Attachment 1b - Legislative authority

Attachment 1B

PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1101

Public Law 106–310
106th Congress
An Act
To amend the Public Health Service Act with respect to children’s health.

Be it enacted by the Senate and House of Representatives of
the United States of America in Congress assembled,
SECTION 1. SHORT TITLE.

Oct. 17, 2000
[H.R. 4365]
Children’s Health
Act of 2000.
42 USC 201 note.

This Act may be cited as the ‘‘Children’s Health Act of 2000’’.
SEC. 2. TABLE OF CONTENTS.

The table of contents for this Act is as follows:
Sec. 1. Short title.
Sec. 2. Table of contents.
DIVISION A—CHILDREN’S HEALTH
TITLE I—AUTISM
Sec. 101. Expansion, intensification, and coordination of activities of National Institutes of Health with respect to research on autism.
Sec. 102. Developmental disabilities surveillance and research programs.
Sec. 103. Information and education.
Sec. 104. Inter-agency Autism Coordinating Committee.
Sec. 105. Report to Congress.
TITLE II—RESEARCH AND DEVELOPMENT REGARDING FRAGILE X
Sec. 201. National Institute of Child Health and Human Development; research on
fragile X.
TITLE III—JUVENILE ARTHRITIS AND RELATED CONDITIONS
Sec. 301. National Institute of Arthritis and Musculoskeletal and Skin Diseases;
research on juvenile arthritis and related conditions.
Sec. 302. Information clearinghouse.
TITLE IV—REDUCING BURDEN OF DIABETES AMONG CHILDREN AND
YOUTH
Sec. 401. Programs of Centers for Disease Control and Prevention.
Sec. 402. Programs of National Institutes of Health.
TITLE V—ASTHMA SERVICES FOR CHILDREN
Subtitle A—Asthma Services
Sec. 501. Grants for children’s asthma relief.
Sec. 502. Technical and conforming amendments.
Subtitle B—Prevention Activities
Sec. 511. Preventive health and health services block grant; systems for reducing
asthma-related illnesses through integrated pest management.
Subtitle C—Coordination of Federal Activities
Sec. 521. Coordination through National Institutes of Health.
Subtitle D—Compilation of Data
Sec. 531. Compilation of data by Centers for Disease Control and Prevention.

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114 STAT. 1102

PUBLIC LAW 106–310—OCT. 17, 2000
TITLE VI—BIRTH DEFECTS PREVENTION ACTIVITIES

Subtitle A—Folic Acid Promotion
Sec. 601. Program regarding effects of folic acid in prevention of birth defects.
Subtitle B—National Center on Birth Defects and Developmental Disabilities
Sec. 611. National Center on Birth Defects and Developmental Disabilities.
TITLE VII—EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING
HEARING LOSS IN INFANTS
Sec. 701. Purposes.
Sec. 702. Programs of Health Resources and Services Administration, Centers for
Disease Control and Prevention, and National Institutes of Health.
TITLE VIII—CHILDREN AND EPILEPSY
Sec. 801. National public health campaign on epilepsy; seizure disorder demonstration projects in medically underserved areas.
TITLE IX—SAFE MOTHERHOOD; INFANT HEALTH PROMOTION
Subtitle A—Safe Motherhood Prevention Research
Sec. 901. Prevention research and other activities.
Subtitle B—Pregnant Women and Infants Health Promotion
Sec. 911. Programs regarding prenatal and postnatal health.
TITLE X—PEDIATRIC RESEARCH INITIATIVE
Sec. 1001. Establishment of pediatric research initiative.
Sec. 1002. Investment in tomorrow’s pediatric researchers.
Sec. 1003. Review of regulations.
Sec. 1004. Long-term child development study.
TITLE XI—CHILDHOOD MALIGNANCIES
Sec. 1101. Programs of Centers for Disease Control and Prevention and National Institutes of Health.
TITLE XII—ADOPTION AWARENESS
Subtitle A—Infant Adoption Awareness
Sec. 1201. Grants regarding infant adoption awareness.
Subtitle B—Special Needs Adoption Awareness
Sec. 1211. Special needs adoption programs; public awareness campaign and other
activities.
TITLE XIII—TRAUMATIC BRAIN INJURY
Sec. 1301. Programs of Centers for Disease Control and Prevention.
Sec. 1302. Study and monitor incidence and prevalence.
Sec. 1303. Programs of National Institutes of Health.
Sec. 1304. Programs of Health Resources and Services Administration.
Sec. 1305. State grants for protection and advocacy services.
Sec. 1306. Authorization of appropriations for certain programs.
TITLE XIV—CHILD CARE SAFETY AND HEALTH GRANTS
Sec. 1401. Definitions.
Sec. 1402. Authorization of appropriations.
Sec. 1403. Programs.
Sec. 1404. Amounts reserved; allotments.
Sec. 1405. State applications.
Sec. 1406. Use of funds.
Sec. 1407. Reports.
TITLE XV—HEALTHY START INITIATIVE
Sec. 1501. Continuation of healthy start program.
TITLE XVI—ORAL HEALTH PROMOTION AND DISEASE PREVENTION
Sec. 1601. Identification of interventions that reduce the burden and transmission of
oral, dental, and craniofacial diseases in high risk populations; development of approaches for pediatric oral and craniofacial assessment.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1103

Sec. 1602. Oral health promotion and disease prevention.
Sec. 1603. Coordinated program to improve pediatric oral health.
TITLE XVII—VACCINE-RELATED PROGRAMS
Subtitle A—Vaccine Compensation Program
Sec. 1701. Content of petitions.
Subtitle B—Childhood Immunizations
Sec. 1711. Childhood immunizations.
TITLE XVIII—HEPATITIS C
Sec. 1801. Surveillance and education regarding hepatitis C.
TITLE XIX—NIH INITIATIVE ON AUTOIMMUNE DISEASES
Sec. 1901. Autoimmune diseases; initiative through Director of National Institutes of
Health.
TITLE XX—GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN’S
HOSPITALS
Sec. 2001. Provisions to revise and extend program.
TITLE XXI—SPECIAL NEEDS OF CHILDREN REGARDING ORGAN
TRANSPLANTATION
Sec. 2101. Organ Procurement and Transplantation Network; amendments regarding
needs of children.
TITLE XXII—MUSCULAR DYSTROPHY RESEARCH
Sec. 2201. Muscular dystrophy research.
TITLE XXIII—CHILDREN AND TOURETTE SYNDROME AWARENESS
Sec. 2301. Grants regarding Tourette Syndrome.
TITLE XXIV—CHILDHOOD OBESITY PREVENTION
Sec. 2401. Programs operated through the Centers for Disease Control and
Prevention.
TITLE XXV—EARLY DETECTION AND TREATMENT REGARDING
CHILDHOOD LEAD POISONING
Sec. 2501. Centers for Disease Control and Prevention efforts to combat childhood
lead poisoning.
Sec. 2502. Grants for lead poisoning related activities.
Sec. 2503. Training and reports by the Health Resources and Services
Administration.
Sec. 2504. Screenings, referrals, and education regarding lead poisoning.
TITLE XXVI—SCREENING FOR HERITABLE DISORDERS
Sec. 2601. Program to improve the ability of States to provide newborn and child
screening for heritable disorders.
TITLE XXVII—PEDIATRIC RESEARCH PROTECTIONS
Sec. 2701. Requirement for additional protections for children involved in research.
TITLE XXVIII—MISCELLANEOUS PROVISIONS
Sec. 2801. Report regarding research on rare diseases in children.
Sec. 2802. Study on metabolic disorders.
TITLE XXIX—EFFECTIVE DATE
Sec. 2901. Effective date.
DIVISION B—YOUTH DRUG AND MENTAL HEALTH SERVICES
Sec. 3001. Short title.
TITLE XXXI—PROVISIONS RELATING TO SERVICES FOR CHILDREN AND
ADOLESCENTS
Sec. 3101. Children and violence.
Sec. 3102. Emergency response.

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Attachment 1B

114 STAT. 1104

PUBLIC LAW 106–310—OCT. 17, 2000

Sec. 3103. High risk youth reauthorization.
Sec. 3104. Substance abuse treatment services for children and adolescents.
Sec. 3105. Comprehensive community services for children with serious emotional
disturbance.
Sec. 3106. Services for children of substance abusers.
Sec. 3107. Services for youth offenders.
Sec. 3108. Grants for strengthening families through community partnerships.
Sec. 3109. Programs to reduce underage drinking.
Sec. 3110. Services for individuals with fetal alcohol syndrome.
Sec. 3111. Suicide prevention.
Sec. 3112. General provisions.
TITLE XXXII—PROVISIONS RELATING TO MENTAL HEALTH
Sec. 3201. Priority mental health needs of regional and national significance.
Sec. 3202. Grants for the benefit of homeless individuals.
Sec. 3203. Projects for assistance in transition from homelessness.
Sec. 3204. Community mental health services performance partnership block grant.
Sec. 3205. Determination of allotment.
Sec. 3206. Protection and Advocacy for Mentally Ill Individuals Act of 1986.
Sec. 3207. Requirement relating to the rights of residents of certain facilities.
Sec. 3208. Requirement relating to the rights of residents of certain non-medical,
community-based facilities for children and youth.
Sec. 3209. Emergency mental health centers.
Sec. 3210. Grants for jail diversion programs.
Sec. 3211. Improving outcomes for children and adolescents through services integration between child welfare and mental health services.
Sec. 3212. Grants for the integrated treatment of serious mental illness and
co-occurring substance abuse.
Sec. 3213. Training grants.
TITLE XXXIII—PROVISIONS RELATING TO SUBSTANCE ABUSE
Sec. 3301. Priority substance abuse treatment needs of regional and national
significance.
Sec. 3302. Priority substance abuse prevention needs of regional and national
significance.
Sec. 3303. Substance abuse prevention and treatment performance partnership block
grant.
Sec. 3304. Determination of allotments.
Sec. 3305. Nondiscrimination and institutional safeguards for religious providers.
Sec. 3306. Alcohol and drug prevention or treatment services for Indians and
Native Alaskans.
Sec. 3307. Establishment of commission.
TITLE XXXIV—PROVISIONS RELATING TO FLEXIBILITY AND
ACCOUNTABILITY
Sec. 3401. General authorities and peer review.
Sec. 3402. Advisory councils.
Sec. 3403. General provisions for the performance partnership block grants.
Sec. 3404. Data infrastructure projects.
Sec. 3405. Repeal of obsolete addict referral provisions.
Sec. 3406. Individuals with co-occurring disorders.
Sec. 3407. Services for individuals with co-occurring disorders.
TITLE XXXV—WAIVER AUTHORITY FOR PHYSICIANS WHO DISPENSE OR
PRESCRIBE
CERTAIN
NARCOTIC
DRUGS
FOR
MAINTENANCE
TREATMENT OR DETOXIFICATION TREATMENT
Sec. 3501. Short title.
Sec. 3502. Amendment to Controlled Substances Act.
TITLE XXXVI—METHAMPHETAMINE AND OTHER CONTROLLED
SUBSTANCES
Sec. 3601. Short title.
Subtitle A—Methamphetamine Production, Trafficking, and Abuse
PART I—CRIMINAL PENALTIES
Sec. 3611. Enhanced punishment of amphetamine laboratory operators.
Sec. 3612. Enhanced punishment of amphetamine or methamphetamine laboratory
operators.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1105

Sec. 3613. Mandatory restitution for violations of Controlled Substances Act and Controlled Substances Import and Export Act relating to amphetamine and
methamphetamine.
Sec. 3614. Methamphetamine paraphernalia.
PART II—ENHANCED LAW ENFORCEMENT
Sec. 3621. Environmental hazards associated with illegal manufacture of
amphetamine and methamphetamine.
Sec. 3622. Reduction in retail sales transaction threshold for non-safe harbor
products containing pseudoephedrine or phenylpropanolamine.
Sec. 3623. Training for Drug Enforcement Administration and State and local law
enforcement personnel relating to clandestine laboratories.
Sec. 3624. Combating methamphetamine and amphetamine in high intensity drug
trafficking areas.
Sec. 3625. Combating amphetamine and methamphetamine manufacturing and trafficking.
PART III—ABUSE PREVENTION AND TREATMENT
Sec. 3631. Expansion of methamphetamine research.
Sec. 3632. Methamphetamine and amphetamine treatment initiative by Center for
Substance Abuse Treatment.
Sec. 3633. Study of methamphetamine treatment.
PART IV—REPORTS
Sec. 3641. Reports on consumption of methamphetamine and other illicit drugs in
rural areas, metropolitan areas, and consolidated metropolitan areas.
Sec. 3642. Report on diversion of ordinary, over-the-counter pseudoephedrine and
phenylpropanolamine products.
Subtitle B—Controlled Substances Generally
Sec. 3651. Enhanced punishment for trafficking in list I chemicals.
Sec. 3652. Mail order requirements.
Sec. 3653. Theft and transportation of anhydrous ammonia for purposes of illicit production of controlled substances.
Subtitle C—Ecstasy Anti-Proliferation Act of 2000
Sec. 3661. Short title.
Sec. 3662. Findings.
Sec. 3663. Enhanced punishment of Ecstasy traffickers.
Sec. 3664. Emergency authority to United States Sentencing Commission.
Sec. 3665. Expansion of Ecstasy and club drugs abuse prevention efforts.
Subtitle D—Miscellaneous
Sec. 3671. Antidrug messages on Federal Government Internet websites.
Sec. 3672. Reimbursement by Drug Enforcement Administration of
incurred to remediate methamphetamine laboratories.
Sec. 3673. Severability.

expenses

DIVISION A—CHILDREN’S HEALTH
TITLE I—AUTISM
SEC. 101. EXPANSION, INTENSIFICATION, AND COORDINATION OF
ACTIVITIES OF NATIONAL INSTITUTES OF HEALTH WITH
RESPECT TO RESEARCH ON AUTISM.

Part B of title IV of the Public Health Service Act (42 U.S.C.
284 et seq.) is amended by adding at the end the following section:
‘‘EXPANSION,

INTENSIFICATION, AND COORDINATION OF ACTIVITIES OF
NATIONAL INSTITUTES OF HEALTH WITH RESPECT TO RESEARCH ON
AUTISM

‘‘SEC. 409C. (a) IN GENERAL.—
‘‘(1) EXPANSION OF ACTIVITIES.—The Director of NIH (in
this section referred to as the ‘Director’) shall expand, intensify,

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Attachment 1B

114 STAT. 1106

Grants.
Contracts.

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PUBLIC LAW 106–310—OCT. 17, 2000
and coordinate the activities of the National Institutes of Health
with respect to research on autism.
‘‘(2) ADMINISTRATION OF PROGRAM; COLLABORATION AMONG
AGENCIES.—The Director shall carry out this section acting
through the Director of the National Institute of Mental Health
and in collaboration with any other agencies that the Director
determines appropriate.
‘‘(b) CENTERS OF EXCELLENCE.—
‘‘(1) IN GENERAL.—The Director shall under subsection
(a)(1) make awards of grants and contracts to public or nonprofit private entities to pay all or part of the cost of planning,
establishing, improving, and providing basic operating support
for centers of excellence regarding research on autism.
‘‘(2) RESEARCH.—Each center under paragraph (1) shall
conduct basic and clinical research into autism. Such research
should include investigations into the cause, diagnosis, early
detection, prevention, control, and treatment of autism. The
centers, as a group, shall conduct research including the fields
of
developmental
neurobiology,
genetics,
and
psychopharmacology.
‘‘(3) SERVICES FOR PATIENTS.—
‘‘(A) IN GENERAL.—A center under paragraph (1) may
expend amounts provided under such paragraph to carry
out a program to make individuals aware of opportunities
to participate as subjects in research conducted by the
centers.
‘‘(B) REFERRALS AND COSTS.—A program under
subparagraph (A) may, in accordance with such criteria
as the Director may establish, provide to the subjects
described in such subparagraph, referrals for health and
other services, and such patient care costs as are required
for research.
‘‘(C) AVAILABILITY AND ACCESS.—The extent to which
a center can demonstrate availability and access to clinical
services shall be considered by the Director in decisions
about awarding grants to applicants which meet the scientific criteria for funding under this section.
‘‘(4) COORDINATION OF CENTERS; REPORTS.—The Director
shall, as appropriate, provide for the coordination of information
among centers under paragraph (1) and ensure regular communication between such centers, and may require the periodic
preparation of reports on the activities of the centers and
the submission of the reports to the Director.
‘‘(5) ORGANIZATION OF CENTERS.—Each center under paragraph (1) shall use the facilities of a single institution, or
be formed from a consortium of cooperating institutions,
meeting such requirements as may be prescribed by the
Director.
‘‘(6) NUMBER OF CENTERS; DURATION OF SUPPORT.—
‘‘(A) IN GENERAL.—The Director shall provide for the
establishment of not less than five centers under paragraph
(1).
‘‘(B) DURATION.—Support for a center established
under paragraph (1) may be provided under this section
for a period of not to exceed 5 years. Such period may
be extended for one or more additional periods not
exceeding 5 years if the operations of such center have

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1107

been reviewed by an appropriate technical and scientific
peer review group established by the Director and if such
group has recommended to the Director that such period
should be extended.
‘‘(c) FACILITATION OF RESEARCH.—The Director shall under subsection (a)(1) provide for a program under which samples of tissues
and genetic materials that are of use in research on autism are
donated, collected, preserved, and made available for such research.
The program shall be carried out in accordance with accepted
scientific and medical standards for the donation, collection, and
preservation of such samples.
‘‘(d) PUBLIC INPUT.—The Director shall under subsection (a)(1)
provide for means through which the public can obtain information
on the existing and planned programs and activities of the National
Institutes of Health with respect to autism and through which
the Director can receive comments from the public regarding such
programs and activities.
‘‘(e) FUNDING.—There are authorized to be appropriated such
sums as may be necessary to carry out this section. Amounts
appropriated under this subsection are in addition to any other
amounts appropriated for such purpose.’’.
SEC.

102.

DEVELOPMENTAL DISABILITIES
RESEARCH PROGRAMS.

SURVEILLANCE

AND

Appropriation
authorization.

42 USC 247b–4b.

(a) NATIONAL AUTISM AND PERVASIVE DEVELOPMENTAL DISABILSURVEILLANCE PROGRAM.—
(1) IN GENERAL.—The Secretary of Health and Human
Services (in this section referred to as the ‘‘Secretary’’), acting
through the Director of the Centers for Disease Control and
Prevention, may make awards of grants and cooperative agreements for the collection, analysis, and reporting of data on
autism and pervasive developmental disabilities. In making
such awards, the Secretary may provide direct technical assistance in lieu of cash.
(2) ELIGIBILITY.—To be eligible to receive an award under
paragraph (1) an entity shall be a public or nonprofit private
entity (including health departments of States and political
subdivisions of States, and including universities and other
educational entities).
(b) CENTERS OF EXCELLENCE IN AUTISM AND PERVASIVE
DEVELOPMENTAL DISABILITIES EPIDEMIOLOGY.—
(1) IN GENERAL.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
shall establish not less than three regional centers of excellence
in autism and pervasive developmental disabilities epidemiology for the purpose of collecting and analyzing information
on the number, incidence, correlates, and causes of autism
and related developmental disabilities.
(2) RECIPIENTS OF AWARDS FOR ESTABLISHMENT OF CENTERS.—Centers under paragraph (1) shall be established and
operated through the awarding of grants or cooperative agreements to public or nonprofit private entities that conduct
research, including health departments of States and political
subdivisions of States, and including universities and other
educational entities.
(3) CERTAIN REQUIREMENTS.—An award for a center under
paragraph (1) may be made only if the entity involved submits
ITIES

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114 STAT. 1108

PUBLIC LAW 106–310—OCT. 17, 2000

to the Secretary an application containing such agreements
and information as the Secretary may require, including an
agreement that the center involved will operate in accordance
with the following:
(A) The center will collect, analyze, and report autism
and pervasive developmental disabilities data according
to guidelines prescribed by the Director, after consultation
with relevant State and local public health officials, private
sector developmental disability researchers, and advocates
for those with developmental disabilities.
(B) The center will assist with the development and
coordination of State autism and pervasive developmental
disabilities surveillance efforts within a region.
(C) The center will identify eligible cases and controls
through its surveillance systems and conduct research into
factors which may cause autism and related developmental
disabilities.
(D) The center will develop or extend an area of special
research expertise (including genetics, environmental exposure to contaminants, immunology, and other relevant
research specialty areas).
(c) CLEARINGHOUSE.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention, shall
carry out the following:
(1) The Secretary shall establish a clearinghouse within
the Centers for Disease Control and Prevention for the collection and storage of data generated from the monitoring programs established by this title. Through the clearinghouse,
such Centers shall serve as the coordinating agency for autism
and pervasive developmental disabilities surveillance activities.
The functions of such a clearinghouse shall include facilitating
the coordination of research and policy development relating
to the epidemiology of autism and other pervasive developmental disabilities.
(2) The Secretary shall coordinate the Federal response
to requests for assistance from State health department officials
regarding potential or alleged autism or developmental disability clusters.
(d) DEFINITION.—In this title, the term ‘‘State’’ means each
of the several States, the District of Columbia, the Commonwealth
of Puerto Rico, American Samoa, Guam, the Commonwealth of
the Northern Mariana Islands, the Virgin Islands, and the Trust
Territory of the Pacific Islands.
(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated such sums as may be necessary to carry out
this section.
42 USC 247b–4c.

SEC. 103. INFORMATION AND EDUCATION.

(a) IN GENERAL.—The Secretary shall establish and implement
a program to provide information and education on autism to health
professionals and the general public, including information and
education on advances in the diagnosis and treatment of autism
and training and continuing education through programs for scientists, physicians, and other health professionals who provide care
for patients with autism.

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Attachment 1B

PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1109

(b) STIPENDS.—The Secretary may use amounts made available
under this section to provide stipends for health professionals who
are enrolled in training programs under this section.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated such sums as may be necessary to carry out
this section.
SEC. 104. INTER-AGENCY AUTISM COORDINATING COMMITTEE.

42 USC 247b–4d.

(a) ESTABLISHMENT.—The Secretary shall establish a committee
to be known as the ‘‘Autism Coordinating Committee’’ (in this
section referred to as the ‘‘Committee’’) to coordinate all efforts
within the Department of Health and Human Services concerning
autism, including activities carried out through the National
Institutes of Health and the Centers for Disease Control and
Prevention under this title (and the amendment made by this
title).
(b) MEMBERSHIP.—
(1) IN GENERAL.—The Committee shall be composed of the
Directors of such national research institutes, of the Centers
for Disease Control and Prevention, and of such other agencies
and such other officials as the Secretary determines appropriate.
(2) ADDITIONAL MEMBERS.—If determined appropriate by
the Secretary, the Secretary may appoint to the Committee—
(A) parents or legal guardians of individuals with
autism or other pervasive developmental disorders; and
(B) representatives of other governmental agencies that
serve children with autism such as the Department of
Education.
(c) ADMINISTRATIVE SUPPORT; TERMS OF SERVICE; OTHER PROVISIONS.—The following shall apply with respect to the Committee:
(1) The Committee shall receive necessary and appropriate
administrative support from the Department of Health and
Human Services.
(2) Members of the Committee appointed under subsection
(b)(2)(A) shall serve for a term of 3 years, and may serve
for an unlimited number of terms if reappointed.
(3) The Committee shall meet not less than two times
each year.
SEC. 105. REPORT TO CONGRESS.

42 USC 247b–4e.

Not later than January 1, 2001, and each January 1 thereafter,
the Secretary shall prepare and submit to the appropriate committees of Congress, a report concerning the implementation of this
title and the amendments made by this title.

Deadline.

TITLE II—RESEARCH AND
DEVELOPMENT REGARDING FRAGILE X
SEC. 201. NATIONAL INSTITUTE OF CHILD HEALTH AND HUMAN
DEVELOPMENT; RESEARCH ON FRAGILE X.

Subpart 7 of part C of title IV of the Public Health Service
Act is amended by adding at the end the following section:

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114 STAT. 1110

PUBLIC LAW 106–310—OCT. 17, 2000
‘‘FRAGILE

42 USC 285g–9.

Grants.
Contracts.

