance of hope and healing like no other right now.
Mr. TONY GONZALES of Texas. Mr. Speaker, I rise today to support H.R.
7666, the Restoring Hope for Mental Health and Well-Being Act of 2022.
One month ago, a gunman fired on Robb Elementary School in Uvalde,
[[Page H5777]]
Texas, 38 miles from where I grew up. This despicable crime led to the
death of 19 innocent children and two teachers. As a father of six, I
am absolutely heartbroken.
As a Congressman who represents Uvalde, I am focusing on delivering
change. The change starts with addressing the serious lack of mental
health resources in our country.
{time} 1430
In a 2022 report by Mental Health America, Texas was ranked as the
worst State for access to mental health care. In rural communities,
that gap is felt even more intensely.
It is in places like Uvalde that mental health clinicians are few and
far between, and parents have to drive more than 4 hours roundtrip for
access to inpatient care. Communities like Uvalde are desperately in
need of mental health resources now and well into the future.
That is why I am proud to support this bipartisan package that will
commit significant resources to mental health awareness, training, and
treatment.
It is time for Congress to address the solution to the mental health
crisis in America, and that starts with supporting H.R. 7666.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
New Hampshire (Ms. Kuster), a member of the Energy and Commerce
Committee.
Ms. KUSTER. Mr. Speaker, I rise today in support of H.R. 7666, the
Restoring Hope for Mental Health and Well-Being Act of 2022.
It has never been more urgent to pass this comprehensive legislation
that will help deliver essential mental health and substance use
disorder treatment and support to communities across this country.
Americans continue to lose loved ones to addiction and mental health
struggles every day. Mr. Speaker, 2021 marked the deadliest year yet,
with nearly 108,000 overdose deaths here in the United States. In
Nashua, New Hampshire, in my district, the rate of fatal overdoses
doubled from March to April just this year, and it is on track to reach
the highest number of opioid deaths since the epidemic began.
We cannot wait another day to pass this critical legislation.
As founder and co-chair of the Bipartisan Addiction and Mental Health
Task Force, I am pleased to see the Restoring Hope for Mental Health
and Well-Being Act include many of the bills from our task force
agenda, bills like the Mainstreaming Addiction Treatment Act to remove
outdated barriers that prevent healthcare providers from prescribing
essential treatment for substance use disorder.
I am also pleased to see the Restoring Hope for Mental Health and
Well-Being Act include the KIDS CARE Act, legislation I introduced with
Congressman Hudson to improve Medicaid in schools and provide mental
health screenings for justice-involved youth.
Importantly, H.R. 7666 addresses the many unmet needs of communities
that have suffered because of inadequate mental health resources, from
bolstering grants for depression screening and suicide prevention to
strengthening the behavioral health workforce.
I support this legislation because it responds to the urgency of
today's crisis and will improve mental health and addiction care all
across the country.
Mr. Speaker, I thank Chairman Pallone and his staff for his
leadership on this bill and the Speaker for giving us the opportunity
to discuss this legislation. I urge a ``yes'' vote.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 2 minutes to the
gentlemen from North Dakota (Mr. Armstrong), a leader on the committee.
Mr. ARMSTRONG. Mr. Speaker, I rise today in strong support of the
Restoring Hope for Mental Health and Well-Being Act.
This bipartisan mental health package includes my legislation, the
Summer Barrow Prevention, Treatment, and Recovery Act. This bill
reauthorizes several substance use disorder programs administered by
SAMHSA that help local communities provide substance use disorder and
mental health services to those most in need.
This is particularly important for rural States like North Dakota,
where individuals struggle to access all treatment options that may
work for them.
The package also includes the Mainstreaming Addiction Treatment Act,
or MAT Act. The MAT Act would remove the burdensome requirement that a
healthcare practitioner apply for a separate waiver, known as the X
waiver, through the Drug Enforcement Agency to prescribe certain drugs
for substance use disorder treatment.
The X waiver requirement limits access to lifesaving treatment, which
is particularly painful considering recent news that drug overdose
deaths hit a record high of more than 107,000 in 2021.
Lastly, I offer my support for an amendment I offered with my friend
Congressman Trone of Maryland that will come to the floor soon. Our
amendment would add the State Opioid Response Grants Act to this
program.
This amendment will provide $8.75 billion over 5 years in flexible
financing for State Opioid Response grants and Tribal Opioid Response
grants, providing States and Tribes certainty and stability to
implement prevention, treatment, and recovery.
Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentleman from
Maryland (Mr. Hoyer), the House majority leader.
Mr. HOYER. Mr. Speaker, I thank the chairman and ranking member for
the work they have done together and with the committee to bring this
very important bipartisan bill to the floor. I thank them both for
their hard work, and the committee for its hard work, in compiling this
bipartisan package to combat two of the most important issues, Mr.
Speaker, facing communities today: mental health and drug addiction.
The COVID-19 pandemic exacerbated mental health and addiction
challenges that were already present in our communities. For those
already experiencing severe depression, anxiety, or even substance
abuse and addiction disorders, the pandemic made it harder to access
mental health care and essential help and resources, and it created, of
course, much greater anxiety.
This bill would reauthorize key mental health and addiction programs
while helping to strengthen communities' crisis response.
There are many important programs included, but I will highlight just
a few.
Mr. Speaker, among them is legislation from my friend Representative
David Trone to help States expand the availability of high-quality
recovery housing for treatment from substance abuse. Representative
Trone has been a leader on this issue as co-chair of the Bipartisan
Addiction and Mental Health Task Force.
Mr. Speaker, also included is legislation from my friends
Representatives Cindy Axne and Chris Pappas to revise opioid treatment
program criteria to help those in need of treatment access it more
quickly.
Our in-house pediatrician, Representative Kim Schrier, authored a
provision to help children and teens who have had their lives upended
by the pandemic access the mental health care and services that they so
badly need.
Mr. Speaker, I also mention a critical section added by
Representative Susie Lee to provide important resources for virtual
peer support programs. Representative Lee knows how much her
constituents have benefited from these types of programs and how much
more good they can do if given the proper resources.
Representative Tonko from New York, included legislation to expand
access to prescription medications that help patients overcome
addiction disorders.
Mr. Speaker, these are just a few of the very beneficial policies
included in this legislation that will improve lives and, indeed, save
lives.
I am so proud of the Energy and Commerce Committee and all the
Members whose legislation is included in this bipartisan package, which
demonstrates how we can join together, Democrats and Republicans, to
pass important legislation and show those we serve they are not alone
in facing these challenges.
Mr. Speaker, I hope this strong vote today will help move these
critical policies through the Senate and see them quickly enacted into
law.
Mr. Speaker, I urge a ``yes'' vote.
Mrs. RODGERS of Washington. Mr. Speaker, I reserve the balance of my
time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
[[Page H5778]]
Washington (Ms. Schrier), a member of the Energy and Commerce
Committee.
Ms. SCHRIER. Mr. Speaker, I express my support for H.R. 7666, the
Restoring Hope for Mental Health and Well-Being Act of 2022.
In over 20 years as a pediatrician, I saw steadily escalating levels
of mental illness in my patients. There was a big uptick after 2007
that many associate with ubiquitous social media use. Of course, the
pandemic further accelerated rates of depression, anxiety, eating
disorders, and self-harm. We are seeing 9-year-olds with eating
disorders and 10-year-olds with suicidal ideation. This is alarming.
We all agree that our children need help, but resources are limited.
There just aren't enough behavioral health specialists out there to
meet the need, particularly in rural areas like some of those I
represent.
There are ways to extend the reach of people who have dedicated their
lives to supporting our mental health, to leverage those resources so
they stretch a little further. One example is the Partnership Access
Line, or PAL, that I was able to access as a pediatrician. If I was
seeing a patient with a more complicated behavioral health concern,
something really beyond the scope of a general pediatrician, I could
get a psychiatrist on the line and in-the-moment advice on how to treat
that patient.
Another example is integrative care, where a mental worker works
alongside physicians and other healthcare providers, providing support
as needed throughout the day for patients who are struggling with
mental illness.
These programs and more are supported in the package of bills we will
be voting on this week, including mine, the Supporting Children's
Mental Health Care Access Act.
Mr. Speaker, I encourage my colleagues to vote ``yes'' on this
excellent bill.
Mrs. RODGERS of Washington. Mr. Speaker, I reserve the balance of my
time.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Michigan (Mrs. Dingell), a member of the committee.
Mrs. DINGELL. Mr. Speaker, I rise in support of the Restoring Hope
for Mental Health and Well-Being Act of 2022.
I thank all of my committee members on both sides for months of work
on this important bipartisan legislation, which reauthorizes and
strengthens critical mental and behavioral health programs that will
help address public health issues like the opioid epidemic, which
claimed over 107,000 lives in the United States last year alone.
The mental health package before us contains strong mental health
parity provisions that my colleague Congresswoman Katie Porter and I
led. This will close a critical gap in healthcare coverage for mental
health and substance abuse treatment for thousands of frontline workers
across the country.
It also includes a provision I worked on with my friend and
colleague, Congressman French Hill, that provides incentives for co-
prescribing when a doctor pairs an opioid prescription with a
prescription of an opioid overdose reversal drug like naloxone. This is
a proven method to reduce overdose deaths.
Finally, it is good to see consideration of an amendment I coauthored
with Congressman McKinley cracking down on suspicious orders of
opioids, which will help further curb abuses and save lives.
Mr. Speaker, all of us have had family members or know someone who
has had a mental health crisis or issue or suffered from depression.
For too long, people have been afraid to even acknowledge it, to seek
help, or to get help. There has been a stigma associated with it.
Today, all of us on both sides of this aisle need to help remove that
stigma.
My sister died of a drug overdose, and my father was a drug addict.
Perhaps we wouldn't have suffered some of the traumas had people not
been afraid to speak of it.
Mr. Speaker, this is a strong package that will improve our national
response, and I urge my colleagues to support this bill.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 2 minutes to the
gentleman from Florida (Mr. Bilirakis), a leader on the committee and
on this legislation.
Mr. BILIRAKIS. Mr. Speaker, I thank the ranking member and the
chairman for this very important bill.
I rise in strong support of H.R. 7666, the Restoring Hope for Mental
Health and Well-Being Act, which reauthorizes and improves key SAMHSA
block grant programs for mental health and substance use disorder
prevention and treatment services. These are all targeted toward
helping our constituents who have struggled with anxiety, stress, and
isolation.
Sadly, our Nation is experiencing an unprecedented mental health
crisis, particularly among our children and teens. It has only gotten
worse during the COVID pandemic, Mr. Speaker. We have seen a disturbing
spike in rates of depression, self-harm, suicide attempts, and death
among teens. Teen depression, in particular, has risen by 60 percent.
We cannot afford to wait any longer to address this mental health and
addiction crisis, and this package presents much-needed solutions that
will enact meaningful changes to help combat the trends we have seen.
Specifically, I am very glad to see in the manager's amendment a
provision I have long advocated for that will require HHS to conduct
research on smartphone and social media use by adolescents and the
effects of such use on emotional and behavioral health.
{time} 1445
All of us agree on the need to better protect our children and their
mental health from social media, and this is an excellent start. We are
also going to consider an amendment I am proud to support with my good
friend Rodney Davis that will contain H.R. 2355, the Opioid
Prescription Verification Act, to help prevent opioid abuse through e-
prescribing.
In closing, this is a strong, bipartisan package, and I urge my
colleagues to fully support it.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Texas (Mrs. Fletcher), who is also a member of the Energy and Commerce
Committee.
Mrs. FLETCHER. Mr. Speaker, I thank the chairman for his leadership
and support and making it possible for us to be here today to pass the
Restoring Hope for Mental Health and Well-Being Act of 2022. It is an
important effort, and I am so glad that the bipartisan bill that I
introduced last year with Congresswoman Jaime Herrera Beutler, the
Collaborate in an Orderly and Cohesive Manner Act, H.R. 5218, is
included in it.
Many people first display symptoms of a mental health condition or
substance use disorder in the primary care setting. Often they can't
access the necessary follow-up treatment, it is either too expensive or
too difficult for them to find the necessary mental health professional
or overcome other obstacles, including stigma.
That is why enabling patients to access behavioral health treatment
at their first point of care is critical, and that is what this bill
does.
The collaborative care model addresses obstacles including stigma, a
shortage of mental health professionals, and cost by integrating
behavioral healthcare within the primary care setting, with their
trusted family doctors, which allows patients to access the care they
need in a setting where they feel most comfortable.
The collaborative care model is a measurement-based model featuring a
primary care physician, a psychiatric consultant, and care manager all
working together to provide mental health care for patients and
ensuring that that care is delivered effectively.
There are more than 90 published trials demonstrating its success in
different settings for both adults and children. It extends the reach
of our psychiatrists, which is essential as we work to address demand
in the face of workforce shortages. It is covered by Medicare, most
private insurers, and many State Medicaid programs, alleviating the
huge financial burden that can often be associated with accessing
mental health care.
Despite its proven effectiveness, implementation of the collaborative
care model remains low because of the upfront costs and lack of
technical assistance for providers. This bill addresses this roadblock
by providing grant funding for States to work with primary
[[Page H5779]]
care physicians and practices looking to adopt this model.
Mr. Speaker, I thank my colleagues, Congresswomen Herrera Beutler and
Eshoo and Chairman Pallone for addressing the mental health crisis in
this country.
Mrs. RODGERS of Washington. Mr. Speaker, may I inquire as to how much
time is remaining.
The SPEAKER pro tempore. The gentlewoman from Washington has 14\1/2\
minutes remaining. The gentleman from New Jersey has 8\1/2\ minutes
remaining.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 1\1/2\ minutes to
the gentlewoman from California (Mrs. Kim), who is a leader on a
provision within the larger package.
Mrs. KIM of California. Mr. Speaker, I thank Ranking Member Rodgers
for yielding. I rise today in support of the Restoring Hope for Mental
Health and Well-Being Act of 2022.
The pandemic and shutdowns left many Americans, especially women and
children, feeling isolated, anxious, and alone. Depression, self-harm,
substance abuse, and suicide have reached crisis levels.
I am glad we can help provide meaningful, targeted hope and healing
to communities who need it. I am proud that two bills that I worked on,
the Into the Light for Maternal Mental Health Act and the Garrett Lee
Smith Memorial Act, were included in this package to prevent student
suicide and support women facing mental health and substance abuse
disorders during pregnancy.
We must keep working to turn despair into hope.
As a mom of four and a new grandma, I will always fight for the
health and well-being of communities in southern California and across
our Nation.
Mr. Speaker, I urge my colleagues to pass this commonsense,
bipartisan H.R. 7666.
Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentleman from
Oregon (Mr. Blumenauer).
Mr. BLUMENAUER. Mr. Speaker, I am pleased we are taking up this
bipartisan legislation today to reauthorize critical programs to
address mental health.
We cannot, however, address mental health without acknowledging and
addressing the climate impact. Our children are experiencing twin
crises of mental health and climate change anxiety.
Last week, the Oregon Health Authority released a report raising the
alarm of the effect of climate change on our youth. From the impact of
climate-related disasters to climate anxiety, our children are facing
stress and trauma that we need to address with them.
If we want to invest in our youth and their mental health, we must
acknowledge the impact and give them hope that we understand and are
working to reduce that threat. We simply cannot leave climate out of
the conversation.
I appreciate the work that Chairman Pallone has done for both youth
mental health and climate, and I look forward to working with him to
address both these critical issues.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 1 minute to the
gentleman from Georgia (Mr. Carter), who is a leader on the issue.
Mr. CARTER of Georgia. Mr. Speaker, I thank the gentlewoman for
yielding.
Mr. Speaker, we are all witnessing the decline in America's mental
health brought about by the COVID-19 pandemic. Between family members
and friends, we all are either affected ourselves or we know someone
with a mental health condition. I am a father and a grandfather, and
there is nothing more important to me than the safety and well-being of
my children and grandchildren.
The urgency to address this mental health crisis has become more dire
as we are seeing how fear, anxiety, and particularly isolation have
compounded these issues. We owe it to our constituents to turn despair
into hope and keep our children safe at school and in their community.
The Restoring Hope for Mental Health and Well-Being Act will help
communities provide much-needed lifesaving care to our children.
America's children are our Nation's future. It is time we take action
and protect our loved ones and pass the Restoring Hope for Mental
Health and Well-Being Act.
Mr. Speaker, I support this bill, and I encourage my colleagues to do
the same.
Mr. PALLONE. Mr. Speaker, I yield 1 minute to the gentleman from
Virginia (Mr. Beyer).
Mr. BEYER. Mr. Speaker, the pandemic magnified suicide risk, anxiety,
and depression with two out of five adults reporting symptoms of
anxiety and depression. The Kaiser Family Foundation released a report
this morning that found that suicide death rates rose by 12 percent
from 2010 to 2020--with rates rising fastest among people of color,
younger people, and our good citizens in rural areas.
