USC Subpart 3

USC Subpart 3
in effect

42 U.S.C. § 290bb–31 Center for Mental Health Services

(a) EstablishmentThere is established in the Administration a Center for Mental Health Services (hereafter in this section referred to as the “Center”). The Center shall be headed by a Director (hereafter in this section referred to as the “Director”) appointed by the Secretary from among individuals with extensive experience or academic qualifications in the provision of mental health services or in the evaluation of mental health service systems. (b) DutiesThe Director of the Center shall—(1) design national goals and establish national priorities for—(A) the prevention of mental illness; and (B) the promotion of mental health; (2) encourage and assist local entities and State agencies to achieve the goals and priorities described in paragraph (1); (3) collaborate with the Director of the National Institute of Mental Health and the Chief Medical Officer, appointed under section 290aa(g) of this title, to ensure that, as appropriate, programs related to the prevention and treatment of mental illness and the promotion of mental health and recovery support are carried out in a manner that reflects the best available science and evidence-based practices, including culturally and linguistically appropriate services, as appropriate; (4) collaborate with the Department of Education and the Department of Justice to develop programs to assist local communities in addressing violence among children and adolescents; (5) develop and coordinate Federal prevention policies and programs and to assure increased focus on the prevention of mental illness and the promotion of mental health, including through programs that reduce risk and promote resiliency; (6) in collaboration with the Director of the National Institute of Mental Health, develop improved methods of treating individuals with mental health problems and improved methods of assisting the families of such individuals; (7) administer the mental health services block grant program authorized in section 300x of this title; (8) promote policies and programs at Federal, State, and local levels and in the private sector that foster independence, increase meaningful participation of individuals with mental illness in programs and activities of the Administration, and protect the legal rights of persons with mental illness, including carrying out the provisions of the Protection and Advocacy of Mentally Ill Individuals Act 11 See References in Text note below. [42 U.S.C. 10801 et seq.]; (9) carry out the programs under part C; and (10) carry out responsibilities for the Human Resource Development programs; (11) conduct services-related assessments, including evaluations of the organization and financing of care, self-help and consumer-run programs, mental health economics, mental health service systems, rural mental health and tele-mental health, and improve the capacity of State to conduct evaluations of publicly funded mental health programs; (12) disseminate mental health information, including evidence-based practices, to States, political subdivisions, educational agencies and institutions, treatment and prevention service providers, and the general public, including information concerning the practical application of research supported by the National Institute of Mental Health that is applicable to improving the delivery of services; (13) provide technical assistance to public and private entities that are providers of mental health services; (14) monitor and enforce obligations incurred by community mental health centers pursuant to the Community Mental Health Centers Act (as in effect prior to the repeal of such Act on August 13, 1981, by section 902(e)(2)(B) of Public Law 97–35 (95 Stat. 560)); (15) conduct surveys with respect to mental health, such as the National Reporting Program; (16) assist States in improving their mental health data collection; and (17) ensure the consistent documentation of the application of criteria when awarding grants and the ongoing oversight of grantees after such grants are awarded. (c) Grants and contractsIn carrying out the duties established in subsection (b), the Director may make grants to and enter into contracts and cooperative agreements with public and nonprofit private entities.

42 U.S.C. § 290bb–32 Priority mental health needs of regional and national significance

(a) ProjectsThe Secretary shall address priority mental health needs of regional and national significance (as determined under subsection (b)) through the provision of or through assistance for—(1) knowledge development and application projects for prevention, treatment, and rehabilitation, and the conduct or support of evaluations of such projects; (2) training and technical assistance programs; (3) targeted capacity response programs; and (4) systems change grants including statewide family network grants and client-oriented and consumer run self-help activities, which may include technical assistance centers. The Secretary may carry out the activities described in this subsection directly or through grants, contracts, or cooperative agreements with States, political subdivisions of States, Indian Tribes or Tribal organizations (as such terms are defined in section 5304 of title 25), health facilities, or programs operated by or in accordance with a contract or grant with the Indian Health Service, or,11 So in original. The comma probably should not appear. other public or private nonprofit entities. (b) Priority mental health needs(1) Determination of needsPriority mental health needs of regional and national significance shall be determined by the Secretary in consultation with States and other interested groups. The Secretary shall meet with the States and interested groups on an annual basis to discuss program priorities. (2) Special considerationIn developing program priorities described in paragraph (1), the Secretary shall give special consideration to promoting the integration of mental health services into primary health care systems. (c) Requirements(1) In generalRecipients of grants, contracts, and cooperative agreements under this section shall comply with information and application requirements determined appropriate by the Secretary. (2) Duration of awardWith respect to a grant, contract, or cooperative agreement awarded under this section, the period during which payments under such award are made to the recipient may not exceed 5 years. (3) Matching fundsThe Secretary may, for projects carried out under subsection (a), require that entities that apply for grants, contracts, or cooperative agreements under this section provide non-Federal matching funds, as determined appropriate by the Secretary, to ensure the institutional commitment of the entity to the projects funded under the grant, contract, or cooperative agreement. Such non-Federal matching funds may be provided directly or through donations from public or private entities and may be in cash or in kind, fairly evaluated, including plant, equipment, or services. (4) Maintenance of effortWith respect to activities for which a grant, contract or cooperative agreement is awarded under this section, the Secretary may require that recipients for specific projects under subsection (a) agree to maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal year for which the entity receives such a grant, contract, or cooperative agreement. (d) EvaluationThe Secretary shall evaluate each project carried out under subsection (a)(1) and shall disseminate the findings with respect to each such evaluation to appropriate public and private entities. (e) Information and education(1) In generalThe Secretary shall establish information and education programs to disseminate and apply the findings of the knowledge development and application, training, and technical assistance programs, and targeted capacity response programs, under this section to the general public, to health care professionals, and to interested groups. The Secretary shall make every effort to provide linkages between the findings of supported projects and State agencies responsible for carrying out mental health services. (2) Rural and underserved areasIn disseminating information on evidence-based practices in the provision of children’s mental health services under this subsection, the Secretary shall ensure that such information is distributed to rural and medically underserved areas. (3) Geriatric mental disordersThe Secretary shall, as appropriate, provide technical assistance to grantees regarding evidence-based practices for the prevention and treatment of geriatric mental disorders and co-occurring mental health and substance use disorders among geriatric populations, as well as disseminate information about such evidence-based practices to States and nongrantees throughout the United States. (f) Authorization of appropriationsThere are authorized to be appropriated to carry out this section $599,036,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–33 Student suicide awareness and prevention training