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X

‘‘SEC. 452E. (a) EXPANSION AND COORDINATION OF RESEARCH
ACTIVITIES.—The Director of the Institute, after consultation with
the advisory council for the Institute, shall expand, intensify, and
coordinate the activities of the Institute with respect to research
on the disease known as fragile X.
‘‘(b) RESEARCH CENTERS.—
‘‘(1) IN GENERAL.—The Director of the Institute shall make
grants or enter into contracts for the development and operation
of centers to conduct research for the purposes of improving
the diagnosis and treatment of, and finding the cure for, fragile
X.
‘‘(2) NUMBER OF CENTERS.—
‘‘(A) IN GENERAL.—In carrying out paragraph (1), the
Director of the Institute shall, to the extent that amounts
are appropriated, and subject to subparagraph (B), provide
for the establishment of at least three fragile X research
centers.
‘‘(B) PEER REVIEW REQUIREMENT.—The Director of the
Institute shall make a grant to, or enter into a contract
with, an entity for purposes of establishing a center under
paragraph (1) only if the grant or contract has been recommended after technical and scientific peer review
required by regulations under section 492.
‘‘(3) ACTIVITIES.—The Director of the Institute, with the
assistance of centers established under paragraph (1), shall
conduct and support basic and biomedical research into the
detection and treatment of fragile X.
‘‘(4) COORDINATION AMONG CENTERS.—The Director of the
Institute shall, as appropriate, provide for the coordination
of the activities of the centers assisted under this section,
including providing for the exchange of information among
the centers.
‘‘(5) CERTAIN ADMINISTRATIVE REQUIREMENTS.—Each center
assisted under paragraph (1) shall use the facilities of a single
institution, or be formed from a consortium of cooperating
institutions, meeting such requirements as may be prescribed
by the Director of the Institute.
‘‘(6) DURATION OF SUPPORT.—Support may be provided to
a center under paragraph (1) for a period not exceeding 5
years. Such period may be extended for one or more additional
periods, each of which may not exceed 5 years, if the operations
of such center have been reviewed by an appropriate technical
and scientific peer review group established by the Director
and if such group has recommended to the Director that such
period be extended.
‘‘(7) AUTHORIZATION OF APPROPRIATIONS.—For the purpose
of carrying out this subsection, there are authorized to be
appropriated such sums as may be necessary for each of the
fiscal years 2001 through 2005.’’.

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Attachment 1B

PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1111

TITLE III—JUVENILE ARTHRITIS AND
RELATED CONDITIONS
SEC.

301.

NATIONAL INSTITUTE OF ARTHRITIS AND MUSCULOSKELETAL AND SKIN DISEASES; RESEARCH ON JUVENILE
ARTHRITIS AND RELATED CONDITIONS.

(a) IN GENERAL.—Subpart 4 of part C of title IV of the Public
Health Service Act (42 U.S.C. 285d et seq.) is amended by inserting
after section 442 the following section:
‘‘JUVENILE

ARTHRITIS AND RELATED CONDITIONS

‘‘SEC. 442A. (a) EXPANSION AND COORDINATION OF ACTIVITIES.—
The Director of the Institute, in coordination with the Director
of the National Institute of Allergy and Infectious Diseases, shall
expand and intensify the programs of such Institutes with respect
to research and related activities concerning juvenile arthritis and
related conditions.
‘‘(b) COORDINATION.—The Directors referred to in subsection
(a) shall jointly coordinate the programs referred to in such subsection and consult with the Arthritis and Musculoskeletal Diseases
Interagency Coordinating Committee.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.
(b) PEDIATRIC RHEUMATOLOGY.—Subpart 1 of part E of title
VII of the Public Health Service Act (42 U.S.C. 294n et seq.)
is amended by adding at the end the following:

42 USC 285d–8.

‘‘SEC. 763. PEDIATRIC RHEUMATOLOGY.

42 USC 294p.

‘‘(a) IN GENERAL.—The Secretary, acting through the appropriate agencies, shall evaluate whether the number of pediatric
rheumatologists is sufficient to address the health care needs of
children with arthritis and related conditions, and if the Secretary
determines that the number is not sufficient, shall develop strategies to help address the shortfall.
‘‘(b) REPORT TO CONGRESS.—Not later than October 1, 2001,
the Secretary shall submit to the Congress a report describing
the results of the evaluation under subsection (a), and as applicable,
the strategies developed under such subsection.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

Deadline.

SEC. 302. INFORMATION CLEARINGHOUSE.

Section 438(b) of the Public Health Service Act (42 U.S.C.
285d–3(b)) is amended by inserting ‘‘, including juvenile arthritis
and related conditions,’’ after ‘‘diseases’’.

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Attachment 1B

114 STAT. 1112

PUBLIC LAW 106–310—OCT. 17, 2000

TITLE IV—REDUCING BURDEN OF DIABETES AMONG CHILDREN AND YOUTH
SEC. 401. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION.

Part B of title III of the Public Health Service Act (42 U.S.C.
243 et seq.) is amended by inserting after section 317G the following
section:
‘‘DIABETES
42 USC 247b–9.

IN CHILDREN AND YOUTH

‘‘SEC. 317H. (a) SURVEILLANCE ON JUVENILE DIABETES.—The
Secretary, acting through the Director of the Centers for Disease
Control and Prevention, shall develop a sentinel system to collect
data on juvenile diabetes, including with respect to incidence and
prevalence, and shall establish a national database for such data.
‘‘(b) TYPE 2 DIABETES IN YOUTH.—The Secretary shall implement a national public health effort to address type 2 diabetes
in youth, including—
‘‘(1) enhancing surveillance systems and expanding
research to better assess the prevalence and incidence of type
2 diabetes in youth and determine the extent to which type
2 diabetes is incorrectly diagnosed as type 1 diabetes among
children; and
‘‘(2) developing and improving laboratory methods to assist
in diagnosis, treatment, and prevention of diabetes including,
but not limited to, developing noninvasive ways to monitor
blood glucose to prevent hypoglycemia and improving existing
glucometers that measure blood glucose.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.
SEC. 402. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.

Subpart 3 of part C of title IV of the Public Health Service
Act (42 U.S.C. 285c et seq.) is amended by inserting after section
434 the following section:
‘‘JUVENILE
42 USC 285c–9.

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DIABETES

‘‘SEC. 434A. (a) LONG-TERM EPIDEMIOLOGY STUDIES.—The
Director of the Institute shall conduct or support long-term epidemiology studies in which individuals with or at risk for type 1, or
juvenile, diabetes are followed for 10 years or more. Such studies
shall investigate the causes and characteristics of the disease and
its complications.
‘‘(b) CLINICAL TRIAL INFRASTRUCTURE/INNOVATIVE TREATMENTS
FOR JUVENILE DIABETES.—The Secretary, acting through the
Director of the National Institutes of Health, shall support regional
clinical research centers for the prevention, detection, treatment,
and cure of juvenile diabetes.
‘‘(c) PREVENTION OF TYPE 1 DIABETES.—The Secretary, acting
through the appropriate agencies, shall provide for a national effort
to prevent type 1 diabetes. Such effort shall provide for a combination of increased efforts in research and development of prevention
strategies, including consideration of vaccine development, coupled

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1113

with appropriate ability to test the effectiveness of such strategies
in large clinical trials of children and young adults.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

TITLE V—ASTHMA SERVICES FOR
CHILDREN
Subtitle A—Asthma Services
SEC. 501. GRANTS FOR CHILDREN’S ASTHMA RELIEF.

Title III of the Public Health Service Act (42 U.S.C. 241 et
seq.) is amended by adding at the end the following part:

‘‘PART P—ADDITIONAL PROGRAMS
‘‘SEC. 399L. CHILDREN’S ASTHMA TREATMENT GRANTS PROGRAM.

42 USC 280g.

‘‘(a) AUTHORITY TO MAKE GRANTS.—
‘‘(1) IN GENERAL.—In addition to any other payments made
under this Act or title V of the Social Security Act, the Secretary
shall award grants to eligible entities to carry out the following
purposes:
‘‘(A) To provide access to quality medical care for children who live in areas that have a high prevalence of
asthma and who lack access to medical care.
‘‘(B) To provide on-site education to parents, children,
health care providers, and medical teams to recognize the
signs and symptoms of asthma, and to train them in the
use of medications to treat asthma and prevent its exacerbations.
‘‘(C) To decrease preventable trips to the emergency
room by making medication available to individuals who
have not previously had access to treatment or education
in the management of asthma.
‘‘(D) To provide other services, such as smoking cessation programs, home modification, and other direct and
support services that ameliorate conditions that exacerbate
or induce asthma.
‘‘(2) CERTAIN PROJECTS.—In making grants under paragraph (1), the Secretary may make grants designed to develop
and expand the following projects:
‘‘(A) Projects to provide comprehensive asthma services
to children in accordance with the guidelines of the
National Asthma Education and Prevention Program
(through the National Heart, Lung and Blood Institute),
including access to care and treatment for asthma in a
community-based setting.
‘‘(B) Projects to fully equip mobile health care clinics
that provide preventive asthma care including diagnosis,
physical examinations, pharmacological therapy, skin
testing, peak flow meter testing, and other asthma-related
health care services.

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114 STAT. 1114

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(C) Projects to conduct validated asthma management
education programs for patients with asthma and their
families, including patient education regarding asthma
management, family education on asthma management,
and the distribution of materials, including displays and
videos, to reinforce concepts presented by medical teams.
‘‘(2) AWARD OF GRANTS.—
‘‘(A) APPLICATION.—
‘‘(i) IN GENERAL.—An eligible entity shall submit
an application to the Secretary for a grant under this
section in such form and manner as the Secretary
may require.
‘‘(ii) REQUIRED INFORMATION.—An application submitted under this subparagraph shall include a plan
for the use of funds awarded under the grant and
such other information as the Secretary may require.
‘‘(B) REQUIREMENT.—In awarding grants under this
section, the Secretary shall give preference to eligible entities that demonstrate that the activities to be carried out
under this section shall be in localities within areas of
known or suspected high prevalence of childhood asthma
or high asthma-related mortality or high rate of hospitalization or emergency room visits for asthma (relative to the
average asthma prevalence rates and associated mortality
rates in the United States). Acceptable data sets to demonstrate a high prevalence of childhood asthma or high
asthma-related mortality may include data from Federal,
State, or local vital statistics, claims data under title XIX
or XXI of the Social Security Act, other public health statistics or surveys, or other data that the Secretary, in consultation with the Director of the Centers for Disease Control and Prevention, deems appropriate.
‘‘(3) DEFINITION OF ELIGIBLE ENTITY.—For purposes of this
section, the term ‘eligible entity’ means a public or nonprofit
private entity (including a State or political subdivision of a
State), or a consortium of any of such entities.
‘‘(b) COORDINATION WITH OTHER CHILDREN’S PROGRAMS.—An
eligible entity shall identify in the plan submitted as part of an
application for a grant under this section how the entity will coordinate operations and activities under the grant with—
‘‘(1) other programs operated in the State that serve children with asthma, including any such programs operated under
title V, XIX, or XXI of the Social Security Act; and
‘‘(2) one or more of the following—
‘‘(A) the child welfare and foster care and adoption
assistance programs under parts B and E of title IV of
such Act;
‘‘(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
‘‘(C) the program of assistance under the special supplemental nutrition program for women, infants and children
(WIC) under section 17 of the Child Nutrition Act of 1966
(42 U.S.C. 1786);
‘‘(D) local public and private elementary or secondary
schools; or
‘‘(E) public housing agencies, as defined in section 3
of the United States Housing Act of 1937 (42 U.S.C. 1437a).

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1115

‘‘(c) EVALUATION.—An eligible entity that receives a grant under
this section shall submit to the Secretary an evaluation of the
operations and activities carried out under the grant that includes—
‘‘(1) a description of the health status outcomes of children
assisted under the grant;
‘‘(2) an assessment of the utilization of asthma-related
health care services as a result of activities carried out under
the grant;
‘‘(3) the collection, analysis, and reporting of asthma data
according to guidelines prescribed by the Director of the Centers
for Disease Control and Prevention; and
‘‘(4) such other information as the Secretary may require.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.
SEC. 502. TECHNICAL AND CONFORMING AMENDMENTS.

Title III of the Public Health Service Act (42 U.S.C. 241 et
seq.) is amended—
(1) in part L, by redesignating section 399D as section
399A;
(2) in part M—
(A) by redesignating sections 399H through 399L as
sections 399B through 399F, respectively;
(B) in section 399B (as so redesignated), in subsection
(e)—
(i) by striking ‘‘section 399K(b)’’ and inserting ‘‘subsection (b) of section 399E’’; and
(ii) by striking ‘‘section 399C’’ and inserting ‘‘such
section’’;
(C) in section 399E (as so redesignated), in subsection
(c), by striking ‘‘section 399H(a)’’ and inserting ‘‘section
399B(a)’’; and
(D) in section 399F (as so redesignated)—
(i) in subsection (a), by striking ‘‘section 399I’’ and
inserting ‘‘section 399C’’;
(ii) in subsection (a), by striking ‘‘subsection 399J’’
and inserting ‘‘section 399D’’; and
(iii) in subsection (b), by striking ‘‘subsection 399K’’
and inserting ‘‘section 399E’’;
(3) in part N, by redesignating section 399F as section
399G; and
(4) in part O—
(A) by redesignating sections 399G through 399J as
sections 399H through 399K, respectively;
(B) in section 399H (as so redesignated), in subsection
(b), by striking ‘‘section 399H’’ and inserting ‘‘section 399I’’;
(C) in section 399J (as so redesignated), in subsection
(b), by striking ‘‘section 399G(d)’’ and inserting ‘‘section
399H(d)’’; and
(D) in section 399K (as so redesignated), by striking
‘‘section 399G(d)(1)’’ and inserting ‘‘section 399H(d)(1)’’.

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42 USC 280d.

42 USC 280e–
280e–4.
42 USC 280e.

42 USC 280e–3.

42 USC 280e–4.

42 USC 280d–11,
280e–11.
42 USC 280f–
280f–3.
42 USC 280f.
42 USC 280f–2.

42 USC 280f–3.

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114 STAT. 1116

PUBLIC LAW 106–310—OCT. 17, 2000

Subtitle B—Prevention Activities
SEC. 511. PREVENTIVE HEALTH AND HEALTH SERVICES BLOCK GRANT;
SYSTEMS FOR REDUCING ASTHMA-RELATED ILLNESSES
THROUGH INTEGRATED PEST MANAGEMENT.

Section 1904(a)(1) of the Public Health Service Act (42 U.S.C.
300w–3(a)(1)) is amended—
(1) by redesignating subparagraphs (E) and (F) as subparagraphs (F) and (G), respectively;
(2) by adding a period at the end of subparagraph (G)
(as so redesignated);
(3) by inserting after subparagraph (D), the following:
‘‘(E) The establishment, operation, and coordination of effective and cost-efficient systems to reduce the prevalence of illness
due to asthma and asthma-related illnesses, especially among
children, by reducing the level of exposure to cockroach allergen
or other known asthma triggers through the use of integrated
pest management, as applied to cockroaches or other known
allergens. Amounts expended for such systems may include
the costs of building maintenance and the costs of programs
to promote community participation in the carrying out at
such sites of integrated pest management, as applied to cockroaches or other known allergens. For purposes of this subparagraph, the term ‘integrated pest management’ means an
approach to the management of pests in public facilities that
combines biological, cultural, physical, and chemical tools in
a way that minimizes economic, health, and environmental
risks.’’;
(4) in subparagraph (F) (as so redesignated), by striking
‘‘subparagraphs (A) through (D)’’ and inserting ‘‘subparagraphs
(A) through (E)’’; and
(5) in subparagraph (G) (as so redesignated), by striking
‘‘subparagraphs (A) through (E)’’ and inserting ‘‘subparagraphs
(A) through (F)’’.

Subtitle C—Coordination of Federal
Activities
SEC.

521.

COORDINATION
HEALTH.

THROUGH

NATIONAL

INSTITUTES

OF

Subpart 2 of part C of title IV of the Public Health Service
Act (42 U.S.C. 285b et seq.) is amended by inserting after section
424A the following section:
‘‘COORDINATION
42 USC 285b–7b.

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OF FEDERAL ASTHMA ACTIVITIES

‘‘SEC. 424B (a) IN GENERAL.—The Director of Institute shall,
through the National Asthma Education Prevention Program
Coordinating Committee—
‘‘(1) identify all Federal programs that carry out asthmarelated activities;
‘‘(2) develop, in consultation with appropriate Federal agencies and professional and voluntary health organizations, a
Federal plan for responding to asthma; and

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1117

‘‘(3) not later than 12 months after the date of the enactment of the Children’s Health Act of 2000, submit recommendations to the appropriate committees of the Congress on ways
to strengthen and improve the coordination of asthma-related
activities of the Federal Government.
‘‘(b) REPRESENTATION OF THE DEPARTMENT OF HOUSING AND
URBAN DEVELOPMENT.—A representative of the Department of
Housing and Urban Development shall be included on the National
Asthma Education Prevention Program Coordinating Committee
for the purpose of performing the tasks described in subsection
(a).
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

Subtitle D—Compilation of Data
SEC. 531. COMPILATION OF DATA BY CENTERS FOR DISEASE CONTROL
AND PREVENTION.

Part B of title III of the Public Health Service Act, as amended
by section 401 of this Act, is amended by inserting after section
317H the following section:
‘‘COMPILATION

OF DATA ON ASTHMA

‘‘SEC. 317I. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
shall—
‘‘(1) conduct local asthma surveillance activities to collect
data on the prevalence and severity of asthma and the quality
of asthma management;
‘‘(2) compile and annually publish data on the prevalence
of children suffering from asthma in each State; and
‘‘(3) to the extent practicable, compile and publish data
on the childhood mortality rate associated with asthma nationally.
‘‘(b) SURVEILLANCE ACTIVITIES.—The Director of the Centers
for Disease Control and Prevention, acting through the representative of the Director on the National Asthma Education Prevention
Program Coordinating Committee, shall, in carrying out subsection
(a), provide an update on surveillance activities at each Committee
meeting.
‘‘(c) COLLABORATIVE EFFORTS.—The activities described in subsection (a)(1) may be conducted in collaboration with eligible entities
awarded a grant under section 399L.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

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42 USC 247b–10.

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114 STAT. 1118

PUBLIC LAW 106–310—OCT. 17, 2000

TITLE VI—BIRTH DEFECTS
PREVENTION ACTIVITIES
Subtitle A—Folic Acid Promotion
SEC. 601. PROGRAM REGARDING EFFECTS OF FOLIC ACID IN PREVENTION OF BIRTH DEFECTS.

Part B of title III of the Public Health Service Act, as amended
by section 531 of this Act, is amended by inserting after section
317I the following section:
‘‘EFFECTS
Grants.
Contracts.
42 USC 247b–11.

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OF FOLIC ACID IN PREVENTION OF BIRTH DEFECTS

‘‘SEC. 317J. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
shall expand and intensify programs (directly or through grants
or contracts) for the following purposes:
‘‘(1) To provide education and training for health professionals and the general public for purposes of explaining the
effects of folic acid in preventing birth defects and for purposes
of encouraging each woman of reproductive capacity (whether
or not planning a pregnancy) to consume on a daily basis
a dietary supplement that provides an appropriate level of
folic acid.
‘‘(2) To conduct research with respect to such education
and training, including identifying effective strategies for
increasing the rate of consumption of folic acid by women
of reproductive capacity.
‘‘(3) To conduct research to increase the understanding
of the effects of folic acid in preventing birth defects, including
understanding with respect to cleft lip, cleft palate, and heart
defects.
‘‘(4) To provide for appropriate epidemiological activities
regarding folic acid and birth defects, including epidemiological
activities regarding neural tube defects.
‘‘(b) CONSULTATIONS WITH STATES AND PRIVATE ENTITIES.—
In carrying out subsection (a), the Secretary shall consult with
the States and with other appropriate public or private entities,
including national nonprofit private organizations, health professionals, and providers of health insurance and health plans.
‘‘(c) TECHNICAL ASSISTANCE.—The Secretary may (directly or
through grants or contracts) provide technical assistance to public
and nonprofit private entities in carrying out the activities described
in subsection (a).
‘‘(d) EVALUATIONS.—The Secretary shall (directly or through
grants or contracts) provide for the evaluation of activities under
subsection (a) in order to determine the extent to which such
activities have been effective in carrying out the purposes of the
program under such subsection, including the effects on various
demographic populations. Methods of evaluation under the preceding sentence may include surveys of knowledge and attitudes
on the consumption of folic acid and on blood folate levels. Such
methods may include complete and timely monitoring of infants
who are born with neural tube defects.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1119

such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

Subtitle B—National Center on Birth
Defects and Developmental Disabilities
SEC. 611. NATIONAL CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL DISABILITIES.

Section 317C of the Public Health Service Act (42 U.S.C. 247b–
4) is amended—
(1) by striking the heading for the section and inserting
the following:
‘‘NATIONAL

CENTER ON BIRTH DEFECTS AND DEVELOPMENTAL
DISABILITIES’’;

(2) by striking ‘‘SEC. 317C. (a)’’ and all that follows through
the end of subsection (a) and inserting the following:
‘‘SEC. 317C. (a) IN GENERAL.—
‘‘(1) NATIONAL CENTER.—There is established within the
Centers for Disease Control and Prevention a center to be
known as the National Center on Birth Defects and Developmental Disabilities (referred to in this section as the ‘Center’),
which shall be headed by a director appointed by the Director
of the Centers for Disease Control and Prevention.
‘‘(2) GENERAL DUTIES.—The Secretary shall carry out
programs—
‘‘(A) to collect, analyze, and make available data on
birth defects and developmental disabilities (in a manner
that facilitates compliance with subsection (d)(2)), including
data on the causes of such defects and disabilities and
on the incidence and prevalence of such defects and disabilities;
‘‘(B) to operate regional centers for the conduct of
applied epidemiological research on the prevention of such
defects and disabilities; and
‘‘(C) to provide information and education to the public
on the prevention of such defects and disabilities.
‘‘(3) FOLIC ACID.—The Secretary shall carry out section
317J through the Center.
‘‘(4) CERTAIN PROGRAMS.—
‘‘(A) TRANSFERS.—All programs and functions described
in subparagraph (B) are transferred to the Center, effective
upon the expiration of the 180-day period beginning on
the date of the enactment of the Children’s Health Act
of 2000.
‘‘(B) RELEVANT PROGRAMS.—The programs and functions described in this subparagraph are all programs and
functions that—
‘‘(i) relate to birth defects; folic acid; cerebral palsy;
mental retardation; child development; newborn
screening; autism; fragile X syndrome; fetal alcohol
syndrome; pediatric genetic disorders; disability
prevention; or other relevant diseases, disorders, or
conditions as determined the Secretary; and

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Establishment.

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114 STAT. 1120

PUBLIC LAW 106–310—OCT. 17, 2000
‘‘(ii) were carried out through the National Center
for Environmental Health as of the day before the
date of the enactment of the Act referred to in subparagraph (A).
‘‘(C) RELATED TRANSFERS.—Personnel employed in
connection with the programs and functions specified in
subparagraph (B), and amounts available for carrying out
the programs and functions, are transferred to the Center,
effective upon the expiration of the 180-day period beginning on the date of the enactment of the Act referred
to in subparagraph (A). Such transfer of amounts does
not affect the period of availability of the amounts, or
the availability of the amounts with respect to the purposes
for which the amounts may be expended.’’; and
(3) in subsection (b)(1), in the matter preceding subparagraph (A), by striking ‘‘(a)(1)’’ and inserting ‘‘(a)(2)(A)’’.

TITLE VII—EARLY DETECTION, DIAGNOSIS, AND TREATMENT REGARDING
HEARING LOSS IN INFANTS
42 USC 280g–1
note.

VerDate 11-MAY-2000

SEC. 701. PURPOSES.

The purposes of this title are to clarify the authority within
the Public Health Service Act to authorize statewide newborn and
infant hearing screening, evaluation and intervention programs
and systems, technical assistance, a national applied research program, and interagency and private sector collaboration for policy
development, in order to assist the States in making progress
toward the following goals:
(1) All babies born in hospitals in the United States and
its territories should have a hearing screening before leaving
the birthing facility. Babies born in other countries and residing
in the United States via immigration or adoption should have
a hearing screening as early as possible.
(2) All babies who are not born in hospitals in the United
States and its territories should have a hearing screening
within the first 3 months of life.
(3) Appropriate audiologic and medical evaluations should
be conducted by 3 months for all newborns and infants suspected of having hearing loss to allow appropriate referral
and provisions for audiologic rehabilitation, medical and early
intervention before the age of 6 months.
(4) All newborn and infant hearing screening programs
and systems should include a component for audiologic
rehabilitation, medical and early intervention options that
ensures linkage to any new and existing state-wide systems
of intervention and rehabilitative services for newborns and
infants with hearing loss.
(5) Public policy in regard to newborn and infant hearing
screening and intervention should be based on applied research
and the recognition that newborns, infants, toddlers, and children who are deaf or hard-of-hearing have unique language,
learning, and communication needs, and should be the result
of consultation with pertinent public and private sectors.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1121

SEC. 702. PROGRAMS OF HEALTH RESOURCES AND SERVICES ADMINISTRATION, CENTERS FOR DISEASE CONTROL AND
PREVENTION, AND NATIONAL INSTITUTES OF HEALTH.