Help can't come fast enough.
I thank the Rules Committee for allowing the Katko-Napolitano-Beyer
amendment to be included in the first en bloc today. This reauthorizes
and ensures sufficient funding and provides oversight of the National
Suicide Prevention Lifeline.
As the House and Senate finalize any mental health package to be
signed into law, I want to flag my bill with Adam Kinzinger--the
Campaign to Prevent Suicide--which was passed by the committee and the
House last year. It would help educate the American public both on the
new 988 suicide lifeline number and also change the culture from one in
crisis and avoidance to one that connects to resources.
SAMHSA has stated that the campaign is crucial to the success of 988.
We can save an untold number of lives. 988 can be among the most
important bipartisan success we have ever had.
Mr. Speaker, I thank Chair Pallone, Cathy McMorris Rodgers, and the
committee staff for their commitment to tackling mental health. It is
2022, and we know far, far more than ever before in human history. It
is time to put our healing knowledge to work.
Mrs. RODGERS of Washington. Mr. Speaker, I yield 1\1/2\ minutes to
the gentlewoman from Iowa (Mrs. Miller-Meeks).
Mrs. MILLER-MEEKS. Mr. Speaker, I thank Ranking Member McMorris
Rodgers for yielding time.
Mr. Speaker, I rise today in support of H.R. 7666, the Restoring Hope
for Mental Health and Well-Being Act.
This bill takes serious action to address mental health and substance
use disorder, especially as we are coming out of the COVID-19 pandemic.
I am pleased that the House was able to come together to create a
bipartisan solution to deliver real results to the American people,
both adults and children.
I also thank Ms. Schrier for partnering with me as we introduced the
Supporting Children's Mental Health Care Access Act, which is included
in this bipartisan package. This bill reauthorizes two grant programs
that support pediatric mental and behavioral health services and
interventions. Reauthorizing the pediatric mental health care access
grant program is an important step in ensuring that our students have
equal access to quality mental health care.
I would also like to thank Representatives Axne, Bucshon, and Pappas
for joining me to introduce the Timely Treatment for Opioid Use
Disorder Act which is also included in H.R. 7666. This bill increases
access to treatment for individuals suffering from opioid use disorder.
Opioid addiction does not have a timeline and does not discriminate.
Patients should be able to begin treatment for opioid addiction as soon
as possible.
I strongly encourage all of my colleagues to join me in supporting
H.R. 7666, the bipartisan, results driven, and commonsense Restoring
Hope for Mental Health and Well-Being Act.
Mr. PALLONE. Mr. Speaker, I yield 2 minutes to the gentlewoman from
Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. Mr. Speaker, I thank the chairman for yielding. As I
begin--I am going to ask the chairman to enter into a colloquy--but,
first, let me express my strong support for H.R. 7666 and the work that
has been done in a bipartisan manner by both the chairman and the
ranking member, and the importance of the issue of dealing with opioid
addictions and other addictions that require this additional work. I am
gratified to rise to support that.
I thank Chairman Pallone, and ask, as I said, that he engages in a
colloquy with me on the need to support the mental health needs of
trauma victims impacted by trauma and, yes, mass
[[Page H5780]]
shootings. I think I have been here in the United States Congress
during Columbine, Virginia Tech, Sandy Hook, Mother Emanuel, Santa Fe,
Parkland--and the list goes on--and tragically Uvalde with 19 children,
2 adults, and 1 individual who died of heartbreak. I was in Uvalde, and
I saw the impact on our children, to see 9-year-olds--9-year-olds--
crying and saying that because I spoke to them, they said you are
making me happy because you spoke to me, and you said you care. Out of
the mouth of a 9-year-old.
So we know there is a mental health crisis as relates to the trauma
of those who certainly are survivors and those who are in the
community.
We also know that too many families and children in this country are
hurting from the preventable epidemic of gun violence, shootings, and
mass casualty events. These tragic events have lasting scars on the
families, friends, and communities. I have seen this pain with my own
eyes. And so I am interested in--as my amendment that I withdrew
indicated--is there a prioritization of those children who are impacted
by trauma?
Madam Speaker, I would like to be able to work with Chairman Pallone
on this issue. Will the gentleman yield for the purpose of a colloquy?
Mr. PALLONE. Madam Speaker, I just wanted to stress that H.R. 7666
includes programs focused on supporting youth mental health.
The SPEAKER pro tempore (Mrs. Beatty). The time of the gentlewoman
has expired.
Mr. PALLONE. I thank the gentlewoman for her leadership on this
issue. In fact, H.R. 7666 includes programs focused on supporting youth
mental health including due to such traumatic events that were
mentioned by the gentlewoman.
The SAMHSA Garrett Lee Smith State/Tribal Youth Suicide Prevention
and Early Intervention Program, for instance, and HRSA's Pediatric
Mental Health Care Access program, which helps integrate behavioral
health into pediatric primary care, extends resources to support
Project AWARE, building student, families, and school behavioral health
resiliency. Further, the bill provides support to complement SAMHSA's
launch of the new 988 National Suicide Prevention Lifeline dialing code
next month that will expand access to crisis care support through call,
text, or chat functions for millions of Americans.
Madam Speaker, I yield an additional 1 minute to the gentlewoman from
Texas (Ms. Jackson Lee).
Ms. JACKSON LEE. I thank the chairman for answering my questions
regarding the Restoring Hope Act that there will be provisions for
mental health care and services for children, families, and communities
who experience these traumatic and violent events.
I look forward working with the chairman on these vital resources.
With your partnership I would like to continue to work with you and the
administration to ensure that when this legislation is enacted, the
needs of the vulnerable victims and those closest to them are in the
front of our minds.
Will the gentleman commit to working with me on this matter?
The SPEAKER pro tempore. The time of the gentlewoman has again
expired.
Mr. PALLONE. Let me just add, I am pleased to work with the
gentlewoman from Texas on this critical matter.
I thank her for her support in ensuring children and families have
access to the mental health support and services they need to lead
healthy and hopeful lives.
Madam Speaker, I yield an additional 30 seconds to the gentlewoman
from Texas.
Ms. JACKSON LEE. Madam Speaker, I thank the chairman for his support.
I will support this legislation.
Mr. Speaker, I rise as a staunch advocate for mental health services
to speak in favor of the Restoring Hope for Mental Health and Well-
Being Act of 2022.
This bill amends the Public Health Service Act to reauthorize
critical mental health programs for those dealing with mental health or
substance abuse disorders.
H.R. 7666 works to mitigate some of the most pressing issues of our
time by designating grants, expanding the availability of high-quality
recovery housing, reauthorizing treatment programs, and combatting
substance abuse.
In 2019, an estimated 10.1 million people in the U.S. aged 12 or
older misused opioids in the past year. Specifically, 9.7 million
people misused prescription pain relievers and 745,000 people used
heroin.
The bill eliminates a key restrictive classification of opioid
addiction so that access to treatment programs is expanded.
These issues disproportionately impact tribal communities. According
to the American Addiction Centers, 10% of Native Americans have a
substance use disorder.
H.R. 7666 specifically funds the prevention and treatment of mental
health and substance use disorders for tribal populations.
This is a needed step in protecting a community with a history of
being mistreated by the Federal government.
This bill's expansion of access to mental health care services, most
importantly of all, would make these services much more available to
children and adolescents, who must always be our top priority.
For example, this bill increases mental health services for our youth
by integrating behavioral health into public education in primary
schools and creating a grant for pediatric mental health services.
This legislation also addresses another pressing issue that afflicts
young Americans: eating disorders. As many as 10 in 100 young women
suffer from an eating disorder.
H.R. 7666 provides federal funding for the identification and
treatment of eating disorders.
But, above all, Mr. Speaker, who among all of our children, need
mental health services more than those who have just experienced the
unconscionable? Senseless shootings leave our students, some as young
as five years old, devastated and vulnerable.
As adults, the thought of having our peers murdered in front of us is
disturbing. How much more traumatizing would that be for pre-school
students?
This bill acts as a conduit for protecting children who are victims
of a mass shooting or mass casualty event.
Mass shootings, especially school shootings, can leave lethal and
obvious physical wounds on victims.
However, the long-lasting and subtle mental trauma is the invisible
scar left on many survivors. Friends, family, and classmates often
suffer with extreme guilt and sadness.
There have been 278 mass shooting in this year alone. Firearms are
now the leading cause of death for children and teens.
In addition to those tragically killed, millions more are left
behind, coping with these deaths. An estimated 3 million children in
the US are exposed to shootings per year.
Since Columbine, there have been 337 school shootings and 311,000
students have experienced gun violence at school. Even more disturbing,
just since Uvalde, there have been 65 mass shootings.
This is not a one-state issue. From the 28 killed at Sandy Hook in
Connecticut, to the 17 killed at Marjorie Stoneman-Douglas in Florida,
to the 10 killed at Red Lake in Minnesota, to the 22 killed at Robb
Elementary in my home state of Texas, school shootings have become a
disgusting norm.
Children exposed to violence, crime, and abuse are more likely to
abuse drugs and alcohol; suffer from depression, anxiety, and
posttraumatic stress disorder; fail or have difficulties in school; and
engage in criminal activity.
These children don't stay children forever. These mental health
struggles translate to a life of pain and suffering where crime, drug
use, and suicide are more likely.
This trauma has real consequences: in the year following the 2018
massacre at Stoneman-Douglas High school, two students took their own
life after suffering with the mental anguish of the events they had
lived through.
Passage of this bill will not solve the gun crisis or mass shootings
in this country. Only common-sense gun-control will do that.
However, this bill will set a foundation for the government to
address the toll of gun violence on children's mental health.
Additionally, enactment of this legislation demonstrates Congress'
support of victims of mass casualty events by prioritizing access to
mental health services.
Children are the future of our country. Far too many of them have
their hopes and dreams stripped away by senseless shootings.
{time} 1500
Mrs. RODGERS of Washington. Madam Speaker, I yield 1\1/2\ minutes to
the gentleman from Kentucky (Mr. Comer).
Mr. COMER. Madam Speaker, I have become increasingly concerned that
the consolidation and monopolistic nature of pharmacy benefit managers,
or PBMs has negatively impacted competition in the pharmaceutical
marketplace, leading Americans to spend more on prescription drugs than
any
[[Page H5781]]
other country. These PBMs not only raise patient costs but are
potentially engaged in anticompetitive behavior.
The legislation before us today includes language requiring PBMs to
issue reports to employer sponsors of health plans outlining
information that they have been unwilling to provide to their
customers, including copays applied by insurers to drug manufacturer
costs, rebates received from manufacturers, and the PBM's rationale for
choosing certain brand name drugs over more affordable biosimilars,
generics, or therapeutics for their formularies.
Simply providing this information to the participants in group health
plans is expected to save over $2 billion over 10 years. These
biannual, employer or sponsor-specific reports will allow participants
in group health plans to make informed decisions about the services
their PBM is providing and reduce patient costs for prescription drugs.
We cannot have a serious conversation about lowering drug prices in
America without examining PBMs' ever-growing influence.
Mr. PALLONE. Madam Speaker, I yield 1 minute to the gentleman from
California (Mr. Levin).
Mr. LEVIN of California. Madam Speaker, I thank the gentleman for
yielding.
Madam Speaker, the substance use disorder crisis has touched almost
every American in one way or another. Too many families have felt the
extraordinary pain of burying a son or daughter, a father or a mother
who struggled with the disease of addiction.
Tragically, many families have also experienced the heartbreak and
deep frustration that comes after a loved one enters a residential
recovery home that ultimately doesn't provide them with adequate care
to get and stay on the path toward recovery.
We must ensure that residential recovery homes meet a high standard
of care and provide those who are struggling with the support they need
to recover.
We can and must do better. That is why I introduced the SOBER Homes
Act, parts of which are included in H.R. 7666, the legislation we are
voting on today. It includes $1.5 million for a Federal study of the
effectiveness of recovery housing and to identify recommendations
promoting the availability of high-quality recovery housing.
This legislation will help us better understand where these
facilities are falling short and how we can improve them to ensure
everyone in recovery housing receives the help they need and deserve.
Finally, I thank all the advocates who have been fighting so hard on
this issue. The information from this effort will save lives, which is
why I implore my colleagues to support this bill and vote ``aye.''
Mrs. RODGERS of Washington. Madam Speaker, I yield 3 minutes to the
gentleman from Pennsylvania (Mr. Joyce), a member of the Committee on
Energy and Commerce.
Mr. JOYCE of Pennsylvania. Madam Speaker, I thank the gentlewoman for
yielding.
Right now, today, as we all are here in the Halls of Congress, our
Nation is facing a mental health crisis. And this crisis followed 2
years of lockdowns and remote learning that have left so many Americans
feeling isolated, lost, and, in some cases, hopeless. Particularly, our
young Americans feel all of these emotions.
I rise today in support of this legislation that would help to
address this crisis head-on by helping to ensure that those who are
struggling can receive the help that they so desperately need, that
they need, and they need our attention to it right now.
The Restoring Hope for Mental Health and Well-Being Act of 2022
expands access to care for millions of Americans, including children
and teenagers who are desperately in need of this assistance.
As a doctor, I have treated patients who have later lost their lives
to mental illness. Just last week, we had physicians here on the Hill,
pediatricians, family doctors, telling us that they have seen the shift
of the pendulum; that they see on a daily basis more and more cases in
their patients, specifically involving mental health.
And there is not a single American who has not in some way been
impacted by the effects that mental illness is having today.
In the past year, over 107,000 Americans have lost their lives to
drug overdoses. Far too many grandparents, far too many fathers,
mothers, sons, and daughters are dying. We cannot wait to act any
longer. We need to act and vote on this legislation.
To help address the tragedy of addiction, this bill increases support
for opioid recovery programs that will help people who are struggling
to receive the care that they need.
This bill would go on to make mental health screenings a part of each
person's annual physical exam and evaluation and help to ensure that
everyone who sees a doctor is able to have a conversation frankly,
concisely, clearly, about their mental health and the mental health
issues that they are facing.
Most importantly, this bill would provide a whole-of-care approach
that would fund prevention, treatment, and recovery services for the
people who are suffering with addiction. We have worked as a committee,
as a conference addressing these important issues.
I urge all of my colleagues to vote to pass this important piece of
legislation.
Mr. PALLONE. Madam Speaker, I yield 1 minute to the gentleman from
Rhode Island (Mr. Cicilline).
Mr. CICILLINE. Madam Speaker, for too long, Americans, including
children, struggling with mental illness and substance abuse, have
suffered in silence, intimidated by stigma and unable to access
treatment.
The 2019 Rhode Island Youth Risk Behavior Survey found that 15
percent of Rhode Island high school students reported attempting
suicide one or more times in the previous 12 months. That is 4 students
in a class of 25.
There is a mental health crisis in Rhode Island and throughout our
country, and we have to address it now.
The Restoring Hope for Mental Health and Well-Being Act will save
lives by expanding access to mental health and substance abuse disorder
treatment through: Establishing the Behavioral Health Crisis
Coordination Office; reauthorizing critical public health programs to
prevent suicide and expand access to mental health and substance use
disorder treatment; and eliminating unnecessary limits on providers'
ability to prescribe treatments for opioid use disorder.
I urge my colleagues to join with me in support of this critical
legislation to save lives and to help us address addiction all across
our country.
Mrs. RODGERS of Washington. Madam Speaker, I yield 1 minute to the
gentleman from Ohio (Mr. Balderson).
Mr. BALDERSON. Madam Speaker, I thank Ranking Member Rodgers for this
work.
Madam Speaker, I rise today in support of H.R. 7666, the Restoring
Hope for Mental Health and Well-Being Act.
Lockdowns, isolations, economic instability, disruptions to learning
and daily routines. For well over a year, school closures, mask
mandates, and online learning became the new normal for far too many
young Americans.
As a result, a new crisis is afoot in our country, one with
potentially dire consequences for our future, a mental health crisis
among younger Americans.
Today, nearly 7 in 10 parents of young children in Ohio are worried
about their kids' mental or emotional health. Drug overdose is now the
leading cause of death of Americans ages 18 to 45. Our kids are
counting on us, and we are counting on them.
Madam Speaker, I urge a ``yes'' vote on H.R. 7666.
Mr. PALLONE. Madam Speaker, I have no additional speakers. I am
prepared to close. I reserve the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I yield 2 minutes to the
gentleman from Indiana (Mr. Bucshon).
Mr. BUCSHON. Madam Speaker, I rise today in support of H.R. 7666, the
Restore Hope for Mental Health and Well-Being Act of 2022.