(a) In generalIn awarding funds under section 290bb–32 of this title, the Secretary shall give priority to applications under such section from a State educational agency, local educational agency, or Tribal educational agency, submitted directly or through a State or Indian Tribe, for funding for activities in secondary schools, where such agency has implemented, or includes in such application a plan to implement, a student suicide awareness and prevention training policy, which may include applicable youth suicide early intervention and prevention strategies implemented through section 290bb–36 of this title—(1) establishing and implementing a school-based student suicide awareness and prevention training policy in accordance with subsection (c); (2) consulting with stakeholders (including principals, teachers, parents, local Tribal officials, and other relevant experts) and, as appropriate, utilizing information, models, and other resources made available by the Suicide Prevention Technical Assistance Center authorized under section 290bb–34 of this title in the development of the policy under paragraph (1); and (3) collecting and reporting information in accordance with subsection (d). (b) ConsiderationIn giving priority to applicants as described in subsection (a), the Secretary shall, as appropriate, take into consideration the incidence and prevalence of suicide in the applicable jurisdiction and the costs of establishing and implementing, as applicable, a school-based student suicide awareness and prevention training policy. (c) School-based student suicide awareness and prevention training policyA school-based student suicide awareness and prevention training policy implemented pursuant to subsection (a)(1) shall—(1) be evidence-based; (2) be culturally- and linguistically-appropriate; (3) provide evidence-based training to students in grades 6 through 12, in coordination with school-based mental health resources, as applicable, regarding—(A) suicide prevention education and awareness, including associated risk factors; (B) methods that students can use to seek help; and (C) student resources for suicide awareness and prevention; and (4) provide for periodic retraining of such students. (d) Collection of information and reportingEach State educational agency, local educational agency, and Tribal educational agency that receives priority to implement a new training policy pursuant to subsection (a)(1) shall report to the Secretary the following aggregated information, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws:(1) The number of trainings conducted, including the number of student trainings conducted, and the training delivery method used. (2) The number of students trained, disaggregated by age and grade level. (3) The number of help-seeking reports made by students after implementation of such policy. (e) Evidence-based program availabilityThe Secretary shall coordinate with the Secretary of Education and the Secretary of the Interior to—(1) make publicly available the policies established by State educational agencies, local educational agencies, and Tribal educational agencies pursuant to this section and the training that is available to students and teams pursuant to such policies, in accordance with section 290dd–2a of this title; and (2) provide technical assistance and disseminate best practices on student suicide awareness and prevention training policies, including through the Suicide Prevention Technical Assistance Center authorized under section 290bb–34 of this title, as applicable, to State educational agencies, local educational agencies, and Tribal agencies. (f) ImplementationNot later than September 30, 2024, the Secretary shall report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives the number of recipients of funds under section 290bb–32 of this title who have implemented training policies described in subsection (a)(1) and a summary of the information received under subsection (d). (g) DefinitionsIn this section:(1) The term “evidence-based” has the meaning given such term in section 7801 of title 20. (2) The term “local educational agency” has the meaning given to such term in section 7801 of title 20. (3) The term “State educational agency” has the meaning given to such term in section 7801 of title 20. (4) The term “Tribal educational agency” has the meaning given to the term “tribal educational agency” in section 7452 of title 20.

42 U.S.C. § 290bb–34 Suicide prevention technical assistance center

(a) Program authorized(1) In generalThe Secretary, acting through the Assistant Secretary, shall establish a research, training, and technical assistance resource center to provide appropriate information, training, and technical assistance to States, political subdivisions of States, federally recognized Indian Tribes, Tribal organizations, institutions of higher education, public organizations, or private nonprofit organizations regarding the prevention of suicide among all ages, particularly among groups that are at a high risk for suicide. (2) CollaborationIn carrying out this subsection, as applicable with respect to assistance to entities serving members of the Armed Forces and veterans, the Secretary shall, as appropriate, collaborate with the Secretary of Defense and the Secretary of Veterans Affairs. (b) Responsibilities of the CenterThe center established under subsection (a) shall conduct activities for the purpose of—(1) developing and continuing statewide or Tribal suicide early intervention and prevention strategies for all ages, particularly among groups that are at a high risk for suicide; (2) ensuring the surveillance of suicide early intervention and prevention strategies for all ages, particularly among groups that are at a high risk for suicide; (3) studying the costs and effectiveness of statewide and Tribal suicide early intervention and prevention strategies in order to provide information concerning relevant issues of importance to State, Tribal, and national policymakers; (4) further identifying and understanding causes and associated risk factors for suicide; (5) analyzing the efficacy of new and existing suicide early intervention and prevention techniques and technology; (6) ensuring the surveillance of suicidal behaviors and nonfatal suicidal attempts; (7) studying the effectiveness of State-sponsored statewide and Tribal suicide early intervention and prevention strategies on the overall wellness and health promotion strategies related to suicide attempts; (8) promoting the sharing of data regarding suicide with Federal agencies involved with suicide early intervention and prevention, and State-sponsored statewide or Tribal suicide early intervention and prevention strategies for the purpose of identifying previously unknown mental health causes and associated risk factors for suicide; (9) evaluating and disseminating outcomes and best practices of mental health and substance use disorder services at institutions of higher education; and (10) conducting other activities determined appropriate by the Secretary. (c) Authorization of appropriationsFor the purpose of carrying out this section, there are authorized to be appropriated $9,000,000 for each of fiscal years 2023 through 2027. (d) Annual reportNot later than 2 years after December 29, 2022, 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 a report on the activities carried out by the center established under subsection (a) during the year involved, including the potential effects of such activities, and the States, organizations, and institutions that have worked with the center.