Part P of title III of the Public Health Service Act, as added
by section 501 of this Act, is amended by adding at the end the
following section:
‘‘SEC.

399M.

EARLY DETECTION, DIAGNOSIS, AND
REGARDING HEARING LOSS IN INFANTS.

TREATMENT

42 USC 280g–1.

‘‘(a) STATEWIDE NEWBORN AND INFANT HEARING SCREENING,
EVALUATION AND INTERVENTION PROGRAMS AND SYSTEMS.—The Secretary, acting through the Administrator of the Health Resources
and Services Administration, shall make awards of grants or
cooperative agreements to develop statewide newborn and infant
hearing screening, evaluation and intervention programs and systems for the following purposes:
‘‘(1) To develop and monitor the efficacy of state-wide newborn and infant hearing screening, evaluation and intervention
programs and systems. Early intervention includes referral to
schools and agencies, including community, consumer, and
parent-based agencies and organizations and other programs
mandated by part C of the Individuals with Disabilities Education Act, which offer programs specifically designed to meet
the unique language and communication needs of deaf and
hard of hearing newborns, infants, toddlers, and children.
‘‘(2) To collect data on statewide newborn and infant
hearing screening, evaluation and intervention programs and
systems that can be used for applied research, program evaluation and policy development.
‘‘(b) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND APPLIED
RESEARCH.—
‘‘(1) CENTERS FOR DISEASE CONTROL AND PREVENTION.—
The Secretary, acting through the Director of the Centers for
Disease Control and Prevention, shall make awards of grants
or cooperative agreements to provide technical assistance to
State agencies to complement an intramural program and to
conduct applied research related to newborn and infant hearing
screening, evaluation and intervention programs and systems.
The program shall develop standardized procedures for data
management and program effectiveness and costs, such as—
‘‘(A) to ensure quality monitoring of newborn and infant
hearing loss screening, evaluation, and intervention programs and systems;
‘‘(B) to provide technical assistance on data collection
and management;
‘‘(C) to study the costs and effectiveness of newborn
and infant hearing screening, evaluation and intervention
programs and systems conducted by State-based programs
in order to answer issues of importance to State and
national policymakers;
‘‘(D) to identify the causes and risk factors for congenital hearing loss;
‘‘(E) to study the effectiveness of newborn and infant
hearing screening, audiologic and medical evaluations and
intervention programs and systems by assessing the health,
intellectual and social developmental, cognitive, and language status of these children at school age; and

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PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(F) to promote the sharing of data regarding early
hearing loss with State-based birth defects and developmental disabilities monitoring programs for the purpose
of identifying previously unknown causes of hearing loss.
‘‘(2) NATIONAL INSTITUTES OF HEALTH.—The Director of the
National Institutes of Health, acting through the Director of
the National Institute on Deafness and Other Communication
Disorders, shall for purposes of this section, continue a program
of research and development on the efficacy of new screening
techniques and technology, including clinical studies of
screening methods, studies on efficacy of intervention, and
related research.
‘‘(c) COORDINATION AND COLLABORATION.—
‘‘(1) IN GENERAL.—In carrying out programs under this
section, the Administrator of the Health Resources and Services
Administration, the Director of the Centers for Disease Control
and Prevention, and the Director of the National Institutes
of Health shall collaborate and consult with other Federal
agencies; State and local agencies, including those responsible
for early intervention services pursuant to title XIX of the
Social Security Act (Medicaid Early and Periodic Screening,
Diagnosis and Treatment Program); title XXI of the Social
Security Act (State Children’s Health Insurance Program); title
V of the Social Security Act (Maternal and Child Health Block
Grant Program); and part C of the Individuals with Disabilities
Education Act; consumer groups of and that serve individuals
who are deaf and hard-of-hearing and their families; appropriate national medical and other health and education specialty organizations; persons who are deaf and hard-of-hearing
and their families; other qualified professional personnel who
are proficient in deaf or hard-of-hearing children’s language
and who possess the specialized knowledge, skills, and
attributes needed to serve deaf and hard-of-hearing newborns,
infants, toddlers, children, and their families; third-party
payers and managed care organizations; and related commercial
industries.
‘‘(2) POLICY DEVELOPMENT.—The Administrator of the
Health Resources and Services Administration, the Director
of the Centers for Disease Control and Prevention, and the
Director of the National Institutes of Health shall coordinate
and collaborate on recommendations for policy development
at the Federal and State levels and with the private sector,
including consumer, medical and other health and education
professional-based organizations, with respect to newborn and
infant hearing screening, evaluation and intervention programs
and systems.
‘‘(3) STATE EARLY DETECTION, DIAGNOSIS, AND INTERVENTION
PROGRAMS AND SYSTEMS; DATA COLLECTION.—The Administrator
of the Health Resources and Services Administration and the
Director of the Centers for Disease Control and Prevention
shall coordinate and collaborate in assisting States to establish
newborn and infant hearing screening, evaluation and intervention programs and systems under subsection (a) and to develop
a data collection system under subsection (b).
‘‘(d) RULE OF CONSTRUCTION; RELIGIOUS ACCOMMODATION.—
Nothing in this section shall be construed to preempt or prohibit
any State law, including State laws which do not require the

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1123

screening for hearing loss of newborn infants or young children
of parents who object to the screening on the grounds that such
screening conflicts with the parents’ religious beliefs.
‘‘(e) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘audiologic evaluation’ refers to procedures
to assess the status of the auditory system; to establish the
site of the auditory disorder; the type and degree of hearing
loss, and the potential effects of hearing loss on communication;
and to identify appropriate treatment and referral options.
Referral options should include linkage to State coordinating
agencies under part C of the Individuals with Disabilities Education Act or other appropriate agencies, medical evaluation,
hearing aid /sensory aid assessment, audiologic rehabilitation
treatment, national and local consumer, self-help, parent, and
education organizations, and other family-centered services.
‘‘(2) The terms ‘audiologic rehabilitation’ and ‘audiologic
intervention’ refer to procedures, techniques, and technologies
to facilitate the receptive and expressive communication abilities of a child with hearing loss.
‘‘(3) The term ‘early intervention’ refers to providing appropriate services for the child with hearing loss, including nonmedical services, and ensuring that families of the child are
provided comprehensive, consumer-oriented information about
the full range of family support, training, information services,
communication options and are given the opportunity to consider the full range of educational and program placements
and options for their child.
‘‘(4) The term ‘medical evaluation by a physician’ refers
to key components including history, examination, and medical
decision making focused on symptomatic and related body systems for the purpose of diagnosing the etiology of hearing
loss and related physical conditions, and for identifying appropriate treatment and referral options.
‘‘(5) The term ‘medical intervention’ refers to the process
by which a physician provides medical diagnosis and direction
for medical and /or surgical treatment options of hearing loss
and /or related medical disorder associated with hearing loss.
‘‘(6) The term ‘newborn and infant hearing screening’ refers
to objective physiologic procedures to detect possible hearing
loss and to identify newborns and infants who, after rescreening, require further audiologic and medical evaluations.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) STATEWIDE NEWBORN AND INFANT HEARING SCREENING,
EVALUATION AND INTERVENTION PROGRAMS AND SYSTEMS.—For
the purpose of carrying out subsection (a), there are authorized
to be appropriated to the Health Resources and Services
Administration such sums as may be necessary for fiscal year
2002.
‘‘(2) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND
APPLIED RESEARCH; CENTERS FOR DISEASE CONTROL AND PREVENTION.—For the purpose of carrying out subsection (b)(1), there
are authorized to be appropriated to the Centers for Disease
Control and Prevention such sums as may be necessary for
fiscal year 2002.
‘‘(3) TECHNICAL ASSISTANCE, DATA MANAGEMENT, AND
APPLIED RESEARCH; NATIONAL INSTITUTE ON DEAFNESS AND

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114 STAT. 1124

PUBLIC LAW 106–310—OCT. 17, 2000
OTHER COMMUNICATION DISORDERS.—For the purpose of carrying out subsection (b)(2), there are authorized to be appropriated to the National Institute on Deafness and Other
Communication Disorders such sums as may be necessary for
fiscal year 2002.’’.

TITLE VIII—CHILDREN AND EPILEPSY
SEC. 801. NATIONAL PUBLIC HEALTH CAMPAIGN ON EPILEPSY; SEIZURE DISORDER DEMONSTRATION PROJECTS IN MEDICALLY UNDERSERVED AREAS.

Subpart I of part D of title III of the Public Health Service
Act (42 U.S.C. 254b) is amended by adding at the end the following
section:
42 USC 254c–5.

‘‘SEC. 330E. EPILEPSY; SEIZURE DISORDER.

‘‘(a) NATIONAL PUBLIC HEALTH CAMPAIGN.—
‘‘(1) IN GENERAL.—The Secretary shall develop and implement public health surveillance, education, research, and intervention strategies to improve the lives of persons with epilepsy,
with a particular emphasis on children. Such projects may
be carried out by the Secretary directly and through awards
of grants or contracts to public or nonprofit private entities.
The Secretary may directly or through such awards provide
technical assistance with respect to the planning, development,
and operation of such projects.
‘‘(2) CERTAIN ACTIVITIES.—Activities under paragraph (1)
shall include—
‘‘(A) expanding current surveillance activities through
existing monitoring systems and improving registries that
maintain data on individuals with epilepsy, including children;
‘‘(B) enhancing research activities on the diagnosis,
treatment, and management of epilepsy;
‘‘(C) implementing public and professional information
and education programs regarding epilepsy, including initiatives which promote effective management of the disease
through children’s programs which are targeted to parents,
schools, daycare providers, patients;
‘‘(D) undertaking educational efforts with the media,
providers of health care, schools and others regarding
stigmas and secondary disabilities related to epilepsy and
seizures, and its effects on youth;
‘‘(E) utilizing and expanding partnerships with
organizations with experience addressing the health and
related needs of people with disabilities; and
‘‘(F) other activities the Secretary deems appropriate.
‘‘(3) COORDINATION OF ACTIVITIES.—The Secretary shall
ensure that activities under this subsection are coordinated
as appropriate with other agencies of the Public Health Service
that carry out activities regarding epilepsy and seizure.
‘‘(b) SEIZURE DISORDER; DEMONSTRATION PROJECTS IN MEDICALLY UNDERSERVED AREAS.—

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1125

‘‘(1) IN GENERAL.—The Secretary, acting through the
Administrator of the Health Resources and Services Administration, may make grants for the purpose of carrying out demonstration projects to improve access to health and other services regarding seizures to encourage early detection and treatment in children and others residing in medically underserved
areas.
‘‘(2) APPLICATION FOR GRANT.—A grant may not be awarded
under paragraph (1) unless an application therefore is submitted to the Secretary and the Secretary approves such
application. Such application shall be submitted in such form
and manner and shall contain such information as the Secretary
may prescribe.
‘‘(c) DEFINITIONS.—For purposes of this section:
‘‘(1) The term ‘epilepsy’ refers to a chronic and serious
neurological condition characterized by excessive electrical discharges in the brain causing recurring seizures affecting all
life activities. The Secretary may revise the definition of such
term to the extent the Secretary determines necessary.
‘‘(2) The term ‘medically underserved’ has the meaning
applicable under section 799B(6).
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

TITLE IX—SAFE MOTHERHOOD; INFANT
HEALTH PROMOTION
Subtitle A—Safe Motherhood Prevention
Research
SEC. 901. PREVENTION RESEARCH AND OTHER ACTIVITIES.

Part B of title III of the Public Health Service Act, as amended
by section 601 of this Act, is amended by inserting after section
317J the following section:
‘‘SAFE

MOTHERHOOD

‘‘SEC. 317K. (a) SURVEILLANCE.—
‘‘(1) PURPOSE.—The purpose of this subsection is to develop
surveillance systems at the local, State, and national level
to better understand the burden of maternal complications
and mortality and to decrease the disparities among population
at risk of death and complications from pregnancy.
‘‘(2) ACTIVITIES.—For the purpose described in paragraph
(1), the Secretary, acting through the Director of the Centers
for Disease Control and Prevention, may carry out the following
activities:
‘‘(A) The Secretary may establish and implement a
national surveillance program to identify and promote the
investigation of deaths and severe complications that occur
during pregnancy.

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114 STAT. 1126

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(B) The Secretary may expand the Pregnancy Risk
Assessment Monitoring System to provide surveillance and
collect data in each State.
‘‘(C) The Secretary may expand the Maternal and Child
Health Epidemiology Program to provide technical support,
financial assistance, or the time-limited assignment of
senior epidemiologists to maternal and child health programs in each State.
‘‘(b) PREVENTION RESEARCH.—
‘‘(1) PURPOSE.—The purpose of this subsection is to provide
the Secretary with the authority to further expand research
concerning risk factors, prevention strategies, and the roles
of the family, health care providers and the community in
safe motherhood.
‘‘(2) RESEARCH.—The Secretary may carry out activities
to expand research relating to—
‘‘(A) encouraging preconception counseling, especially
for at risk populations such as diabetics;
‘‘(B) the identification of critical components of prenatal
delivery and postpartum care;
‘‘(C) the identification of outreach and support services,
such as folic acid education, that are available for pregnant
women;
‘‘(D) the identification of women who are at high risk
for complications;
‘‘(E) preventing preterm delivery;
‘‘(F) preventing urinary tract infections;
‘‘(G) preventing unnecessary caesarean sections;
‘‘(H) an examination of the higher rates of maternal
mortality among African American women;
‘‘(I) an examination of the relationship between
domestic violence and maternal complications and mortality;
‘‘(J) preventing and reducing adverse health consequences that may result from smoking, alcohol and illegal
drug use before, during and after pregnancy;
‘‘(K) preventing infections that cause maternal and
infant complications; and
‘‘(L) other areas determined appropriate by the Secretary.
‘‘(c) PREVENTION PROGRAMS.—
‘‘(1) IN GENERAL.—The Secretary may carry out activities
to promote safe motherhood, including—
‘‘(A) public education campaigns on healthy pregnancies and the building of partnerships with outside
organizations concerned about safe motherhood;
‘‘(B) education programs for physicians, nurses and
other health care providers; and
‘‘(C) activities to promote community support services
for pregnant women.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1127

Subtitle B—Pregnant Women and Infants
Health Promotion
SEC.

911.

PROGRAMS
HEALTH.

REGARDING

PRENATAL

AND

POSTNATAL

Part B of title III of the Public Health Service Act, as amended
by section 901 of this Act, is amended by inserting after section
317K the following section:
‘‘PRENATAL

AND POSTNATAL HEALTH

‘‘SEC. 317L. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
shall carry out programs—
‘‘(1) to collect, analyze, and make available data on prenatal
smoking, alcohol and illegal drug use, including data on the
implications of such activities and on the incidence and prevalence of such activities and their implications;
‘‘(2) to conduct applied epidemiological research on the
prevention of prenatal and postnatal smoking, alcohol and
illegal drug use;
‘‘(3) to support, conduct, and evaluate the effectiveness
of educational and cessation programs; and
‘‘(4) to provide information and education to the public
on the prevention and implications of prenatal and postnatal
smoking, alcohol and illegal drug use.
‘‘(b) GRANTS.—In carrying out subsection (a), the Secretary
may award grants to and enter into contracts with States, local
governments, scientific and academic institutions, federally qualified health centers, and other public and nonprofit entities, and
may provide technical and consultative assistance to such entities.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

42 USC 247b–13.

TITLE X— PEDIATRIC RESEARCH
INITIATIVE
SEC. 1001. ESTABLISHMENT OF PEDIATRIC RESEARCH INITIATIVE.

Part B of title IV of the Public Health Service Act, as amended
by section 101 of this Act, is amended by adding at the end the
following:
‘‘PEDIATRIC

RESEARCH INITIATIVE

‘‘SEC. 409D. (a) ESTABLISHMENT.—The Secretary shall establish
within the Office of the Director of NIH a Pediatric Research
Initiative (referred to in this section as the ‘Initiative’) to conduct
and support research that is directly related to diseases, disorders,
and other conditions in children. The Initiative shall be headed
by the Director of NIH.
‘‘(b) PURPOSE.—The purpose of the Initiative is to provide funds
to enable the Director of NIH—

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114 STAT. 1128

Reports.

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(1) to increase support for pediatric biomedical research
within the National Institutes of Health to realize the
expanding opportunities for advancement in scientific investigations and care for children;
‘‘(2) to enhance collaborative efforts among the Institutes
to conduct and support multidisciplinary research in the areas
that the Director deems most promising; and
‘‘(3) in coordination with the Food and Drug Administration, to increase the development of adequate pediatric clinical
trials and pediatric use information to promote the safer and
more effective use of prescription drugs in the pediatric population.
‘‘(c) DUTIES.—In carrying out subsection (b), the Director of
NIH shall—
‘‘(1) consult with the Director of the National Institute
of Child Health and Human Development and the other
national research institutes, in considering their requests for
new or expanded pediatric research efforts, and consult with
the Administrator of the Health Resources and Services
Administration and other advisors as the Director determines
to be appropriate;
‘‘(2) have broad discretion in the allocation of any Initiative
assistance among the Institutes, among types of grants, and
between basic and clinical research so long as the assistance
is directly related to the illnesses and conditions of children;
and
‘‘(3) be responsible for the oversight of any newly appropriated Initiative funds and annually report to Congress and
the public on the extent of the total funds obligated to conduct
or support pediatric research across the National Institutes
of Health, including the specific support and research awards
allocated through the Initiative.
‘‘(d) AUTHORIZATION.—For the purpose of carrying out this section, there are authorized to be appropriated $50,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the
fiscal years 2002 through 2005.
‘‘(e) TRANSFER OF FUNDS.—The Director of NIH may transfer
amounts appropriated under this section to any of the Institutes
for a fiscal year to carry out the purposes of the Initiative under
this section.’’.
SEC. 1002. INVESTMENT IN TOMORROW’S PEDIATRIC RESEARCHERS.

(a) IN GENERAL.—Subpart 7 of part C of title IV of the Public
Health Service Act, as amended by section 921 of this Act, is
amended by adding at the end the following:
‘‘INVESTMENT
42 USC 285g–10.

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IN TOMORROW’S PEDIATRIC RESEARCHERS

‘‘SEC. 452G. (a) ENHANCED SUPPORT.—In order to ensure the
future supply of researchers dedicated to the care and research
needs of children, the Director of the Institute, after consultation
with the Administrator of the Health Resources and Services
Administration, shall support activities to provide for—
‘‘(1) an increase in the number and size of institutional
training grants to institutions supporting pediatric training;
and

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1129

‘‘(2) an increase in the number of career development
awards for health professionals who intend to build careers
in pediatric basic and clinical research.
‘‘(b) AUTHORIZATION.—For the purpose of carrying out subsection (a), there are authorized to be appropriated such sums
as may be necessary for each of the fiscal years 2001 through
2005.’’.
(b) PEDIATRIC RESEARCH LOAN REPAYMENT PROGRAM.—Part
G of title IV of the Public Health Service Act (42 U.S.C. 288
et seq.) is amended by inserting after section 487E the following
section:
‘‘PEDIATRIC

RESEARCH LOAN REPAYMENT PROGRAM

‘‘SEC. 487F. (a) IN GENERAL.—The Secretary, in consultation
with the Director of NIH, may establish a pediatric research loan
repayment program. Through such program—
‘‘(1) the Secretary shall enter into contracts with qualified
health professionals under which such professionals will agree
to conduct pediatric research, in consideration of the Federal
Government agreeing to repay, for each year of such service,
not more than $35,000 of the principal and interest of the
educational loans of such professionals; and
‘‘(2) the Secretary shall, for the purpose of providing
reimbursements for tax liability resulting from payments made
under paragraph (1) on behalf of an individual, make payments,
in addition to payments under such paragraph, to the individual
in an amount equal to 39 percent of the total amount of loan
repayments made for the taxable year involved.
‘‘(b) APPLICATION OF OTHER PROVISIONS.—The provisions of
sections 338B, 338C, and 338E shall, except as inconsistent with
paragraph (1), apply to the program established under such paragraph to the same extent and in the same manner as such provisions
apply to the National Health Service Corps Loan Repayment Program established under subpart III of part D of title III.
‘‘(c) FUNDING.—
‘‘(1) IN GENERAL.—For the purpose of carrying out this
section with respect to a national research institute the Secretary may reserve, from amounts appropriated for such
institute for the fiscal year involved, such amounts as the
Secretary determines to be appropriate.
‘‘(2) AVAILABILITY OF FUNDS.—Amounts made available to
carry out this section shall remain available until the expiration
of the second fiscal year beginning after the fiscal year for
which such amounts were made available.’’.

42 USC 288–6.

Contracts.

SEC. 1003. REVIEW OF REGULATIONS.

(a) REVIEW.—By not later than 6 months after the date of
the enactment of this Act, the Secretary of Health and Human
Services shall conduct a review of the regulations under subpart
D of part 46 of title 45, Code of Federal Regulations, consider
any modifications necessary to ensure the adequate and appropriate
protection of children participating in research, and report the
findings of the Secretary to Congress.
(b) AREAS OF REVIEW.—In conducting the review under subsection (a), the Secretary of Health and Human Services shall
consider—

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114 STAT. 1130

PUBLIC LAW 106–310—OCT. 17, 2000

(1) the appropriateness of the regulations for children of
differing ages and maturity levels, including legal status;
(2) the definition of ‘‘minimal risk’’ for a healthy child
or for a child with an illness;
(3) the definitions of ‘‘assent’’ and ‘‘permission’’ for child
clinical research participants and their parents or guardians
and of ‘‘adequate provisions’’ for soliciting assent or permission
in research as such definitions relate to the process of obtaining
the agreement of children participating in research and the
parents or guardians of such children;
(4) the definitions of ‘‘direct benefit to the individual subjects’’ and ‘‘generalizable knowledge about the subject’s disorder
or condition’’;
(5) whether payment (financial or otherwise) may be provided to a child or his or her parent or guardian for the
participation of the child in research, and if so, the amount
and type given;
(6) the expectations of child research participants and their
parent or guardian for the direct benefits of the child’s research
involvement;
(7) safeguards for research involving children conducted
in emergency situations with a waiver of informed assent;
(8) parent and child notification in instances in which
the regulations have not been complied with;
(9) compliance with the regulations in effect on the date
of the enactment of this Act, the monitoring of such compliance,
and enforcement actions for violations of such regulations; and
(10) the appropriateness of current practices for recruiting
children for participation in research.
(c) CONSULTATION.—In conducting the review under subsection
(a), the Secretary of Health and Human Services shall consult
broadly with experts in the field, including pediatric pharmacologists, pediatricians, pediatric professional societies, bioethics
experts, clinical investigators, institutional review boards, industry
experts, appropriate Federal agencies, and children who have
participated in research studies and the parents, guardians, or
families of such children.
(d) CONSIDERATION OF ADDITIONAL PROVISIONS.—In conducting
the review under subsection (a), the Secretary of Health and Human
Services shall consider and, not later than 6 months after the
date of the enactment of this Act, report to Congress concerning—
(1) whether the Secretary should establish data and safety
monitoring boards or other mechanisms to review adverse
events associated with research involving children; and
(2) whether the institutional review board oversight of clinical trials involving children is adequate to protect children.
42 USC 285g
note.

Establishment.

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SEC. 1004. LONG-TERM CHILD DEVELOPMENT STUDY.