I am proud to be a member of a committee that works in a bipartisan
way to help solve the problems facing our constituents every day. Right
now, that means addressing the Nation's mental health crisis.
[[Page H5782]]
Though many challenges existed before the start of the COVID-19
pandemic, 2\1/2\ years of widespread fear, social isolation, and
financial uncertainty has further increased Americans' need for mental
health support systems.
This bill reauthorizes many of the critical mental health programs
Americans currently rely on, but also provides for new measures.
Especially important to me is the inclusion of the TRIUMPH for New
Moms Act, a bipartisan bill I coauthored with Representative Barragan.
It aims to establish a no-cost, interdepartmental task force to address
the U.S. maternal mental health crisis by eliminating duplication and
coordinating Federal resources toward maternal mental health.
This task force would also work closely with State Governors to
alleviate the maternal mental health challenges in their States.
Current Federal efforts to support women suffering from maternal
mental health conditions lack coordinated action and organization
toward this issue. And, as a result, 50 percent of these new moms never
receive treatment.
This bill will increase mental health support for pregnant and new
mothers by offering targeted solutions that have proven success, a fact
that is particularly important to me, given Indiana's maternal
mortality rate, which is one of the highest in the Nation.
Passing this bill will help provide better support for future
generations of mothers and children.
Again, I thank the chair and ranking member of the Energy and
Commerce Committee for their dedication to these issues, and I look
forward to passage of H.R. 7666.
Mr. PALLONE. Madam Speaker, I reserve the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I yield myself the balance
of my time.
Madam Speaker, I want to again just express appreciation to the
chairman of the committee, all the Members that have participated in
helping bring this package of very important mental health proposals to
the House today. I urge a strong ``yes'' vote.
As many have said, we have a mental health crisis. At a time when
there is so much fear and anxiety and stress, we see increased suicide.
We see drug overdoses, and it is time that we act, and act in a way
that is really going to make a difference for America's families and
our youth in particular.
Madam Speaker, I urge support, and I yield back the balance of my
time.
Mr. PALLONE. Madam Speaker, I yield myself the balance of my time.
Let me just reiterate what the ranking member said. This was really a
bipartisan bill. I thank Mrs. Rodgers, Mr. Guthrie, Ms. Anna Eshoo, and
all the staff that worked so hard on this legislation.
It is important that we have as big a vote as possible because this
bill has a real chance of passing the Senate and getting to the
President's desk and will really address the mental health and
substance abuse concerns that we have and the crisis that we have. So I
urge everyone to vote ``yes.''
Madam Speaker, I yield back the balance of my time.
Mrs. NAPOLITANO. Madam Speaker, I rise today in strong support of
H.R. 7666, the Restoring Hope for Mental Health and Well-Being Act. I
am honored to have my bill, H.R. 721, the Mental Health Services for
Students Act, included in this package. Today is a historic day in
recognizing the need for more comprehensive school-based mental health
resources.
The COVID-19 pandemic has upended the lives of our nation's children
and youth and added additional stressors that have significantly
strained and continues to strain their mental health and well-being.
Children and youth across the nation continue to confront the traumatic
challenges of this pandemic, including disruptions to their lives, fear
and anxiety about the virus, and the tragic death of loved ones.
According to the Centers for Disease Control and Prevention (CDC),
mental health disorders are chronic conditions that, without proper
diagnosis and treatment, can lead to problems for children at home and
in school, interfering with their health and future development.
H.R. 721 acknowledges this problem by providing $130 million in
competitive grants for school-based mental health programs nationwide.
It expands the scope of the Project AWARE program by providing onsite
licensed mental health professionals in schools across the country.
H.R. 721 is based on the successful Youth Suicide Prevention Program
that I helped establish with Pacific Clinics in Los Angeles County in
2001, after learning 1 in 3 Latina adolescents, age 9 to 11, had
contemplated suicide. We need to secure the long-term availability of
mental health services to ensure a bright future for our students,
which my bill would help accomplish.
I would like to thank the many advocates in and outside of Congress
who have played an integral role in this legislation. H.R. 721 has 86
bipartisan co-sponsors and has the support of over 50 mental health
organizations, as well as local governments and teacher unions. I would
also like to thank my co-lead Rep. John Katko, Chairman Pallone and his
staff, and my own staff who contributed toward today's passage.
Madam Speaker, I ask my colleagues to support the underlying bill,
H.R. 7666, which will help address our ongoing mental health crisis. it
is now time to act on this bill and provide the necessary funding and
resources to reach children and youth early on in life.
Ms. ROYBAL-ALLARD. Madam Speaker, I rise in support of this bill,
which seeks to address our national mental health and substance use
crisis. I thank Congressman Pallone for this package of bills, which
includes my bill, H.R. 7105, known as the STOP Act.
The STOP Act advances a comprehensive and effective national effort
on underage drinking prevention, which includes a national adult-
oriented media campaign and grants for community-based prevention
coalitions.
The legislation recognizes the importance of alcohol regulation and
the fact that alcohol is different than other consumer products and is
best regulated by states, consistent with the 21st Amendment.
Since the passage of the original STOP Act in 2006, we have witnessed
a 12.7 percent decrease in alcohol use amongst 12-to-20-year-olds. Yet,
alcohol continues to be the most widely used substance amongst youth,
accounting for 3,900 deaths and 225,000 years of potential life lost
annually.
We must continue to lead efforts to reduce underage alcohol use and
ensure the safety of our youth. I urge my colleagues to vote YES on
this bill.
Ms. MOORE of Wisconsin. Madam Speaker, today, I rise in support of
H.R. 7666, a bipartisan response to rising substance use disorders and
mental health needs in our communities.
The need for this bill is clear.
We've heard about the growing mental health crisis, including about
alarming rates of mental health hospitalizations, suicide rates and
depression. The need for mental health services continues to grow,
including among our children. In my district, the emergency department
at Children's Wisconsin saw a 60 percent increase in young patients who
attempted suicide between 2020 and 2021.
Substance misuse also remains a crisis in our communities. Milwaukee
county has among the highest rates of overdose deaths in Wisconsin and
has seen high numbers of emergency calls related to overdoses in the
past few years. According to Milwaukee County, from 2014 to 2020, the
opioid overdose fatality rate in the country was 30.9 per 100,000
persons, more than twice the rate statewide.
This bill includes strong provisions to reauthorize and revitalize
federal programs that support access to treatment and services, while
boosting access to crisis services. The whole continuum of services
needs to be strengthened to ensure that no one in need of help goes
without.
The bill would also reauthorize and increase funding for the Mental
Health First Aid grant program. Mental Health First Aid is an
evidenced-based program that teaches ordinary people how to identify,
understand, and respond to the signs of mental illness and substance
use disorder.
The bill would also reauthorize the Pediatric Mental Health Care
Access Grant, a program that supports the ability of pediatric primary
care providers to deliver mental health care with the help of rapid
consultation with psychiatrists, social workers, and/or psychologists.
The program also provides training and education on early
identification, diagnosis, and treatment of behavioral health
condition, allowing more families to access high-quality mental health
treatment in their pediatrician's office.
I am pleased to offer an amendment that will improve this bill by
ensuring that state and local officials who administer programs serving
pregnant and postpartum individuals are consulted by those operating
the new maternal mental health hotline. This hotline will provide free
and confidential support before, during, and after pregnancy providing
yet another tool for those in need.
Through programs such as WIC, SNAP and the Maternal and Child Health
Service Block grant, among others, the federal government reaches
numerous pregnant and postpartum individuals. State and local officials
are key
[[Page H5783]]
partners in the operations of those programs and often are on the
frontlines of reaching and serving populations that would immensely
benefit from access to this important new resource. It only makes sense
that they be involved in efforts related to making this hotline truly
effective and that individuals know about the resources it offers.
I thank the chairman and Ranking Member for their support of my
amendment. I urge my colleagues to support it and the underlying bill.
The SPEAKER pro tempore. All time for debate has expired.
Each further amendment printed in part E of House Report 117-381 not
earlier considered as part of the amendments en bloc pursuant to
section 6 of House Resolution 1191 shall be considered only in the
order printed in the report, may be offered only by a Member designated
in the report, shall be considered as read, shall be debatable for the
time specified in the report equally divided and controlled by the
proponent and an opponent, may be withdrawn by the proponent at any
time before the question is put thereon, shall not be subject to
amendment, and shall not be subject to a demand for division of the
question.
It shall be in order at any time for the chair of the Committee on
Energy and Commerce or his designee to offer amendments en bloc
consisting of further amendments printed in part E of House Report 117-
381, not earlier disposed of. Amendments en bloc shall be considered as
read, shall be debatable for 20 minutes equally divided and controlled
by the chair and ranking minority member of the Committee on Energy and
Commerce or their respective designees, shall not be subject to
amendment, and shall not be subject to a demand for division of the
question.
{time} 1515
amendments en bloc no. 1 offered by mr. pallone of new jersey
Mr. PALLONE. Madam Speaker, pursuant to House Resolution No. 1191, I
rise to offer amendments en bloc No. 1.
The SPEAKER pro tempore. The Clerk will designate the amendments en
bloc.
Amendments en bloc No. 1 consisting of amendment Nos. 1, 5, 9, 10,
13, 14, 15, and 16, printed in part E of House Report 117-381, offered
by Mr. Pallone of New Jersey:
amendment no. 1 offered by mr. bera of california
After section 331, insert the following new subtitle:
Subtitle E--Improving Emergency Department Mental Health Access,
Services, and Responders
SEC. 341. HELPING EMERGENCY RESPONDERS OVERCOME.
(a) Data System to Capture National Public Safety Officer
Suicide Incidence.--The Public Health Service Act is amended
by inserting before section 318 of such Act (42 U.S.C. 247c)
the following:
``SEC. 317V. DATA SYSTEM TO CAPTURE NATIONAL PUBLIC SAFETY
OFFICER SUICIDE INCIDENCE.
``(a) In General.--The Secretary, in coordination with the
Director of the Centers for Disease Control and Prevention
and other agencies as the Secretary determines appropriate,
may--
``(1) develop and maintain a data system, to be known as
the Public Safety Officer Suicide Reporting System, for the
purposes of--
``(A) collecting data on the suicide incidence among public
safety officers; and
``(B) facilitating the study of successful interventions to
reduce suicide among public safety officers; and
``(2) integrate such system into the National Violent Death
Reporting System, so long as the Secretary determines such
integration to be consistent with the purposes described in
paragraph (1).
``(b) Data Collection.--In collecting data for the Public
Safety Officer Suicide Reporting System, the Secretary shall,
at a minimum, collect the following information:
``(1) The total number of suicides in the United States
among all public safety officers in a given calendar year.
``(2) Suicide rates for public safety officers in a given
calendar year, disaggregated by--
``(A) age and gender of the public safety officer;
``(B) State;
``(C) occupation; including both the individual's role in
their public safety agency and their primary occupation in
the case of volunteer public safety officers;
``(D) where available, the status of the public safety
officer as volunteer, paid-on-call, or career; and
``(E) status of the public safety officer as active or
retired.
``(c) Consultation During Development.--In developing the
Public Safety Officer Suicide Reporting System, the Secretary
shall consult with non-Federal experts to determine the best
means to collect data regarding suicide incidence in a safe,
sensitive, anonymous, and effective manner. Such non-Federal
experts shall include, as appropriate, the following:
``(1) Public health experts with experience in developing
and maintaining suicide registries.
``(2) Organizations that track suicide among public safety
officers.
``(3) Mental health experts with experience in studying
suicide and other profession-related traumatic stress.
``(4) Clinicians with experience in diagnosing and treating
mental health issues.
``(5) Active and retired volunteer, paid-on-call, and
career public safety officers.
``(6) Relevant national police, and fire and emergency
medical services, organizations.
``(d) Data Privacy and Security.--In developing and
maintaining the Public Safety Officer Suicide Reporting
System, the Secretary shall ensure that all applicable
Federal privacy and security protections are followed to
ensure that--
``(1) the confidentiality and anonymity of suicide victims
and their families are protected, including so as to ensure
that data cannot be used to deny benefits; and
``(2) data is sufficiently secure to prevent unauthorized
access.
``(e) Reporting.--
``(1) Annual report.--Not later than 2 years after the date
of enactment of the Restoring Hope for Mental Health and
Well-Being Act of 2022, and biannually thereafter, the
Secretary shall submit a report to the Congress on the
suicide incidence among public safety officers. Each such
report shall--
``(A) include the number and rate of such suicide
incidence, disaggregated by age, gender, and State of
employment;
``(B) identify characteristics and contributing
circumstances for suicide among public safety officers;
``(C) disaggregate rates of suicide by--
``(i) occupation;
``(ii) status as volunteer, paid-on-call, or career; and
``(iii) status as active or retired;
``(D) include recommendations for further study regarding
the suicide incidence among public safety officers;
``(E) specify in detail, if found, any obstacles in
collecting suicide rates for volunteers and include
recommended improvements to overcome such obstacles;
``(F) identify options for interventions to reduce suicide
among public safety officers; and
``(G) describe procedures to ensure the confidentiality and
anonymity of suicide victims and their families, as described
in subsection (d)(1).
``(2) Public availability.--Upon the submission of each
report to the Congress under paragraph (1), the Secretary
shall make the full report publicly available on the website
of the Centers for Disease Control and Prevention.
``(f) Definition.--In this section, the term `public safety
officer' means--
``(1) a public safety officer as defined in section 1204 of
the Omnibus Crime Control and Safe Streets Act of 1968; or
``(2) a public safety telecommunicator as described in
detailed occupation 43-5031 in the Standard Occupational
Classification Manual of the Office of Management and Budget
(2018).
``(g) Prohibited Use of Information.--Notwithstanding any
other provision of law, if an individual is identified as
deceased based on information contained in the Public Safety
Officer Suicide Reporting System, such information may not be
used to deny or rescind life insurance payments or other
benefits to a survivor of the deceased individual.''.
(b) Peer-Support Behavioral Health and Wellness Programs
Within Fire Departments and Emergency Medical Service
Agencies.--
(1) In general.--Part B of title III of the Public Health
Service Act (42 U.S.C. 243 et seq.) is amended by adding at
the end the following:
``SEC. 320C. PEER-SUPPORT BEHAVIORAL HEALTH AND WELLNESS
PROGRAMS WITHIN FIRE DEPARTMENTS AND EMERGENCY
MEDICAL SERVICE AGENCIES.
``(a) In General.--The Secretary may award grants to
eligible entities for the purpose of establishing or
enhancing peer-support behavioral health and wellness
programs within fire departments and emergency medical
services agencies.
``(b) Program Description.--A peer-support behavioral
health and wellness program funded under this section shall--
``(1) use career and volunteer members of fire departments
or emergency medical services agencies to serve as peer
counselors;
``(2) provide training to members of career, volunteer, and
combination fire departments or emergency medical service
agencies to serve as such peer counselors;
``(3) purchase materials to be used exclusively to provide
such training; and
``(4) disseminate such information and materials as are
necessary to conduct the program.
``(c) Definition.--In this section:
``(1) The term `eligible entity' means a nonprofit
organization with expertise and experience with respect to
the health and life safety of members of fire and emergency
medical services agencies.
``(2) The term `member'--
``(A) with respect to an emergency medical services agency,
means an employee, regardless of rank or whether the employee
receives compensation (as defined in section
[[Page H5784]]
1204(7) of the Omnibus Crime Control and Safe Streets Act of
1968); and
``(B) with respect to a fire department, means any
employee, regardless of rank or whether the employee receives
compensation, of a Federal, State, Tribal, or local fire
department who is responsible for responding to calls for
emergency service.''.
(2) Technical correction.--Effective as if included in the
enactment of the Children's Health Act of 2000 (Public Law
106-310), the amendment instruction in section 1603 of such
Act is amended by striking ``Part B of the Public Health
Service Act'' and inserting ``Part B of title III of the
Public Health Service Act''.
(c) Health Care Provider Behavioral Health and Wellness
Programs.--Part B of title III of the Public Health Service
Act (42 U.S.C. 243 et seq.), as amended by subsection (b)(1),
is further amended by adding at the end the following:
``SEC. 320D. HEALTH CARE PROVIDER BEHAVIORAL HEALTH AND
WELLNESS PROGRAMS.
``(a) In General.--The Secretary may award grants to
eligible entities for the purpose of establishing or
enhancing behavioral health and wellness programs for health
care providers.
``(b) Program Description.--A behavioral health and
wellness program funded under this section shall--
``(1) provide confidential support services for health care
providers to help handle stressful or traumatic patient-
related events, including counseling services and wellness
seminars;
``(2) provide training to health care providers to serve as
peer counselors to other health care providers;
``(3) purchase materials to be used exclusively to provide
such training; and
``(4) disseminate such information and materials as are
necessary to conduct such training and provide such peer
counseling.