42 U.S.C. § 290bb–36 Youth suicide early intervention and prevention strategies

(a) In generalThe Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, shall award grants or cooperative agreements to eligible entities to—(1) develop and implement State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies in schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, pediatric health programs, and other child and youth support organizations; (2) support public organizations and private nonprofit organizations actively involved in State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies and in the development and continuation of State-sponsored statewide youth suicide early intervention and prevention strategies; (3) provide grants to institutions of higher education to coordinate the implementation of State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies; (4) collect and analyze data on State-sponsored statewide or Tribal youth suicide early intervention and prevention services that can be used to monitor the effectiveness of such services and for research, technical assistance, and policy development; and (5) assist eligible entities, through State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies, in achieving targets for youth suicide reductions under title V of the Social Security Act [42 U.S.C. 701 et seq.]. (b) Eligible entity(1) DefinitionIn this section, the term “eligible entity” means—(A) a State; (B) a public organization or private nonprofit organization designated by a State or Indian Tribe (as defined in section 4 of the Indian Self-Determination and Education Assistance Act [25 U.S.C. 5304]) to develop or direct the State-sponsored statewide or Tribal youth suicide early intervention and prevention strategy; or (C) a Federally recognized Indian Tribe or Tribal organization (as defined in the Indian Self-Determination and Education Assistance Act [25 U.S.C. 5301 et seq.]) or an urban Indian organization (as defined in the Indian Health Care Improvement Act [25 U.S.C. 1601 et seq.]) that is actively involved in the development and continuation of a Tribal youth suicide early intervention and prevention strategy. (2) LimitationIn carrying out this section, the Secretary shall ensure that a State does not receive more than 1 grant or cooperative agreement under this section at any 1 time. For purposes of the preceding sentence, a State shall be considered to have received a grant or cooperative agreement if the eligible entity involved is the State or an entity designated by the State under paragraph (1)(B). Nothing in this paragraph shall be construed to apply to entities described in paragraph (1)(C). (3) ConsiderationIn awarding grants under this section, the Secretary shall take into consideration the extent of the need of the applicant, including the incidence and prevalence of suicide in the State and among the populations of focus, including rates of suicide determined by the Centers for Disease Control and Prevention for the State or population of focus. (4) ConsultationAn entity described in paragraph (1)(A) or (1)(B) that applies for a grant or cooperative agreement under this section shall agree to consult or confer with entities described in paragraph (1)(C) and Native Hawaiian Health Care Systems, as applicable, in the applicable State with respect to the development and implementation of a statewide early intervention strategy. (c) PreferenceIn providing assistance under a grant or cooperative agreement under this section, an eligible entity shall give preference to public organizations, private nonprofit organizations, political subdivisions, institutions of higher education, and Tribal organizations actively involved with the State-sponsored statewide or Tribal youth suicide early intervention and prevention strategy that—(1) provide early intervention and assessment services, including screening programs, to youth who are at risk for mental or emotional disorders that may lead to a suicide attempt, and that are integrated with school systems, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, pediatric health programs, and other child and youth support organizations; (2) demonstrate collaboration among early intervention and prevention services or certify that entities will engage in future collaboration; (3) employ or include in their applications a commitment to evaluate youth suicide early intervention and prevention practices and strategies adapted to the local community; (4) provide timely referrals for appropriate community-based mental health care and treatment of youth who are at risk for suicide in child-serving settings and agencies; (5) provide immediate support and information resources to families of youth who are at risk for suicide; (6) offer access to services and care to youth with diverse linguistic and cultural backgrounds; (7) offer appropriate postsuicide intervention services, care, and information to families, friends, schools, educational institutions, juvenile justice systems, substance use disorder programs, mental health programs, foster care systems, pediatric health programs, and other child and youth support organizations of youth who recently completed suicide; (8) offer continuous and up-to-date information and awareness campaigns that target parents, family members, child care professionals, community care providers, and the general public and highlight the risk factors associated with youth suicide and the life-saving help and care available from early intervention and prevention services; (9) ensure that information and awareness campaigns on youth suicide risk factors, and early intervention and prevention services, use effective communication mechanisms that are targeted to and reach youth, families, schools, educational institutions, pediatric health programs, and youth organizations; (10) provide a timely response system to ensure that child-serving professionals and providers are properly trained in youth suicide early intervention and prevention strategies and that child-serving professionals and providers involved in early intervention and prevention services are properly trained in effectively identifying youth who are at risk for suicide; (11) provide continuous training activities for child care professionals and community care providers on the latest youth suicide early intervention and prevention services practices and strategies; (12) conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations; (13) provide services in areas or regions with rates of youth suicide that exceed the national average as determined by the Centers for Disease Control and Prevention; (14) obtain informed written consent from a parent or legal guardian of an at-risk child before involving the child in a youth suicide early intervention and prevention program; and (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. (d) Requirement for suicide prevention activitiesNot less than 85 percent of grant funds received under this section shall be used to provide suicide prevention activities. (e) Coordination and collaboration(1) In generalIn carrying out this section, the Secretary shall collaborate with relevant Federal agencies and suicide working groups responsible for early intervention and prevention services relating to youth suicide. (2) ConsultationIn carrying out this section, the Secretary shall consult with—(A) State and local agencies, including agencies responsible for early intervention and prevention services under title XIX of the Social Security Act [42 U.S.C. 1396 et seq.], the State Children’s Health Insurance Program under title XXI of the Social Security Act [42 U.S.C. 1397aa et seq.], and programs funded by grants under title V of the Social Security Act [42 U.S.C. 701 et seq.]; (B) local and national organizations that serve youth at risk for suicide and their families; (C) relevant national medical and other health and education specialty organizations; (D) youth who are at risk for suicide, who have survived suicide attempts, or who are currently receiving care from early intervention services; (E) families and friends of youth who are at risk for suicide, who have survived suicide attempts, who are currently receiving care from early intervention and prevention services, or who have completed suicide; (F) qualified professionals who possess the specialized knowledge, skills, experience, and relevant attributes needed to serve youth at risk for suicide and their families; and (G) third-party payers, managed care organizations, and related commercial industries. (3) Policy developmentIn carrying out this section, the Secretary shall—(A) coordinate and collaborate on policy development at the Federal level with the relevant Department of Health and Human Services agencies and suicide working groups and the Department of Education, as appropriate; and (B) consult on policy development at the Federal level with the private sector, including consumer, medical, suicide prevention advocacy groups, and other health and education professional-based organizations, with respect to State-sponsored statewide or Tribal youth suicide early intervention and prevention strategies. (f) Rule of construction; religious and moral accommodationNothing in this section shall be construed to require suicide assessment, early intervention, or treatment services for youth whose parents or legal guardians object based on the parents’ or legal guardians’ religious beliefs or moral objections. (g) Evaluations and report(1) Evaluations by eligible entitiesNot later than 24 months after receiving a grant or cooperative agreement under this section, an eligible entity shall submit to the Secretary the results of an evaluation to be conducted by the entity concerning the effectiveness of the activities carried out under the grant or agreement. (2) ReportNot later than December 31, 2025, the Secretary shall submit to the appropriate committees of Congress a report concerning the results of—(A) the evaluations conducted under paragraph (1); and (B) an evaluation conducted by the Secretary to analyze the effectiveness and efficacy of the activities conducted with grants, collaborations, and consultations under this section. (h) Rule of construction; student medicationNothing in this section or section 290bb–36a of this title shall be construed to allow school personnel to require that a student obtain any medication as a condition of attending school or receiving services. (i) ProhibitionFunds appropriated to carry out this section, section 290bb–34 of this title, section 290bb–36a of this title, or section 290bb–36b of this title shall not be used to pay for or refer for abortion. (j) Parental consentStates and entities receiving funding under this section and section 290bb–36a of this title shall obtain prior written, informed consent from the child’s parent or legal guardian for assessment services, school-sponsored programs, and treatment involving medication related to youth suicide conducted in elementary and secondary schools. The requirement of the preceding sentence does not apply in the following cases:(1) In an emergency, where it is necessary to protect the immediate health and safety of the student or other students. (2) Other instances, as defined by the State, where parental consent cannot reasonably be obtained. (k) Relation to education provisionsNothing in this section or section 290bb–36a of this title shall be construed to supersede section 1232g of title 20, including the requirement of prior parental consent for the disclosure of any education records. Nothing in this section or section 290bb–36a of this title shall be construed to modify or affect parental notification requirements for programs authorized under the Elementary and Secondary Education Act of 1965 [20 U.S.C. 6301 et seq.] (as amended by the No Child Left Behind Act of 2001; Public Law 107–110). (l) DefinitionsIn this section:(1) Early interventionThe term “early intervention” means a strategy or approach that is intended to prevent an outcome or to alter the course of an existing condition. (2) Educational institution; institution of higher education; schoolThe term—(A) “educational institution” means a school or institution of higher education; (B) “institution of higher education” has the meaning given such term in section 1001 of title 20; and (C) “school” means an elementary school or secondary school (as such terms are defined in section 8101 of the Elementary and Secondary Education Act of 1965 [20 U.S.C. 7801]). (3) PreventionThe term “prevention” means a strategy or approach that reduces the likelihood or risk of onset, or delays the onset, of adverse health problems that have been known to lead to suicide. (4) YouthThe term “youth” means individuals who are up to 24 years of age. (m) Authorization of appropriationsFor the purpose of carrying out this section, there are authorized to be appropriated $40,000,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–36a Suicide prevention for youth