(a) PURPOSE.—It is the purpose of this section to authorize
the National Institute of Child Health and Human Development
to conduct a national longitudinal study of environmental influences
(including physical, chemical, biological, and psychosocial) on children’s health and development.
(b) IN GENERAL.—The Director of the National Institute of
Child Health and Human Development shall establish a consortium
of representatives from appropriate Federal agencies (including the

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1131

Centers for Disease Control and Prevention, the Environmental
Protection Agency) to—
(1) plan, develop, and implement a prospective cohort study,
from birth to adulthood, to evaluate the effects of both chronic
and intermittent exposures on child health and human development; and
(2) investigate basic mechanisms of developmental disorders and environmental factors, both risk and protective,
that influence health and developmental processes.
(c) REQUIREMENT.—The study under subsection (b) shall—
(1) incorporate behavioral, emotional, educational, and
contextual consequences to enable a complete assessment of
the physical, chemical, biological and psychosocial environmental influences on children’s well-being;
(2) gather data on environmental influences and outcomes
on diverse populations of children, which may include the
consideration of prenatal exposures; and
(3) consider health disparities among children which may
include the consideration of prenatal exposures.
(d) REPORT.—Beginning not later than 3 years after the date
of the enactment of this Act, and periodically thereafter for the
duration of the study under this section, the Director of the National
Institute of Child Health and Human Development shall prepare
and submit to the appropriate committees of Congress a report
on the implementation and findings made under the planning and
feasibility study conducted under this section.
(e) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section $18,000,000 for fiscal
year 2001, and such sums as may be necessary for each the fiscal
years 2002 through 2005.

Deadline.

TITLE XI—CHILDHOOD MALIGNANCIES
SEC. 1101. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION AND NATIONAL INSTITUTES OF HEALTH.

Part P of title III of the Public Health Service Act, as amended
by section 702 of this Act, is amended by adding at the end the
following section:
‘‘SEC. 399N. CHILDHOOD MALIGNANCIES.

42 USC 280g–2.

‘‘(a) IN GENERAL.—The Secretary, acting as appropriate through
the Director of the Centers for Disease Control and Prevention
and the Director of the National Institutes of Health, shall study
environmental and other risk factors for childhood cancers
(including skeletal malignancies, leukemias, malignant tumors of
the central nervous system, lymphomas, soft tissue sarcomas, and
other malignant neoplasms) and carry out projects to improve outcomes among children with childhood cancers and resultant secondary conditions, including limb loss, anemia, rehabilitation, and
palliative care. Such projects shall be carried out by the Secretary
directly and through awards of grants or contracts.
‘‘(b) CERTAIN ACTIVITIES.—Activities under subsection (a)
include—
‘‘(1) the expansion of current demographic data collection
and population surveillance efforts to include childhood cancers
nationally;

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‘‘(2) the development of a uniform reporting system under
which treating physicians, hospitals, clinics, and States report
the diagnosis of childhood cancers, including relevant associated
epidemiological data; and
‘‘(3) support for the National Limb Loss Information Center
to address, in part, the primary and secondary needs of persons
who experience childhood cancers in order to prevent or minimize the disabling nature of these cancers.
‘‘(c) COORDINATION OF ACTIVITIES.—The Secretary shall assure
that activities under this section are coordinated as appropriate
with other agencies of the Public Health Service that carry out
activities focused on childhood cancers and limb loss.
‘‘(d) DEFINITION.—For purposes of this section, the term ‘childhood cancer’ refers to a spectrum of different malignancies that
vary by histology, site of disease, origin, race, sex, and age. The
Secretary may for purposes of this section revise the definition
of such term to the extent determined by the Secretary to be
appropriate.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

TITLE XII—ADOPTION AWARENESS
Subtitle A—Infant Adoption Awareness
SEC. 1201. GRANTS REGARDING INFANT ADOPTION AWARENESS.

Subpart I of part D of title III of the Public Health Service
Act, as amended by section 801 of this Act, is amended by adding
at the end the following section:
42 USC 254c–6.

‘‘SEC. 330F. CERTAIN SERVICES FOR PREGNANT WOMEN.

‘‘(a) INFANT ADOPTION AWARENESS.—
‘‘(1) IN GENERAL.—The Secretary shall make grants to
national, regional, or local adoption organizations for the purpose of developing and implementing programs to train the
designated staff of eligible health centers in providing adoption
information and referrals to pregnant women on an equal basis
with all other courses of action included in nondirective counseling to pregnant women.
‘‘(2) BEST-PRACTICES GUIDELINES.—
‘‘(A) IN GENERAL.—A condition for the receipt of a
grant under paragraph (1) is that the adoption organization
involved agree that, in providing training under such paragraph, the organization will follow the guidelines developed
under subparagraph (B).
‘‘(B) PROCESS FOR DEVELOPMENT OF GUIDELINES.—
‘‘(i) IN GENERAL.—The Secretary shall establish
and supervise a process described in clause (ii) in which
the participants are—
‘‘(I) an appropriate number and variety of
adoption organizations that, as a group, have
expertise in all models of adoption practice and
that represent all members of the adoption triad
(birth mother, infant, and adoptive parent); and

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114 STAT. 1133

‘‘(II) affected public health entities.
‘‘(ii) DESCRIPTION OF PROCESS.—The process
referred to in clause (i) is a process in which the
participants described in such clause collaborate to
develop best-practices guidelines on the provision of
adoption information and referrals to pregnant women
on an equal basis with all other courses of action
included in nondirective counseling to pregnant
women.
‘‘(iii) DATE CERTAIN FOR DEVELOPMENT.—The Secretary shall ensure that the guidelines described in
clause (ii) are developed not later than 180 days after
the date of the enactment of the Children’s Health
Act of 2000.
‘‘(C) RELATION TO AUTHORITY FOR GRANTS.—The Secretary may not make any grant under paragraph (1) before
the date on which the guidelines under subparagraph (B)
are developed.
‘‘(3) USE OF GRANT.—
‘‘(A) IN GENERAL.—With respect to a grant under paragraph (1)—
‘‘(i) an adoption organization may expend the grant
to carry out the programs directly or through grants
to or contracts with other adoption organizations;
‘‘(ii) the purposes for which the adoption organization expends the grant may include the development
of a training curriculum, consistent with the guidelines
developed under paragraph (2)(B); and
‘‘(iii) a condition for the receipt of the grant is
that the adoption organization agree that, in providing
training for the designated staff of eligible health centers, such organization will make reasonable efforts
to ensure that the individuals who provide the training
are individuals who are knowledgeable in all elements
of the adoption process and are experienced in providing adoption information and referrals in the
geographic areas in which the eligible health centers
are located, and that the designated staff receive the
training in such areas.
‘‘(B) RULE OF CONSTRUCTION REGARDING TRAINING OF
TRAINERS.—With respect to individuals who under a grant
under paragraph (1) provide training for the designated
staff of eligible health centers (referred to in this subparagraph as ‘trainers’), subparagraph (A)(iii) may not be construed as establishing any limitation regarding the
geographic area in which the trainers receive instruction
in being such trainers. A trainer may receive such instruction in a different geographic area than the area in which
the trainer trains (or will train) the designated staff of
eligible health centers.
‘‘(4) ADOPTION ORGANIZATIONS; ELIGIBLE HEALTH CENTERS;
OTHER DEFINITIONS.—For purposes of this section:
‘‘(A) The term ‘adoption organization’ means a national,
regional, or local organization—
‘‘(i) among whose primary purposes are adoption;

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Reports.

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‘‘(ii) that is knowledgeable in all elements of the
adoption process and on providing adoption information
and referrals to pregnant women; and
‘‘(iii) that is a nonprofit private entity.
‘‘(B) The term ‘designated staff’, with respect to an
eligible health center, means staff of the center who provide
pregnancy or adoption information and referrals (or will
provide such information and referrals after receiving
training under a grant under paragraph (1)).
‘‘(C) The term ‘eligible health centers’ means public
and nonprofit private entities that provide health services
to pregnant women.
‘‘(5) TRAINING FOR CERTAIN ELIGIBLE HEALTH CENTERS.—
A condition for the receipt of a grant under paragraph (1)
is that the adoption organization involved agree to make reasonable efforts to ensure that the eligible health centers with
respect to which training under the grant is provided include—
‘‘(A) eligible health centers that receive grants under
section 1001 (relating to voluntary family planning
projects);
‘‘(B) eligible health centers that receive grants under
section 330 (relating to community health centers, migrant
health centers, and centers regarding homeless individuals
and residents of public housing); and
‘‘(C) eligible health centers that receive grants under
this Act for the provision of services in schools.
‘‘(6) PARTICIPATION OF CERTAIN ELIGIBLE HEALTH CLINICS.—
In the case of eligible health centers that receive grants under
section 330 or 1001:
‘‘(A) Within a reasonable period after the Secretary
begins making grants under paragraph (1), the Secretary
shall provide eligible health centers with complete information about the training available from organizations
receiving grants under such paragraph. The Secretary shall
make reasonable efforts to encourage eligible health centers
to arrange for designated staff to participate in such
training. Such efforts shall affirm Federal requirements,
if any, that the eligible health center provide nondirective
counseling to pregnant women.
‘‘(B) All costs of such centers in obtaining the training
shall be reimbursed by the organization that provides the
training, using grants under paragraph (1).
‘‘(C) Not later than 1 year after the date of the enactment of the Children’s Health Act of 2000, the Secretary
shall submit to the appropriate committees of the Congress
a report evaluating the extent to which adoption information and referral, upon request, are provided by eligible
health centers. Within a reasonable time after training
under this section is initiated, the Secretary shall submit
to the appropriate committees of the Congress a report
evaluating the extent to which adoption information and
referral, upon request, are provided by eligible health centers in order to determine the effectiveness of such training
and the extent to which such training complies with subsection (a)(1). In preparing the reports required by this
subparagraph, the Secretary shall in no respect interpret
the provisions of this section to allow any interference

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114 STAT. 1135

in the provider-patient relationship, any breach of patient
confidentiality, or any monitoring or auditing of the counseling process or patient records which breaches patient
confidentiality or reveals patient identity. The reports
required by this subparagraph shall be conducted by the
Secretary acting through the Administrator of the Health
Resources and Services Administration and in collaboration
with the Director of the Agency for Healthcare Research
and Quality.
‘‘(b) APPLICATION FOR GRANT.—The Secretary may make a grant
under subsection (a) only if an application for the grant is submitted
to the Secretary and the application is in such form, is made
in such manner, and contains such agreements, assurances, and
information as the Secretary determines to be necessary to carry
out this section.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

Subtitle B—Special Needs Adoption
Awareness
SEC. 1211. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN AND OTHER ACTIVITIES.

Subpart I of part D of title III of the Public Health Service
Act, as amended by section 1201 of this Act, is amended by adding
at the end the following section:
‘‘SEC. 330G. SPECIAL NEEDS ADOPTION PROGRAMS; PUBLIC AWARENESS CAMPAIGN AND OTHER ACTIVITIES.

‘‘(a) SPECIAL NEEDS ADOPTION AWARENESS CAMPAIGN.—
‘‘(1) IN GENERAL.—The Secretary shall, through making
grants to nonprofit private entities, provide for the planning,
development, and carrying out of a national campaign to provide information to the public regarding the adoption of children
with special needs.
‘‘(2) INPUT ON PLANNING AND DEVELOPMENT.—In providing
for the planning and development of the national campaign
under paragraph (1), the Secretary shall provide for input from
a number and variety of adoption organizations throughout
the States in order that the full national diversity of interests
among adoption organizations is represented in the planning
and development of the campaign.
‘‘(3) CERTAIN FEATURES.—With respect to the national campaign under paragraph (1):
‘‘(A) The campaign shall be directed at various populations, taking into account as appropriate differences
among geographic regions, and shall be carried out in the
language and cultural context that is most appropriate
to the population involved.
‘‘(B) The means through which the campaign may be
carried out include—
‘‘(i) placing public service announcements on television, radio, and billboards; and

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‘‘(ii) providing information through means that the
Secretary determines will reach individuals who are
most likely to adopt children with special needs.
‘‘(C) The campaign shall provide information on the
subsidies and supports that are available to individuals
regarding the adoption of children with special needs.
‘‘(D) The Secretary may provide that the placement
of public service announcements, and the dissemination
of brochures and other materials, is subject to review by
the Secretary.
‘‘(4) MATCHING REQUIREMENT.—
‘‘(A) IN GENERAL.—With respect to the costs of the
activities to be carried out by an entity pursuant to paragraph (1), a condition for the receipt of a grant under
such paragraph is that the entity agree to make available
(directly or through donations from public or private entities) non-Federal contributions toward such costs in an
amount that is not less than 25 percent of such costs.
‘‘(B) DETERMINATION OF AMOUNT CONTRIBUTED.—NonFederal contributions under subparagraph (A) may be in
cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant
extent by the Federal Government, may not be included
in determining the amount of such contributions.
‘‘(b) NATIONAL RESOURCES PROGRAM.—The Secretary shall
(directly or through grant or contract) carry out a program that,
through toll-free telecommunications, makes available to the public
information regarding the adoption of children with special needs.
Such information shall include the following:
‘‘(1) A list of national, State, and regional organizations
that provide services regarding such adoptions, including
exchanges and other information on communicating with the
organizations. The list shall represent the full national diversity
of adoption organizations.
‘‘(2) Information beneficial to individuals who adopt such
children, including lists of support groups for adoptive parents
and other postadoptive services.
‘‘(c) OTHER PROGRAMS.—With respect to the adoption of children
with special needs, the Secretary shall make grants—
‘‘(1) to provide assistance to support groups for adoptive
parents, adopted children, and siblings of adopted children;
and
‘‘(2) to carry out studies to identify—
‘‘(A) the barriers to completion of the adoption process;
and
‘‘(B) those components that lead to favorable long-term
outcomes for families that adopt children with special
needs.
‘‘(d) APPLICATION FOR GRANT.—The Secretary may make an
award of a grant or contract under this section only if an application
for the award is submitted to the Secretary and the application
is in such form, is made in such manner, and contains such agreements, assurances, and information as the Secretary determines
to be necessary to carry out this section.

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114 STAT. 1137

‘‘(e) FUNDING.—For the purpose of carrying out this section,
there are authorized to be appropriated such sums as may be
necessary for each of the fiscal years 2001 through 2005.’’.

TITLE XIII—TRAUMATIC BRAIN INJURY
SEC. 1301. PROGRAMS OF CENTERS FOR DISEASE CONTROL AND
PREVENTION.

(a) IN GENERAL.—Section 393A of the Public Health Service
Act (42 U.S.C. 280b–1b) is amended—
(1) in subsection (b)—
(A) in paragraph (1), by striking ‘‘and’’ at the end;
(B) in paragraph (2), by striking the period and
inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(3) the implementation of a national education and awareness campaign regarding such injury (in conjunction with the
program of the Secretary regarding health-status goals for 2010,
commonly referred to as Healthy People 2010), including—
‘‘(A) the national dissemination of information on—
‘‘(i) incidence and prevalence; and
‘‘(ii) information relating to traumatic brain injury
and the sequelae of secondary conditions arising from
traumatic brain injury upon discharge from hospitals
and trauma centers; and
‘‘(B) the provision of information in primary care settings, including emergency rooms and trauma centers, concerning the availability of State level services and
resources.’’;
(2) in subsection (d)—
(A) in the second sentence, by striking ‘‘anoxia due
to near drowning.’’ and inserting ‘‘anoxia due to trauma.’’;
and
(B) in the third sentence, by inserting before the period
the following: ‘‘, after consultation with States and other
appropriate public or nonprofit private entities’’.
(b) NATIONAL REGISTRY.—Part J of title III of the Public Health
Service Act (42 U.S.C. 280b et seq.) is amended by inserting after
section 393A the following section:
‘‘NATIONAL

PROGRAM FOR TRAUMATIC BRAIN INJURY REGISTRIES

‘‘SEC. 393B. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
may make grants to States or their designees to operate the State’s
traumatic brain injury registry, and to academic institutions to
conduct applied research that will support the development of such
registries, to collect data concerning—
‘‘(1) demographic information about each traumatic brain
injury;
‘‘(2) information about the circumstances surrounding the
injury event associated with each traumatic brain injury;
‘‘(3) administrative information about the source of the
collected information, dates of hospitalization and treatment,
and the date of injury; and
‘‘(4) information characterizing the clinical aspects of the
traumatic brain injury, including the severity of the injury,

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PUBLIC LAW 106–310—OCT. 17, 2000
outcomes of the injury, the types of treatments received, and
the types of services utilized.’’.

SEC. 1302. STUDY AND MONITOR INCIDENCE AND PREVALENCE.

Section 4 of Public Law 104–166 (42 U.S.C. 300d–61 note)
is amended—
(1) in subsection (a)(1)(A)—
(A) by striking clause (i) and inserting the following:
‘‘(i)(I) determine the incidence and prevalence of
traumatic brain injury in all age groups in the general
population of the United States, including institutional
settings; and
‘‘(II) determine appropriate methodological strategies to obtain data on the incidence and prevalence
of mild traumatic brain injury and report to Congress
concerning such within 18 months of the date of the
enactment of the Children’s Health Act of 2000; and’’;
and
(B) in clause (ii), by striking ‘‘, if the Secretary determines that such a system is appropriate’’;
(2) in subsection (a)(1)(B)(i), by inserting ‘‘, including return
to work or school and community participation,’’ after ‘‘functioning’’; and
(3) in subsection (d), to read as follows:
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.’’.
SEC. 1303. PROGRAMS OF NATIONAL INSTITUTES OF HEALTH.

(a) INTERAGENCY PROGRAM.—Section 1261(d)(4) of the Public
Health Service Act (42 U.S.C. 300d–61(d)(4)) is amended—
(1) in subparagraph (A), by striking ‘‘degree of injury’’
and inserting ‘‘degree of brain injury’’;
(2) in subparagraph (B), by striking ‘‘acute injury’’ and
inserting ‘‘acute brain injury’’; and
(3) in subparagraph (D), by striking ‘‘injury treatment’’
and inserting ‘‘brain injury treatment’’.
(b) DEFINITION.—Section 1261(h)(4) of the Public Health Service
Act (42 U.S.C. 300d–61(h)(4)) is amended—
(1) in the second sentence, by striking ‘‘anoxia due to near
drowning.’’ and inserting ‘‘anoxia due to trauma.’’; and
(2) in the third sentence, by inserting before the period
the following: ‘‘, after consultation with States and other appropriate public or nonprofit private entities’’.
(c) RESEARCH ON COGNITIVE AND NEUROBEHAVIORAL DISORDERS
ARISING FROM TRAUMATIC BRAIN INJURY.—Section 1261(d)(4) of
the Public Health Service Act (42 U.S.C. 300d–61(d)(4)) is
amended—
(1) in subparagraph (C), by striking ‘‘and’’ after the semicolon at the end;
(2) in subparagraph (D), by striking the period at the
end and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(E) carrying out subparagraphs (A) through (D) with
respect to cognitive disorders and neurobehavioral consequences arising from traumatic brain injury, including
the development, modification, and evaluation of therapies
and programs of rehabilitation toward reaching or restoring

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114 STAT. 1139

normal capabilities in areas such as reading, comprehension, speech, reasoning, and deduction.’’.
(d) AUTHORIZATION OF APPROPRIATIONS.—Section 1261 of the
Public Health Service Act (42 U.S.C. 300d–61) is amended by adding
at the end the following:
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.
SEC. 1304. PROGRAMS OF HEALTH RESOURCES AND SERVICES
ADMINISTRATION.

Section 1252 of the Public Health Service Act (42 U.S.C. 300d–
51) is amended—
(1) in the section heading by striking ‘‘demonstration’’;
(2) in subsection (a), by striking ‘‘demonstration’’;
(3) in subsection (b)(3)—
(A) in subparagraph (A)(iv), by striking ‘‘representing
traumatic brain injury survivors’’ and inserting ‘‘representing individuals with traumatic brain injury’’; and
(B) in subparagraph (B), by striking ‘‘who are survivors
of’’ and inserting ‘‘with’’;
(4) in subsection (c)—
(A) in paragraph (1), by striking ‘‘, in cash,’’; and
(B) in paragraph (2), by amending the paragraph to
read as follows:
‘‘(2) DETERMINATION OF AMOUNT CONTRIBUTED.—Non-Federal contributions under paragraph (1) may be in cash or in
kind, fairly evaluated, including plant, equipment, or services.
Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount
of such contributions.’’;
(5) by redesignating subsections (e) through (h) as subsections (g) through ( j), respectively;
(6) by inserting after subsection (d) the following subsections:
‘‘(e) CONTINUATION OF PREVIOUSLY AWARDED DEMONSTRATION
PROJECTS.—A State that received a grant under this section prior
to the date of the enactment of the Children’s Health Act of 2000
may compete for new project grants under this section after such
date of the enactment.
‘‘(f ) USE OF STATE GRANTS.—
‘‘(1) COMMUNITY SERVICES AND SUPPORTS.—A State shall
(directly or through awards of contracts to nonprofit private
entities) use amounts received under a grant under this section
for the following:
‘‘(A) To develop, change, or enhance community-based
service delivery systems that include timely access to comprehensive appropriate services and supports. Such service
and supports—
‘‘(i) shall promote full participation by individuals
with brain injury and their families in decision making
regarding the services and supports; and
‘‘(ii) shall be designed for children and other
individuals with traumatic brain injury.

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‘‘(B) To focus on outreach to underserved and inappropriately served individuals, such as individuals in institutional settings, individuals with low socioeconomic
resources, individuals in rural communities, and individuals in culturally and linguistically diverse communities.
‘‘(C) To award contracts to nonprofit entities for consumer or family service access training, consumer support,
peer mentoring, and parent to parent programs.
‘‘(D) To develop individual and family service coordination or case management systems.
‘‘(E) To support other needs identified by the advisory
board under subsection (b) for the State involved.
‘‘(2) BEST PRACTICES.—
‘‘(A) IN GENERAL.—State services and supports provided under a grant under this section shall reflect the
best practices in the field of traumatic brain injury, shall
be in compliance with title II of the Americans with Disabilities Act of 1990, and shall be supported by quality assurance measures as well as state-of-the-art health care and
integrated community supports, regardless of the severity
of injury.
‘‘(B) DEMONSTRATION BY STATE AGENCY.—The State
agency responsible for administering amounts received
under a grant under this section shall demonstrate that
it has obtained knowledge and expertise of traumatic brain
injury and the unique needs associated with traumatic
brain injury.
‘‘(3) STATE CAPACITY BUILDING.—A State may use amounts
received under a grant under this section to—
‘‘(A) educate consumers and families;
‘‘(B) train professionals in public and private sector
financing (such as third party payers, State agencies,
community-based providers, schools, and educators);
‘‘(C) develop or improve case management or service
coordination systems;
‘‘(D) develop best practices in areas such as family
or consumer support, return to work, housing or supportive
living personal assistance services, assistive technology and
devices, behavioral health services, substance abuse services, and traumatic brain injury treatment and rehabilitation;
‘‘(E) tailor existing State systems to provide accommodations to the needs of individuals with brain injury
(including systems administered by the State departments
responsible for health, mental health, labor/employment,
education, mental retardation /developmental disorders,
transportation, and correctional systems);
‘‘(F) improve data sets coordinated across systems and
other needs identified by a State plan supported by its
advisory council; and
‘‘(G) develop capacity within targeted communities.’’;
(7) in subsection (g) (as so redesignated), by striking ‘‘agencies of the Public Health Service’’ and inserting ‘‘Federal agencies’’;
(8) in subsection (i) (as redesignated by paragraph (3))—

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(A) in the second sentence, by striking ‘‘anoxia due
to near drowning.’’ and inserting ‘‘anoxia due to trauma.’’;
and
(B) in the third sentence, by inserting before the period
the following: ‘‘, after consultation with States and other
appropriate public or nonprofit private entities’’; and
(9) in subsection ( j) (as so redesignated), by amending
the subsection to read as follows:
‘‘( j) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.
SEC. 1305. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.

Part E of title XII of the Public Health Service Act (42 U.S.C.
300d–51 et seq.) is amended by adding at the end the following:
‘‘SEC. 1253. STATE GRANTS FOR PROTECTION AND ADVOCACY SERVICES.