``(c) Definitions.--In this section, the term `eligible
entity' means a hospital, including a critical access
hospital (as defined in section 1861(mm)(1) of the Social
Security Act) or a disproportionate share hospital (as
defined under section 1923(a)(1)(A) of such Act), a
Federally-qualified health center (as defined in section
1905(1)(2)(B) of such Act), or any other health care
facility.''.
(d) Development of Resources for Educating Mental Health
Professionals About Treating Fire Fighters and Emergency
Medical Services Personnel.--
(1) In general.--The Secretary of Health and Human Services
shall develop and make publicly available resources that may
be used by the Federal Government and other entities to
educate mental health professionals about--
(A) the culture of Federal, State, Tribal, and local
career, volunteer, and combination fire departments and
emergency medical services agencies;
(B) the different stressors experienced by firefighters and
emergency medical services personnel, supervisory
firefighters and emergency medical services personnel, and
chief officers of fire departments and emergency medical
services agencies;
(C) challenges encountered by retired firefighters and
emergency medical services personnel; and
(D) evidence-based therapies for mental health issues
common to firefighters and emergency medical services
personnel within such departments and agencies.
(2) Consultation.--In developing resources under paragraph
(1), the Secretary of Health and Human Services shall consult
with national fire and emergency medical services
organizations.
(3) Definitions.--In this subsection:
(A) The term ``firefighter'' means any employee, regardless
of rank or whether the employee receives compensation, of a
Federal, State, Tribal, or local fire department who is
responsible for responding to calls for emergency service.
(B) The term ``emergency medical services personnel'' means
any employee, regardless of rank or whether the employee
receives compensation, as defined in section 1204(7) of the
Omnibus Crime Control and Safe Streets Act of 1968 (34 U.S.C.
10284(7)).
(C) The term ``chief officer'' means any individual who is
responsible for the overall operation of a fire department or
an emergency medical services agency, irrespective of whether
such individual also serves as a firefighter or emergency
medical services personnel.
(e) Best Practices and Other Resources for Addressing
Posttraumatic Stress Disorder in Public Safety Officers.--
(1) Development; updates.--The Secretary of Health and
Human Services shall--
(A) develop and assemble evidence-based best practices and
other resources to identify, prevent, and treat posttraumatic
stress disorder and co-occurring disorders in public safety
officers; and
(B) reassess and update, as the Secretary determines
necessary, such best practices and resources, including based
upon the options for interventions to reduce suicide among
public safety officers identified in the annual reports
required by section 317V(e)(1)(F) of the Public Health
Service Act, as added by subsection (a).
(2) Consultation.--In developing, assembling, and updating
the best practices and resources under paragraph (1), the
Secretary of Health and Human Services shall consult with, at
a minimum, the following:
(A) Public health experts.
(B) Mental health experts with experience in studying
suicide and other profession-related traumatic stress.
(C) Clinicians with experience in diagnosing and treating
mental health issues.
(D) Relevant national police, fire, and emergency medical
services organizations.
(3) Availability.--The Secretary of Health and Human
Services shall make the best practices and resources under
paragraph (1) available to Federal, State, and local fire,
law enforcement, and emergency medical services agencies.
(4) Federal training and development programs.--The
Secretary of Health and Human Services shall work with
Federal departments and agencies, including the United States
Fire Administration, to incorporate education and training on
the best practices and resources under paragraph (1) into
Federal training and development programs for public safety
officers.
(5) Definition.--In this subsection, the term ``public
safety officer'' means--
(A) a public safety officer as defined in section 1204 of
the Omnibus Crime Control and Safe Streets Act of 1968 (34
U.S.C. 10284); or
(B) a public safety telecommunicator as described in
detailed occupation 43-5031 in the Standard Occupational
Classification Manual of the Office of Management and Budget
(2018).
amendment no. 5 offered by mr. feenstra of iowa
Page 5, after line 21, insert the following new
subparagraph (and redesignate the subsequent subparagraphs
accordingly):
``(B) the Veterans Crisis Line;
amendment no. 9 offered by mr. joyce of ohio
At the end of title I, add the following new subtitle:
Subtitle G--Military Suicide Prevention in the 21st Century
SEC. 155. PILOT PROGRAM ON PRE-PROGRAMMING OF SUICIDE
PREVENTION RESOURCES INTO SMART DEVICES ISSUED
TO MEMBERS OF THE ARMED FORCES.
(a) In General.--Commencing not later than 120 days after
the date of the enactment of this Act, the Secretary of
Defense shall carry out a pilot program under which the
Secretary--
(1) pre-downloads the Virtual Hope Box application of the
Defense Health Agency, or such successor application, on
smart devices individually issued to members of the Armed
Forces;
(2) pre-programs the National Suicide Hotline number and
Veterans Crisis Line number into the contacts for such
devices; and
(3) provides training, as part of training on suicide
awareness and prevention conducted throughout the Department
of Defense, on the preventative resources described in
paragraphs (1) and (2).
(b) Duration.--The Secretary shall carry out the pilot
program under this section for a two-year period.
(c) Scope.--The Secretary shall determine the appropriate
scope of individuals participating in the pilot program under
this section to best represent each Armed Force and to ensure
a relevant sample size.
(d) Identification of Other Resources.--In carrying out the
pilot program under this section, the Secretary shall
coordinate with the Director of the Defense Health Agency and
the Secretary of Veterans Affairs to identify other useful
technology-related resources for use in the pilot program.
(e) Report.--Not later than 30 days after completing the
pilot program under this section, the Secretary shall submit
to the Committee on Armed Services of the Senate and the
Committee on Armed Services of the House of Representatives a
report on the pilot program.
(f) Veterans Crisis Line Defined.--In this section, the
term ``Veterans Crisis Line'' means the toll-free hotline for
veterans established under section 1720F(h) of title 38,
United States Code.
amendment no. 10 offered by mr. katko of new york
After section 102, insert the following new section:
SEC. 103. SUICIDE PREVENTION LIFELINE IMPROVEMENT.
(a) Suicide Prevention Lifeline.--
(1) Plan.--Section 520E-3 of the Public Health Service Act
(42 U.S.C. 290bb-36c) is amended--
(A) by redesignating subsection (c) as subsection (e); and
(B) by inserting after subsection (b) the following:
``(c) Plan.--
``(1) In general.--For purposes of maintaining the suicide
prevention hotline under subsection (b)(2), the Secretary
shall develop and implement a plan to ensure the provision of
high-quality service.
``(2) Contents.--The plan required by paragraph (1) shall
include the following:
``(A) Quality assurance provisions, including--
``(i) clearly defined and measurable performance indicators
and objectives to improve the responsiveness and performance
of the hotline, including at backup call centers; and
``(ii) quantifiable timeframes to track the progress of the
hotline in meeting such performance indicators and
objectives.
``(B) Standards that crisis centers and backup centers must
meet--
``(i) to participate in the network under subsection
(b)(1); and
[[Page H5785]]
``(ii) to ensure that each telephone call, online chat
message, and other communication received by the hotline,
including at backup call centers, is answered in a timely
manner by a person, consistent with the guidance established
by the American Association of Suicidology or other guidance
determined by the Secretary to be appropriate.
``(C) Guidelines for crisis centers and backup centers to
implement evidence-based practices including with respect to
followup and referral to other health and social services
resources.
``(D) Guidelines to ensure that resources are available and
distributed to individuals using the hotline who are not
personally in a time of crisis but know of someone who is.
``(E) Guidelines to carry out periodic testing of the
hotline, including at crisis centers and backup centers,
during each fiscal year to identify and correct any problems
in a timely manner.
``(F) Guidelines to operate in consultation with the State
department of health, local governments, Indian tribes, and
tribal organizations.
``(3) Initial plan; updates.--The Secretary shall--
``(A) not later than 6 months after the date of enactment
of the Restoring Hope for Mental Health and Well-Being Act of
2022, complete development of the initial version of the plan
required by paragraph (1), begin implementation of such plan,
and make such plan publicly available; and
``(B) periodically thereafter, update such plan and make
the updated plan publicly available.''.
(2) Transmission of data to cdc.--Section 520E-3 of the
Public Health Service Act (42 U.S.C. 290bb-36c) is amended by
inserting after subsection (c) of such section, as added by
paragraph (1), the following:
``(d) Transmission of Data to CDC.--The Secretary shall
formalize and strengthen agreements between the National
Suicide Prevention Lifeline program and the Centers for
Disease Control and Prevention to transmit any necessary
epidemiological data from the program to the Centers,
including local call center data, to assist the Centers in
suicide prevention efforts.''.
(3) Authorization of appropriations.--Subsection (e) of
section 520E-3 of the Public Health Service Act (42 U.S.C.
290bb-36c) is amended to read as follows:
``(e) Authorization of Appropriations.--
``(1) In general.--To carry out this section, there are
authorized to be appropriated $101,621,000 for each of fiscal
years 2023 through 2027.
``(2) Allocation.--Of the amount authorized to be
appropriated by paragraph (1) for each of fiscal years 2023
through 2027--
``(A) at least 80 percent shall be made available to crisis
centers; and
``(B) not more than 10 percent may be used for carrying out
the pilot program in section 103(b)(1) of the Restoring Hope
for Mental Health and Well-Being Act of 2022.''.
(b) Pilot Program on Innovative Technologies.--
(1) In general.--The Secretary of Health and Human
Services, acting through the Assistant Secretary for Mental
Health and Substance Use, shall carry out a pilot program to
research, analyze, and employ various technologies and
platforms of communication (including social media platforms,
texting platforms, and email platforms) for suicide
prevention in addition to the telephone and online chat
service provided by the Suicide Prevention Lifeline.
(2) Report.--Not later than 24 months after the date on
which the pilot program under paragraph (1) commences, the
Secretary of Health and Human Services, acting through the
Assistant Secretary for Mental Health and Substance Use,
shall submit to the Congress a report on the pilot program.
With respect to each platform of communication employed
pursuant to the pilot program, the report shall include--
(A) a full description of the program;
(B) the number of individuals served by the program;
(C) the average wait time for each individual to receive a
response;
(D) the cost of the program, including the cost per
individual served; and
(E) any other information the Secretary determines
appropriate.
(c) HHS Study and Report.--Not later than 24 months after
the Secretary of Health and Human Services begins
implementation of the plan required by section 520E-3(c) of
the Public Health Service Act, as added by subsection
(a)(1)(B), the Secretary shall--
(1) complete a study on--
(A) the implementation of such plan, including the progress
towards meeting the objectives identified pursuant to
paragraph (2)(A)(i) of such section 520E-3(c) by the
timeframes identified pursuant to paragraph (2)(A)(ii) of
such section 520E-3(c); and
(B) in consultation with the Director of the Centers for
Disease Control and Prevention, options to expand data
gathering from calls to the Suicide Prevention Lifeline in
order to better track aspects of usage such as repeat calls,
consistent with applicable Federal and State privacy laws;
and
(2) submit a report to the Congress on the results of such
study, including recommendations on whether additional
legislation or appropriations are needed.
(d) GAO Study and Report.--
(1) In general.--Not later than 24 months after the
Secretary of Health and Human Services begins implementation
of the plan required by section 520E-3(c) of the Public
Health Service Act, as added by subsection (a)(1)(B), the
Comptroller General of the United States shall--
(A) complete a study on the Suicide Prevention Lifeline;
and
(B) submit a report to the Congress on the results of such
study.
(2) Issues to be studied.--The study required by paragraph
(1) shall address--
(A) the feasibility of geolocating callers to direct calls
to the nearest crisis center;
(B) operation shortcomings of the Suicide Prevention
Lifeline;
(C) geographic coverage of each crisis call center;
(D) the call answer rate of each crisis call center;
(E) the call wait time of each crisis call center;
(F) the hours of operation of each crisis call center;
(G) funding avenues of each crisis call center;
(H) the implementation of the plan under section 520E-3(c)
of the Public Health Service Act, as added by subsection
(a)(1)(B), including the progress towards meeting the
objectives identified pursuant to paragraph (2)(A)(i) of such
section 520E-3(c) by the timeframes identified pursuant to
paragraph (2)(A)(ii) of such section 520E-3(c); and
(I) service to individuals requesting a foreign language
speaker, including--
(i) the number of calls or chats the Lifeline receives from
individuals speaking a foreign language;
(ii) the capacity of the Lifeline to handle these calls or
chats; and
(iii) the number of crisis centers with the capacity to
serve foreign language speakers, in house.
(3) Recommendations.--The report required by paragraph (1)
shall include recommendations for improving the Suicide
Prevention Lifeline, including recommendations for
legislative and administrative actions.
(e) Definition.--In this section, the term ``Suicide
Prevention Lifeline'' means the suicide prevention hotline
maintained pursuant to section 520E-3 of the Public Health
Service Act (42 U.S.C. 290bb-36c).
amendment no. 13 offered by ms. moore of wisconsin
Page 20, line 4, strike ``and''.
Page 20, line 9, strike the period at the end and insert
``; and''.
Page 20, after line 9, add the following:
``(4) consult with appropriate State, local, and Tribal
public health officials, including officials that administer
programs that serve low-income pregnant and postpartum
individuals.''.
amendment no. 14 offered by mrs. napolitano of california
After section 402, insert the following new section:
SEC. 403. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND
ADOLESCENTS.
(a) Technical Amendments.--The second part G (relating to
services provided through religious organizations) of title V
of the Public Health Service Act (42 U.S.C. 290kk et seq.) is
amended--
(1) by redesignating such part as part J; and
(2) by redesignating sections 581 through 584 as sections
596 through 596C, respectively.
(b) School-Based Mental Health and Children.--Section 581
of the Public Health Service Act (42 U.S.C. 290hh) (relating
to children and violence) is amended to read as follows:
``SEC. 581. SCHOOL-BASED MENTAL HEALTH; CHILDREN AND
ADOLESCENTS.
``(a) In General.--The Secretary, in consultation with the
Secretary of Education, shall, through grants, contracts, or
cooperative agreements awarded to eligible entities described
in subsection (c), provide comprehensive school-based mental
health services and supports to assist children in local
communities and schools (including schools funded by the
Bureau of Indian Education) dealing with traumatic
experiences, grief, bereavement, risk of suicide, and
violence. Such services and supports shall be--
``(1) developmentally, linguistically, and culturally
appropriate;
``(2) trauma-informed; and
``(3) incorporate positive behavioral interventions and
supports.
``(b) Activities.--Grants, contracts, or cooperative
agreements awarded under subsection (a), shall, as
appropriate, be used for--
``(1) implementation of school and community-based mental
health programs that--
``(A) build awareness of individual trauma and the
intergenerational, continuum of impacts of trauma on
populations;
``(B) train appropriate staff to identify, and screen for,
signs of trauma exposure, mental health disorders, or risk of
suicide; and
``(C) incorporate positive behavioral interventions, family
engagement, student treatment, and multigenerational supports
to foster the health and development of children, prevent
mental health disorders, and ameliorate the impact of trauma;
``(2) technical assistance to local communities with
respect to the development of programs described in paragraph
(1);
``(3) facilitating community partnerships among families,
students, law enforcement agencies, education agencies,
mental health and substance use disorder service systems,
family-based mental health service systems, child welfare
agencies, health care providers (including primary care
physicians, mental health professionals, and other
professionals
[[Page H5786]]
who specialize in children's mental health such as child and
adolescent psychiatrists), institutions of higher education,
faith-based programs, trauma networks, and other community-
based systems to address child and adolescent trauma, mental
health issues, and violence; and
``(4) establishing mechanisms for children and adolescents
to report incidents of violence or plans by other children,
adolescents, or adults to commit violence.
``(c) Requirements.--
``(1) In general.--To be eligible for a grant, contract, or
cooperative agreement under subsection (a), an entity shall
be a partnership that includes--
``(A) a State educational agency, as defined in section
8101 of the Elementary and Secondary Education Act of 1965,
in coordination with one or more local educational agencies,
as defined in section 8101 of the Elementary and Secondary
Education Act of 1965, or a consortium of any entities
described in subparagraph (B), (C), (D), or (E) of section
8101(30) of such Act; and
``(B) at least 1 community-based mental health provider,
including a public or private mental health entity, health
care entity, family-based mental health entity, trauma
network, or other community-based entity, as determined by
the Secretary (and which may include additional entities such
as a human services agency, law enforcement or juvenile
justice entity, child welfare agency, agency, an institution
of higher education, or another entity, as determined by the
Secretary).
``(2) Compliance with hipaa.--Any patient records developed
by covered entities through activities under the grant shall
meet the regulations promulgated under section 264(c) of the
Health Insurance Portability and Accountability Act of 1996.