(a) In generalThe Secretary shall award grants or cooperative agreements to public organizations, private nonprofit organizations, political subdivisions, consortia of political subdivisions, consortia of States, or Federally recognized Indian tribes or tribal organizations to design early intervention and prevention strategies that will complement the State-sponsored statewide or tribal youth suicide early intervention and prevention strategies developed pursuant to section 290bb–36 of this title. (b) CollaborationIn carrying out subsection (a), the Secretary shall ensure that activities under this section are coordinated with the relevant Department of Health and Human Services agencies and suicide working groups. (c) RequirementsA public organization, private nonprofit organization, political subdivision, consortium of political subdivisions, consortium of States, or federally recognized Indian tribe or tribal organization desiring a grant, contract, or cooperative agreement under this section shall demonstrate that the suicide prevention program such entity proposes will—(1)(A) comply with the State-sponsored statewide early intervention and prevention strategy as developed under section 290bb–36 of this title; and (B) in the case of a consortium of States, receive the support of all States involved; (2) provide for the timely assessment, treatment, or referral for mental health or substance abuse services of youth at risk for suicide; (3) be based on suicide prevention practices and strategies that are adapted to the local community; (4) integrate its suicide prevention program into the existing health care system in the community including general, mental, and behavioral health services, and substance abuse services; (5) be integrated into other systems in the community that address the needs of youth including the school systems, educational institutions, juvenile justice system, substance abuse programs, mental health programs, foster care systems, and community child and youth support organizations; (6) use primary prevention methods to educate and raise awareness in the local community by disseminating evidence-based information about suicide prevention; (7) include suicide prevention, mental health, and related information and services for the families and friends of those who completed suicide, as needed; (8) offer access to services and care to youth with diverse linguistic and cultural backgrounds; (9) conduct annual self-evaluations of outcomes and activities, including consulting with interested families and advocacy organizations; 11 So in original. Probably should be followed by “and”. (10) ensure that staff used in the program are trained in suicide prevention and that professionals involved in the system of care have received training in identifying persons at risk of suicide. (d) Use of fundsAmounts provided under a grant or cooperative agreement under this section shall be used to supplement, and not supplant, Federal and non-Federal funds available for carrying out the activities described in this section. Applicants shall provide financial information to demonstrate compliance with this section. (e) ConditionAn applicant for a grant or cooperative agreement under subsection (a) shall demonstrate to the Secretary that the application complies with the State-sponsored statewide early intervention and prevention strategy as developed under section 290bb–36 of this title and the applicant has the support of the local community and relevant public health officials. (f) Special populationsIn awarding grants and cooperative agreements under subsection (a), the Secretary shall ensure that such awards are made in a manner that will focus on the needs of communities or groups that experience high or rapidly rising rates of suicide. (g) ApplicationA public organization, private nonprofit organization, political subdivision, consortium of political subdivisions, consortium of States, or Federally recognized Indian tribe or tribal organization receiving a grant or cooperative agreement under subsection (a) shall prepare and submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require. Such application shall include a plan for the rigorous evaluation of activities funded under the grant or cooperative agreement, including a process and outcome evaluation. (h) Distribution of awardsIn awarding grants and cooperative agreements under subsection (a), the Secretary shall ensure that such awards are distributed among the geographical regions of the United States and between urban and rural settings. (i) EvaluationA public organization, private nonprofit organization, political subdivision, consortium of political subdivisions, consortium of States, or Federally recognized Indian tribe or tribal organization receiving a grant or cooperative agreement under subsection (a) shall prepare and submit to the Secretary at the end of the program period, an evaluation of all activities funded under this section. (j) Dissemination and educationThe Secretary shall ensure that findings derived from activities carried out under this section are disseminated to State, county and local governmental agencies and public and private nonprofit organizations active in promoting suicide prevention and family support activities. (k) Duration of projectsWith respect to a grant, contract, or cooperative agreement awarded under this section, the period during which payments under such award may be made to the recipient may not exceed 3 years. (l) StudyWithin 1 year after October 17, 2000, the Secretary shall, directly or by grant or contract, initiate a study to assemble and analyze data to identify—(1) unique profiles of children under 13 who attempt or complete suicide; (2) unique profiles of youths between ages 13 and 24 who attempt or complete suicide; and (3) a profile of services available to these groups and the use of these services by children and youths from paragraphs (1) and (2). (m) DefinitionsIn this section, the terms “early intervention”, “educational institution”, “institution of higher education”, “prevention”, “school”, and “youth” have the meanings given to those terms in section 290bb–36 of this title. (n) Authorization of appropriationFor purposes of carrying out this section, there is authorized to be appropriated $75,000,000 for fiscal year 2001 and such sums as may be necessary for each of the fiscal years 2002 through 2003.

42 U.S.C. § 290bb–36b Mental health and substance use disorder services for students in higher education

(a) In generalThe Secretary, acting through the Director of the Center for Mental Health Services and in consultation with the Secretary of Education, may award grants on a competitive basis to institutions of higher education to enhance services for students with mental health or substance use disorders that can lead to school failure, such as depression, substance use disorders, and suicide attempts, prevent mental and substance use disorders, reduce stigma, and improve the identification and treatment for students at risk, so that students will successfully complete their studies. (b) Use of fundsThe Secretary may not make a grant to an institution of higher education under this section unless the institution agrees to use the grant only for one or more of the following:(1) Educating students, families, faculty, and staff to increase awareness of mental health and substance use disorders and promote resiliency. (2) The operation of hotlines. (3) Preparing informational material. (4) Providing outreach services to notify students about available mental health and substance use disorder resources and services. (5) Administering voluntary mental health and substance use disorder screenings and assessments. (6) Supporting the training of students, faculty, and staff to recognize and respond effectively and appropriately to students experiencing mental health and substance use disorders. (7) Creating a network infrastructure to link institutions of higher education with health care providers who treat mental health and substance use disorders. (8) Providing mental health and substance use. 11 So in original. disorders prevention and treatment services to students, which may include recovery support services and programming and early intervention, treatment, and management, including through the use of telehealth services. (9) Conducting research through a counseling or health center at the institution of higher education involved to improve the behavioral health of students through clinical services, outreach, prevention, promotion of mental health, or academic success, in a manner that is in compliance with all applicable personal privacy laws. (10) Supporting student groups on campus, including athletic teams, that engage in activities to educate students, including activities to reduce stigma surrounding mental and behavioral health disorders, and promote mental health. (11) Employing appropriately trained staff. (12) Developing and supporting evidence-based and emerging best practices, including a focus on culturally and linguistically appropriate best practices, and trauma-informed practices. (c) Eligible grant recipientsAny institution of higher education receiving a grant under this section may carry out activities under the grant through—(1) college counseling centers; (2) college and university psychological service centers; (3) mental health centers; (4) psychology training clinics; or (5) institution of higher education supported, evidence-based, mental health and substance use disorder programs. (d) ApplicationTo be eligible to receive a grant under this section, an institution of higher education shall prepare and submit an application to the Secretary at such time and in such manner as the Secretary may require. At a minimum, the application shall include the following:(1) A description of the population to be targeted by the program carried out under the grant, including veterans whenever possible and appropriate, and of identified mental health and substance use disorder needs of students at the institution of higher education. (2) A description of Federal, State, local, private, and institutional resources currently available to address the needs described in paragraph (1) at the institution of higher education, which may include, as appropriate and in accordance with subsection (b)(7), a plan to seek input from relevant stakeholders in the community, including appropriate public and private entities, in order to carry out the program under the grant. (3) A description of the outreach strategies of the institution of higher education for promoting mental health and access to services, including a proposed plan for reaching those students most in need of mental health services. (4) A plan to evaluate program outcomes, including a description of the proposed use of funds, the program objectives, and how the objectives will be met. (5) An assurance that the institution will submit a report to the Secretary each fiscal year on the activities carried out with the grant and the results achieved through those activities. (6) An outline of the objectives of the program carried out under the grant. (7) For an institution of higher education proposing to use the grant for an activity described in paragraph (8) or (9) of subsection (b), a description of the policies and procedures of the institution of higher education that are related to applicable laws regarding access to, and sharing of, treatment records of students at any campus-based mental health center or partner organization, including the policies and State laws governing when such records can be accessed and shared for non-treatment purposes and a description of the process used by the institution of higher education to notify students of these policies and procedures, including the extent to which written consent is required. (8) An assurance that grant funds will be used to supplement and not supplant any other Federal, State, or local funds available to carry out activities of the type carried out under the grant. (e) Requirement of matching funds(1) In generalThe Secretary may make a grant under this section to an institution of higher education only if the institution agrees to make available (directly or through donations from public or private entities) non-Federal contributions in an amount that is not less than $1 for each $1 of Federal funds provided in the grant, toward the costs of activities carried out with the grant (as described in subsection (b)) and other activities by the institution to reduce student mental health and substance use disorders. (2) Determination of amount contributedNon-Federal contributions required under paragraph (1) may be in cash or in kind. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. (3) WaiverThe Secretary may waive the requirement established in paragraph (1) with respect to an institution of higher education if the Secretary determines that extraordinary need at the institution justifies the waiver. (f) ReportsFor each fiscal year that grants are awarded under this section, the Secretary shall conduct a study on the results of the grants and submit to the 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 such results that includes the following:(1) An evaluation of the grant program outcomes, including a summary of activities carried out with the grant and the results achieved through those activities. (2) Recommendations on how to improve access to mental health and substance use disorder services at institutions of higher education, including through prevention, early detection, early intervention, and efforts to reduce the incidence of suicide and substance use disorders. (3) An assessment of the mental health and substance use disorder needs of the populations served by recipients of grants under this section. (g) DefinitionIn this section, the term “institution of higher education” has the meaning given such term in section 1001 of title 20. (h) Technical assistanceThe Secretary may provide technical assistance to grantees in carrying out this section. (i) Authorization of appropriationsFor the purpose of carrying out this section, there are authorized to be appropriated $7,000,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–36c National Suicide Prevention Lifeline program