42 USC 300d–53.

‘‘(a) IN GENERAL.—The Secretary, acting through the Administrator of the Health Resources and Services Administration
(referred to in this section as the ‘Administrator’), shall make grants
to protection and advocacy systems for the purpose of enabling
such systems to provide services to individuals with traumatic
brain injury.
‘‘(b) SERVICES PROVIDED.—Services provided under this section
may include the provision of—
‘‘(1) information, referrals, and advice;
‘‘(2) individual and family advocacy;
‘‘(3) legal representation; and
‘‘(4) specific assistance in self-advocacy.
‘‘(c) APPLICATION.—To be eligible to receive a grant under this
section, a protection and advocacy system shall submit an application to the Administrator at such time, in such form and manner,
and accompanied by such information and assurances as the
Administrator may require.
‘‘(d) APPROPRIATIONS LESS THAN $2,700,000.—
‘‘(1) IN GENERAL.—With respect to any fiscal year in which
the amount appropriated under subsection (i) to carry out this
section is less than $2,700,000, the Administrator shall make
grants from such amount to individual protection and advocacy
systems within States to enable such systems to plan for,
develop outreach strategies for, and carry out services authorized under this section for individuals with traumatic brain
injury.
‘‘(2) AMOUNT.—The amount of each grant provided under
paragraph (1) shall be determined as set forth in paragraphs
(2) and (3) of subsection (e).
‘‘(e) APPROPRIATIONS OF $2,700,000 OR MORE.—
‘‘(1) POPULATION BASIS.—Except as provided in paragraph
(2), with respect to each fiscal year in which the amount appropriated under subsection (i) to carry out this section is
$2,700,000 or more, the Administrator shall make a grant
to a protection and advocacy system within each State.
‘‘(2) AMOUNT.—The amount of a grant provided to a system
under paragraph (1) shall be equal to an amount bearing the
same ratio to the total amount appropriated for the fiscal

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PUBLIC LAW 106–310—OCT. 17, 2000

year involved under subsection (i) as the population of the
State in which the grantee is located bears to the population
of all States.
‘‘(3) MINIMUMS.—Subject to the availability of appropriations, the amount of a grant a protection and advocacy system
under paragraph (1) for a fiscal year shall—
‘‘(A) in the case of a protection and advocacy system
located in American Samoa, Guam, the United States
Virgin Islands, or the Commonwealth of the Northern Mariana Islands, and the protection and advocacy system
serving the American Indian consortium, not be less than
$20,000; and
‘‘(B) in the case of a protection and advocacy system
in a State not described in subparagraph (A), not be less
than $50,000.
‘‘(4) INFLATION ADJUSTMENT.—For each fiscal year in which
the total amount appropriated under subsection (i) to carry
out this section is $5,000,000 or more, and such appropriated
amount exceeds the total amount appropriated to carry out
this section in the preceding fiscal year, the Administrator
shall increase each of the minimum grants amount described
in subparagraphs (A) and (B) of paragraph (3) by a percentage
equal to the percentage increase in the total amount appropriated under subsection (i) to carry out this section between
the preceding fiscal year and the fiscal year involved.
‘‘(f ) CARRYOVER.—Any amount paid to a protection and
advocacy system that serves a State or the American Indian consortium for a fiscal year under this section that remains unobligated
at the end of such fiscal year shall remain available to such system
for obligation during the next fiscal year for the purposes for which
such amount was originally provided.
‘‘(g) DIRECT PAYMENT.—Notwithstanding any other provision
of law, the Administrator shall pay directly to any protection and
advocacy system that complies with the provisions of this section,
the total amount of the grant for such system, unless the system
provides otherwise for such payment.
‘‘(h) ANNUAL REPORT.—Each protection and advocacy system
that receives a payment under this section shall submit an annual
report to the Administrator concerning the services provided to
individuals with traumatic brain injury by such system.
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section $5,000,000 for fiscal
year 2001, and such sums as may be necessary for each the fiscal
years 2002 through 2005.
‘‘( j) DEFINITIONS.—In this section:
‘‘(1) AMERICAN INDIAN CONSORTIUM.—The term ‘American
Indian consortium’ means a consortium established under part
C of the Developmental Disabilities Assistance Bill of Rights
Act (42 U.S.C. 6042 et seq.).
‘‘(2) PROTECTION AND ADVOCACY SYSTEM.—The term ‘protection and advocacy system’ means a protection and advocacy
system established under part C of the Developmental Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6042 et
seq.).
‘‘(3) STATE.—The term ‘State’, unless otherwise specified,
means the several States of the United States, the District
of Columbia, the Commonwealth of Puerto Rico, the United

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114 STAT. 1143

States Virgin Islands, Guam, American Samoa, and the
Commonwealth of the Northern Mariana Islands.’’.
SEC. 1306. AUTHORIZATION OF APPROPRIATIONS FOR CERTAIN PROGRAMS.

Section 394A of the Public Health Service Act (42 U.S.C. 280b–
3) is amended by striking ‘‘and’’ after ‘‘1994’’ and by inserting
before the period the following: ‘‘, and such sums as may be necessary for each of the fiscal years 2001 through 2005.’’.

TITLE XIV—CHILD CARE SAFETY AND
HEALTH GRANTS
SEC. 1401. DEFINITIONS.

42 USC 9859.

In this title:
(1) CHILD WITH A DISABILITY; INFANT OR TODDLER WITH
A DISABILITY.—The terms ‘‘child with a disability’’ and ‘‘infant
or toddler with a disability’’ have the meanings given the terms
in sections 602 and 632 of the Individuals with Disabilities
Education Act (20 U.S.C. 1401 and 1431).
(2) ELIGIBLE CHILD CARE PROVIDER.—The term ‘‘eligible
child care provider’’ means a provider of child care services
for compensation, including a provider of care for a schoolage child during non-school hours, that—
(A) is licensed, regulated, registered, or otherwise
legally operating, under State and local law; and
(B) satisfies the State and local requirements,
applicable to the child care services the provider provides.
(3) SECRETARY.—The term ‘‘Secretary’’ means the Secretary
of Health and Human Services.
(4) STATE.—The term ‘‘State’’ means any of the several
States of the United States, the District of Columbia, the
Commonwealth of Puerto Rico, the United States Virgin
Islands, Guam, American Samoa, and the Commonwealth of
the Northern Mariana Islands.
SEC. 1402. AUTHORIZATION OF APPROPRIATIONS.

42 USC 9859a.

There are authorized to be appropriated to carry out this title
$200,000,000 for fiscal year 2001, and such sums as may be necessary for each subsequent fiscal year.
SEC. 1403. PROGRAMS.

42 USC 9859b.

The Secretary shall make allotments to eligible States under
section 1404. The Secretary shall make the allotments to enable
the States to establish programs to improve the health and safety
of children receiving child care outside the home, by preventing
illnesses and injuries associated with that care and promoting the
health and well-being of children receiving that care.
SEC. 1404. AMOUNTS RESERVED; ALLOTMENTS.

42 USC 9859c.

(a) AMOUNTS RESERVED.—The Secretary shall reserve not more
than one-half of 1 percent of the amount appropriated under section
1402 for each fiscal year to make allotments to Guam, American
Samoa, the United States Virgin Islands, and the Commonwealth
of the Northern Mariana Islands to be allotted in accordance with
their respective needs.
(b) STATE ALLOTMENTS.—

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PUBLIC LAW 106–310—OCT. 17, 2000

(1) GENERAL RULE.—From the amounts appropriated under
section 1402 for each fiscal year and remaining after reservations are made under subsection (a), the Secretary shall allot
to each State an amount equal to the sum of—
(A) an amount that bears the same ratio to 50 percent
of such remainder as the product of the young child factor
of the State and the allotment percentage of the State
bears to the sum of the corresponding products for all
States; and
(B) an amount that bears the same ratio to 50 percent
of such remainder as the product of the school lunch factor
of the State and the allotment percentage of the State
bears to the sum of the corresponding products for all
States.
(2) YOUNG CHILD FACTOR.—In this subsection, the term
‘‘young child factor’’ means the ratio of the number of children
under 5 years of age in a State to the number of such children
in all States, as provided by the most recent annual estimates
of population in the States by the Census Bureau of the Department of Commerce.
(3) SCHOOL LUNCH FACTOR.—In this subsection, the term
‘‘school lunch factor’’ means the ratio of the number of children
who are receiving free or reduced price lunches under the
school lunch program established under the National School
Lunch Act (42 U.S.C. 1751 et seq.) in the State to the number
of such children in all States, as determined annually by the
Department of Agriculture.
(4) ALLOTMENT PERCENTAGE.—
(A) IN GENERAL.—For purposes of this subsection, the
allotment percentage for a State shall be determined by
dividing the per capita income of all individuals in the
United States, by the per capita income of all individuals
in the State.
(B) LIMITATIONS.—If an allotment percentage determined under subparagraph (A) for a State—
(i) is more than 1.2 percent, the allotment percentage of the State shall be considered to be 1.2 percent;
and
(ii) is less than 0.8 percent, the allotment percentage of the State shall be considered to be 0.8 percent.
(C) PER CAPITA INCOME.—For purposes of subparagraph (A), per capita income shall be—
(i) determined at 2-year intervals;
(ii) applied for the 2-year period beginning on
October 1 of the first fiscal year beginning after the
date such determination is made; and
(iii) equal to the average of the annual per capita
incomes for the most recent period of 3 consecutive
years for which satisfactory data are available from
the Department of Commerce on the date such determination is made.
(c) DATA AND INFORMATION.—The Secretary shall obtain from
each appropriate Federal agency, the most recent data and information necessary to determine the allotments provided for in subsection (b).

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114 STAT. 1145

(d) DEFINITION.—In this section, the term ‘‘State’’ includes only
the several States of the United States, the District of Columbia,
and the Commonwealth of Puerto Rico.
SEC. 1405. STATE APPLICATIONS.

42 USC 9859d.

To be eligible to receive an allotment under section 1404, a
State shall submit an application to the Secretary at such time,
in such manner, and containing such information as the Secretary
may require. The application shall contain information assessing
the needs of the State with regard to child care health and safety,
the goals to be achieved through the program carried out by the
State under this title, and the measures to be used to assess
the progress made by the State toward achieving the goals.
SEC. 1406. USE OF FUNDS.

42 USC 9859e.

(a) IN GENERAL.—A State that receives an allotment under
section 1404 shall use the funds made available through the allotment to carry out two or more activities consisting of—
(1) providing training and education to eligible child care
providers on preventing injuries and illnesses in children, and
promoting health-related practices;
(2) strengthening licensing, regulation, or registration
standards for eligible child care providers;
(3) assisting eligible child care providers in meeting
licensing, regulation, or registration standards, including
rehabilitating the facilities of the providers, in order to bring
the facilities into compliance with the standards;
(4) enforcing licensing, regulation, or registration standards
for eligible child care providers, including holding increased
unannounced inspections of the facilities of those providers;
(5) providing health consultants to provide advice to eligible
child care providers;
(6) assisting eligible child care providers in enhancing the
ability of the providers to serve children with disabilities and
infants and toddlers with disabilities;
(7) conducting criminal background checks for eligible child
care providers and other individuals who have contact with
children in the facilities of the providers;
(8) providing information to parents on what factors to
consider in choosing a safe and healthy child care setting;
or
(9) assisting in improving the safety of transportation practices for children enrolled in child care programs with eligible
child care providers.
(b) SUPPLEMENT, NOT SUPPLANT.—Funds appropriated pursuant to the authority of this title shall be used to supplement
and not supplant other Federal, State, and local public funds
expended to provide services for eligible individuals.
SEC. 1407. REPORTS.

42 USC 9859f.

Each State that receives an allotment under section 1404 shall
annually prepare and submit to the Secretary a report that
describes—
(1) the activities carried out with funds made available
through the allotment; and
(2) the progress made by the State toward achieving the
goals described in the application submitted by the State under
section 1405.

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114 STAT. 1146

PUBLIC LAW 106–310—OCT. 17, 2000

TITLE XV—HEALTHY START INITIATIVE
SEC. 1501. CONTINUATION OF HEALTHY START PROGRAM.

Subpart I of part D of title III of the Public Health Service
Act, as amended by section 1211 of this Act, is amended by adding
at the end the following section:
42 USC 254c–8.

‘‘SEC. 330H. HEALTHY START FOR INFANTS.

‘‘(a) IN GENERAL.—
‘‘(1) CONTINUATION AND EXPANSION OF PROGRAM.—The Secretary, acting through the Administrator of the Health
Resources and Services Administration, Maternal and Child
Health Bureau, shall under authority of this section continue
in effect the Healthy Start Initiative and may, during fiscal
year 2001 and subsequent years, carry out such program on
a national basis.
‘‘(2) DEFINITION.—For purposes of paragraph (1), the term
‘Healthy Start Initiative’ is a reference to the program that,
as an initiative to reduce the rate of infant mortality and
improve perinatal outcomes, makes grants for project areas
with high annual rates of infant mortality and that, prior
to the effective date of this section, was a demonstration program carried out under section 301.
‘‘(3) ADDITIONAL GRANTS.—Effective upon increased funding
beyond fiscal year 1999 for such Initiative, additional grants
may be made to States to assist communities with technical
assistance, replication of successful projects, and State policy
formation to reduce infant and maternal mortality and morbidity.
‘‘(b) REQUIREMENTS FOR MAKING GRANTS.—In making grants
under subsection (a), the Secretary shall require that applicants
(in addition to meeting all eligibility criteria established by the
Secretary) establish, for project areas under such subsection,
community-based consortia of individuals and organizations
(including agencies responsible for administering block grant programs under title V of the Social Security Act, consumers of project
services, public health departments, hospitals, health centers under
section 330, and other significant sources of health care services)
that are appropriate for participation in projects under subsection
(a).
‘‘(c) COORDINATION.—Recipients of grants under subsection (a)
shall coordinate their services and activities with the State agency
or agencies that administer block grant programs under title V
of the Social Security Act in order to promote cooperation, integration, and dissemination of information with Statewide systems and
with other community services funded under the Maternal and
Child Health Block Grant.
‘‘(d) RULE OF CONSTRUCTION.—Except to the extent inconsistent
with this section, this section may not be construed as affecting
the authority of the Secretary to make modifications in the program
carried out under subsection (a).
‘‘(e) ADDITIONAL SERVICES FOR AT-RISK PREGNANT WOMEN AND
INFANTS.—
‘‘(1) IN GENERAL.—The Secretary may make grants to conduct and support research and to provide additional health
care services for pregnant women and infants, including grants

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114 STAT. 1147

to increase access to prenatal care, genetic counseling,
ultrasound services, and fetal or other surgery.
‘‘(2) ELIGIBLE PROJECT AREA.—The Secretary may make
a grant under paragraph (1) only if the geographic area in
which services under the grant will be provided is a geographic
area in which a project under subsection (a) is being carried
out, and if the Secretary determines that the grant will add
to or expand the level of health services available in such
area to pregnant women and infants.
‘‘(3) EVALUATION BY GENERAL ACCOUNTING OFFICE.—
‘‘(A) IN GENERAL.—During fiscal year 2004, the Comptroller General of the United States shall conduct an
evaluation of activities under grants under paragraph (1)
in order to determine whether the activities have been
effective in serving the needs of pregnant women with
respect to services described in such paragraph. The evaluation shall include an analysis of whether such activities
have been effective in reducing the disparity in health
status between the general population and individuals who
are members of racial or ethnic minority groups. Not later
than January 10, 2004, the Comptroller General shall
submit to the Committee on Commerce in the House of
Representatives, and to the Committee on Health, Education, Labor, and Pensions in the Senate, a report
describing the findings of the evaluation.
‘‘(B) RELATION TO GRANTS REGARDING ADDITIONAL SERVICES FOR AT-RISK PREGNANT WOMEN AND INFANTS.—Before
the date on which the evaluation under subparagraph (A)
is submitted in accordance with such subparagraph—
‘‘(i) the Secretary shall ensure that there are not
more than five grantees under paragraph (1); and
‘‘(ii) an entity is not eligible to receive grants under
such paragraph unless the entity has substantial
experience in providing the health services described
in such paragraph.
‘‘(f ) FUNDING.—
‘‘(1) GENERAL PROGRAM.—
‘‘(A) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of carrying out this section (other than subsection
(e)), there are authorized to be appropriated such sums
as may be necessary for each of the fiscal years 2001
through 2005.
‘‘(B) ALLOCATIONS.—
‘‘(i) PROGRAM ADMINISTRATION.—Of the amounts
appropriated under subparagraph (A) for a fiscal year,
the Secretary may reserve up to 5 percent for coordination, dissemination, technical assistance, and data
activities that are determined by the Secretary to be
appropriate for carrying out the program under this
section.
‘‘(ii) EVALUATION.—Of the amounts appropriated
under subparagraph (A) for a fiscal year, the Secretary
may reserve up to 1 percent for evaluations of projects
carried out under subsection (a). Each such evaluation
shall include a determination of whether such projects
have been effective in reducing the disparity in health

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PUBLIC LAW 106–310—OCT. 17, 2000
status between the general population and individuals
who are members of racial or ethnic minority groups.
‘‘(2) ADDITIONAL SERVICES FOR AT-RISK PREGNANT WOMEN
AND INFANTS.—
‘‘(A) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of carrying out subsection (e), there are authorized
to be appropriated such sums as may be necessary for
each of the fiscal years 2001 through 2005.
‘‘(B) ALLOCATION FOR COMMUNITY-BASED MOBILE
HEALTH UNITS.—Of the amounts appropriated under
subparagraph (A) for a fiscal year, the Secretary shall
make available not less than 10 percent for providing services under subsection (e) (including ultrasound services)
through visits by mobile units to communities that are
eligible for services under subsection (a).’’.

TITLE XVI—ORAL HEALTH PROMOTION
AND DISEASE PREVENTION
42 USC 247b–
14a.

SEC. 1601. IDENTIFICATION OF INTERVENTIONS THAT REDUCE THE
BURDEN AND TRANSMISSION OF ORAL, DENTAL, AND
CRANIOFACIAL DISEASES IN HIGH RISK POPULATIONS;
DEVELOPMENT OF APPROACHES FOR PEDIATRIC ORAL
AND CRANIOFACIAL ASSESSMENT.

(a) IN GENERAL.—The Secretary of Health and Human Services,
through the Maternal and Child Health Bureau, the Indian Health
Service, and in consultation with the National Institutes of Health
and the Centers for Disease Control and Prevention, shall—
(1) support community-based research that is designed to
improve understanding of the etiology, pathogenesis, diagnosis,
prevention, and treatment of pediatric oral, dental, craniofacial
diseases and conditions and their sequelae in high risk populations;
(2) support demonstrations of preventive interventions in
high risk populations including nutrition, parenting, and
feeding techniques; and
(3) develop clinical approaches to assess individual patients
for the risk of pediatric dental disease.
(b) COMPLIANCE WITH STATE PRACTICE LAWS.—Treatment and
other services shall be provided pursuant to this section by licensed
dental health professionals in accordance with State practice and
licensing laws.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated such sums as may be necessary to carry out
this section for each the fiscal years 2001 through 2005.
SEC. 1602. ORAL HEALTH PROMOTION AND DISEASE PREVENTION.

Part B of title III of the Public Health Service Act, as amended
by section 911 of this Act, is amended by inserting after section
317L the following section:
‘‘ORAL
42 USC 247b–14.

HEALTH PROMOTION AND DISEASE PREVENTION

‘‘SEC. 317M. (a) GRANTS TO INCREASE RESOURCES
WATER FLUORIDATION.—

FOR

COMMU-

NITY

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114 STAT. 1149

‘‘(1) IN GENERAL.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention,
may make grants to States and Indian tribes for the purpose
of increasing the resources available for community water
fluoridation.
‘‘(2) USE OF FUNDS.—A State shall use amounts provided
under a grant under paragraph (1)—
‘‘(A) to purchase fluoridation equipment;
‘‘(B) to train fluoridation engineers;
‘‘(C) to develop educational materials on the benefits
of fluoridation; or
‘‘(D) to support the infrastructure necessary to monitor
and maintain the quality of water fluoridation.
‘‘(b) COMMUNITY WATER FLUORIDATION.—
‘‘(1) IN GENERAL.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention
and in collaboration with the Director of the Indian Health
Service, shall establish a demonstration project that is designed
to assist rural water systems in successfully implementing the
water fluoridation guidelines of the Centers for Disease Control
and Prevention that are entitled ‘Engineering and Administrative Recommendations for Water Fluoridation, 1995’ (referred
to in this subsection as the ‘EARWF’).
‘‘(2) REQUIREMENTS.—
‘‘(A) COLLABORATION.—In collaborating under paragraph (1), the Directors referred to in such paragraph
shall ensure that technical assistance and training are
provided to tribal programs located in each of the 12 areas
of the Indian Health Service. The Director of the Indian
Health Service shall provide coordination and administrative support to tribes under this section.
‘‘(B) GENERAL USE OF FUNDS.—Amounts made available
under paragraph (1) shall be used to assist small water
systems in improving the effectiveness of water fluoridation
and to meet the recommendations of the EARWF.
‘‘(C) FLUORIDATION SPECIALISTS.—
‘‘(i) IN GENERAL.—In carrying out this subsection,
the Secretary shall provide for the establishment of
fluoridation specialist engineering positions in each of
the Dental Clinical and Preventive Support Centers
through which technical assistance and training will
be provided to tribal water operators, tribal utility
operators and other Indian Health Service personnel
working directly with fluoridation projects.
‘‘(ii) LIAISON.—A fluoridation specialist shall serve
as the principal technical liaison between the Indian
Health Service and the Centers for Disease Control
and Prevention with respect to engineering and fluoridation issues.
‘‘(iii) CDC.—The Director of the Centers for Disease Control and Prevention shall appoint individuals
to serve as the fluoridation specialists.
‘‘(D) IMPLEMENTATION.—The project established under
this subsection shall be planned, implemented and evaluated over the 5-year period beginning on the date on which
funds are appropriated under this section and shall be

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PUBLIC LAW 106–310—OCT. 17, 2000

designed to serve as a model for improving the effectiveness
of water fluoridation systems of small rural communities.
‘‘(3) EVALUATION.—In conducting the ongoing evaluation
as provided for in paragraph (2)(D), the Secretary shall ensure
that such evaluation includes—
‘‘(A) the measurement of changes in water fluoridation
compliance levels resulting from assistance provided under
this section;
‘‘(B) the identification of the administrative, technical
and operational challenges that are unique to the fluoridation of small water systems;
‘‘(C) the development of a practical model that may
be easily utilized by other tribal, State, county or local
governments in improving the quality of water fluoridation
with emphasis on small water systems; and
‘‘(D) the measurement of any increased percentage of
Native Americans or Alaskan Natives who receive the benefits of optimally fluoridated water.
‘‘(c) SCHOOL-BASED DENTAL SEALANT PROGRAM.—
‘‘(1) IN GENERAL.—The Secretary, acting through the
Director of the Centers for Disease Control and Prevention
and in collaboration with the Administrator of the Health
Resources and Services Administration, may award grants to
States and Indian tribes to provide for the development of
school-based dental sealant programs to improve the access
of children to sealants.
‘‘(2) USE OF FUNDS.—A State shall use amounts received
under a grant under paragraph (1) to provide funds to eligible
school-based entities or to public elementary or secondary
schools to enable such entities or schools to provide children
with access to dental care and dental sealant services. Such
services shall be provided by licensed dental health professionals in accordance with State practice licensing laws.
‘‘(3) ELIGIBILITY.—To be eligible to receive funds under
paragraph (1), an entity shall—
‘‘(A) prepare and submit to the State an application
at such time, in such manner and containing such information as the State may require; and
‘‘(B) be a public elementary or secondary school—
‘‘(i) that is located in an urban area in which
and more than 50 percent of the student population
is participating in Federal or State free or reduced
meal programs; or
‘‘(ii) that is located in a rural area and, with respect
to the school district in which the school is located,
the district involved has a median income that is at
or below 235 percent of the poverty line, as defined
in section 673(2) of the Community Services Block
Grant Act (42 U.S.C. 9902(2)).
‘‘(d) DEFINITIONS.—For purposes of this section, the term ‘Indian
tribe’ means an Indian tribe or tribal organization as defined in
section 4(b) and section 4(c) of the Indian Self-Determination and
Education Assistance Act.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1151

SEC. 1603. COORDINATED PROGRAM TO IMPROVE PEDIATRIC ORAL
HEALTH.