``(3) Compliance with ferpa.--Section 444 of the General
Education Provisions Act (commonly known as the `Family
Educational Rights and Privacy Act of 1974') shall apply to
any entity that is a member of the partnership in the same
manner that such section applies to an educational agency or
institution (as that term is defined in such section).
``(d) Geographical Distribution.--The Secretary shall
ensure that grants, contracts, or cooperative agreements
under subsection (a) will be distributed equitably among the
regions of the country and among urban and rural areas.
``(e) Duration of Awards.--With respect to a grant,
contract, or cooperative agreement under subsection (a), the
period during which payments under such an award will be made
to the recipient shall be 5 years, with options for renewal.
``(f) Evaluation and Measures of Outcomes.--
``(1) Development of process.--The Assistant Secretary
shall develop a fiscally appropriate process for evaluating
activities carried out under this section. Such process shall
include--
``(A) the development of guidelines for the submission of
program data by grant, contract, or cooperative agreement
recipients;
``(B) the development of measures of outcomes (in
accordance with paragraph (2)) to be applied by such
recipients in evaluating programs carried out under this
section; and
``(C) the submission of annual reports by such recipients
concerning the effectiveness of programs carried out under
this section.
``(2) Measures of outcomes.--The Assistant Secretary shall
develop measures of outcomes to be applied by recipients of
assistance under this section to evaluate the effectiveness
of programs carried out under this section, including
outcomes related to the student, family, and local
educational systems supported by this Act.
``(3) Submission of annual data.--An eligible entity
described in subsection (c) that receives a grant, contract,
or cooperative agreement under this section shall annually
submit to the Assistant Secretary a report that includes data
to evaluate the success of the program carried out by the
entity based on whether such program is achieving the
purposes of the program. Such reports shall utilize the
measures of outcomes under paragraph (2) in a reasonable
manner to demonstrate the progress of the program in
achieving such purposes.
``(4) Evaluation by assistant secretary.--Based on the data
submitted under paragraph (3), the Assistant Secretary shall
annually submit to Congress a report concerning the results
and effectiveness of the programs carried out with assistance
received under this section.
``(5) Limitation.--An eligible entity shall use not more
than 20 percent of amounts received under a grant under this
section to carry out evaluation activities under this
subsection.
``(g) Information and Education.--The Secretary shall
disseminate best practices based on the findings of the
knowledge development and application under this section.
``(h) Amount of Grants and Authorization of
Appropriations.--
``(1) Amount of grants.--A grant under this section shall
be in an amount that is not more than $2,000,000 for each of
the first 5 fiscal years following the date of enactment of
the Restoring Hope for Mental Health and Well-Being Act of
2022. The Secretary shall determine the amount of each such
grant based on the population of children up to age 21 of the
area to be served under the grant.
``(2) Authorization of appropriations.--There is authorized
to be appropriated to carry out this section, $130,000,000
for each of fiscal years 2023 through 2027.''.
(c) Conforming Amendment.--Part G of title V of the Public
Health Service Act (42 U.S.C. 290hh et seq.), as amended by
subsection (b), is further amended by striking the part
designation and heading and inserting the following:
``PART G--SCHOOL-BASED MENTAL HEALTH''.
amendment no. 15 offered by ms. pressley of massachusetts
After section 402, insert the following new section:
SEC. 403. CO-OCCURRING CHRONIC CONDITIONS AND MENTAL HEALTH
IN YOUTH STUDY.
Not later than 12 months after the date of enactment of
this Act, the Secretary of Health and Human Services shall--
(1) complete a study on the rates of suicidal behaviors
among children and adolescents with chronic illnesses,
including substance use disorders, autoimmune disorders, and
heritable blood disorders; and
(2) submit a report to the Congress on the results of such
study, including recommendations for early intervention
services for such children and adolescents at risk of
suicide, the dissemination of best practices to support the
emotional and mental health needs of youth, and strategies to
lower the rates of suicidal behaviors in children and
adolescents described in paragraph (1) to reduce any
demographic disparities in such rates.
amendment no. 16 offered by mr. reschenthaler of pennsylvania
At the end of subtitle C of title I, add the following new
section:
SEC. 124. STUDY ON THE COSTS OF SERIOUS MENTAL ILLNESS.
(a) In General.--The Secretary of Health and Human
Services, in consultation with the Assistant Secretary for
Mental Health and Substance Use, the Assistant Secretary for
Planning and Evaluation, the Attorney General of the United
States, the Secretary of Labor, and the Secretary of Housing
and Urban Development, shall conduct a study on the direct
and indirect costs of serious mental illness with respect
to--
(1) nongovernmental entities; and
(2) the Federal Government and State, local, and Tribal
governments.
(b) Content.--The study under subsection (a) shall consider
each of the following:
(1) The costs to the health care system for health
services, including with respect to--
(A) office-based physician visits;
(B) residential and inpatient treatment programs;
(C) outpatient treatment programs;
(D) emergency room visits;
(E) crisis stabilization programs;
(F) home health care;
(G) skilled nursing and long-term care facilities;
(H) prescription drugs and digital therapeutics; and
(I) any other relevant health services.
(2) The costs of homelessness, including with respect to--
(A) homeless shelters;
(B) street outreach activities;
(C) crisis response center visits; and
(D) other supportive services.
(3) The costs of structured residential facilities and
other supportive housing for residential and custodial care
services.
(4) The costs of law enforcement encounters and encounters
with the criminal justice system, including with respect to--
(A) encounters that do and do not result in an arrest;
(B) criminal and judicial proceedings;
(C) services provided by law enforcement and judicial staff
(including public defenders, prosecutors, and private
attorneys); and
(D) incarceration.
(5) The costs of serious mental illness on employment.
(6) With respect to family members and caregivers, the
costs of caring for an individual with a serious mental
illness.
(7) Any other relevant costs for programs and services
administered by the Federal Government or State, Tribal, or
local governments.
(c) Data Disaggregation.--In conducting the study under
subsection (a), the Secretary of Health and Human Services
shall (to the extent feasible)--
(1) disaggregate data by--
(A) costs to nongovernmental entities, the Federal
Government, and State, local, and Tribal governments;
(B) types of serious mental illnesses and medical chronic
diseases common in patients with a serious mental illness;
and
(C) demographic characteristics, including race, ethnicity,
sex, age (including pediatric subgroups), and other
characteristics determined by the Secretary; and
(2) include an estimate of--
(A) the total number of individuals with a serious mental
illness in the United States, including in traditional and
nontraditional housing; and
(B) the percentage of such individuals in--
(i) homeless shelters;
(ii) penal facilities, including Federal prisons, State
prisons, and county and municipal jails; and
(iii) nursing facilities.
(d) Report.--Not later than 2 years after the date of the
enactment of this Act, the Secretary of Health and Human
Services shall--
(1) submit to the Congress a report containing the results
of the study conducted under this section; and
[[Page H5787]]
(2) make such report publicly available.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
gentleman from New Jersey (Mr. Pallone) and the gentlewoman from
Washington (Mrs. Rodgers) each will control 10 minutes.
The Chair recognizes the gentleman from New Jersey.
Mr. PALLONE. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, I rise in support of the eight mental health
amendments under this en bloc consideration. Collectively, these
amendments further strengthen the bipartisan nature of the underlying
comprehensive bill, the Restoring Hope for Mental Health and Well-Being
Act of 2022.
I thank my colleagues for their leadership and contributions to
furthering the health of the American people and wish to speak in
strong support of their adoption into H.R. 7666.
Many of these amendments, Madam Speaker, include provisions from
bills that previously passed the House this Congress on suspension that
the Senate has yet to act upon.
I am pleased that we have the opportunity to, once again, emphasize
their importance by including them in this crucial legislative package.
The amendment offered by Congressman Bera and Congressman Fitzpatrick
is just such an amendment. Like the bill it reflects, the HERO Act,
which passed the House last year, it will improve data collection and
services to ensure our first responders and public safety officers
receive the mental health care services they need.
Additionally, Congresswoman Napolitano and Congressman Katko
submitted an amendment which extends and revises SAMHSA's Project AWARE
program providing school-based mental health services, including
screening, treatment, and outreach programs, provisions that likewise
passed the House last year in H.R. 721, the Mental Health Services for
Students Act of 2021.
Representatives Katko and Napolitano were also joined by Congressmen
Beyer, Raskin, Cardenas, and Fitzpatrick in offering an additional
amendment that includes provisions from H.R. 2981, the Suicide
Prevention Lifeline Improvement Act of 2021, which also passed the
House last year.
The amendment extends funding for SAMHSA's Lifeline--crucial in this
Nation's moment of mental health crisis, supporting crisis care
response and support as we prepare for the launch of the new 988
dialing code next month.
I appreciate the additional focus on the particular needs of certain
communities in our country that several amendments add to the
underlying bill.
I thank Representatives Reschenthaler, Morelle, Wild, and Dean for
their amendment requiring a study to determine the true cost of
untreated serious mental illness on families, healthcare systems,
public housing, and law enforcement in America.
In addition, we certainly cannot do enough to support the men and
women who have valiantly served our Nation in the Armed Forces.
I thank Congressman Joyce for his amendment that requires the
Department of Defense to carry out a 2-year pilot program aimed at
preventing suicides amongst Active-Duty members of the Armed Forces.
I also appreciate and support the amendment submitted by Congressman
Feenstra requiring the new Behavioral Health Crisis Coordinating Office
established within SAMHSA by H.R. 7666, to provide technical assistance
and support to the Veterans Crisis Line.
Further, Madam Speaker, I support the mental health and well-being of
those who are pregnant or postpartum. The amendment offered by
Congresswoman Moore makes important improvements to the Maternal Mental
Health Hotline authorization to ensure those implementing the hotline
consult with appropriate State, local, and Tribal public officials and
those working with low-income people.
I am particularly pleased that H.R. 7666 would establish a new
authorization for a Maternal Mental Health Hotline, and I appreciate
Representative Moore's amendment that will serve to improve the
underlying legislation.
Finally, Madam Speaker, while we know children in this country are
facing a mental health crisis, unfortunately, we know that all too many
also experience other chronic health challenges.
I am grateful to Representative Pressley for her amendment requiring
the Secretary of Health and Human Services conduct a study on the rates
and risks of suicidal behaviors among youth with chronic illnesses and
to provide Congress with recommendations for ways to provide early
intervention, best practices, and strategies to address disparities.
I am pleased to support these amendments and encourage my colleagues
to do the same.
Madam Speaker, I reserve the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I yield myself such time
as I may consume. I rise in support of the amendments offered en bloc.
I rise today to express my strong support for this group of amendments.
Included in this en bloc are important bills that have already
overwhelmingly passed the House, including Representative Katko's
Suicide Prevention Lifeline Improvement Act, which reauthorizes the
National Suicide Prevention Lifeline program and ensures resources are
available for the continued operation of the hotline, especially with
9-8-8 going live next month.
Representative Katko also has included in this en bloc the Mental
Health Services for Students Act, which provides an authorization for
the Substance Abuse and Mental Health Services Administration's Project
AWARE grant.
Project AWARE is a successful program which supports partnerships
between the State and local systems in increasing awareness of mental
health issues among school-aged youth; providing training for school
personnel to detect and respond to mental health issues; and connecting
students with behavioral health issues and their families to needed
services.
The en bloc also includes the Reschenthaler amendment, which would
authorize a study on the cost of untreated serious mental illness on
families, the health system, the justice system, and the economy.
While very treatable, serious mental illness remains a neglected
health issue, and I am hopeful that the data gleaned from this study
will convince policymakers to do more to address this condition,
including addressing the IMD exclusion.
This group of amendments demonstrates the good work Congress can do
when both parties come together to find meaningful solutions to address
mental health in America.
Madam Speaker, I urge adoption, and I reserve the balance of my time.
Mr. PALLONE. Madam Speaker, I yield 4 minutes to the gentlewoman from
Massachusetts (Ms. Pressley), who has one of the important amendments
included in this en bloc.
Ms. PRESSLEY. Madam Speaker, I rise today in support of my amendment
to require the Secretary of Health and Human Services to study the
suicide crises among children living with chronic illnesses and
conditions, including autoimmune diseases like alopecia.
Across this Nation, our children are carrying unprecedented amounts
of trauma and grief in their emotional backpacks.
For an entire generation of youngsters living with chronic
conditions, the solitude, grief, and uncertainty of the past 2 years
have only exacerbated the emotional and mental health challenges that
already weighed so heavily.
Like millions of Americans, I am living with the autoimmune disease
alopecia. There are several forms of alopecia. I am living with
alopecia universalis.
Navigating the world as a bald woman is disruptive to many. I am 48
years old, I am an adult, and I have built up some pretty thick skin,
but there are days that even bring me to my knees because of the social
stigmatization, the bullying, the taunting that I experience as an
adult.
Although this does not threaten my life, that does not mean that it
does not impact it. I was a caregiver to my mother in her cancer
battle, and her very first concern and worry--even though she was
fighting for her life--was, am I going to lose my hair.
This is something much more than cosmetic for all who are living with
[[Page H5788]]
this. Certainly, for women and girls, there is an added layer, in that
this challenge defies societal norms of what is feminine, what is
pretty, what is acceptable, and what is appropriate.
For the millions of children--again, I am a 48-year-old adjusted
woman, but for the millions of children living with this disease, the
challenges may sometimes feel too much to bear.
While there are public misconceptions that alopecia areata is purely
cosmetic, the fact is the National Institute of Mental Health has found
that alopecia areata has been linked to higher rates of depression,
sadness, anxiety, and other mental challenges.
Some have offered: Why not just wear a wig? Well, I am working on
that, too, because many of our children can't afford a medically
durable wig. So for children who are just beginning their journey,
growing comfortable in their own skin and finding their place in the
world, these challenges can feel even harder.
Earlier this year, our alopecia community lost one of our own. She is
not the first, but one of the most recent: Miss Rio Allred. May she
rest in peace. She was 12 years old, and took her life by suicide
because of the emotional turmoil and relentless bullying she faced
every day in school due to her alopecia.
I have spoken to Rio's mother. I have heard her express the pain no
parent should ever know. I asked her to tell me about Rio. She was a
great big sister, a writer, a reader, was funny, and a light to the
world and all around her.
Her mother has now established Rio's Rainbow, a foundation in her
honor, and the mission of that, in Rio's honor, is that kids should
feel safe being who they are. One life lost to the emotional distress
associated with this disease, and any chronic condition for that
matter, is one too many.
I make no appeal today for sympathy, but for empathy, for support, to
be seen. I am not here just to take up space. I am here to create it. I
choose not to wear a wig because I know what that representation means
to the millions of Americans that are living with alopecia.
It is long past time that we study the troubling suicide crisis among
children living with chronic illnesses and conditions, including those
within our alopecia community, and invest in the early interventions
and best practices necessary to save lives. I urge my colleagues to
support this amendment, which would do just that.
Mrs. RODGERS of Washington. Madam Speaker, I yield 3 minutes to the
gentleman from Ohio (Mr. Joyce).
Mr. JOYCE of Ohio. Madam Speaker, I rise today in support of my
amendment to H.R. 7666 which would add the text of the Military Suicide
Prevention in the 21st Century Act to the underlying bill.
=========================== NOTE ===========================
June 22, 2022, on page H5788, in the first column, the following
appeared: Mrs. RODGERS of Washington. Madam Speaker, I yield 3
minutes to the gentleman from Ohio (Mr. Joyce). Mr. JOYCE of
Pennsylvania. Madam Speaker, I rise today in support of my
The online version has been corrected to read: Mrs. RODGERS of
Washington. Madam Speaker, I yield 3 minutes to the gentleman from
Ohio (Mr. Joyce). Mr. JOYCE of Ohio. Madam Speaker, I rise today
in support of my
========================= END NOTE =========================
The men and the women of America's Armed Forces dedicate their lives
in service to this Nation. Unfortunately, countless servicemembers are
left with scars that linger long after they return home.
Rates of serious mental illness experienced by those in the Armed
Forces are on the rise, and tragically, so too is the number of
soldiers who ultimately take their lives.
According to DOD's most recent report, suicide in the military
community is at its highest rate since 1938. An estimated 7,000
servicemembers have died in combat or training exercises since 9/11.
During that same time, over 30,000 Active-Duty personnel and veterans
who recently served died by suicide. Those numbers should bring pause
to every Member in this Chamber. More importantly, they should spur us
into action.
That is why I introduced the Military Suicide Prevention in the 21st
Century Act. This commonsense bill would direct the DOD to utilize
modern technology to prevent suicides in our military community.
In addition to requiring the National Suicide Hotline and the
Veterans Crisis Hotline to be preprogrammed into government-issued
smart devices such as phones, tablets, and laptops, the bill would
require the DOD to proactively download the Virtual Hope Box app onto
these devices.