(a) In generalThe Secretary, acting through the Assistant Secretary, shall maintain the National Suicide Prevention Lifeline program (referred to in this section as the “program”), authorized under section 290bb–32 of this title and in effect prior to December 13, 2016. (b) ActivitiesIn maintaining the program, the activities of the Secretary shall include—(1) supporting and coordinating a network of crisis centers across the United States for providing suicide prevention and mental health crisis intervention services, including appropriate follow-up services, to individuals seeking help at any time, day or night; (2) maintaining a suicide prevention hotline to link callers to local emergency, mental health, and social services resources; (3) consulting with the Secretary of Veterans Affairs to ensure that veterans calling the suicide prevention hotline have access to a specialized veterans’ suicide prevention hotline; (4) improving awareness of the program for suicide prevention and mental health crisis intervention services, including by conducting an awareness initiative and ongoing outreach to the public; (5) improving the collection and analysis of demographic information, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws, in order to understand disparities in access to the program among individuals who are seeking help; and (6) taking such steps as may be necessary to ensure the suicide prevention hotline is protected from cybersecurity incidents and eliminates known cybersecurity vulnerabilities. (c) Plan(1) In generalFor purposes of supporting the crisis centers under subsection (b)(1) and maintaining the suicide prevention hotline under subsection (b)(2), the Secretary shall develop and implement a plan to ensure the provision of high-quality services. (2) ContentsThe plan required by paragraph (1) shall include the following:(A) Program evaluation, including performance measures to assess progress toward the goals and objectives of the program and to improve the responsiveness and performance of the hotline, including at all backup call centers. (B) Requirements that crisis centers and backup centers must meet—(i) to participate in the network under subsection (b)(1); and (ii) to ensure that each telephone call and applicable other communication received by the hotline, including at backup call centers, is answered in a timely manner, consistent with evidence-based guidance or other guidance or best practices, as appropriate. (C) Specific recommendations and strategies for implementing evidence-based practices, including with respect to followup and communicating the availability of resources in the community for individuals in need. (D) Criteria for carrying out periodic testing of the hotline during each fiscal year, including at crisis centers and backup centers, to identify and address any problems in a timely manner. (3) ConsultationIn developing requirements under paragraph (2)(B), the Secretary shall consult with State departments of health, local governments, Indian Tribes, and Tribal organizations. (4) Initial plan; updatesThe Secretary shall—(A) not later than 1 year after December 29, 2022, complete development of the initial plan under paragraph (1) and make such plan publicly available; and (B) periodically thereafter, update such plan and make the updated plan publicly available. (d) Improving epidemiological dataThe Secretary shall, as appropriate, formalize and strengthen agreements between the Suicide Prevention Lifeline program and the Centers for Disease Control and Prevention with respect to the secure sharing of de-identified epidemiological data. Such agreements shall include appropriate privacy and security protections that meet the requirements of applicable Federal law, at a minimum. (e) Data to assist State and local suicide prevention activitiesThe Secretary shall ensure that the aggregated information collected and any applicable analyses conducted under subsection (b)(5), including from local call centers, as applicable, are made available in a usable format to State and local agencies in order to inform suicide prevention activities. (f) Cybersecurity reporting(1) Notification(A) In generalThe program’s network administrator receiving Federal funding pursuant to subsection (a) shall report to the Assistant Secretary, in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws—(i) any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such a vulnerability; and (ii) any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident. (B) Local and regional crisis centersLocal and regional crisis centers participating in the program shall report to the program’s network administrator identified under subparagraph (A), in a manner that protects personal privacy, consistent with applicable Federal and State privacy laws—(i) any identified cybersecurity vulnerabilities to the program within a reasonable amount of time after identification of such vulnerability; and (ii) any identified cybersecurity incidents to the program within a reasonable amount of time after identification of such incident. (2) NotificationIf the program’s network administrator receiving funding pursuant to subsection (a) discovers, or is informed by a local or regional crisis center pursuant to paragraph (1)(B) of, a cybersecurity vulnerability or incident, within a reasonable amount of time after such discovery or receipt of information, such entity shall report the vulnerability or incident to the Assistant Secretary. (3) Clarification(A) Oversight(i) Local and regional crisis centersExcept as provided in clause (ii), local and regional crisis centers participating in the program shall oversee all technology each center employs in the provision of services as a participant in the program. (ii) Network administratorThe program’s network administrator receiving Federal funding pursuant to subsection (a) shall oversee the technology each crisis center employs in the provision of services as a participant in the program if such oversight responsibilities are established in the applicable network participation agreement. (B) Supplement, not supplantThe cybersecurity incident reporting requirements under this subsection shall supplement, and not supplant, cybersecurity incident reporting requirements under other provisions of applicable Federal law that are in effect on December 1, 2025. (g) Authorization of appropriationsTo carry out this section, there are authorized to be appropriated $101,621,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–36d Treatment Referral Routing Service

(a) In generalThe Secretary, acting through the Assistant Secretary, shall maintain the National Treatment Referral Routing Service (referred to in this section as the “Routing Service”) to assist individuals and families in locating mental and substance use disorders treatment providers. (b) Activities of the SecretaryTo maintain the Routing Service, the activities of the Assistant Secretary shall include administering—(1) a nationwide, telephone number providing year-round access to information that is updated on a regular basis regarding local behavioral health providers and community-based organizations in a manner that is confidential, without requiring individuals to identify themselves, is in languages that include at least English and Spanish, and is at no cost to the individual using the Routing Service; and (2) an Internet website to provide a searchable, online treatment services locator of behavioral health treatment providers and community-based organizations, which shall include information on the name, location, contact information, and basic services provided by such providers and organizations. (c) Removing practitioner contact informationIn the event that the Internet website described in subsection (b)(2) contains information on any practitioner who prescribes narcotic drugs in schedule III, IV, or V of section 812 of title 21 for the purpose of maintenance or detoxification treatment, the Assistant Secretary—(1) shall provide an opportunity to such practitioner to have the contact information of the practitioner removed from the website at the request of the practitioner; and (2) may evaluate other methods to periodically update the information displayed on such website. (d) Rule of constructionNothing in this section shall be construed to prevent the Assistant Secretary from using any unobligated amounts otherwise made available to the Administration to maintain the Routing Service.

42 U.S.C. § 290bb–37 Mental health crisis response partnership pilot program

(a) In generalThe 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 disorder crises from law enforcement to mobile crisis teams, as described in subsection (b). (b) Mobile crisis teams describedA mobile crisis team, for purposes of this section, is a team of individuals—(1) that is available to respond to individuals in mental health and substance use disorder crises 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 mental health and substance use disorder crisis calls from the 9–1–1 system to the 9–8–8 system. (c) PriorityIn 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 reportNot later than September 30, 2024, the Secretary shall submit to Congress a report on steps taken by States, localities, territories, Indian Tribes, and Tribal organizations prior to December 29, 2022, to strengthen the partnerships among mental health providers, substance use disorder treatment providers, primary care physicians, mental health and substance use disorder crisis teams, paramedics, law enforcement officers, and other first responders. (2) Progress reportsNot 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 made to community-based resources or short-term crisis receiving and stabilization facilities, as applicable, 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; (D) identification and, where appropriate, recommendations of best practices from States and localities providing mobile crisis response and stabilization services for youth and adults; and (E) identification of any opportunities for improvements to the program established under this section. (e) Authorization of appropriationsThere are authorized to be appropriated to carry out this section, $10,000,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–38 Grants for jail diversion programs