Part B of the Public Health Service Act (42 U.S.C. 243 et
seq.) is amended by adding at the end the following:
‘‘COORDINATED

PROGRAM TO IMPROVE PEDIATRIC ORAL HEALTH

‘‘SEC. 320A. (a) IN GENERAL.—The Secretary, acting through
the Administrator of the Health Resources and Services Administration, shall establish a program to fund innovative oral health activities that improve the oral health of children under 6 years of
age who are eligible for services provided under a Federal health
program, to increase the utilization of dental services by such
children, and to decrease the incidence of early childhood and
baby bottle tooth decay.
‘‘(b) GRANTS.—The Secretary shall award grants to or enter
into contracts with public or private nonprofit schools of dentistry
or accredited dental training institutions or programs, community
dental programs, and programs operated by the Indian Health
Service (including federally recognized Indian tribes that receive
medical services from the Indian Health Service, urban Indian
health programs funded under title V of the Indian Health Care
Improvement Act, and tribes that contract with the Indian Health
Service pursuant to the Indian Self-Determination and Education
Assistance Act) to enable such schools, institutions, and programs
to develop programs of oral health promotion, to increase training
of oral health services providers in accordance with State practice
laws, or to increase the utilization of dental services by eligible
children.
‘‘(c) DISTRIBUTION.—In awarding grants under this section, the
Secretary shall, to the extent practicable, ensure an equitable
national geographic distribution of the grants, including areas of
the United States where the incidence of early childhood caries
is highest.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section $10,000,000 for each
the fiscal years 2001 through 2005.’’.

42 USC 247d–1.

Contracts.

TITLE XVII—VACCINE-RELATED
PROGRAMS
Subtitle A—Vaccine Compensation
Program
SEC. 1701. CONTENT OF PETITIONS.

(a) IN GENERAL.—Section 2111(c)(1)(D) of the Public Health
Service Act (42 U.S.C. 300aa–11(c)(1)(D)) is amended by striking
‘‘and’’ at the end and inserting ‘‘or (iii) suffered such illness, disability, injury, or condition from the vaccine which resulted in
inpatient hospitalization and surgical intervention, and’’.
(b) EFFECTIVE DATE.—The amendment made by subsection (a)
takes effect upon the date of the enactment of this Act, including
with respect to petitions under section 2111 of the Public Health
Service Act that are pending on such date.

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PUBLIC LAW 106–310—OCT. 17, 2000

Subtitle B—Childhood Immunizations
SEC. 1711. CHILDHOOD IMMUNIZATIONS.

Section 317( j)(1) of the Public Health Service Act (42 U.S.C.
247b( j)(1)) is amended in the first sentence by striking ‘‘1998’’
and all that follows and inserting ‘‘1998 through 2005.’’.

TITLE XVIII—HEPATITIS C
SEC. 1801. SURVEILLANCE AND EDUCATION REGARDING HEPATITIS
C.

Part B of title III of the Public Health Service Act, as amended
by section 1602 of this Act, is amended by inserting after section
317M the following section:
‘‘SURVEILLANCE
42 USC 247b–15.

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AND EDUCATION REGARDING HEPATITIS C VIRUS

‘‘SEC. 317N. (a) IN GENERAL.—The Secretary, acting through
the Director of the Centers for Disease Control and Prevention,
may (directly and through grants to public and nonprofit private
entities) provide for programs to carry out the following:
‘‘(1) To cooperate with the States in implementing a
national system to determine the incidence of hepatitis C virus
infection (in this section referred to as ‘HCV infection’) and
to assist the States in determining the prevalence of such
infection, including the reporting of chronic HCV cases.
‘‘(2) To identify, counsel, and offer testing to individuals
who are at risk of HCV infection as a result of receiving
blood transfusions prior to July 1992, or as a result of other
risk factors.
‘‘(3) To provide appropriate referrals for counseling, testing,
and medical treatment of individuals identified under paragraph (2) and to ensure, to the extent practicable, the provision
of appropriate follow-up services.
‘‘(4) To develop and disseminate public information and
education programs for the detection and control of HCV infection, with priority given to high risk populations as determined
by the Secretary.
‘‘(5) To improve the education, training, and skills of health
professionals in the detection and control of HCV infection,
with priority given to pediatricians and other primary care
physicians, and obstetricians and gynecologists.
‘‘(b) LABORATORY PROCEDURES.—The Secretary may (directly
and through grants to public and nonprofit private entities) carry
out programs to provide for improvements in the quality of clinicallaboratory procedures regarding hepatitis C, including reducing
variability in laboratory results on hepatitis C antibody and PCR
testing.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1153

TITLE XIX—NIH INITIATIVE ON
AUTOIMMUNE DISEASES
SEC. 1901. AUTOIMMUNE DISEASES; INITIATIVE THROUGH DIRECTOR
OF NATIONAL INSTITUTES OF HEALTH.

Part B of title IV of the Public Health Service Act (42 U.S.C.
284 et seq.), as amended by section 1001 of this Act, is amended
by adding at the end the following:
‘‘SEC. 409E. AUTOIMMUNE DISEASES.

42 USC 284i.

‘‘(a) EXPANSION, INTENSIFICATION, AND COORDINATION OF
ACTIVITIES.—
‘‘(1) IN GENERAL.—The Director of NIH shall expand, intensify, and coordinate research and other activities of the National
Institutes of Health with respect to autoimmune diseases.
‘‘(2) ALLOCATIONS BY DIRECTOR OF NIH.—With respect to
amounts appropriated to carry out this section for a fiscal
year, the Director of NIH shall allocate the amounts among
the national research institutes that are carrying out paragraph
(1).
‘‘(3) DEFINITION.—The term ‘autoimmune disease’ includes,
for purposes of this section such diseases or disorders with
evidence of autoimmune pathogensis as the Secretary determines to be appropriate.
‘‘(b) COORDINATING COMMITTEE.—
‘‘(1) IN GENERAL.—The Secretary shall ensure that the
Autoimmune Diseases Coordinating Committee (referred to in
this section as the ‘Coordinating Committee’) coordinates activities across the National Institutes and with other Federal
health programs and activities relating to such diseases.
‘‘(2) COMPOSITION.—The Coordinating Committee shall be
composed of the directors or their designees of each of the
national research institutes involved in research with respect
to autoimmune diseases and representatives of all other Federal
departments and agencies whose programs involve health functions or responsibilities relevant to such diseases, including
the Centers for Disease Control and Prevention and the Food
and Drug Administration.
‘‘(3) CHAIR.—
‘‘(A) IN GENERAL.—With respect to autoimmune diseases, the Chair of the Committee shall serve as the principal advisor to the Secretary, the Assistant Secretary for
Health, and the Director of NIH, and shall provide advice
to the Director of the Centers for Disease Control and
Prevention, the Commissioner of Food and Drugs, and other
relevant agencies.
‘‘(B) DIRECTOR OF NIH.—The Chair of the Committee
shall be directly responsible to the Director of NIH.
‘‘(c) PLAN FOR NIH ACTIVITIES.—
‘‘(1) IN GENERAL.—Not later than 1 year after the date
of the enactment of this section, the Coordinating Committee
shall develop a plan for conducting and supporting research
and education on autoimmune diseases through the national
research institutes and shall periodically review and revise
the plan. The plan shall—

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PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(A) provide for a broad range of research and education activities relating to biomedical, psychosocial, and
rehabilitative issues, including studies of the disproportionate impact of such diseases on women;
‘‘(B) identify priorities among the programs and activities of the National Institutes of Health regarding such
diseases; and
‘‘(C) reflect input from a broad range of scientists,
patients, and advocacy groups.
‘‘(2) CERTAIN ELEMENTS OF PLAN.—The plan under paragraph (1) shall, with respect to autoimmune diseases, provide
for the following as appropriate:
‘‘(A) Research to determine the reasons underlying the
incidence and prevalence of the diseases.
‘‘(B) Basic research concerning the etiology and causes
of the diseases.
‘‘(C) Epidemiological studies to address the frequency
and natural history of the diseases, including any differences among the sexes and among racial and ethnic
groups.
‘‘(D) The development of improved screening techniques.
‘‘(E) Clinical research for the development and evaluation of new treatments, including new biological agents.
‘‘(F) Information and education programs for health
care professionals and the public.
‘‘(3) IMPLEMENTATION OF PLAN.—The Director of NIH shall
ensure that programs and activities of the National Institutes
of Health regarding autoimmune diseases are implemented in
accordance with the plan under paragraph (1).
‘‘(d) REPORTS TO CONGRESS.—The Coordinating Committee
under subsection (b)(1) shall biennially submit to the Committee
on Commerce of the House of Representatives, and the Committee
on Health, Education, Labor and Pensions of the Senate, a report
that describes the research, education, and other activities on autoimmune diseases being conducted or supported through the national
research institutes, and that in addition includes the following:
‘‘(1) The plan under subsection (c)(1) (or revisions to the
plan, as the case may be).
‘‘(2) Provisions specifying the amounts expended by the
National Institutes of Health with respect to each of the autoimmune diseases included in the plan.
‘‘(3) Provisions identifying particular projects or types of
projects that should in the future be considered by the national
research institutes or other entities in the field of research
on autoimmune diseases.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005. The authorization of appropriations established in
the preceding sentence is in addition to any other authorization
of appropriations that is available for conducting or supporting
through the National Institutes of Health research and other activities with respect to autoimmune diseases.’’.

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114 STAT. 1155

TITLE XX—GRADUATE MEDICAL EDUCATION PROGRAMS IN CHILDREN’S
HOSPITALS
SEC. 2001. PROVISIONS TO REVISE AND EXTEND PROGRAM.

(a) PAYMENTS.—Section 340E(a) of the Public Health Service
Act (42 U.S.C. 256e(a)) is amended—
(1) by striking ‘‘and 2001’’ and inserting ‘‘through 2005’’;
and
(2) by adding at the end the following: ‘‘The Secretary
shall promulgate regulations pursuant to the rulemaking
requirements of title 5, United States Code, which shall govern
payments made under this subpart.’’.
(b) UPDATING RATES.—Section 340E(c)(2)(F) of the Public
Health Service Act (42 U.S.C. 256e(c)(2)(F)) is amended by striking
‘‘hospital’s cost reporting period that begins during fiscal year 2000’’
and inserting ‘‘Federal fiscal year for which payments are made’’.
(c) RESIDENT COUNT FOR INTERIM PAYMENTS.—Section
340E(e)(1) of the Public Health Service Act (42 U.S.C. 256e(e)(1))
is amended by adding at the end the following: ‘‘Such interim
payments to each individual hospital shall be based on the number
of residents reported in the hospital’s most recently filed Medicare
cost report prior to the application date for the Federal fiscal
year for which the interim payment amounts are established. In
the case of a hospital that does not report residents on a Medicare
cost report, such interim payments shall be based on the number
of residents trained during the hospital’s most recently completed
Medicare cost report filing period.’’.
(d) WITHHOLDING.—Section 340E(e)(2) of the Public Health
Service Act (42 U.S.C. 256e(e)(2)) is amended—
(1) by adding ‘‘and indirect’’ after ‘‘direct’’; and
(2) by adding at the end the following: ‘‘The Secretary
shall withhold up to 25 percent from each interim installment
for direct and indirect graduate medical education paid under
paragraph (1) as necessary to ensure a hospital will not be
overpaid on an interim basis.’’.
(e) RECONCILIATION.—Section 340E(e)(3) of the Public Health
Service Act (42 U.S.C. 256e(e)(3)) is amended to read as follows:
‘‘(3) RECONCILIATION.—Prior to the end of each fiscal year,
the Secretary shall determine any changes to the number of
residents reported by a hospital in the application of the hospital for the current fiscal year to determine the final amount
payable to the hospital for the current fiscal year for both
direct expense and indirect expense amounts. Based on such
determination, the Secretary shall recoup any overpayments
made to pay any balance due to the extent possible. The final
amount so determined shall be considered a final intermediary
determination for the purposes of section 1878 of the Social
Security Act and shall be subject to administrative and judicial
review under that section in the same manner as the amount
of payment under section 1186(d) of such Act is subject to
review under such section.’’.
(f ) AUTHORIZATION OF APPROPRIATIONS.—Section 340E(f ) of the
Public Health Service Act (42 U.S.C. 256e(f )) is amended—
(1) in paragraph (1)(A)—

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PUBLIC LAW 106–310—OCT. 17, 2000

(A) in clause (i), by striking ‘‘and’’ at the end;
(B) in clause (ii), by striking the period and inserting
‘‘; and’’; and
(C) by adding at the end the following:
‘‘(iii) for each of the fiscal years 2002 through
2005, such sums as may be necessary.’’; and
(2) in paragraph (2)—
(A) in subparagraph (A), by striking ‘‘and’’ at the end;
(B) in subparagraph (B), by striking the period and
inserting ‘‘; and’’; and
(C) by adding at the end the following:
‘‘(C) for each of the fiscal years 2002 through 2005,
such sums as may be necessary.’’.
(g) DEFINITION OF CHILDREN’S HOSPITAL.—Section 340E(g)(2)
of the Public Health Service Act (42 U.S.C. 256e(g)(2)) is amended
by striking ‘‘described in’’ and all that follows and inserting the
following: ‘‘with a Medicare payment agreement and which is
excluded from the Medicare inpatient prospective payment system
pursuant to section 1886(d)(1)(B)(iii) of the Social Security Act
and its accompanying regulations.’’.

TITLE XXI—SPECIAL NEEDS OF CHILDREN REGARDING ORGAN TRANSPLANTATION
SEC. 2101. ORGAN PROCUREMENT AND TRANSPLANTATION NETWORK;
AMENDMENTS REGARDING NEEDS OF CHILDREN.

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(a) IN GENERAL.—Section 372(b)(2) of the Public Health Service
Act (42 U.S.C. 274(b)(2)) is amended—
(1) in subparagraph (J), by striking ‘‘and’’ at the end;
(2) in each of subparagraphs (K) and (L), by striking the
period and inserting a comma; and
(3) by adding at the end the following subparagraphs:
‘‘(M) recognize the differences in health and in organ
transplantation issues between children and adults
throughout the system and adopt criteria, polices, and
procedures that address the unique health care needs of
children,
‘‘(N) carry out studies and demonstration projects for
the purpose of improving procedures for organ donation
procurement and allocation, including but not limited to
projects to examine and attempt to increase transplantation
among populations with special needs, including children
and individuals who are members of racial or ethnic
minority groups, and among populations with limited
access to transportation, and
‘‘(O) provide that for purposes of this paragraph, the
term ‘children’ refers to individuals who are under the
age of 18.’’.
(b) STUDY REGARDING IMMUNOSUPPRESSIVE DRUGS.—
(1) IN GENERAL.—The Secretary of Health and Human
Services (referred to in this subsection as the ‘‘Secretary’’) shall
provide for a study to determine the costs of immunosuppressive
drugs that are provided to children pursuant to organ transplants and to determine the extent to which health plans and

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114 STAT. 1157

health insurance cover such costs. The Secretary may carry
out the study directly or through a grant to the Institute
of Medicine (or other public or nonprofit private entity).
(2) RECOMMENDATIONS REGARDING CERTAIN ISSUES.—The
Secretary shall ensure that, in addition to making determinations under paragraph (1), the study under such paragraph
makes recommendations regarding the following issues:
(A) The costs of immunosuppressive drugs that are
provided to children pursuant to organ transplants and
to determine the extent to which health plans, health insurance and government programs cover such costs.
(B) The extent of denial of organs to be released for
transplant by coroners and medical examiners.
(C) The special growth and developmental issues that
children have pre- and post-organ transplantation.
(D) Other issues that are particular to the special
health and transplantation needs of children.
(3) REPORT.—The Secretary shall ensure that, not later
than December 31, 2001, the study under paragraph (1) is
completed and a report describing the findings of the study
is submitted to the Congress.

Deadline.

TITLE XXII—MUSCULAR DYSTROPHY
RESEARCH
SEC. 2201. MUSCULAR DYSTROPHY RESEARCH.

Part B of title IV of the Public Health Service Act, as amended
by section 1901 of this Act, is amended by adding at the end
the following:
‘‘MUSCULAR

DYSTROPHY RESEARCH

‘‘SEC. 409F. (a) COORDINATION OF ACTIVITIES.—The Director
of NIH shall expand and increase coordination in the activities
of the National Institutes of Health with respect to research on
muscular dystrophies, including Duchenne muscular dystrophy.
‘‘(b) ADMINISTRATION OF PROGRAM; COLLABORATION AMONG
AGENCIES.—The Director of NIH shall carry out this section through
the appropriate institutes, including the National Institute of
Neurological Disorders and Stroke and in collaboration with any
other agencies that the Director determines appropriate.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated such sums as may be necessary to carry out
this section for each of the fiscal years 2001 through 2005. Amounts
appropriated under this subsection shall be in addition to any
other amounts appropriated for such purpose.’’.

42 USC 284j.

TITLE XXIII—CHILDREN AND
TOURETTE SYNDROME AWARENESS
SEC. 2301. GRANTS REGARDING TOURETTE SYNDROME.

Part A of title XI of the Public Health Service Act is amended
by adding at the end the following section:

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PUBLIC LAW 106–310—OCT. 17, 2000
‘‘TOURETTE

42 USC 300b–7.

SYNDROME

‘‘SEC. 1108. (a) IN GENERAL.—The Secretary shall develop and
implement outreach programs to educate the public, health care
providers, educators and community based organizations about the
etiology, symptoms, diagnosis and treatment of Tourette Syndrome,
with a particular emphasis on children with Tourette Syndrome.
Such programs may be carried out by the Secretary directly and
through awards of grants or contracts to public or nonprofit private
entities.
‘‘(b) CERTAIN ACTIVITIES.—Activities under subsection (a) shall
include—
‘‘(1) the production and translation of educational materials, including public service announcements;
‘‘(2) the development of training material for health care
providers, educators and community based organizations; and
‘‘(3) outreach efforts directed at the misdiagnosis and
underdiagnosis of Tourette Syndrome in children and in
minority groups.
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary for each of the fiscal years 2001
through 2005.’’.

TITLE XXIV—CHILDHOOD OBESITY
PREVENTION
SEC. 2401. PROGRAMS OPERATED THROUGH THE CENTERS FOR DISEASE CONTROL AND PREVENTION.

Title III of the Public Health Service Act (42 U.S.C. 241 et
seq.), as amended by section 1101 of this Act, is amended by
adding at the end the following part:

‘‘PART Q—PROGRAMS TO IMPROVE THE
HEALTH OF CHILDREN
42 USC 280h.

‘‘SEC. 399W. GRANTS TO PROMOTE CHILDHOOD NUTRITION AND PHYSICAL ACTIVITY.

‘‘(a) IN GENERAL.—The Secretary, acting though the Director
of the Centers for Disease Control and Prevention, shall award
competitive grants to States and political subdivisions of States
for the development and implementation of State and communitybased intervention programs to promote good nutrition and physical
activity in children and adolescents.
‘‘(b) ELIGIBILITY.—To be eligible to receive a grant under this
section a State or political subdivision of a State shall prepare
and submit to the Secretary an application at such time, in such
manner, and containing such information as the Secretary may
require, including a plan that describes—
‘‘(1) how the applicant proposes to develop a comprehensive
program of school- and community-based approaches to encourage and promote good nutrition and appropriate levels of physical activity with respect to children or adolescents in local
communities;

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114 STAT. 1159

‘‘(2) the manner in which the applicant shall coordinate
with appropriate State and local authorities, such as State
and local school departments, State departments of health,
chronic disease directors, State directors of programs under
section 17 of the Child Nutrition Act of 1966, 5-a-day coordinators, governors councils for physical activity and good nutrition,
and State and local parks and recreation departments; and
‘‘(3) the manner in which the applicant will evaluate the
effectiveness of the program carried out under this section.
‘‘(c) USE OF FUNDS.—A State or political subdivision of a State
shall use amount received under a grant under this section to—
‘‘(1) develop, implement, disseminate, and evaluate schooland community-based strategies in States to reduce inactivity
and improve dietary choices among children and adolescents;
‘‘(2) expand opportunities for physical activity programs
in school- and community-based settings; and
‘‘(3) develop, implement, and evaluate programs that promote good eating habits and physical activity including
opportunities for children with cognitive and physical disabilities.
‘‘(d) TECHNICAL ASSISTANCE.—The Secretary may set-aside an
amount not to exceed 10 percent of the amount appropriated for
a fiscal year under subsection (h) to permit the Director of the
Centers for Disease Control and Prevention to—
‘‘(1) provide States and political subdivisions of States with
technical support in the development and implementation of
programs under this section; and
‘‘(2) disseminate information about effective strategies and
interventions in preventing and treating obesity through the
promotion of good nutrition and physical activity.
‘‘(e) LIMITATION ON ADMINISTRATIVE COSTS.—Not to exceed 10
percent of the amount of a grant awarded to the State or political
subdivision under subsection (a) for a fiscal year may be used
by the State or political subdivision for administrative expenses.
‘‘(f ) TERM.—A grant awarded under subsection (a) shall be
for a term of 3 years.
‘‘(g) DEFINITION.—In this section, the term ‘children and adolescents’ means individuals who do not exceed 18 years of age.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
‘‘SEC. 399X. APPLIED RESEARCH PROGRAM.

42 USC 280h–1.

‘‘(a) IN GENERAL.—The Secretary, acting through the Centers
for Disease Control and Prevention and in consultation with the
Director of the National Institutes of Health, shall—
‘‘(1) conduct research to better understand the relationship
between physical activity, diet, and health and factors that
influence health-related behaviors;
‘‘(2) develop and evaluate strategies for the prevention and
treatment of obesity to be used in community-based interventions and by health professionals;
‘‘(3) develop and evaluate strategies for the prevention and
treatment of eating disorders, such as anorexia and bulimia;
‘‘(4) conduct research to establish the prevalence, consequences, and costs of childhood obesity and its effects in
adulthood;

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‘‘(5) identify behaviors and risk factors that contribute to
obesity;
‘‘(6) evaluate materials and programs to provide nutrition
education to parents and teachers of children in child care
or pre-school and the food service staff of such child care
and pre-school entities; and
‘‘(7) evaluate materials and programs that are designed
to educate and encourage physical activity in child care and
pre-school facilities.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
42 USC 280h–2.

‘‘SEC. 399Y. EDUCATION CAMPAIGN.

‘‘(a) IN GENERAL.—The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, and in collaboration with national, State, and local partners, physical activity
organizations, nutrition experts, and health professional organizations, shall develop a national public campaign to promote and
educate children and their parents concerning—
‘‘(1) the health risks associated with obesity, inactivity,
and poor nutrition;
‘‘(2) ways in which to incorporate physical activity into
daily living; and
‘‘(3) the benefits of good nutrition and strategies to improve
eating habits.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
42 USC 280h–3.

‘‘SEC. 399Z. HEALTH PROFESSIONAL EDUCATION AND TRAINING.

‘‘(a) IN GENERAL.—The Secretary, acting through the Director
of the Centers for Disease Control and Prevention, in collaboration
with the Administrator of the Health Resources and Services
Administration and the heads of other agencies, and in consultation
with appropriate health professional associations, shall develop and
carry out a program to educate and train health professionals
in effective strategies to—
‘‘(1) better identify and assess patients with obesity or
an eating disorder or patients at-risk of becoming obese or
developing an eating disorder;
‘‘(2) counsel, refer, or treat patients with obesity or an
eating disorder; and
‘‘(3) educate patients and their families about effective
strategies to improve dietary habits and establish appropriate
levels of physical activity.
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.’’.

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114 STAT. 1161

TITLE XXV—EARLY DETECTION AND
TREATMENT REGARDING CHILDHOOD
LEAD POISONING
SEC. 2501. CENTERS FOR DISEASE CONTROL AND PREVENTION
EFFORTS TO COMBAT CHILDHOOD LEAD POISONING.