This app can be set up with the photos of friends and family, sound
bites of loved ones, videos of special moments, music, relaxation
exercises, games, and reminders of reasons for living.
Nothing we do here in Washington will ever truly repay the sacrifices
made by our Nation's servicemembers, but by passing this legislation,
we can help make a meaningful difference in the lives of countless
American heroes and their families.
We owe an incredible debt to the men and women of our Armed Forces
who risk their lives fighting for our freedoms and our security. It is
past time Congress do more to fight for them here at home.
I urge my colleagues to support my amendment so we can make real
progress toward providing improved support for America's servicemembers
struggling with their mental health.
Mr. PALLONE. Madam Speaker, I have no additional speakers, and I
yield back the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I yield back the balance
of my time.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
previous question is ordered on the amendments en bloc offered by the
gentleman from New Jersey (Mr. Pallone).
The question is on the amendments en bloc.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. TIFFANY. Madam Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this question
are postponed.
{time} 1530
Amendments En Bloc No. 2 Offered by Mr. Pallone of New Jersey
Mr. PALLONE. Madam Speaker, pursuant to House Resolution 1191, I rise
to offer amendments en bloc No. 2.
The SPEAKER pro tempore. The Clerk will designate the amendments en
bloc.
Amendments en bloc No. 2 consisting of amendment Nos. 2, 3, 7, 11,
12, and 17, printed in part E of House Report 117-381, offered by Mr.
Pallone of New Jersey:
Amendment No. 2 Offered By Mr. Rodney Davis of Illinois
At the end of title II, add the following new subtitle:
Subtitle G--Opioid Epidemic Response
SEC. 271. OPIOID PRESCRIPTION VERIFICATION.
(a) Materials for Training Pharmacists on Certain
Circumstances Under Which a Pharmacist May Decline to Fill a
Prescription.--
(1) Updates to materials.--Section 3212(a) of the SUPPORT
for Patients and Communities Act (21 U.S.C. 829 note) is
amended by striking ``Not later than 1 year after the date of
enactment of this Act, the Secretary of Health and Human
Services, in consultation with the Administrator of the Drug
Enforcement Administration, Commissioner of Food and Drugs,
Director of the Centers for Disease Control and Prevention,
and Assistant Secretary for Mental Health and Substance Use,
shall develop and disseminate'' and inserting ``The Secretary
of Health and Human Services, in consultation with the
Administrator of the Drug Enforcement Administration,
Commissioner of Food and Drugs, Director of the Centers for
Disease Control and Prevention, and Assistant Secretary for
Mental Health and Substance Use, shall develop and
disseminate not later than 1 year after the date of enactment
of this Act, and update periodically thereafter''.
(2) Materials included.--Section 3212(b) of the SUPPORT for
Patients and Communities Act (21 U.S.C. 829 note) is
amended--
(A) by redesignating paragraphs (1) and (2) as paragraphs
(2) and (3), respectively; and
(B) by inserting before paragraph (2), as so redesignated,
the following new paragraph:
``(1) pharmacists on how to verify the identity of the
patient;''.
(3) Materials for training on patient verification .--
Section 3212 of the SUPPORT for Patients and Communities Act
(21 U.S.C. 829 note) is amended by adding at the end the
following new subsection:
``(d) Materials for Training on Verification of Identity.--
Not later than 1 year after the date of enactment of this
subsection, the Secretary of Health and Human Services, after
seeking stakeholder input in accordance with subsection (c),
shall--
``(1) update the materials developed under subsection (a)
to include information for pharmacists on how to verify the
identity the patient; and
``(2) disseminate, as appropriate, the updated
materials.''.
(b) Incentivizing States To Facilitate Responsible,
Informed Dispensing of Controlled Substances.--
(1) In general.--Section 392A of the Public Health Service
Act (42 U.S.C. 280b-1) is amended--
[[Page H5789]]
(A) by redesignating subsections (c) and (d) as subsections
(d) and (e), respectively; and
(B) by inserting after subsection (b) the following new
subsection:
``(c) Preference.--In determining the amounts of grants
awarded to States under subsections (a) and (b), the Director
of the Centers for Disease Control and Prevention may give
preference to States in accordance with such criteria as the
Director may specify and may choose to give preference to
States that--
``(1) maintain a prescription drug monitoring program;
``(2) require prescribers of controlled substances in
schedule II, III, or IV to issue such prescriptions
electronically, and make such requirement subject to
exceptions in the cases listed in section 1860D-4(e)(7)(B) of
the Social Security Act; and
``(3) require dispensers of such controlled substances to
enter certain information about the purchase of such
controlled substances into the respective State's
prescription drug monitoring program, including--
``(A) the National Drug Code or, in the case of compounded
medications, compound identifier;
``(B) the quantity dispensed;
``(C) the patient identifier; and
``(D) the date filled.''.
(2) Definitions.--
(A) In general.--Subsection (d) of section 392A of the
Public Health Service Act (42 U.S.C. 280b-1), as redesignated
by paragraph (1)(A), is amended to read as follows:
``(d) Definitions.--In this section:
``(1) Controlled substance.--The term `controlled
substance' has the meaning given that term in section 102 of
the Controlled Substances Act.
``(2) Dispenser.--The term `dispenser' means a physician,
pharmacist, or other person that dispenses a controlled
substance to an ultimate user.
``(3) Indian tribe.--The term `Indian Tribe' has the
meaning given that term in section 4 of the Indian Self-
Determination and Education Assistance Act.''.
(B) Conforming change.--Section 392A of the Public Health
Service Act (42 U.S.C. 280b-1) is amended by striking
``Indian tribes'' each place it appears and inserting
``Indian Tribes''.
Amendment No. 3 Offered By Ms. Dean of Pennsylvania
After section 263, insert the following new section:
SEC. 264. INCREASE IN NUMBER OF DAYS BEFORE WHICH CERTAIN
CONTROLLED SUBSTANCES MUST BE ADMINISTERED.
Section 309A(a)(5) of the Controlled Substances Act (21
U.S.C. 829a(a)(5)) is amended by striking ``14 days'' and
inserting ``60 days''.
Amendment No. 7 Offered By Mr. Gottheimer of new jersey
Page 9, line 22, insert ``veterans,'' after
``minorities,''.
Amendment No. 11 Offered By Mr. kim of new jersey
At the end of title II, add the following new subtitle:
Subtitle G--Opioid Epidemic Response
SEC. 271. SYNTHETIC OPIOID DANGER AWARENESS.
(a) Synthetic Opioids Public Awareness Campaign.--Part B of
title III of the Public Health Service Act is amended by
inserting after section 317U (42 U.S.C. 247b-23) the
following new section:
``SEC. 317V. SYNTHETIC OPIOIDS PUBLIC AWARENESS CAMPAIGN.
``(a) In General.--Not later than one year after the date
of the enactment of this section, the Secretary shall provide
for the planning and implementation of a public education
campaign to raise public awareness of synthetic opioids
(including fentanyl and its analogues). Such campaign shall
include the dissemination of information that--
``(1) promotes awareness about the potency and dangers of
fentanyl and its analogues and other synthetic opioids;
``(2) explains services provided by the Substance Abuse and
Mental Health Services Administration and the Centers for
Disease Control and Prevention (and any entity providing such
services under a contract entered into with such agencies)
with respect to the misuse of opioids, particularly as such
services relate to the provision of alternative, non-opioid
pain management treatments; and
``(3) relates generally to opioid use and pain management.
``(b) Use of Media.--The campaign under subsection (a) may
be implemented through the use of television, radio,
internet, in-person public communications, and other
commercial marketing venues and may be targeted to specific
age groups.
``(c) Consideration of Report Findings.--In planning and
implementing the public education campaign under subsection
(a), the Secretary shall take into consideration the findings
of the report required under section 7001 of the SUPPORT for
Patients and Communities Act (Public Law 115-271).
``(d) Consultation.--In coordinating the campaign under
subsection (a), the Secretary shall consult with the
Assistant Secretary for Mental Health and Substance Use to
provide ongoing advice on the effectiveness of information
disseminated through the campaign.
``(e) Requirement of Campaign.--The campaign implemented
under subsection (a) shall not be duplicative of any other
Federal efforts relating to eliminating the misuse of
opioids.
``(f) Evaluation.--
``(1) In general.--The Secretary shall ensure that the
campaign implemented under subsection (a) is subject to an
independent evaluation, beginning 2 years after the date of
the enactment of this section, and every 2 years thereafter.
``(2) Measures and benchmarks.--For purposes of an
evaluation conducted pursuant to paragraph (1), the Secretary
shall--
``(A) establish baseline measures and benchmarks to
quantitatively evaluate the impact of the campaign under this
section; and
``(B) conduct qualitative assessments regarding the
effectiveness of strategies employed under this section.
``(g) Report.--The Secretary shall, beginning 2 years after
the date of the enactment of this section, and every 2 years
thereafter, submit to Congress a report on the effectiveness
of the campaign implemented under subsection (a) towards
meeting the measures and benchmarks established under
subsection (e)(2).
``(h) Dissemination of Information Through Providers.--The
Secretary shall develop and implement a plan for the
dissemination of information related to synthetic opioids, to
health care providers who participate in Federal programs,
including programs administered by the Department of Health
and Human Services, the Indian Health Service, the Department
of Veterans Affairs, the Department of Defense, and the
Health Resources and Services Administration, the Medicare
program under title XVIII of the Social Security Act, and the
Medicaid program under title XIX of such Act.''.
(b) Training Guide and Outreach on Synthetic Opioid
Exposure Prevention.--
(1) Training guide.--Not later than 18 months after the
date of the enactment of this Act, the Secretary of Health
and Human Services shall design, publish, and make publicly
available on the internet website of the Department of Health
and Human Services, a training guide and webinar for first
responders and other individuals who also may be at high risk
of exposure to synthetic opioids that details measures to
prevent that exposure.
(2) Outreach.--Not later than 18 months after the date of
the enactment of this Act, the Secretary of Health and Human
Services shall also conduct outreach about the availability
of the training guide and webinar published under paragraph
(1) to--
(A) police and fire managements;
(B) sheriff deputies in city and county jails;
(C) ambulance transport and hospital emergency room
personnel;
(D) clinicians; and
(E) other high-risk occupations, as identified by the
Assistant Secretary for Mental Health and Substance Use.
amendment no. 12 offered by mr. mckinley of west virginia
After section 263, insert the following new section:
SEC. 264. BLOCK, REPORT, AND SUSPEND SUSPICIOUS SHIPMENTS.
(a) Clarification of Process for Registrants to Exercise
Due Diligence Upon Discovering a Suspicious Order.--Paragraph
(3) of section 312(a) of the Controlled Substances Act (21
U.S.C. 832(a)) is amended to read as follows:
``(3) upon discovering a suspicious order or series of
orders, and in a manner consistent with the other
requirements of this section--
``(A) exercise due diligence as appropriate;
``(B) establish and maintain (for not less than a period to
be determined by the Administrator of the Drug Enforcement
Administration) a record of the due diligence that was
performed;
``(C) decline to fill the order or series of orders if the
due diligence fails to dispel all of the indicators that give
rise to the suspicion that, if the order or series of orders
is filled, the drugs that are the subject of the order or
series of orders are likely to be diverted; and
``(D) notify the Administrator of the Drug Enforcement
Administration and the Special Agent in Charge of the
Division Office of the Drug Enforcement Administration for
the area in which the registrant is located or conducts
business of--
``(i) each suspicious order or series of orders discovered
by the registrant; and
``(ii) the indicators giving rise to the suspicion that, if
the order or series of orders is filled, the drugs that are
the subject of the order or series of orders are likely to be
diverted.''.
(b) Resolution of Suspicious Indicators.--Section 312 of
the Controlled Substances Act (21 U.S.C. 832) is amended--
(1) by redesignating subsection (b) and (c) as subsections
(c) and (d), respectively; and
(2) by inserting after subsection (a) the following:
``(b) Resolution of Suspicious Indicators.--If a registrant
resolves all of the indicators giving rise to suspicion about
an order or series of orders under subsection (a)(3)--
``(1) notwithstanding subsection (a)(3)(C), the registrant
may choose to fill the order or series of orders; and
``(2) notwithstanding subsection (a)(3)(D), the registrant
may choose not to make the notification otherwise required by
such subsection.''.
(c) Regulations.--Not later than 1 year after the date of
enactment of this Act, for purposes of subsections (a)(3) and
(b) of section 312 of the Controlled Substances Act, as
[[Page H5790]]
amended or inserted by subsection (a), the Attorney General
of the United States shall promulgate a final regulation
specifying the indicators that give rise to a suspicion that,
if an order or series of orders is filled, the drugs that are
the subject of the order or series of orders are likely to be
diverted.
(d) Applicability.--Subsections (a)(3) and (b) of section
312 of the Controlled Substances Act, as amended or inserted
by subsection (a), shall apply beginning on the day that is 1
year after the date of enactment of this Act. Until such day,
section 312(a)(3) of the Controlled Substances Act shall
apply as such section 312(a)(3) was in effect on the day
before the date of enactment of this Act.
amendment no. 17 offered by mr. trone of maryland
At the end of title II, add the following new subtitle:
Subtitle I--Opioid Epidemic Response
SEC. 271. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO
OPIOID AND STIMULANT USE AND MISUSE.
Section 1003 of the 21st Century Cures Act (42 U.S.C.
290ee-3 note) is amended to read as follows:
``SEC. 1003. GRANT PROGRAM FOR STATE AND TRIBAL RESPONSE TO
OPIOID AND STIMULANT USE AND MISUSE.
``(a) In General.--The Secretary of Health and Human
Services (referred to in this section as the `Secretary')
shall carry out the grant program described in subsection (b)
for purposes of addressing opioid and stimulant use and
misuse, within States, Indian Tribes, and populations served
by Tribal organizations and Urban Indian organizations.
``(b) Grants Program.--
``(1) In general.--Subject to the availability of
appropriations, the Secretary shall award grants to States,
Indian Tribes, Tribal organizations, and Urban Indian
organizations for the purpose of addressing opioid and
stimulant use and misuse, within such States, such Indian
Tribes, and populations served by such Tribal organizations
and Urban Indian organizations, in accordance with paragraph
(2).
``(2) Minimum allocations; preference.--In determining
grant amounts for each recipient of a grant under paragraph
(1), the Secretary shall--
``(A) ensure that each State receives not less than
$4,000,000; and
``(B) give preference to States, Indian Tribes, Tribal
organizations, and Urban Indian organizations whose
populations have an incidence or prevalence of opioid use
disorders or stimulant use or misuse that is substantially
higher relative to the populations of other States, other
Indian Tribes, Tribal organizations, or Urban Indian
organizations, as applicable.
``(3) Formula methodology.--
``(A) In general.--Before publishing a funding opportunity
announcement with respect to grants under this section, the
Secretary shall--
``(i) develop a formula methodology to be followed in
allocating grant funds awarded under this section among
grantees, which includes performance assessments for
continuation awards; and
``(ii) not later than 30 days after developing the formula
methodology under clause (i), submit the formula methodology
to--
``(I) the Committee on Energy and Commerce and the
Committee on Appropriations of the House of Representatives;
and
``(II) the Committee on Health, Education, Labor, and
Pensions and the Committee on Appropriations of the Senate.
``(B) Report.--Not later than two years after the date of
the enactment of the Restoring Hope for Mental Health and
Well-Being Act of 2022, the Comptroller General of the United
States shall submit to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on Energy
and Commerce of the House of Representatives a report that--
``(i) assesses how grant funding is allocated to States
under this section and how such allocations have changed over
time;
``(ii) assesses how any changes in funding under this
section have affected the efforts of States to address opioid
or stimulant use or misuse; and
``(iii) assesses the use of funding provided through the
grant program under this section and other similar grant
programs administered by the Substance Abuse and Mental
Health Services Administration.
``(4) Use of funds.--Grants awarded under this subsection
shall be used for carrying out activities that supplement
activities pertaining to opioid and stimulant use and misuse,
undertaken by the State agency responsible for administering
the substance abuse prevention and treatment block grant
under subpart II of part B of title XIX of the Public Health
Service Act (42 U.S.C. 300x-21 et seq.), which may include
public health-related activities such as the following:
``(A) Implementing prevention activities, and evaluating
such activities to identify effective strategies to prevent
substance use disorders.
``(B) Establishing or improving prescription drug
monitoring programs.
``(C) Training for health care practitioners, such as best
practices for prescribing opioids, pain management,
recognizing potential cases of substance use disorders,
referral of patients to treatment programs, preventing
diversion of controlled substances, and overdose prevention.
``(D) Supporting access to health care services,
including--
``(i) services provided by federally certified opioid
treatment programs;
``(ii) outpatient and residential substance use disorder
treatment services that utilize medication-assisted
treatment, as appropriate; or
``(iii) other appropriate health care providers to treat
substance use disorders.