(a) Program authorizedThe Secretary shall make grants to States, political subdivisions of States, and Indian Tribes and Tribal organizations (as the terms “Indian tribes” and “tribal organizations” are defined in section 4 of the Indian Self-Determination and Education Assistance Act [25 U.S.C. 5304]), acting directly or through agreements with other public or nonprofit entities, or a health facility or program operated by or in accordance with a contract or grant with the Indian Health Service, to develop and implement programs to divert individuals with a mental illness from the criminal justice system to community-based services. (b) Administration(1) ConsultationThe Secretary shall consult with the Attorney General and any other appropriate officials in carrying out this section. (2) Regulatory authorityThe Secretary shall issue regulations and guidelines necessary to carry out this section, including methodologies and outcome measures for evaluating programs carried out by States, political subdivisions of States, Indian Tribes, and Tribal organizations receiving grants under subsection (a). (c) Applications(1) In generalTo receive a grant under subsection (a), the chief executive of a State, chief executive of a subdivision of a State, an Indian Tribe or Tribal organization, a health facility or program described in subsection (a), or a public or nonprofit entity referred to in subsection (a) shall prepare and submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary shall reasonably require. (2) ContentSuch application shall—(A) contain an assurance that—(i) community-based mental health services will be available for the individuals who are diverted from the criminal justice system, and that such services are based on evidence-based practices, reflect current research findings, include case management, assertive community treatment, medication management and access, integrated mental health and co-occurring substance use disorder treatment, peer recovery support services, and psychiatric rehabilitation, and will be coordinated with social services, including life skills training, housing placement, vocational training, education job placement, and health care; (ii) there has been relevant interagency collaboration between the appropriate criminal justice, mental health, and substance use disorder systems; and (iii) the Federal support provided will be used to supplement, and not supplant, State, local, Indian Tribe, or Tribal organization sources of funding that would otherwise be available; (B) demonstrate that the diversion program will be integrated with an existing system of care for those with mental illness; (C) explain the applicant’s inability to fund the program adequately without Federal assistance; (D) specify plans for obtaining necessary support and continuing the proposed program following the conclusion of Federal support; and (E) describe methodology and outcome measures that will be used in evaluating the program. (d) Special consideration regarding veteransIn awarding grants under subsection (a), the Secretary shall, as appropriate, give special consideration to entities proposing to use grant funding to support jail diversion services for veterans. (e) Use of fundsA State, political subdivision of a State, Indian Tribe, or Tribal organization that receives a grant under subsection (a) may use funds received under such grant to—(1) integrate the diversion program into the existing system of care; (2) create or expand community-based mental health and co-occurring mental illness and substance use disorder services to accommodate the diversion program; (3) train professionals and paraprofessionals involved in the system of care, and law enforcement officers, attorneys, and judges; (4) provide community outreach and crisis intervention; and (5) develop programs to divert individuals prior to booking, arrest, or release. (f) Federal share(1) In generalThe Secretary shall pay to a State, political subdivision of a State, Indian Tribe, or Tribal organization receiving a grant under subsection (a) the Federal share of the cost of activities described in the application. (2) Federal shareThe Federal share of a grant made under this section shall not exceed 75 percent of the total cost of the program carried out by the State, political subdivision of a State, Indian Tribe, or Tribal organization. Such share shall be used for new expenses of the program carried out by such State, political subdivision of a State, Indian Tribe, or Tribal organization. (3) Non-Federal shareThe non-Federal share of payments made under this section may be made in cash or in kind fairly evaluated, including planned equipment or services. The Secretary may waive the requirement of matching contributions. (g) Geographic distributionThe Secretary shall ensure that such grants awarded under subsection (a) are equitably distributed among the geographical regions of the United States and between urban and rural populations. (h) Training and technical assistanceTraining and technical assistance may be provided by the Secretary to assist a State, political subdivision of a State, Indian Tribe, or Tribal organization receiving a grant under subsection (a) in establishing and operating a diversion program. (i) EvaluationsThe programs described in subsection (a) shall be evaluated not less than one time in every 12-month period using the methodology and outcome measures identified in the grant application. (j) Authorization of appropriationsThere are authorized to be appropriated to carry out this section $14,000,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–39 Peer-supported mental health services

(a) Grants authorizedThe Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, 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 fundsGrants awarded under subsection (a) shall be used to develop, expand, and enhance national, statewide, or community-focused programs, including virtual peer-support services and technology-related capabilities, 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 through the adoption of technologies and capabilities to expand access to virtual peer mental health support services, such as by acquiring equipment and software necessary to efficiently run virtual peer-support services; 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 considerationIn carrying out this section, the Secretary shall give special consideration to the unique needs of rural areas. (d) DefinitionIn this section, the term “eligible entity” means—(1) a consumer-run nonprofit 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) an Indian Tribe, Tribal organization, Urban Indian organization, or consortium of Tribes or Tribal organizations. (e) Authorization of appropriationsThere is authorized to be appropriated to carry out this section $13,000,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–39a Best practices for behavioral and mental health intervention teams

(a) In generalThe Secretary, acting through the Assistant Secretary for Mental Health and Substance Use, and in consultation with the Secretary of Education, shall submit to the Health Education, Labor, and Pensions Committee of the Senate and the Energy and Commerce Committee of the House of Representatives a report that identifies best practices related to using behavioral and mental health intervention teams, which may be used to assist elementary schools, secondary schools, and institutions of higher education interested in voluntarily establishing and using such teams to support students exhibiting behaviors interfering with learning at school or who are at risk of harm to self or others. (b) ElementsThe report under subsection (a) shall assess evidence supporting such best practices and, as appropriate, include consideration of the following:(1) How behavioral and mental health intervention teams might operate effectively from an evidence-based, objective perspective while protecting the constitutional and civil rights and privacy of individuals. (2) The use of behavioral and mental health intervention teams—(A) to identify and support students exhibiting behaviors interfering with learning or posing a risk of harm to self or others; and (B) to implement evidence-based interventions to meet the behavioral and mental health needs of such students. (3) How behavioral and mental health intervention teams can—(A) access evidence-based professional development to support students described in paragraph (2)(A); and (B) ensure that such teams—(i) are composed of trained, diverse stakeholders with expertise in child and youth development, behavioral and mental health, and disability; and (ii) use cross validation by a wide-range of individual perspectives on the team. (4) How behavioral and mental health intervention teams can help mitigate inappropriate referral to mental health services or law enforcement by implementing evidence-based interventions that meet student needs. (c) ConsultationIn carrying out subsection (a), the Secretary shall consult with—(1) the Secretary of Education; (2) the Director of the National Threat Assessment Center of the United States Secret Service; (3) the Attorney General; (4) teachers (which shall include special education teachers), principals and other school leaders, school board members, behavioral and mental health professionals (including school-based mental health professionals), and parents of students; (5) local law enforcement agencies and campus law enforcement administrators; (6) privacy, disability, and civil rights experts; and (7) other education and mental health professionals as the Secretary deems appropriate. (d) PublicationThe Secretary shall publish the report under subsection (a) in an accessible format on the internet website of the Department of Health and Human Services. (e) DefinitionsIn this section:(1) The term “behavioral and mental health intervention team” means a multidisciplinary team of trained individuals who—(A) are trained to identify and assess the behavioral health needs of children and youth and who are responsible for identifying, supporting, and connecting students exhibiting behaviors interfering with learning at school, or who are at risk of harm to self or others, with appropriate behavioral health services; and (B) develop and facilitate implementation of evidence-based interventions to—(i) mitigate the threat of harm to self or others posed by a student described in subparagraph (A); (ii) meet the mental and behavioral health needs of such students; and (iii) support positive, safe, and supportive learning environments. (2) The terms “elementary school”, “parent”, and “secondary school” have the meanings given to such terms in section 7801 of title 20. (3) The term “institution of higher education” has the meaning given to such term in section 1002 of title 20.