(a) REQUIREMENTS FOR LEAD POISONING PREVENTION
GRANTEES.—Section 317A of the Public Health Service Act (42
U.S.C. 247b–1) is amended—
(1) in subsection (d)—
(A) by redesignating paragraph (7) as paragraph (8);
and
(B) by inserting after paragraph (6) the following:
‘‘(7) Assurances satisfactory to the Secretary that the
applicant will ensure complete and consistent reporting of all
blood lead test results from laboratories and health care providers to State and local health departments in accordance
with guidelines of the Centers for Disease Control and Prevention for standardized reporting as described in subsection (m).’’;
and
(2) in subsection ( j)(2)—
(A) in subparagraph (F) by striking ‘‘(E)’’ and inserting
‘‘(F)’’;
(B) by redesignating subparagraph (F) as subparagraph
(G); and
(C) by inserting after subparagraph (E) the following:
‘‘(F) The number of grantees that have established
systems to ensure mandatory reporting of all blood lead
tests from laboratories and health care providers to State
and local health departments.’’.
(b) GUIDELINES FOR STANDARDIZED REPORTING.—Section 317A
of the Public Health Service Act (42 U.S.C. 247b–1) is amended
by adding at the end the following:
‘‘(m) GUIDELINES FOR STANDARDIZED REPORTING.—The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall develop national guidelines for the uniform reporting of all blood lead test results to State and local
health departments.’’.
(c) DEVELOPMENT AND IMPLEMENTATION OF EFFECTIVE DATA
MANAGEMENT BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION.—
(1) IN GENERAL.—The Director of the Centers for Disease
Control and Prevention shall—
(A) assist with the improvement of data linkages
between State and local health departments and between
State health departments and the Centers for Disease Control and Prevention;
(B) assist States with the development of flexible, comprehensive State-based data management systems for the
surveillance of children with lead poisoning that have the
capacity to contribute to a national data set;
(C) assist with the improvement of the ability of Statebased data management systems and federally-funded
means-tested public benefit programs (including the special
supplemental food program for women, infants and children

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114 STAT. 1162

PUBLIC LAW 106–310—OCT. 17, 2000
(WIC) under section 17 of the Child Nutrition Act of 1966
(42 U.S.C. 1786) and the early head start program under
section 645A of the Head Start Act (42 U.S.C. 9840a(h))
to respond to ad hoc inquiries and generate progress reports
regarding the lead blood level screening of children enrolled
in those programs;
(D) assist States with the establishment of a capacity
for assessing how many children enrolled in the Medicaid,
WIC, early head start, and other federally-funded meanstested public benefit programs are being screened for lead
poisoning at age-appropriate intervals;
(E) use data obtained as result of activities under
this section to formulate or revise existing lead blood
screening and case management policies; and
(F) establish performance measures for evaluating
State and local implementation of the requirements and
improvements described in subparagraphs (A) through (E).
(2) AUTHORIZATION OF APPROPRIATIONS.—There are authorized to be appropriated to carry out this subsection such sums
as may be necessary for each the fiscal years 2001 through
2005.
(3) EFFECTIVE DATE.—This subsection takes effect on the
date of the enactment of this Act.

SEC. 2502. GRANTS FOR LEAD POISONING RELATED ACTIVITIES.

(a) IN GENERAL.—Part B of title III of the Public Health Service
Act (42 U.S.C. 243 et seq.), as amended by section 1801 of this
Act, is amended by inserting after section 317N the following section:
‘‘GRANTS
42 USC 247b–16.

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FOR LEAD POISONING RELATED ACTIVITIES

‘‘SEC. 317O. (a) AUTHORITY TO MAKE GRANTS.—
‘‘(1) IN GENERAL.—The Secretary shall make grants to
States to support public health activities in States and localities
where data suggests that at least 5 percent of preschool-age
children have an elevated blood lead level through—
‘‘(A) effective, ongoing outreach and community education targeted to families most likely to be at risk for
lead poisoning;
‘‘(B) individual family education activities that are
designed to reduce ongoing exposures to lead for children
with elevated blood lead levels, including through home
visits and coordination with other programs designed to
identify and treat children at risk for lead poisoning; and
‘‘(C) the development, coordination and implementation
of community-based approaches for comprehensive lead poisoning prevention from surveillance to lead hazard control.
‘‘(2) STATE MATCH.—A State is not eligible for a grant
under this section unless the State agrees to expend (through
State or local funds) $1 for every $2 provided under the grant
to carry out the activities described in paragraph (1).
‘‘(3) APPLICATION.—To be eligible to receive a grant under
this section, a State shall submit an application to the Secretary
in such form and manner and containing such information
as the Secretary may require.
‘‘(b) COORDINATION WITH OTHER CHILDREN’S PROGRAMS.—A
State shall identify in the application for a grant under this section

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114 STAT. 1163

how the State will coordinate operations and activities under the
grant with—
‘‘(1) other programs operated in the State that serve children with elevated blood lead levels, including any such programs operated under title V, XIX, or XXI of the Social Security
Act; and
‘‘(2) one or more of the following—
‘‘(A) the child welfare and foster care and adoption
assistance programs under parts B and E of title IV of
such Act;
‘‘(B) the head start program established under the
Head Start Act (42 U.S.C. 9831 et seq.);
‘‘(C) the program of assistance under the special supplemental nutrition program for women, infants and children
(WIC) under section 17 of the Child Nutrition Act of 1966
(42 U.S.C. 1786);
‘‘(D) local public and private elementary or secondary
schools; or
‘‘(E) public housing agencies, as defined in section 3
of the United States Housing Act of 1937 (42 U.S.C. 1437a).
‘‘(c) PERFORMANCE MEASURES.—The Secretary shall establish
needs indicators and performance measures to evaluate the activities carried out under grants awarded under this section. Such
indicators shall be commensurate with national measures of
maternal and child health programs and shall be developed in
consultation with the Director of the Centers for Disease Control
and Prevention.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.’’.
(b) CONFORMING AMENDMENT.—Section 340D(c)(1) of the Public
Health Service Act (42 U.S.C. 256d(c)(1)) is amended by striking
‘‘317E’’ and inserting ‘‘317F’’.
SEC. 2503. TRAINING AND REPORTS BY THE HEALTH RESOURCES AND
SERVICES ADMINISTRATION.

42 USC 247b–3a.

(a) TRAINING.—The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and
Services Administration and in collaboration with the Administrator
of the Health Care Financing Administration and the Director
of the Centers for Disease Control and Prevention, shall conduct
education and training programs for physicians and other health
care providers regarding childhood lead poisoning, current screening
and treatment recommendations and requirements, and the scientific, medical, and public health basis for those policies.
(b) REPORT.—The Secretary of Health and Human Services,
acting through the Administrator of the Health Resources and
Services Administration, annually shall report to Congress on the
number of children who received services through health centers
established under section 330 of the Public Health Service Act
(42 U.S.C. 254b) and received a blood lead screening test during
the prior fiscal year, noting the percentage that such children
represent as compared to all children who received services through
such health centers.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each the fiscal years 2001 through 2005.

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114 STAT. 1164

PUBLIC LAW 106–310—OCT. 17, 2000

SEC. 2504. SCREENINGS, REFERRALS, AND EDUCATION REGARDING
LEAD POISONING.

Section 317A(l)(1) of the Public Health Service Act (42 U.S.C.
247b–1(l)(1)) is amended by striking ‘‘1994’’ and all that follows
and inserting ‘‘1994 through 2005.’’.

TITLE XXVI—SCREENING FOR
HERITABLE DISORDERS
SEC. 2601. PROGRAM TO IMPROVE THE ABILITY OF STATES TO PROVIDE NEWBORN AND CHILD SCREENING FOR HERITABLE
DISORDERS.

Part A of title XI of the Public Health Service Act, as amended
by section 2301 of this Act, is amended by adding at the end
the following:
42 USC 300b–8.

‘‘SEC. 1109. IMPROVED NEWBORN AND CHILD SCREENING FOR HERITABLE DISORDERS.

Grants.

‘‘(a) IN GENERAL.—The Secretary shall award grants to eligible
entities to enhance, improve or expand the ability of State and
local public health agencies to provide screening, counseling or
health care services to newborns and children having or at risk
for heritable disorders.
‘‘(b) USE OF FUNDS.—Amounts provided under a grant awarded
under subsection (a) shall be used to—
‘‘(1) establish, expand, or improve systems or programs
to provide screening, counseling, testing or specialty services
for newborns and children at risk for heritable disorders;
‘‘(2) establish, expand, or improve programs or services
to reduce mortality or morbidity from heritable disorders;
‘‘(3) establish, expand, or improve systems or programs
to provide information and counseling on available therapies
for newborns and children with heritable disorders;
‘‘(4) improve the access of medically underserved populations to screening, counseling, testing and specialty services
for newborns and children having or at risk for heritable disorders; or
‘‘(5) conduct such other activities as may be necessary
to enable newborns and children having or at risk for heritable
disorders to receive screening, counseling, testing or specialty
services, regardless of income, race, color, religion, sex, national
origin, age, or disability.
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a grant under
subsection (a) an entity shall—
‘‘(1) be a State or political subdivision of a State, or a
consortium of two or more States or political subdivisions of
States; and
‘‘(2) prepare and submit to the Secretary an application
that includes—
‘‘(A) a plan to use amounts awarded under the grant
to meet specific health status goals and objectives relative
to heritable disorders, including attention to needs of medically underserved populations;
‘‘(B) a plan for the collection of outcome data or other
methods of evaluating the degree to which amounts

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114 STAT. 1165

awarded under this grant will be used to achieve the goals
and objectives identified under subparagraph (A);
‘‘(C) a plan for monitoring and ensuring the quality
of services provided under the grant;
‘‘(D) an assurance that amounts awarded under the
grant will be used only to implement the approved plan
for the State;
‘‘(E) an assurance that the provision of services under
the plan is coordinated with services provided under programs implemented in the State under title V, XVIII, XIX,
XX, or XXI of the Social Security Act (subject to Federal
regulations applicable to such programs) so that the coverage of services under such titles is not substantially
diminished by the use of granted funds; and
‘‘(F) such other information determined by the Secretary to be necessary.
‘‘(d) LIMITATION.—An eligible entity may not use amounts
received under this section to—
‘‘(1) provide cash payments to or on behalf of affected
individuals;
‘‘(2) provide inpatient services;
‘‘(3) purchase land or make capital improvements to property; or
‘‘(4) provide for proprietary research or training.
‘‘(e) VOLUNTARY PARTICIPATION.—The participation by any individual in any program or portion thereof established or operated
with funds received under this section shall be wholly voluntary
and shall not be a prerequisite to eligibility for or receipt of any
other service or assistance from, or to participation in, another
Federal or State program.
‘‘(f ) SUPPLEMENT NOT SUPPLANT.—Funds appropriated under
this section shall be used to supplement and not supplant other
Federal, State, and local public funds provided for activities of
the type described in this section.
‘‘(g) PUBLICATION.—
‘‘(1) IN GENERAL.—An application submitted under subsection (c)(2) shall be made public by the State in such a
manner as to facilitate comment from any person, including
through hearings and other methods used to facilitate comments from the public.
‘‘(2) COMMENTS.—Comments received by the State after
the publication described in paragraph (1) shall be addressed
in the application submitted under subsection (c)(2).
‘‘(h) TECHNICAL ASSISTANCE.—The Secretary shall provide to
entities receiving grants under subsection (a) such technical assistance as may be necessary to ensure the quality of programs conducted under this section.
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2005.
‘‘SEC. 1110. EVALUATING THE EFFECTIVENESS OF NEWBORN AND
CHILD SCREENING PROGRAMS.

42 USC 300b–9.

‘‘(a) IN GENERAL.—The Secretary shall award grants to eligible
entities to provide for the conduct of demonstration programs to
evaluate the effectiveness of screening, counseling or health care

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PUBLIC LAW 106–310—OCT. 17, 2000

services in reducing the morbidity and mortality caused by heritable
disorders in newborns and children.
‘‘(b) DEMONSTRATION PROGRAMS.—A demonstration program
conducted under a grant under this section shall be designed to
evaluate and assess, within the jurisdiction of the entity receiving
such grant—
‘‘(1) the effectiveness of screening, counseling, testing or
specialty services for newborns and children at risk for heritable
disorders in reducing the morbidity and mortality associated
with such disorders;
‘‘(2) the effectiveness of screening, counseling, testing or
specialty services in accurately and reliably diagnosing heritable disorders in newborns and children; or
‘‘(3) the availability of screening, counseling, testing or
specialty services for newborns and children at risk for heritable
disorders.
‘‘(c) ELIGIBLE ENTITIES.—To be eligible to receive a grant under
subsection (a) an entity shall be a State or political subdivision
of a State, or a consortium of two or more States or political
subdivisions of States.
42 USC 300b–10.

‘‘SEC. 1111. ADVISORY COMMITTEE ON HERITABLE DISORDERS IN
NEWBORNS AND CHILDREN.

‘‘(a) ESTABLISHMENT.—The Secretary shall establish an advisory
committee to be known as the ‘Advisory Committee on Heritable
Disorders in Newborns and Children’ (referred to in this section
as the ‘Advisory Committee’).
‘‘(b) DUTIES.—The Advisory Committee shall—
‘‘(1) provide advice and recommendations to the Secretary
concerning grants and projects awarded or funded under section
1109;
‘‘(2) provide technical information to the Secretary for the
development of policies and priorities for the administration
of grants under section 1109; and
‘‘(3) provide such recommendations, advice or information
as may be necessary to enhance, expand or improve the ability
of the Secretary to reduce the mortality or morbidity from
heritable disorders.
‘‘(c) MEMBERSHIP.—
‘‘(1) IN GENERAL.—The Secretary shall appoint not to exceed
15 members to the Advisory Committee. In appointing such
members, the Secretary shall ensure that the total membership
of the Advisory Committee is an odd number.
‘‘(2) REQUIRED MEMBERS.—The Secretary shall appoint to
the Advisory Committee under paragraph (1)—
‘‘(A) the Administrator of the Health Resources and
Services Administration;
‘‘(B) the Director of the Centers for Disease Control
and Prevention;
‘‘(C) the Director of the National Institutes of Health;
‘‘(D) the Director of the Agency for Healthcare Research
and Quality;
‘‘(E) medical, technical, or scientific professionals with
special expertise in heritable disorders, or in providing
screening, counseling, testing or specialty services for
newborns and children at risk for heritable disorders;

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114 STAT. 1167

‘‘(F) members of the public having special expertise
about or concern with heritable disorders; and
‘‘(G) representatives from such Federal agencies, public
health constituencies, and medical professional societies
as determined to be necessary by the Secretary, to fulfill
the duties of the Advisory Committee, as established under
subsection (b).’’.

TITLE XXVII—PEDIATRIC RESEARCH
PROTECTIONS
SEC. 2701. REQUIREMENT FOR ADDITIONAL PROTECTIONS FOR CHILDREN INVOLVED IN RESEARCH.

42 USC 289 note.

Notwithstanding any other provision of law, not later than
6 months after the date of the enactment of this Act, the Secretary
of Health and Human Services shall require that all research
involving children that is conducted, supported, or regulated by
the Department of Health and Human Services be in compliance
with subpart D of part 46 of title 45, Code of Federal Regulations.

TITLE XXVIII—MISCELLANEOUS
PROVISIONS
SEC. 2801. REPORT REGARDING RESEARCH ON RARE DISEASES IN
CHILDREN.

Deadline.

Not later than 180 days after the date of the enactment of
this Act, the Director of the National Institutes of Health shall
submit to the Congress a report on—
(1) the activities that, during fiscal year 2000, were conducted and supported by such Institutes with respect to rare
diseases in children, including Friedreich’s ataxia and
Hutchinson-Gilford progeria syndrome; and
(2) the activities that are planned to be conducted and
supported by such Institutes with respect to such diseases
during the fiscal years 2001 through 2005.
SEC. 2802. STUDY ON METABOLIC DISORDERS.

(a) IN GENERAL.—The Secretary of Health and Human Services
(in this section referred to as the ‘‘Secretary’’) shall, in consultation
with relevant experts or through the Institute of Medicine, study
issues related to treatment of PKU and other metabolic disorders
for children, adolescents, and adults, and mechanisms to assure
access to effective treatment, including special diets, for children
and others with PKU and other metabolic disorders. Such mechanisms shall be evidence-based and reflect the best scientific knowledge regarding effective treatment and prevention of disease
progression.
(b) DISSEMINATION OF RESULTS.—Upon completion of the study
referred to in subsection (a), the Secretary shall disseminate and
otherwise make available the results of the study to interested
groups and organizations, including insurance commissioners,
employers, private insurers, health care professionals, State and
local public health agencies, and State agencies that carry out
the Medicaid program under title XIX of the Social Security Act

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114 STAT. 1168

PUBLIC LAW 106–310—OCT. 17, 2000

or the State children’s health insurance program under title XXI
of such Act.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section such sums as may
be necessary for each of the fiscal years 2001 through 2003.

TITLE XXIX—EFFECTIVE DATE
42 USC 201 note.

SEC. 2901. EFFECTIVE DATE.

This division and the amendments made by this division take
effect October 1, 2000, or upon the date of the enactment of this
Act, whichever occurs later.

DIVISION B—YOUTH DRUG AND
MENTAL HEALTH SERVICES

Youth Drug and
Mental Health
Services Act.
42 USC 201 note.

SEC. 3001. SHORT TITLE.

This division may be cited as the ‘‘Youth Drug and Mental
Health Services Act’’.

TITLE XXXI—PROVISIONS RELATING TO
SERVICES FOR CHILDREN AND ADOLESCENTS
SEC. 3101. CHILDREN AND VIOLENCE.

Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by adding at the end the following:
‘‘PART G—PROJECTS

FOR

CHILDREN

AND

VIOLENCE

42 USC 290hh.

‘‘SEC. 581. CHILDREN AND VIOLENCE.

Grants.
Contracts.

‘‘(a) IN GENERAL.—The Secretary, in consultation with the Secretary of Education and the Attorney General, shall carry out
directly or through grants, contracts or cooperative agreements
with public entities a program to assist local communities in developing ways to assist children in dealing with violence.
‘‘(b) ACTIVITIES.—Under the program under subsection (a), the
Secretary may—
‘‘(1) provide financial support to enable local communities
to implement programs to foster the health and development
of children;
‘‘(2) provide technical assistance to local communities with
respect to the development of programs described in paragraph
(1);
‘‘(3) provide assistance to local communities in the development of policies to address violence when and if it occurs;
‘‘(4) assist in the creation of community partnerships among
law enforcement, education systems and mental health and
substance abuse service systems; and
‘‘(5) establish mechanisms for children and adolescents to
report incidents of violence or plans by other children or adolescents to commit violence.

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114 STAT. 1169

‘‘(c) REQUIREMENTS.—An application for a grant, contract or
cooperative agreement under subsection (a) shall demonstrate
that—
‘‘(1) the applicant will use amounts received to create a
partnership described in subsection (b)(4) to address issues
of violence in schools;
‘‘(2) the activities carried out by the applicant will provide
a comprehensive method for addressing violence, that will
include—
‘‘(A) security;
‘‘(B) educational reform;
‘‘(C) the review and updating of school policies;
‘‘(D) alcohol and drug abuse prevention and early intervention services;
‘‘(E) mental health prevention and treatment services;
and
‘‘(F) early childhood development and psychosocial
services; and
‘‘(3) the applicant will use amounts received only for the
services described in subparagraphs (D), (E), and (F) of paragraph (2).
‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary shall ensure
that grants, contracts or cooperative agreements under subsection
(a) will be distributed equitably among the regions of the country
and among urban and rural areas.
‘‘(e) DURATION OF AWARDS.—With respect to a grant, contract
or cooperative agreement under subsection (a), the period during
which payments under such an award will be made to the recipient
may not exceed 5 years.
‘‘(f ) EVALUATION.—The Secretary shall conduct an evaluation
of each project carried out under this section and shall disseminate
the results of such evaluations to appropriate public and private
entities.
‘‘(g) INFORMATION AND EDUCATION.—The Secretary shall establish comprehensive information and education programs to disseminate the findings of the knowledge development and application
under this section to the general public and to health care professionals.
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section, $100,000,000 for fiscal
year 2001, and such sums as may be necessary for each of fiscal
years 2002 and 2003.
‘‘SEC. 582. GRANTS TO ADDRESS THE PROBLEMS OF PERSONS WHO
EXPERIENCE VIOLENCE RELATED STRESS.

42 USC 290hh–1.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts
or cooperative agreements to public and nonprofit private entities,
as well as to Indian tribes and tribal organizations, for the purpose
of developing programs focusing on the behavioral and biological
aspects of psychological trauma response and for developing knowledge with regard to evidence-based practices for treating psychiatric
disorders of children and youth resulting from witnessing or experiencing a traumatic event.
‘‘(b) PRIORITIES.—In awarding grants, contracts or cooperative
agreements under subsection (a) related to the development of
knowledge on evidence-based practices for treating disorders associated with psychological trauma, the Secretary shall give priority

Contracts.

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PUBLIC LAW 106–310—OCT. 17, 2000

to mental health agencies and programs that have established
clinical and basic research experience in the field of trauma-related
mental disorders.
‘‘(c) GEOGRAPHICAL DISTRIBUTION.—The Secretary shall ensure
that grants, contracts or cooperative agreements under subsection
(a) with respect to centers of excellence are distributed equitably
among the regions of the country and among urban and rural
areas.
‘‘(d) EVALUATION.—The Secretary, as part of the application
process, shall require that each applicant for a grant, contract
or cooperative agreement under subsection (a) submit a plan for
the rigorous evaluation of the activities funded under the grant,
contract or agreement, including both process and outcomes evaluation, and the submission of an evaluation at the end of the project
period.
‘‘(e) DURATION OF AWARDS.—With respect to a grant, contract
or cooperative agreement under subsection (a), the period during
which payments under such an award will be made to the recipient
may not exceed 5 years. Such grants, contracts or agreements
may be renewed.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section, $50,000,000 for fiscal
year 2001, and such sums as may be necessary for each of fiscal
years 2002 and 2003.’’.
SEC. 3102. EMERGENCY RESPONSE.

Federal Register,
publication.

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Section 501 of the Public Health Service Act (42 U.S.C. 290aa)
is amended—
(1) by redesignating subsection (m) as subsection (o);
(2) by inserting after subsection (l) the following:
‘‘(m) EMERGENCY RESPONSE.—
‘‘(1) IN GENERAL.—Notwithstanding section 504 and except
as provided in paragraph (2), the Secretary may use not to
exceed 2.5 percent of all amounts appropriated under this title
for a fiscal year to make noncompetitive grants, contracts or
cooperative agreements to public entities to enable such entities
to address emergency substance abuse or mental health needs
in local communities.
‘‘(2) EXCEPTIONS.—Amounts appropriated under part C
shall not be subject to paragraph (1).
‘‘(3) EMERGENCIES.—The Secretary shall establish criteria
for determining that a substance abuse or mental health emergency exists and publish such criteria in the Federal Register
prior to providing funds under this subsection.
‘‘(n) LIMITATION ON THE USE OF CERTAIN INFORMATION.—No
information, if an establishment or person supplying the information or described in it is identifiable, obtained in the course of
activities undertaken or supported under section 505 may be used
for any purpose other than the purpose for which it was supplied
unless such establishment or person has consented (as determined
under regulations of the Secretary) to its use for such other purpose.
Such information may not be published or released in other form
if the person who supplied the information or who is described
in it is identifiable unless such person has consented (as determined
under regulations of the Secretary) to its publication or release
in other form.’’; and

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114 STAT. 1171

(3) in subsection (o) (as so redesignated), by striking ‘‘1993’’
and all that follows through the period and inserting ‘‘2001,
and such sums as may be necessary for each of the fiscal
years 2002 and 2003.’’.
SEC. 3103. HIGH RISK YOUTH REAUTHORIZATION.

Section 517(h) of the Public Health Service Act (42 U.S.C.
290bb–23(h)) is amended by striking ‘‘$70,000,000’’ and all that
follows through ‘‘1994’’ and inserting ‘‘such sums as may be necessary for each of the fiscal years 2001 through 2003’’.
SEC. 3104. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN
AND ADOLESCENTS.

(a) SUBSTANCE ABUSE TREATMENT SERVICES.—Subpart 1 of part
B of title V of the Public Health Service Act (42 U.S.C. 290bb
et seq.) is amended by adding at the end the following:
‘‘SEC. 514. SUBSTANCE ABUSE TREATMENT SERVICES FOR CHILDREN
AND ADOLESCENTS.

42 USC 290bb–7.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to public and private nonprofit entities,
including Native Alaskan entities and Indian tribes and tribal
organizations, for the purpose of providing substance abuse treatment services for children and adolescents.
‘‘(b) PRIORITY.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants who propose to—
‘‘(1) apply evidenced-based and cost effective methods for
the treatment of substance abuse among children and adolescents;
‘‘(2) coordinate the provision of treatment services with
other social service agencies in the community, including educational, juvenile justice, child welfare, and mental health agencies;
‘‘(3) provide a continuum of integrated treatment services,
including case management, for children and adolescents with
substance abuse disorders and their families;
‘‘(4) provide treatment that is gender-specific and culturally
appropriate;
‘‘(5) involve and work with families of children and adolescents receiving treatment;
‘‘(6) provide aftercare services for children and adolescents
and their families after completion of substance abuse treatment; and
‘‘(7) address the relationship between substance abuse and
violence.
‘‘(c) DURATION OF GRANTS.—The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for periods
not to exceed 5 fiscal years.
‘‘(d) APPLICATION.—An entity desiring a grant, contract, or
cooperative agreement under subsection (a) shall submit an application to the Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
‘‘(e) EVALUATION.—An entity that receives a grant, contract,
or cooperative agreement under subsection (a) shall submit, in
the application for such grant, contract, or cooperative agreement,
a plan for the evaluation of any project undertaken with funds
provided under this section. Such entity shall provide the Secretary

Grants.
Contracts.