``(E) Recovery support services, including--
``(i) community-based services that include peer supports;
``(ii) mutual aid recovery programs that support
medication-assisted treatment; or
``(iii) services to address housing needs and family
issues.
``(F) Other public health-related activities, as the State,
Indian Tribe, Tribal organization, or Urban Indian
organization determines appropriate, related to addressing
substance use disorders within the State, Indian Tribe,
Tribal organization, or Urban Indian organization, including
directing resources in accordance with local needs related to
substance use disorders.
``(c) Accountability and Oversight.--A State receiving a
grant under subsection (b) shall include in reporting related
to substance use disorders submitted to the Secretary
pursuant to section 1942 of the Public Health Service Act (42
U.S.C. 300x-52), a description of--
``(1) the purposes for which the grant funds received by
the State under such subsection for the preceding fiscal year
were expended and a description of the activities of the
State under the grant;
``(2) the ultimate recipients of amounts provided to the
State; and
``(3) the number of individuals served through the grant.
``(d) Limitations.--Any funds made available pursuant to
subsection (i)--
``(1) shall not be used for any purpose other than the
grant program under subsection (b); and
``(2) shall be subject to the same requirements as
substance use disorders prevention and treatment programs
under titles V and XIX of the Public Health Service Act (42
U.S.C. 290aa et seq., 300w et seq.).
``(e) Indian Tribes, Tribal Organizations, and Urban Indian
Organizations.--The Secretary, in consultation with Indian
Tribes, Tribal organizations, and Urban Indian organizations,
shall identify and establish appropriate mechanisms for
Indian Tribes, Tribal organizations, and Urban Indian
organizations to demonstrate or report the information as
required under subsections (b), (c), and (d).
``(f) Report to Congress.--Not later than September 30,
2024, and biennially thereafter, the Secretary shall submit
to the Committee on Health, Education, Labor, and Pensions of
the Senate and the Committee on Energy and Commerce of the
House of Representatives, and the Committees on
Appropriations of the House of Representatives and the
Senate, a report that includes a summary of the information
provided to the Secretary in reports made pursuant to
subsections (c) and (e), including--
``(1) the purposes for which grant funds are awarded under
this section;
``(2) the activities of the grant recipients; and
``(3) for each State, Indian Tribe, Tribal organization,
and Urban Indian organization that receives a grant under
this section, the funding level provided to such recipient.
``(g) Technical Assistance.--The Secretary, including
through the Tribal Training and Technical Assistance Center
of the Substance Abuse and Mental Health Services
Administration, shall provide States, Indian Tribes, Tribal
organizations, and Urban Indian organizations, as applicable,
with technical assistance concerning grant application and
submission procedures under this section, award management
activities, and enhancing outreach and direct support to
rural and underserved communities and providers in addressing
substance use disorders.
``(h) Definitions.--In this section:
``(1) Indian tribe.--The term `Indian Tribe' has the
meaning given the term `Indian tribe' in section 4 of the
Indian Self-Determination and Education Assistance Act (25
U.S.C. 5304).
``(2) Tribal organization.--The term `Tribal organization'
has the meaning given the term `tribal organization' in such
section 4.
``(3) State.--The term `State' has the meaning given such
term in section 1954(b) of the Public Health Service Act (42
U.S.C. 300x-64(b)).
``(4) Urban indian organization.--The term `Urban Indian
organization' has the meaning given such term in section 4 of
the Indian Health Care Improvement Act.
``(i) Authorization of Appropriations.--
``(1) In general.--For purposes of carrying out the grant
program under subsection (b), there is authorized to be
appropriated $1,750,000,000 for each of fiscal years 2023
through 2027, to remain available until expended.
``(2) Federal administrative expenses.--Of the amounts made
available for each fiscal year to award grants under
subsection (b), the Secretary shall not use more than 20
percent for Federal administrative expenses, training,
technical assistance, and evaluation.
``(3) Set aside.--Of the amounts made available for each
fiscal year to award grants under subsection (b) for a fiscal
year, the Secretary shall--
``(A) award 5 percent to Indian Tribes, Tribal
organizations, and Urban Indian organizations; and
``(B) of the amount remaining after application of
subparagraph (A), set aside up to 15
[[Page H5791]]
percent for awards to States with the highest age-adjusted
rate of drug overdose death based on the ordinal ranking of
States according to the Director of the Centers for Disease
Control and Prevention.''.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
gentleman from New Jersey (Mr. Pallone) and the gentlewoman from
Washington (Mrs. Rodgers) each will control 10 minutes.
The Chair recognizes the gentleman from New Jersey.
Mr. PALLONE. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, I rise in support of this en bloc amendment. This
package includes bipartisan bills and policies that will increase
access to substance use disorder prevention, treatment, and recovery
support services.
The amendment introduced by Representatives Rodney Davis, Bilirakis,
O'Halleran, Wagner, and Kuster reflects H.R. 2355, the Opioid
Prescription Verification Act of 2021, which has previously passed the
House. The amendment, like the bill it is drawn from, encourages the
use of e-prescribing for opioids and incentivizes States to maintain
and utilize prescription drug monitoring programs.
Likewise, the amendment offered by Representatives Andy Kim and
Davids also reflects a previously House-passed bill, H.R. 2364, the
Synthetic Opioid Danger Awareness Act. Their amendment requires the
Department of Health and Human Services to conduct a public education
campaign about synthetic opioids, including fentanyl and its analogues,
and disseminate information about synthetic opioids to healthcare
providers.
Continuing the theme of bipartisanship, Representatives McKinley and
Dingell introduced an amendment that amends the Controlled Substances
Act to clarify the process for registrants to exercise due diligence
upon discovering a suspicious order. Like the prior amendments, this,
too, is drawn from a prior House-passed bill, H.R. 768, the Block,
Report, And Suspend Suspicious Shipments Act of 2021.
Further, the amendment offered by Representatives Trone, Armstrong,
and Sherrill also draws from a prior House-passed bill extending a
critical authorization for the State Opioid Response grants and Tribal
Opioid Response grants for 5 years.
Another amendment introduced by Representatives Dean, Spartz,
Scanlon, and Fitzpatrick reflects H.R. 5950, the Improving Patient
Access to Care and Treatment Act. This amendment increases the time
from 14 to 60 days that healthcare providers can hold long-acting
injectable buprenorphine before administering it to a patient, giving
patients and practitioners greater flexibility when accessing opioid
use disorder treatment.
Finally, this amendment package includes an amendment offered by
Representative Gottheimer that would ensure that veterans are included
within the crisis response continuum of best practices included in H.R.
7666.
I thank the sponsors of these provisions. These bipartisan amendments
provide strong tools to address the ongoing overdose crisis and will
save lives. I urge my colleagues to support this package of amendments
and include them in the overall bill.
Madam Speaker, I reserve the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I rise in support of the
amendments offered en bloc and yield myself such time as I may consume.
Madam Speaker, I rise today to express my strong support for this
group of amendments addressing substance use disorder.
Included in this en bloc are important bills that have already passed
with overwhelming support, including Representative Rodney Davis'
Opioid Prescription Verification Act, which incentivizes States to use
prescription drug monitoring programs; requires certain controlled
substances to be prescribed electronically; and directs Federal
agencies to develop, disseminate, and periodically update training
materials to help pharmacists identify and report potential cases of
bad actors who attempt to illegally buy and sell controlled substances.
Also included is Representative David McKinley's Block, Report, And
Suspend Suspicious Shipments Act, which places additional obligations
on drug manufacturers and distributors to identify and stop suspicious
orders of controlled substances.
We have seen a devastating increase in overdose deaths that I think
should be called poisonings, teens buying one pill via Snapchat and
immediately overdosing because of a small amount of fentanyl in those
pills. Just because it looks like a pill and someone says it was from a
pharmacy does not make it so. We need to do more to stop both diversion
of legitimate medication and counterfeits that are devastating our
communities.
These amendments are a good step in that direction, and I urge
adoption.
Madam Speaker, I reserve the balance of my time.
Mr. PALLONE. Madam Speaker, I reserve the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I yield 3 minutes to the
gentleman from West Virginia (Mr. McKinley), who has been a longtime
leader on the issues of substance abuse.
Mr. McKINLEY. Madam Speaker, I rise in support of en bloc No. 2,
which includes an amendment to report, track, and take action on
suspicious orders.
While the COVID-19 pandemic raged through our population and
dominated the headlines, the opioid epidemic exploded exponentially,
silently claiming the lives of tens of thousands of Americans every
year. Recent CDC data shows that the overdose death rate for last year
was over 103,000 citizens.
In 2017, the Energy and Commerce Committee conducted a comprehensive
bipartisan investigation into opioid dumping in West Virginia.
Outrageous details came to light, exposing how drug shipments in rural
West Virginia went unconstrained. For example, over 2 million opioids
were sent to a little town of 3,000 people.
Another example: Even after a distributor found numerous red flags
during his site visit, nearly 1.5 million doses of opioids were still
shipped to a single pharmacy in Kermit, West Virginia, with a
population of 406.
The report that was filed by the Energy and Commerce Committee
details failures on the part of both DEA and the distributors to
identify and halt suspicious orders. Distributors felt they didn't have
the authority to halt suspicious orders and could have been subject to
lawsuits.
As recommended in the report, this amendment not only requires the
distributors to report suspicious orders but also to investigate the
situation and decline to fill the order if it is warranted.
American communities deserve to be treated better. This influx of
illegal drugs must be stopped, and this amendment is a step in the
right direction.
Madam Speaker, I urge Members to adopt this amendment.
Mrs. RODGERS of Washington. Madam Speaker, I yield back the balance
of my time.
Mr. PALLONE. Madam Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
previous question is ordered on the amendments en bloc offered by the
gentleman from New Jersey (Mr. Pallone).
The question is on the amendments en bloc.
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. TIFFANY. Madam Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this question
are postponed.
Amendment No. 4 Offered by Mrs. Demings
The SPEAKER pro tempore. It is now in order to consider amendment No.
4 printed in part E of House Report 117-381.
Mrs. DEMINGS. Madam Speaker, I have an amendment at the desk.
The SPEAKER pro tempore. The Clerk will designate the amendment.
The text of the amendment is as follows:
At the end of title III, add the following new subtitle:
Subtitle E--Other Provisions
SEC. 341. REPORT ON LAW ENFORCEMENT MENTAL HEALTH AND
WELLNESS.
(a) In General.--Not later than 270 days after the date of
enactment of this Act, the Attorney General, in consultation
with the
[[Page H5792]]
Director of the Federal Bureau of Investigation, the Director
of the National Institute for Justice, and the Assistant
Secretary for Mental Health and Substance Abuse, shall submit
to the Committee on Health, Education, Labor, and Pensions
and the Committee on the Judiciary of the Senate and the
Committee on Energy and Commerce and the Committee on the
Judiciary of the House of Representatives a report on--
(1) the types, frequency, and severity of mental health and
stress-related responses of law enforcement officers to
aggressive actions or other trauma-inducing incidents against
law enforcement officers;
(2) mental health and stress-related resources or programs
that are available to law enforcement officers at the
Federal, State, and local level, including peer-to-peer
programs;
(3) the extent to which law enforcement officers use the
resources or programs described in paragraph (2);
(4) the availability of, or need for, mental health
screening within Federal, State, and local law enforcement
agencies; and
(5) recommendations for Federal, State, and local law
enforcement agencies to improve the mental health and
wellness of their officers.
(b) Development.--In developing the report required under
subsection (a), the Attorney General, the Director of the
Federal Bureau of Investigation, the Director of the National
Institute of Justice, and the Assistant Secretary for Mental
Health and Substance Abuse shall consult relevant
stakeholders, including--
(1) Federal, State, Tribal and local law enforcement
agencies; and
(2) nongovernmental organizations, international
organizations, academies, or other entities.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
gentlewoman from Florida (Mrs. Demings) and a Member opposed each will
control 5 minutes.
The Chair recognizes the gentlewoman from Florida.
Mrs. DEMINGS. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, the underlying bill is a significant step forward in
supporting community mental health efforts, which I applaud.
As a former social worker and former law enforcement officer, I have
seen the devastating impact when communities fall short of meeting the
needs of persons struggling with mental health and substance addiction.
Florida is 49th in the Nation on access to mental health care. It is
not a position we are proud of, but many States across the Nation have
failed to adequately address these issues.
Law enforcement officers, as we all know, have a tough and dangerous
job, and I was proud to co-lead the Law Enforcement Mental Health and
Wellness Act, signed into law by President Trump, which recognizes that
addressing mental and psychological health is just as important as good
physical health.
My amendment is a simple one. It will insert reporting requirements
on available mental health and stress-related programs for law
enforcement officers and recommend additional tools that may be helpful
or necessary to identify, access, monitor, and improve the overall
well-being of our law enforcement officers.
I am proud to support this bill, as it is critical that we support
our community by boldly addressing mental health issues. I am proud to
offer this amendment that will support the men and women in blue who
support, protect, and serve us.
Madam Speaker, I urge adoption of the amendment, and I yield back the
balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I claim the time in
opposition, but I urge adoption of the amendment.
The SPEAKER pro tempore. Without objection, the gentlewoman is
recognized for 5 minutes.
There was no objection.
Mrs. RODGERS of Washington. Madam Speaker, I rise to urge adoption of
the Demings amendment, which requires a report on the mental health
issues experienced by law enforcement and the available resources or
programs that are available to law enforcement officers to address
mental health and stress.
According to the National Alliance on Mental Illness, law enforcement
officers report high rates of depression, anxiety, and post-traumatic
stress disorders, with nearly one in four having considered suicide. In
fact, more officers die from suicide than do in the line of duty.
The report will include recommendations to Federal, State, and local
law enforcement agencies on how to improve the mental health and well-
being of our officers.
It is a necessary first step in helping us understand what resources
are available to improve the mental health and wellness of law
enforcement officials. Those risking their lives to keep America safe
deserve passage of this amendment.
Madam Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
previous question is ordered on the amendment offered by the
gentlewoman from Florida (Mrs. Demings).
The question is on the amendment offered by the gentlewoman from
Florida (Mrs. Demings).
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. PALLONE. Madam Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this question
are postponed.
{time} 1545
Amendment No. 6 Offered by Mrs. Rodgers of Washington
The SPEAKER pro tempore. It is now in order to consider amendment No.
6 printed in part E of House Report 117-381.
Mrs. RODGERS of Washington. Madam Speaker, as the designee of the
gentleman from Georgia (Mr. Ferguson), I have an amendment at the desk.
The SPEAKER pro tempore. The Clerk will designate the amendment.
The text of the amendment is as follows:
At the end of subtitle A of title IV, add the following new
section:
SEC. 403. BEST PRACTICES FOR BEHAVIORAL INTERVENTION TEAMS.
The Public Health Service Act is amended by inserting after
section 520H of such Act, as added by section 151, the
following new section:
``SEC. 520I. BEST PRACTICES FOR BEHAVIORAL INTERVENTION
TEAMS.
``(a) In General.--The Secretary shall identify and
facilitate the development of best practices to assist
elementary schools, secondary schools, and institutions of
higher education in establishing and using behavioral
intervention teams.
``(b) Elements.--The best practices under subsection (a)(1)
shall include guidance on the following:
``(1) How behavioral intervention teams can operate
effectively from an evidence-based, objective perspective
while protecting the constitutional and civil rights of
individuals.
``(2) The use of behavioral intervention teams to identify
concerning behaviors, implement interventions, and manage
risk through the framework of the school's or institution's
rules or code of conduct, as applicable.
``(3) How behavioral intervention teams can, when assessing
an individual--
``(A) access training on evidence-based, threat-assessment
rubrics;
``(B) ensure that such teams--
``(i) have trained, diverse stakeholders with varied
expertise; and
``(ii) use cross validation by a wide-range of individual
perspectives on the team; and
``(C) use violence risk assessment.
``(4) How behavioral intervention teams can help mitigate--
``(A) inappropriate use of a mental health assessment;
``(B) inappropriate limitations or restrictions on law
enforcement's jurisdiction over criminal matters;
``(C) attempts to substitute the behavioral intervention
process in place of a criminal process, or impede a criminal
process, when an individual's behavior has potential criminal
implications;
``(D) endangerment of an individual's privacy by failing to
ensure that all applicable Federal and State privacy laws are
fully complied with; or
``(E) inappropriate referrals to, or involvement of, law
enforcement when an individual's behavior does not warrant a
criminal response.