42 U.S.C. § 290bb–40 Grants for the integrated treatment of serious mental illness and co-occurring substance abuse

(a) In generalThe Secretary shall award grants, contracts, or cooperative agreements to States, political subdivisions of States, Indian tribes, tribal organizations, and private nonprofit organizations for the development or expansion of programs to provide integrated treatment services for individuals with a serious mental illness and a co-occurring substance abuse disorder. (b) PriorityIn awarding grants, contracts, and cooperative agreements under subsection (a), the Secretary shall give priority to applicants that emphasize the provision of services for individuals with a serious mental illness and a co-occurring substance abuse disorder who—(1) have a history of interactions with law enforcement or the criminal justice system; (2) have recently been released from incarceration; (3) have a history of unsuccessful treatment in either an inpatient or outpatient setting; (4) have never followed through with outpatient services despite repeated referrals; or (5) are homeless. (c) Use of fundsA State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that receives a grant, contract, or cooperative agreement under subsection (a) shall use funds received under such grant—(1) to provide fully integrated services rather than serial or parallel services; (2) to employ staff that are cross-trained in the diagnosis and treatment of both serious mental illness and substance abuse; (3) to provide integrated mental health and substance abuse services at the same location; (4) to provide services that are linguistically appropriate and culturally competent; (5) to provide at least 10 programs for integrated treatment of both mental illness and substance abuse at sites that previously provided only mental health services or only substance abuse services; and (6) to provide services in coordination with other existing public and private community programs. (d) ConditionThe Secretary shall ensure that a State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that receives a grant, contract, or cooperative agreement under subsection (a) maintains the level of effort necessary to sustain existing mental health and substance abuse programs for other populations served by mental health systems in the community. (e) Distribution of awardsThe Secretary shall ensure that grants, contracts, or cooperative agreements awarded under subsection (a) are equitably distributed among the geographical regions of the United States and between urban and rural populations. (f) DurationThe Secretary shall award grants, contract, or cooperative agreements under this subsection for a period of not more than 5 years. (g) ApplicationA State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that desires a grant, contract, or cooperative agreement under this subsection shall prepare and submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require. Such application shall include a plan for the rigorous evaluation of activities funded with an award under such subsection, including a process and outcomes evaluation. (h) EvaluationA State, political subdivision of a State, Indian tribe, tribal organization, or private nonprofit organization that receives a grant, contract, or cooperative agreement under this subsection shall prepare and submit a plan for the rigorous evaluation of the program funded under such grant, contract, or agreement, including both process and outcomes evaluation, and the submission of an evaluation at the end of the project period. (i) Authorization of appropriationThere is authorized to be appropriated to carry out this subsection $40,000,000 for fiscal year 2001, and such sums as may be necessary for fiscal years 2002 through 2003.

42 U.S.C. § 290bb–41 Mental health awareness training grants

(a) In generalThe Secretary shall award grants in accordance with the provisions of this section. (b) Mental health awareness training grants(1) In generalThe Secretary shall award grants to States, political subdivisions of States, Indian Tribes, Tribal organizations, and nonprofit private entities to train teachers and other relevant school personnel to recognize symptoms of childhood and adolescent mental disorders, to refer family members to the appropriate mental health services if necessary, to train emergency services personnel 11 So in original. A comma probably should appear. veterans, law enforcement, and other categories of individuals, as determined by the Secretary, to identify and appropriately respond to persons with a mental illness, and to provide education to such teachers and personnel regarding resources that are available in the community for individuals with a mental illness. (2) Emergency services personnelIn this subsection, the term “emergency services personnel” includes paramedics, firefighters, and emergency medical technicians. (3) Distribution of awardsThe Secretary shall ensure that such grants awarded under this subsection are equitably distributed among the geographical regions of the United States and between urban and rural populations. (4) ApplicationA State, political subdivision of a State, Indian Tribe, Tribal organization, or nonprofit private entity that desires a grant under this subsection shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require, including a plan for the rigorous evaluation of activities that are carried out with funds received under a grant under this subsection. (5) Use of fundsA State, political subdivision of a State, Indian Tribe, Tribal organization, or nonprofit private entity receiving a grant under this subsection shall use funds from such grant for evidence-based programs that provide training and education in accordance with paragraph (1) on matters including—(A) recognizing the signs and symptoms of mental illness; (B)(i) resources available in the community for individuals with a mental illness and other relevant resources; or (ii) safely de-escalating crisis situations involving individuals with a mental illness; and (C) suicide intervention and prevention. (6) EvaluationA State, political subdivision of a State, Indian Tribe, Tribal organization, or nonprofit private entity that receives a grant under this subsection shall prepare and submit an evaluation to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including an evaluation of activities carried out with funds received under the grant under this subsection and a process and outcome evaluation. (7) Technical assistanceThe Secretary may provide technical assistance to grantees in carrying out this section, which may include assistance with—(A) program evaluation and related activities, including related data collection and reporting; (B) implementing and disseminating evidence-based practices and programs; and (C) facilitating collaboration among grantees. (8) Authorization of appropriationsThere is authorized to be appropriated to carry out this subsection $24,963,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–42 Improving uptake and patient access to integrated care services

(a) DefinitionsIn this section:(1) Eligible entityThe 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 300x–2(b)(1) of this title; or (B) 1 or more health centers (as defined in section 254b(a) of this title), rural health clinics (as defined in section 1395x(aa) of this title), or Federally qualified health centers (as defined in such section), or primary care practices serving adult or pediatric patients or both. (2) Integrated care; bidirectional integrated care(A) The term “integrated care” means collaborative models, including the psychiatric collaborative care model and other evidence-based or evidence-informed 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, and the integration of primary and physical health care within specialty behavioral health settings, including within primary health care settings. (3) Psychiatric collaborative care modelThe term “psychiatric 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. (4) Special populationThe term “special population” means—(A) adults with a serious mental illness or adults who have co-occurring mental illness and physical health conditions or chronic disease; (B) children and adolescents with a serious emotional disturbance 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 generalThe 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 fundsA grant or cooperative agreement awarded under this section shall be used—(A) to promote full integration and collaboration in clinical practices between physical and behavioral health care, including for special populations; (B) to support the improvement of integrated care models for physical and behavioral health care to improve overall wellness and physical health status, including for special populations; (C) to promote the implementation and improvement of bidirectional integrated care services provided at entities described in subsection (a)(1), including evidence-based or evidence-informed screening, assessment, diagnosis, prevention, treatment, and recovery services for mental and substance use disorders, and co-occurring physical health conditions and chronic diseases; and (D) in the case of an eligible entity that is collaborating with a primary care practice, to support the implementation of evidence-based or evidence-informed integrated care models, including the psychiatric collaborative care model, including—(i) by hiring staff; (ii) by identifying and formalizing contractual relationships with other health care providers or other relevant entities offering care management and behavioral health consultation to facilitate the adoption of integrated care, including, as applicable, providers who will function as psychiatric consultants and behavioral health care managers in providing behavioral health integration services through the collaborative care model; (iii) by purchasing or upgrading software and other resources, as applicable, needed to appropriately provide behavioral health integration, 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 applicable and appropriate. (c) Applications(1) In generalAn eligible entity that is seeking a grant or cooperative agreement under this section shall submit an application to the Secretary at such time, in such manner, and accompanied by such information as the Secretary may require, including the contents described in paragraph (2). (2) Contents for awardsAny such application of an eligible entity seeking a grant or cooperative agreement under this section shall include, as applicable—(A) a description of a plan to achieve fully collaborative agreements to provide bidirectional integrated care to special populations; (B) a summary of 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 and, as applicable, in areas with demonstrated need, such as Tribal, rural, or other medically underserved communities, such as those with a workforce shortage of mental health and substance use disorder, pediatric mental health, or other related professionals; (D) an agreement and plan to report to the Secretary performance measures necessary to evaluate patient outcomes and facilitate evaluations across participating projects; and (E) a description of the plan or progress in implementing the psychiatric collaborative care model, as applicable and appropriate; (F) a description of the plan or progress of evidence-based or evidence-informed integrated care models other than the psychiatric collaborative care model implemented by primary care practices, as applicable and appropriate; and (G) a plan for sustainability beyond the grant or cooperative agreement period under subsection (e). (d) Grant and cooperative agreement amounts(1) Target amountThe target amount that an eligible entity may receive for a year through a grant or cooperative agreement under this section shall be no more than $2,000,000. (2) Adjustment permittedThe 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 December 29, 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) LimitationAn eligible entity that is receiving funding under subsection (b)—(A) may not allocate more than 10 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) DurationA grant or cooperative agreement under this section shall be for a period not to exceed 5 years. (f) Report on program outcomesAn eligible entity receiving a grant or cooperative agreement under this section shall submit an annual report to the Secretary. Such annual report shall include—(1) the progress made to reduce barriers to integrated care as described in the entity’s application under subsection (c); (2) a description of outcomes with respect to each special population listed in subsection (a)(4), including outcomes related to education, employment, and housing, or, as applicable and appropriate, outcomes for such populations receiving behavioral health care through the psychiatric collaborative care model in primary care practices; and (3) progress in meeting performance metrics and other relevant benchmarks; and (4) such other information that the Secretary may require. (g) Technical assistance for primary-behavioral health care integration(1) Certain recipientsThe Secretary may provide appropriate information, training, and technical assistance to eligible entities that receive a grant or cooperative agreement under subsection (b)(2), 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) as appropriate, appropriate information, training, and technical assistance in implementing the psychiatric collaborative care model when an eligible entity is collaborating with 1 or more primary care practices for the purposes of implementing the psychiatric collaborative care model. (2) Additional dissemination of technical informationIn addition to providing the assistance described in paragraph (1) 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 those terms are defined in section 5304 of title 25, outpatient mental health and addiction treatment centers, community mental health centers that meet the criteria under section 300x–2(c) of this title, 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 1395x(aa) of this title, primary health care practices, the community-based organizations, and other entities engaging in integrated care activities, as the Secretary determines appropriate. (h) Report to CongressNot later than 18 months after December 29, 2022, and annually thereafter, the Secretary shall submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives summarizing the information submitted in reports to the Secretary under subsection (f), including progress made in meeting performance metrics and the uptake of integrated care models, any adjustments made to target amounts pursuant to subsection (d)(2), and any other relevant information. (i) Funding(1) Authorization of appropriationsTo carry out this section, there is authorized to be appropriated $60,000,000 for each of fiscal years 2023 through 2027. (2) Increasing uptake of the psychiatric collaborative care model by primary care practicesNot less than 10 percent of funds appropriated to carry out this section shall be for the purposes of implementing the psychiatric collaborative care model implemented by primary care practices under subsection (b). (3) Funding contingencyParagraph (2) shall not apply to a fiscal year unless the amount made available to carry out this section for such fiscal year exceeds the amount appropriated to carry out this section (as in effect before December 29, 2022) for fiscal year 2022.

42 U.S.C. § 290bb–43 Adult suicide prevention

(a) Grants(1) In generalThe Assistant Secretary shall award grants to eligible entities described in paragraph (2) to implement suicide prevention and intervention programs, for adult individuals, that are designed to raise awareness of suicide prevention, establish referral processes, and improve care and outcomes for such individuals who are at risk of suicide. (2) Eligible entitiesTo be eligible to receive a grant under this section, an entity shall be a community-based primary care or behavioral health care setting, an emergency department, a State mental health agency (or State health agency with mental or behavioral health functions), public health agency, a territory of the United States, or an Indian Tribe or Tribal organization (as the terms “Indian Tribe” and “Tribal organization” are defined in section 5304 of title 25). (3) Use of fundsThe grants awarded under paragraph (1) shall be used to implement programs, in accordance with such paragraph, that include one or more of the following components:(A) Screening for suicide risk, suicide intervention services, and services for referral for treatment for individuals at risk for suicide. (B) Implementing evidence-based practices to provide treatment for individuals at risk for suicide, including appropriate followup services. (C) Raising awareness of suicide prevention resources and promoting help seeking among those at risk for suicide. (b) Evaluations and technical assistanceThe Assistant Secretary shall—(1) evaluate the activities supported by grants awarded under subsection (a), and disseminate, as appropriate, the findings from the evaluation; (2) provide appropriate information, training, and technical assistance, as appropriate, to eligible entities that receive a grant under this section, in order to help such entities to meet the requirements of this section, including assistance with selection and implementation of evidence-based interventions and frameworks to prevent suicide; and (3) identify best practices, as applicable, to improve the identification, assessment, treatment, and timely transition, as appropriate, to additional or follow-up care for individuals in emergency departments who are at risk for suicide and enhance the coordination of care for such individuals during and after discharge, in support of activities under subsection (a). (c) DurationA grant under this section shall be for a period of not more than 5 years. (d) Authorization of appropriationsThere are authorized to be appropriated to carry out this section $30,000,000 for each of fiscal years 2023 through 2027.

42 U.S.C. § 290bb–44 Assertive community treatment grant program

(a) In generalThe Assistant Secretary shall award grants to eligible entities—(1) to establish assertive community treatment programs for adults with a serious mental illness; or (2) to maintain or expand such programs. (b) Eligible entitiesTo be eligible to receive a grant under this section, an entity shall be a State, political subdivision of a State, Indian Tribe or Tribal organization (as such terms are defined in section 5304 of title 25), mental health system, health care facility, or any other entity the Assistant Secretary deems appropriate. (c) Special considerationIn selecting among applicants for a grant under this section, the Assistant Secretary may give special consideration to the potential of the applicant’s program to reduce hospitalization, homelessness, and involvement with the criminal justice system while improving the health and social outcomes of the patient. (d) Additional activitiesThe Assistant Secretary shall—(1) not later than the end of fiscal year 2026, submit a report to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on Energy and Commerce of the House of Representatives on the grant program under this section, including an evaluation of—(A) any cost savings and public health outcomes such as mortality, suicide, substance use disorders, hospitalization, and use of services; (B) rates of involvement with the criminal justice system of patients; (C) rates of homelessness among patients; and (D) patient and family satisfaction with program participation; and (2) provide appropriate information, training, and technical assistance to grant recipients under this section to help such recipients to establish, maintain, or expand their assertive community treatment programs. (e) Authorization of appropriations(1) In generalTo carry out this section, there is authorized to be appropriated $9,000,000 for each of fiscal years 2023 through 2027. (2) Use of certain fundsOf the funds appropriated to carry out this section in any fiscal year, not more than 5 percent shall be available to the Assistant Secretary for carrying out subsection (d).

42 U.S.C. § 290bb–45 Center of Excellence for Eating Disorders for education and training on eating disorders

(a) In generalThe 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 subcontractsThe Center shall coordinate and implement the activities under subsection (c), in whole or in part, which may include by awarding competitive subgrants or subcontracts—(1) across geographical regions; and (2) in a manner that is not duplicative. (c) ActivitiesThe Center—(1) shall—(A) provide training and technical assistance, including for—(i) primary care and mental health providers to carry out screening, brief intervention, and referral to treatment for individuals experiencing, or at risk for, eating disorders; and (ii) other paraprofessionals and relevant individuals providing nonclinical community services to identify and support individuals with, or at disproportionate risk for, eating disorders; (B) facilitate the development of, and provide training materials to, health care providers (including primary care and mental health professionals) regarding the effective treatment and ongoing support of individuals with eating disorders, including children and marginalized populations at disproportionate risk for eating disorders; (C) collaborate and coordinate, as appropriate, with 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 regarding eating disorders; (D) coordinate with the Director of the Centers for Disease Control and Prevention and the Administrator of the Health Resources and Services Administration, and other Federal agencies, as appropriate, to disseminate training to primary care and mental health care providers; and (E) support other activities, as determined appropriate by the Secretary; and (2) may—(A) support the integration of protocols pertaining to screening, brief intervention, and referral to treatment for individuals experiencing, or at risk for, eating disorders, with health information technology systems; (B) develop and provide training materials to health care providers, including primary care and mental health providers, to provide screening, brief intervention, and referral to treatment for members of the military and veterans experiencing, or at risk for, eating disorders; and (C) consult, as appropriate, with the Secretary of Defense and the Secretary of Veterans Affairs on prevention, identification, intervention for, and treatment of eating disorders. (d) Authorization of appropriationsTo carry out this section, there is authorized to be appropriated $1,000,000 for each of fiscal years 2023 through 2027.

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