``(c) Consultation.--In carrying out subsection (a)(1), the
Secretary shall consult with--
``(1) the Secretary of Education;
``(2) the Director of the National Threat Assessment Center
of the United States Secretary Service;
``(3) the Attorney General and the Director of the Bureau
of Justice Assistance;
``(4) teachers and other educators, principals, school
administrators, school board members, school psychologists,
mental health professionals, and parents of students;
``(5) local law enforcement agencies and campus law
enforcement administrators;
[[Page H5793]]
``(6) privacy experts; and
``(7) other education and mental health professionals as
the Secretary deems appropriate.
``(d) Publication.--Not later than 2 years after the date
of enactment of this section, the Secretary shall publish the
best practices under subsection (a)(1) on the internet
website of the Department of Health and Human Services.
``(e) Technical Assistance.--The Secretary shall provide
technical assistance to institutions of higher education,
elementary schools, and secondary schools to assist such
institutions and schools in implementing the best practices
under subsection (a).
``(f) Definitions.--In this section:
``(1) The term `behavioral intervention team' means a team
of qualified individuals who--
``(A) are responsible for identifying and assessing
individuals exhibiting concerning behaviors, experiencing
distress, or who are at risk of harm to self or others;
``(B) develop and facilitate implementation of evidence-
based interventions to mitigate the threat of harm to self or
others posed by an individual and address the mental and
behavioral health needs of individuals to reduce risk; and
``(C) provide information to students, parents, and school
employees on recognizing behavior described in this
subsection.
``(2) The terms `elementary school', `parent', and
`secondary school' have the meanings given to such terms in
section 8101 of the Elementary and Secondary Education Act of
1965.
``(3) The term `institution of higher education' has the
meaning given to such term in section 102 of the Higher
Education Act of 1965.
``(4) The term `mental health assessment' means an
evaluation, primarily focused on diagnosis, determining the
need for involuntary commitment, medication management, and
on-going treatment recommendations.
``(5) The term `violence risk assessment' means a broad
determination of the potential risk of violence based on
evidence-based literature.''.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
gentlewoman from Washington (Mrs. Rodgers) and a Member opposed each
will control 5 minutes.
The Chair recognizes the gentlewoman from Washington.
Mrs. RODGERS of Washington. Mr. Speaker, I yield myself such time as
I may consume.
I rise to express my strong support for the Ferguson amendment, which
would incorporate the language of the bipartisan, House-passed
Behavioral Intervention Guidelines Act to the underlying package.
This important amendment authorizes the Substance Abuse and Mental
Health Services Administration to develop best practices for
establishing and appropriately using behavioral intervention teams in
schools.
Behavioral intervention teams are multidisciplinary teams that
support students' mental health and wellness by identifying students
experiencing stress, anxiety, or other behavioral disturbances, and
conducting intervention and outreach to these students to help manage
risk.
These teams are already active in some educational settings, such as
Texas Tech and the University of California, Los Angeles.
By acting in a proactive manner to assist students and connecting
them with needed resources, behavioral intervention teams help schools
create a safe environment for their students and improve mental health
outcomes in young people.
It is more important now than ever that schools and communities have
guidance on how to provide behavioral health resources and
interventions for their students to facilitate the early intervention
and treatment of mental health conditions.
This amendment will help children get help before their conditions
worsen or reach a crisis level. I strongly urge a ``yes'' vote on this
amendment, and I reserve the balance of my time.
Mr. PALLONE. Madam Speaker, I claim the time in opposition to the
amendment, but I do not oppose the amendment.
The SPEAKER pro tempore. Without objection, the gentleman from New
Jersey is recognized for 5 minutes.
There was no objection.
Mr. PALLONE. Madam Speaker, I yield myself such time as I may
consume.
Madam Speaker, I rise in support of this amendment. Like the bill
that passed the House last year, H.R. 2877, and other House-passed
provisions we hope to include through amendment into the Restoring Hope
Act, this bipartisan amendment is part of the bipartisan approach
Ranking Member Rodgers and I have taken since day one with this
critical bill.
This amendment requires the Secretary to consult with a range of
experts, including mental health and education professionals, to
develop best practices for schools and universities to establish
behavioral intervention teams to identify concerning behaviors and
manage risks among students. The guidance must determine how these
teams can operate effectively while relying on evidence-based,
objective protection of the constitutional and civil rights of students
and staff.
Madam Speaker, I understand that some disability and civil rights
organizations have concerns about the provisions of this amendment and
opposed the original bill. I agree that we must be sensitive to the
concerns of these organizations and not inadvertently perpetuate a
false association of psychiatric disability and gun violence, nor
promote the preemptive use of law enforcement to address problematic
student behaviors, particularly among students with disabilities and/or
students of color, who are already disproportionately excessively
disciplined compared to their peers.
At the same time, I think there is merit to the idea of teams of
behavioral health specialists working in concert with educators to
identify youth and college students who may be at risk of harming
themselves or others and making sure they get the support they need.
This bill has passed the full House twice, as I said, on suspension,
both this Congress and last Congress. My understanding is that the
bill's sponsors have made changes when reintroducing the bill this
Congress to address some of the stakeholders' concerns by including
more robust privacy protections and inappropriate referral protections.
I think these changes improve the bill.
I understand the stakeholders would like to see additional changes,
and as I have indicated in the past, I am committed to examining ways
to address these concerns and add additional guardrails as the bill
progresses through negotiations with our Senate counterparts, including
this amendment for consideration for adoption into H.R. 7666, but we
need to pass the amendment to allow those kinds of negotiations with
the Senate.
I look forward to working closely with stakeholders, Congressman
Ferguson, and the other original leads of H.R. 2877, and, of course,
our ranking member, to strike the right balance that protects the
health, privacy, and rights of all students.
Madam Speaker, I yield back the balance of my time.
Mrs. RODGERS of Washington. Madam Speaker, I yield back the balance
of my time.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
previous question is ordered on the amendment offered by the
gentlewoman from Washington (Mrs. Rodgers).
The question is on the amendment offered by the gentlewoman from
Washington (Mrs. Rodgers).
The question was taken; and the Speaker pro tempore announced that
the ayes appeared to have it.
Mr. PALLONE. Madam Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this question
are postponed.
Amendment No. 8 Offered by Mr. Griffith
The SPEAKER pro tempore. It is now in order to consider amendment No.
8 printed in part E of House Report 117-381.
Mr. GRIFFITH. Madam Speaker, I rise to offer my amendment.
The SPEAKER pro tempore. The Clerk will designate the amendment.
The text of the amendment is as follows:
Page 130, after line 3, insert the following:
(c) Applicability.--The amendments made by this section
shall not apply until January 1, 2024.
The SPEAKER pro tempore. Pursuant to House Resolution 1191, the
gentleman from Virginia (Mr. Griffith) and a Member opposed each will
control 5 minutes.
The Chair recognizes the gentleman from Virginia.
Mr. GRIFFITH. Madam Speaker, I yield myself such time as I may
consume.
[[Page H5794]]
I appreciate the opportunity to present this amendment. This
amendment would delay the implementation of the MAT Act, section 262,
until January of 2024.
Currently, the Act would eliminate the patient cap on the number of
patients a single healthcare provider can provide buprenorphine to.
This cap was created originally in 2000 in the Drug Addiction Treatment
Act, which initially set the cap at 30 patients. Since 2000, the cap
has been increased several times, and the current law is 275 patients
per healthcare practitioner.
This patient cap has never been lifted before or even studied as to
what the effects would be if it was lifted. This is a complex treatment
area. Patients don't just need buprenorphine, or its less addictive
form known by the trade name Suboxone. They need behavioral healthcare
treatment. They need hands-on, detailed guidance. They need to do a
long, step-down process, slowly reducing and then eliminating all of
the opioids that they are using or have used.
Buprenorphine is also an opioid. It is better than heroin or
fentanyl, and it can be used as a treatment very effectively. But it
still can be addictive. There are reports of its sale on the street.
With no cap on the number of patients, I fear we could see abuse.
But if we feel this should be a matter for the States to define
through their medical processes, their medical boards, or their
legislatures, we need to give them time to take that action. Most State
legislatures are not currently in session, so the amendment gives the
States time to take action if they choose to do so.
The overall bill is good, but I don't want us to be inadvertently
creating more problems down the road related to buprenorphine.
Delaying the implementation of the new MAT language until 2024 will
allow States to analyze what they think is a good cap for their
population, if they choose to do so at all, but they need the time in
order to make that decision.
Accordingly, Madam Speaker, I would ask that we vote ``yes'' on this
important amendment, and I reserve the balance of my time.
Mr. PALLONE. Madam Speaker, I claim the time in opposition to the
amendment.
The SPEAKER pro tempore. The gentleman from New Jersey is recognized
for 5 minutes.
Mr. PALLONE. Madam Speaker, I yield myself 2 minutes.
Madam Speaker, I thank the gentleman from Virginia for expressing his
concerns relating to the MAT Act, but I respectfully disagree with his
proposal.
First of all, I take issue with some of his characterizations
regarding buprenorphine. Buprenorphine is not broadly available to all
Americans who need it. In fact, only 1 in 10 individuals with opioid
use disorder receive medications for their condition, including
buprenorphine.
Over half of all rural counties in the United States do not have a
single waivered buprenorphine provider, and 40 percent of all counties
in the United States don't have a single waivered provider, according
to the HHS-OIG.
This is a huge treatment gap. A treatment gap for opioid use
disorders means lives are lost every day unnecessarily when there is
treatment available. This is tragic and not acceptable.
Second, the gentleman has made the argument that buprenorphine is not
effective against fentanyl, but that is not accurate. Buprenorphine is
proven to reduce fentanyl use and overdose deaths, according to the
National Academies of Sciences Consensus Report on Medications for
Opioid Use Disorders and the United States Commission on Combating
Synthetic Opioid Trafficking.
Delaying the elimination of the X waiver to 2024 means extending the
time in which a barrier to treatment is in place, leading to an
increased risk of overdose and death.
It is clear that we are experiencing record numbers of overdose
deaths in America. This is a public health emergency and needs to be
addressed immediately.
Buprenorphine is a proven, evidence-based treatment for opioid use
disorder. Buprenorphine prevents painful withdrawal symptoms, reduces
opioid cravings, and cuts the risk of overdose in half. This is due to
buprenorphine's ceiling effect, which makes it nearly impossible to
overdose on the medication. For these reasons, it is considered safer
than commonly prescribed medications like insulin and blood thinners.
Madam Speaker, eliminating the X waiver is a cornerstone of the
Restoring Hope Act. The MAT Act amendment to this package was adopted
at markup by a vote of 45-10. It received support from the majority of
Republicans and Democrats on the committee.
Further, nothing in this bill limits the ability of States to prepare
and act on the overdose crisis.
The SPEAKER pro tempore. The time of the gentleman has expired.
Mr. PALLONE. Madam Speaker, I yield myself an additional 30 seconds.
To the contrary, this legislation empowers States to determine the
appropriate training, licensing requirements, and tools for providers
who dispense controlled substances and treat patients with substance
use disorders. All the MAT Act does is remove an unnecessary and
outdated Federal barrier to States effectively addressing the opioid
overdose crisis.
If we don't act now, we risk tens of thousands of additional
overdoses and unnecessary loss of life. I urge my colleagues to reject
this amendment, and I reserve the balance of my time.
Mr. GRIFFITH. Madam Speaker, I yield such time as he may consume to
the gentleman from Georgia (Mr. Ferguson).
Mr. FERGUSON. Madam Speaker, I thank my colleague from Virginia for
yielding.
Madam Speaker, while I do, in fact, support his amendment, I would
also like to speak for just a minute on the previous amendment offered
to H.R. 7666, the BIG Act.
We have seen over the past couple of years a significant rise in
mental health issues with our students, whether it is in high school,
whether it is in middle school, or whether it is in college. We have
seen the effects of the pandemic, but there are a lot of other things
that have created this mental health crisis for our children around
America.
What our children need are resources, and they need resources at a
very early age. So what the BIG Act does is it accumulates best
practices from different schools around the country, and it makes sure
that we intervene with students early. We want to get these young
people the resources that they need.
{time} 1600
There are a couple of things about this that we think are very
important:
Number one, early intervention has been proven to show that we can
prevent a catastrophic event. We want students to be healthy and happy
and functioning. What we would also like to do is limit the interaction
with law enforcement. We want to make sure that the students are
getting these resources across the board.
So this body passed the BIG Act last year, and they did it with wide
bipartisan support; however, the Senate did not take this bill up. So I
say, let's do it again. Let's pass it as part of this important
package.
Madam Speaker, I thank the chairman and our ranking members for
making such an effort to get this important piece of legislation across
the finish line.
Mr. GRIFFITH. Madam Speaker, may I inquire how much time is
remaining?
The SPEAKER pro tempore. The gentleman has 1 minute remaining.
Mr. GRIFFITH. Mr. Speaker, I reserve the balance of my time.
Mr. PALLONE. Madam Speaker, I yield such time as he may consume to
the gentleman from New York (Mr. Tonko).
Mr. TONKO. Madam Speaker, I rise in strong opposition to the Griffith
amendment. Not only does this amendment needlessly delay the
implementation of the MAT Act by another year, it does so with the
intent of encouraging States to enact more restrictions on
buprenorphine in the interim, running directly contrary to the intent
of the underlying bill.
Let's remember the facts here. We are in the middle of an
unprecedented crisis. Last year alone, 107,000 were taken from us too
early by drug overdoses. One all-too-common theme in these deaths is a
lack of access to
[[Page H5795]]
treatment. Despite being recognized as the gold standard of care that
can cut the risk of overdose in half, only about 1 in 10 individuals
with opioid use disorder received medications like buprenorphine to
treat their addiction. That is a glaring systemic failure.
H.R. 7666 takes a strong step to address that failure by expanding
access to safe and effective addiction treatment through eliminating
the outdated and redundant requirement that healthcare providers obtain
a special waiver from the DEA to prescribe buprenorphine for the
treatment of addiction.
Despite the lifesaving potential this legislation can bring, this
amendment raises concerns about the impact the MAT Act will have on
safety, abuse, and diversion, and I would take a moment to directly
address these concerns.
Let's start with the basic facts on safety.
Unlike heroin and fentanyl that are causing overdose deaths,
buprenorphine is a safe medication that is highly effective at
protecting people from overdose.
Due to its ceiling effect, buprenorphine does not cause people to
feel high and is unlikely to result in substance use disorder or be a
cause of overdose deaths.
With regard to diversion and abuse, the DEA, which is responsible for
policing illicit diversion, has specifically looked at this issue and
found that the primary reason for buprenorphine diversion is the
failure to access legitimate treatment, and that increasing, not
limiting, buprenorphine treatment may be an effective response to
diversion.
Indeed, as buprenorphine access has increased over the last 5 years
through legislation passed by this Congress, misuse of the medication
has decreased.
So I would say that it is important for us to be responsible here. We
are in the midst of a pandemic, an epidemic that is causing great pain,
great suffering, great death, every day, every week. Every moment we
circumvent our responsibilities, someone is paying the price for that.
Madam Speaker, I strongly oppose this amendment.
Mr. PALLONE. Madam Speaker, I yield back the balance of my time.
Mr. GRIFFITH. Madam Speaker, I yield 1 minute to the gentlewoman from
Washington (Mrs. Rodgers).
Mrs. RODGERS of Washington. Madam Speaker, I appreciate the gentleman
for yielding.
Madam Speaker, I rise in support of the Griffith amendment which
provides additional time for implementation of the provisions of the
Mainstreaming Addiction Treatment Act included in this bill.
I supported the inclusion of this language at committee, as I believe
it will help increase access to substance use disorder treatment, the
underlying language. However, enacting this language will be a huge
policy change from the status quo.
Furthermore, States do regulate the practice of medicine, and each
State has unique, individual regulations and procedures regarding the
dispensing and the prescribing of scheduled narcotics. States could use
the additional time to update their laws with any changes they may want
now that Federal restrictions will be removed.
This is exactly what Mr. Griffith's amendment does. It sets the
implementation date for removing the X waiver requirement to take
effective on January 1, 2024.
Madam Speaker, I support this commonsense amendment that will ensure
that the Mainstreaming Addiction Treatment Act gets appropriately
implemented.
Mr. GRIFFITH. Madam Speaker, I yield back the balance of my time.
The SPEAKER pro tempore. Pursuant to House Resolution Number 1191,
the previous question is ordered on the amendment offered by the
gentleman from Virginia (Mr. Griffith).
The question is on the amendment.
The question was taken; and the Speaker pro tempore announced that
the noes appeared to have it.
Mr. GRIFFITH. Madam Speaker, on that I demand the yeas and nays.
The SPEAKER pro tempore. Pursuant to section 3(s) of House Resolution
8, the yeas and nays are ordered.
Pursuant to clause 8 of rule XX, further proceedings on this question
are postponed.
Pursuant to clause 1(c) of rule XIX, further consideration of H.R.
7666 is postponed.
____________________