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114 STAT. 1172

PUBLIC LAW 106–310—OCT. 17, 2000

with periodic evaluations of the progress of such project and such
evaluation at the completion of such project as the Secretary determines to be appropriate.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section, $40,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 and 2003.
42 USC 290bb–8.

‘‘SEC. 514A. EARLY INTERVENTION SERVICES FOR CHILDREN AND
ADOLESCENTS.

Grants.
Contracts.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to public and private nonprofit entities,
including local educational agencies (as defined in section 14101
of the Elementary and Secondary Education Act of 1965 (20 U.S.C.
8801)), for the purpose of providing early intervention substance
abuse services for children and adolescents.
‘‘(b) PRIORITY.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants who demonstrate an ability to—
‘‘(1) screen for and assess substance use and abuse by
children and adolescents;
‘‘(2) make appropriate referrals for children and adolescents
who are in need of treatment for substance abuse;
‘‘(3) provide early intervention services, including counseling and ancillary services, that are designed to meet the
developmental needs of children and adolescents who are at
risk for substance abuse; and
‘‘(4) develop networks with the educational, juvenile justice,
social services, and other agencies and organizations in the
State or local community involved that will work to identify
children and adolescents who are in need of substance abuse
treatment services.
‘‘(c) CONDITION.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall ensure that
such grants, contracts, or cooperative agreements are allocated,
subject to the availability of qualified applicants, among the principal geographic regions of the United States, to Indian tribes
and tribal organizations, and to urban and rural areas.
‘‘(d) DURATION OF GRANTS.—The Secretary shall award grants,
contracts, or cooperative agreements under subsection (a) for periods
not to exceed 5 fiscal years.
‘‘(e) APPLICATION.—An entity desiring a grant, contract, or
cooperative agreement under subsection (a) shall submit an application to the Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
‘‘(f ) EVALUATION.—An entity that receives a grant, contract,
or cooperative agreement under subsection (a) shall submit, in
the application for such grant, contract, or cooperative agreement,
a plan for the evaluation of any project undertaken with funds
provided under this section. Such entity shall provide the Secretary
with periodic evaluations of the progress of such project and such
evaluation at the completion of such project as the Secretary determines to be appropriate.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section, $20,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 and 2003.’’.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1173

(b) YOUTH INTERAGENCY CENTERS.—Subpart 3 of part B of
title V of the Public Health Service Act (42 U.S.C. 290bb–31 et
seq.) is amended by adding the following:
‘‘SEC. 520C. YOUTH INTERAGENCY RESEARCH, TRAINING, AND TECHNICAL ASSISTANCE CENTERS.

42 USC 290bb–
34.

‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting through the
Administrator of the Substance Abuse and Mental Health Services
Administration, and in consultation with the Administrator of the
Office of Juvenile Justice and Delinquency Prevention, the Director
of the Bureau of Justice Assistance and the Director of the National
Institutes of Health, shall award grants or contracts to public
or nonprofit private entities to establish not more than four
research, training, and technical assistance centers to carry out
the activities described in subsection (c).
‘‘(b) APPLICATION.—A public or private nonprofit entity desiring
a grant or contract under subsection (a) shall prepare and submit
an application to the Secretary at such time, in such manner,
and containing such information as the Secretary may require.
‘‘(c) AUTHORIZED ACTIVITIES.—A center established under a
grant or contract under subsection (a) shall—
‘‘(1) provide training with respect to state-of-the-art mental
health and justice-related services and successful mental health
and substance abuse-justice collaborations that focus on children and adolescents, to public policymakers, law enforcement
administrators, public defenders, police, probation officers,
judges, parole officials, jail administrators and mental health
and substance abuse providers and administrators;
‘‘(2) engage in research and evaluations concerning State
and local justice and mental health systems, including system
redesign initiatives, and disseminate information concerning
the results of such evaluations;
‘‘(3) provide direct technical assistance, including assistance
provided through toll-free telephone numbers, concerning issues
such as how to accommodate individuals who are being processed through the courts under the Americans with Disabilities
Act of 1990 (42 U.S.C. 12101 et seq.), what types of mental
health or substance abuse service approaches are effective
within the judicial system, and how community-based mental
health or substance abuse services can be more effective,
including relevant regional, ethnic, and gender-related considerations; and
‘‘(4) provide information, training, and technical assistance
to State and local governmental officials to enhance the capacity
of such officials to provide appropriate services relating to
mental health or substance abuse.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there is authorized to be appropriated
$4,000,000 for fiscal year 2001, and such sums as may be necessary
for fiscal years 2002 and 2003.’’.
(c) PREVENTION OF ABUSE AND ADDICTION.—Subpart 2 of part
B of title V of the Public Health Service Act (42 U.S.C. 290bb–
21 et seq.) is amended by adding the following:

Grants.
Contracts.

‘‘SEC. 519E. PREVENTION OF METHAMPHETAMINE AND INHALANT
ABUSE AND ADDICTION.

42 USC 290bb–
25e.

‘‘(a) GRANTS.—The Director of the Center for Substance Abuse
Prevention (referred to in this section as the ‘Director’) may make

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114 STAT. 1174

PUBLIC LAW 106–310—OCT. 17, 2000

grants to and enter into contracts and cooperative agreements with
public and nonprofit private entities to enable such entities—
‘‘(1) to carry out school-based programs concerning the dangers of methamphetamine or inhalant abuse and addiction,
using methods that are effective and evidence-based, including
initiatives that give students the responsibility to create their
own anti-drug abuse education programs for their schools; and
‘‘(2) to carry out community-based methamphetamine or
inhalant abuse and addiction prevention programs that are
effective and evidence-based.
‘‘(b) USE OF FUNDS.—Amounts made available under a grant,
contract or cooperative agreement under subsection (a) shall be
used for planning, establishing, or administering methamphetamine
or inhalant prevention programs in accordance with subsection
(c).
‘‘(c) PREVENTION PROGRAMS AND ACTIVITIES.—
‘‘(1) IN GENERAL.—Amounts provided under this section
may be used—
‘‘(A) to carry out school-based programs that are
focused on those districts with high or increasing rates
of methamphetamine or inhalant abuse and addiction and
targeted at populations which are most at risk to start
methamphetamine or inhalant abuse;
‘‘(B) to carry out community-based prevention programs that are focused on those populations within the
community that are most at-risk for methamphetamine
or inhalant abuse and addiction;
‘‘(C) to assist local government entities to conduct
appropriate methamphetamine or inhalant prevention
activities;
‘‘(D) to train and educate State and local law enforcement officials, prevention and education officials, members
of community anti-drug coalitions and parents on the signs
of methamphetamine or inhalant abuse and addiction and
the options for treatment and prevention;
‘‘(E) for planning, administration, and educational
activities related to the prevention of methamphetamine
or inhalant abuse and addiction;
‘‘(F) for the monitoring and evaluation of methamphetamine or inhalant prevention activities, and reporting and
disseminating resulting information to the public; and
‘‘(G) for targeted pilot programs with evaluation components to encourage innovation and experimentation with
new methodologies.
‘‘(2) PRIORITY.—The Director shall give priority in making
grants under this section to rural and urban areas that are
experiencing a high rate or rapid increases in methamphetamine or inhalant abuse and addiction.
‘‘(d) ANALYSES AND EVALUATION.—
‘‘(1) IN GENERAL.—Up to $500,000 of the amount available
in each fiscal year to carry out this section shall be made
available to the Director, acting in consultation with other
Federal agencies, to support and conduct periodic analyses
and evaluations of effective prevention programs for methamphetamine or inhalant abuse and addiction and the development of appropriate strategies for disseminating information
about and implementing these programs.

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114 STAT. 1175

‘‘(2) ANNUAL REPORTS.—The Director shall submit to the
Committee on Health, Education, Labor, and Pensions and
the Committee on Appropriations of the Senate and the Committee on Commerce and Committee on Appropriations of the
House of Representatives, an annual report with the results
of the analyses and evaluation under paragraph (1).
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out subsection (a), $10,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of fiscal years 2002 and 2003.’’.
SEC. 3105. COMPREHENSIVE COMMUNITY SERVICES FOR CHILDREN
WITH SERIOUS EMOTIONAL DISTURBANCE.

(a) MATCHING FUNDS.—Section 561(c)(1)(D) of the Public Health
Service Act (42 U.S.C. 290ff(c)(1)(D)) is amended by striking ‘‘fifth’’
and inserting ‘‘fifth and sixth’’.
(b) FLEXIBILITY FOR INDIAN TRIBES AND TERRITORIES.—Section
562 of the Public Health Service Act (42 U.S.C. 290ff–1) is amended
by adding at the end the following:
‘‘(g) WAIVERS.—The Secretary may waive one or more of the
requirements of subsection (c) for a public entity that is an Indian
Tribe or tribal organization, or American Samoa, Guam, the Marshall Islands, the Federated States of Micronesia, the Commonwealth of the Northern Mariana Islands, the Republic of Palau,
or the United States Virgin Islands if the Secretary determines,
after peer review, that the system of care is family-centered and
uses the least restrictive environment that is clinically appropriate.’’.
(c) DURATION OF GRANTS.—Section 565(a) of the Public Health
Service Act (42 U.S.C. 290ff–4(a)) is amended by striking ‘‘5 fiscal’’
and inserting ‘‘6 fiscal’’.
(d) AUTHORIZATION OF APPROPRIATIONS.—Section 565(f )(1) of
the Public Health Service Act (42 U.S.C. 290ff–4(f )(1)) is amended
by striking ‘‘1993’’ and all that follows and inserting ‘‘2001, and
such sums as may be necessary for each of the fiscal years 2002
and 2003.’’.
(e) CURRENT GRANTEES.—
(1) IN GENERAL.—Entities with active grants under section
561 of the Public Health Service Act (42 U.S.C. 290ff) on
the date of the enactment of this Act shall be eligible to receive
a sixth year of funding under the grant in an amount not
to exceed the amount that such grantee received in the fifth
year of funding under such grant. Such sixth year may be
funded without requiring peer and Advisory Council review
as required under section 504 of such Act (42 U.S.C. 290aa–
3).
(2) LIMITATION.—Paragraph (1) shall apply with respect
to a grantee only if the grantee agrees to comply with the
provisions of section 561 as amended by subsection (a).

42 USC 290ff
note.

SEC. 3106. SERVICES FOR CHILDREN OF SUBSTANCE ABUSERS.

(a) ADMINISTRATION AND ACTIVITIES.—
(1) ADMINISTRATION.—Section 399D(a) of the Public Health
Service Act (42 U.S.C. 280d(a)(1)) is amended—
(A) in paragraph (1), by striking ‘‘Administrator’’ and
all that follows through ‘‘Administration’’ and inserting
‘‘Administrator of the Substance Abuse and Mental Health
Services Administration’’; and

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114 STAT. 1176

PUBLIC LAW 106–310—OCT. 17, 2000

(B) in paragraph (2), by striking ‘‘Administrator of
the Substance Abuse and Mental Health Services Administration’’ and inserting ‘‘Administrator of the Health
Resources and Services Administration’’.
(2) ACTIVITIES.—Section 399D(a)(1) of the Public Health
Service Act (42 U.S.C. 280d(a)(1)) is amended—
(A) in subparagraph (B), by striking ‘‘and’’ at the end;
(B) in subparagraph (C), by striking the period and
inserting the following: ‘‘through youth service agencies,
family social services, child care providers, Head Start,
schools and after-school programs, early childhood development programs, community-based family resource and support centers, the criminal justice system, health, substance
abuse and mental health providers through screenings conducted during regular childhood examinations and other
examinations, self and family member referrals, substance
abuse treatment services, and other providers of services
to children and families; and’’; and
(C) by adding at the end the following:
‘‘(D) to provide education and training to health, substance abuse and mental health professionals, and other
providers of services to children and families through youth
service agencies, family social services, child care, Head
Start, schools and after-school programs, early childhood
development programs, community-based family resource
and support centers, the criminal justice system, and other
providers of services to children and families.’’.
(3) IDENTIFICATION OF CERTAIN CHILDREN.—Section
399D(a)(3)(A) of the Public Health Service Act (42 U.S.C.
280d(a)(3)(A)) is amended—
(A) in clause (i), by striking ‘‘(i) the entity’’ and
inserting ‘‘(i)(I) the entity’’;
(B) in clause (ii)—
(i) by striking ‘‘(ii) the entity’’ and inserting ‘‘(II)
the entity’’; and
(ii) by striking the period and inserting ‘‘; and’’;
and
(C) by adding at the end the following:
‘‘(ii) the entity will identify children who may be
eligible for medical assistance under a State program
under title XIX or XXI of the Social Security Act.’’.
(b) SERVICES FOR CHILDREN.—Section 399D(b) of the Public
Health Service Act (42 U.S.C. 280d(b)) is amended—
(1) in paragraph (1), by inserting ‘‘alcohol and drug,’’ after
‘‘psychological,’’;
(2) by striking paragraph (5) and inserting the following:
‘‘(5) Developmentally and age-appropriate drug and alcohol
early intervention, treatment and prevention services.’’; and
(3) by inserting after paragraph (8), the following:
‘‘Services shall be provided under paragraphs (2) through (8) by
a public health nurse, social worker, or similar professional, or
by a trained worker from the community who is supervised by
a professional, or by an entity, where the professional or entity
provides assurances that the professional or entity is licensed or
certified by the State if required and is complying with applicable
licensure or certification requirements.’’.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1177

(c) SERVICES FOR AFFECTED FAMILIES.—Section 399D(c) of the
Public Health Service Act (42 U.S.C. 280d(c)) is amended—
(1) in paragraph (1)—
(A) in the matter preceding subparagraph (A), by
inserting before the colon the following: ‘‘, or by an entity,
where the professional or entity provides assurances that
the professional or entity is licensed or certified by the
State if required and is complying with applicable licensure
or certification requirements’’; and
(B) by adding at the end the following:
‘‘(D) Aggressive outreach to family members with substance abuse problems.
‘‘(E) Inclusion of consumer in the development,
implementation, and monitoring of Family Services Plan.’’;
(2) in paragraph (2)—
(A) by striking subparagraph (A) and inserting the
following:
‘‘(A) Alcohol and drug treatment services, including
screening and assessment, diagnosis, detoxification, individual, group and family counseling, relapse prevention,
pharmacotherapy treatment, after-care services, and case
management.’’;
(B) in subparagraph (C), by striking ‘‘, including educational and career planning’’ and inserting ‘‘and counseling
on the human immunodeficiency virus and acquired
immune deficiency syndrome’’;
(C) in subparagraph (D), by striking ‘‘conflict and’’;
and
(D) in subparagraph (E), by striking ‘‘Remedial’’ and
inserting ‘‘Career planning and’’; and
(3) in paragraph (3)(D), by inserting ‘‘which include child
abuse and neglect prevention techniques’’ before the period.
(d) ELIGIBLE ENTITIES.—Section 399D(d) of the Public Health
Service Act (42 U.S.C. 280d(d)) is amended—
(1) by striking the matter preceding paragraph (1) and
inserting:
‘‘(d) ELIGIBLE ENTITIES.—The Secretary shall distribute the
grants through the following types of entities:’’;
(2) in paragraph (1), by striking ‘‘drug treatment’’ and
inserting ‘‘drug early intervention, prevention or treatment’’;
and
(3) in paragraph (2)—
(A) in subparagraph (A), by striking ‘‘; and’’ and
inserting ‘‘; or’’; and
(B) in subparagraph (B), by inserting ‘‘or pediatric
health or mental health providers and family mental health
providers’’ before the period.
(e) SUBMISSION OF INFORMATION.—Section 399D(h) of the Public
Health Service Act (42 U.S.C. 280d(h)) is amended—
(1) in paragraph (2)—
(A) by inserting ‘‘including maternal and child health’’
before ‘‘mental’’;
(B) by striking ‘‘treatment programs’’; and
(C) by striking ‘‘and the State agency responsible for
administering public maternal and child health services’’
and inserting ‘‘, the State agency responsible for administering alcohol and drug programs, the State lead agency,

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114 STAT. 1178

PUBLIC LAW 106–310—OCT. 17, 2000

and the State Interagency Coordinating Council under part
H of the Individuals with Disabilities Education Act; and’’;
and
(2) by striking paragraph (3) and redesignating paragraph
(4) as paragraph (3).
(f ) REPORTS TO THE SECRETARY.—Section 399D(i)(6) of the
Public Health Service Act (42 U.S.C. 280d(i)(6)) is amended—
(1) in subparagraph (B), by adding ‘‘and’’ at the end; and
(2) by striking subparagraphs (C), (D), and (E) and
inserting the following:
‘‘(C) the number of case workers or other professionals
trained to identify and address substance abuse issues.’’.
(g) EVALUATIONS.—Section 399D(l) of the Public Health Service
Act (42 U.S.C. 280d(l)) is amended—
(1) in paragraph (3), by adding ‘‘and’’ at the end;
(2) in paragraph (4), by striking the semicolon and inserting
the following: ‘‘, including increased participation in work or
employment-related activities and decreased participation in
welfare programs.’’; and
(3) by striking paragraphs (5) and (6).
(h) REPORT TO CONGRESS.—Section 399D(m) of the Public
Health Service Act (42 U.S.C. 280d(m)) is amended—
(1) in paragraph (2), by adding ‘‘and’’ at the end;
(2) in paragraph (3)—
(A) in subparagraph (A), by adding ‘‘and’’ at the end;
(B) in subparagraph (B), by striking the semicolon
and inserting a period; and
(C) by striking subparagraphs (C), (D), and (E); and
(3) by striking paragraphs (4) and (5).
(i) DATA COLLECTION.—Section 399D(n) of the Public Health
Service Act (42 U.S.C. 280d(n)) is amended by adding at the end
the following: ‘‘The periodic report shall include a quantitative
estimate of the prevalence of alcohol and drug problems in families
involved in the child welfare system, the barriers to treatment
and prevention services facing these families, and policy recommendations for removing the identified barriers, including
training for child welfare workers.’’.
( j) DEFINITION.—Section 399D(o)(2)(B) of the Public Health
Service Act (42 U.S.C. 280d(o)(2)(B)) is amended by striking ‘‘dangerous’’.
(k) AUTHORIZATION OF APPROPRIATIONS.—Section 399D(p) of
the Public Health Service Act (42 U.S.C. 280d(p)) is amended to
read as follows:
‘‘(p) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
$50,000,000 for fiscal year 2001, and such sums as may be necessary
for each of fiscal years 2002 and 2003.’’.
(l) GRANTS FOR TRAINING AND CONFORMING AMENDMENTS.—
Section 399D of the Public Health Service Act (42 U.S.C. 280d)
is amended—
(1) by striking subsection (f );
(2) by striking subsection (k);
(3) by redesignating subsections (d), (e), (g), (h), (i), ( j),
(l), (m), (n), (o), and (p) as subsections (e) through (o), respectively;
(4) by inserting after subsection (c), the following:

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1179

‘‘(d) TRAINING FOR PROVIDERS OF SERVICES TO CHILDREN AND
FAMILIES.—The Secretary may make a grant under subsection (a)
for the training of health, substance abuse and mental health
professionals and other providers of services to children and families
through youth service agencies, family social services, child care
providers, Head Start, schools and after-school programs, early
childhood development programs, community-based family resource
centers, the criminal justice system, and other providers of services
to children and families. Such training shall be to assist professionals in recognizing the drug and alcohol problems of their clients
and to enhance their skills in identifying and understanding the
nature of substance abuse, and obtaining substance abuse early
intervention, prevention and treatment resources.’’;
(5) in subsection (k)(2) (as so redesignated), by striking
‘‘(h)’’ and inserting ‘‘(i)’’; and
(6) in paragraphs (3)(E) and (5) of subsection (m) (as so
redesignated), by striking ‘‘(d)’’ and inserting ‘‘(e)’’.
(m) TRANSFER AND REDESIGNATION.—Section 399D of the Public
Health Service Act (42 U.S.C. 280d), as amended by this section—
(1) is transferred to title V;
(2) is redesignated as section 519; and
(3) is inserted after section 518.
(n) CONFORMING AMENDMENT.—Title III of the Public Health
Service Act (42 U.S.C. 241 et seq.) is amended by striking the
heading of part L.

42 USC 290bb–
25.

SEC. 3107. SERVICES FOR YOUTH OFFENDERS.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3104(b),
is further amended by adding at the end the following:
‘‘SEC. 520D. SERVICES FOR YOUTH OFFENDERS.

‘‘(a) IN GENERAL.—The Secretary, acting through the Director
of the Center for Mental Health Services, and in consultation with
the Director of the Center for Substance Abuse Treatment, the
Administrator of the Office of Juvenile Justice and Delinquency
Prevention, and the Director of the Special Education Programs,
shall award grants on a competitive basis to State or local juvenile
justice agencies to enable such agencies to provide aftercare services
for youth offenders who have been discharged from facilities in
the juvenile or criminal justice system and have serious emotional
disturbances or are at risk of developing such disturbances.
‘‘(b) USE OF FUNDS.—A State or local juvenile justice agency
receiving a grant under subsection (a) shall use the amounts provided under the grant—
‘‘(1) to develop a plan describing the manner in which
the agency will provide services for each youth offender who
has a serious emotional disturbance and has been detained
or incarcerated in facilities within the juvenile or criminal
justice system;
‘‘(2) to provide a network of core or aftercare services or
access to such services for each youth offender, including diagnostic and evaluation services, substance abuse treatment services, outpatient mental health care services, medication
management services, intensive home-based therapy, intensive
day treatment services, respite care, and therapeutic foster
care;

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35.

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114 STAT. 1180

Deadline.

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(3) to establish a program that coordinates with other
State and local agencies providing recreational, social, educational, vocational, or operational services for youth, to enable
the agency receiving a grant under this section to provide
community-based system of care services for each youth
offender that addresses the special needs of the youth and
helps the youth access all of the aforementioned services; and
‘‘(4) using not more than 20 percent of funds received,
to provide planning and transition services as described in
paragraph (3) for youth offenders while such youth are incarcerated or detained.
‘‘(c) APPLICATION.—A State or local juvenile justice agency that
desires a grant under subsection (a) shall submit an application
to the Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
‘‘(d) REPORT.—Not later than 3 years after the date of the
enactment of this section and annually thereafter, the Secretary
shall prepare and submit, to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on Commerce
of the House of Representatives, a report that describes the services
provided pursuant to this section.
‘‘(e) DEFINITIONS.—In this section:
‘‘(1) SERIOUS EMOTIONAL DISTURBANCE.—The term ‘serious
emotional disturbance’ with respect to a youth offender means
an offender who currently, or at any time within the 1-year
period ending on the day on which services are sought under
this section, has a diagnosable mental, behavioral, or emotional
disorder that functionally impairs the offender’s life by substantially limiting the offender’s role in family, school, or community
activities, and interfering with the offender’s ability to achieve
or maintain one or more developmentally-appropriate social,
behavior, cognitive, communicative, or adaptive skills.
‘‘(2) COMMUNITY-BASED SYSTEM OF CARE.—The term
‘community-based system of care’ means the provision of services for the youth offender by various State or local agencies
that in an interagency fashion or operating as a network
addresses the recreational, social, educational, vocational,
mental health, substance abuse, and operational needs of the
youth offender.
‘‘(3) YOUTH OFFENDER.—The term ‘youth offender’ means
an individual who is 21 years of age or younger who has
been discharged from a State or local juvenile or criminal
justice system, except that if the individual is between the
ages of 18 and 21 years, such individual has had contact with
the State or local juvenile or criminal justice system prior
to attaining 18 years of age and is under the jurisdiction
of such a system at the time services are sought.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section $40,000,000 for fiscal
year 2001, and such sums as may be necessary for each of fiscal
years 2002 and 2003.’’.
SEC.

3108.

GRANTS FOR STRENGTHENING
COMMUNITY PARTNERSHIPS.

FAMILIES

THROUGH

Subpart 2 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–21 et seq.) is amended by adding at the
end the following:

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1181

‘‘SEC. 519A. GRANTS FOR STRENGTHENING FAMILIES.

‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting through the
Director of the Prevention Center, may make grants to public
and nonprofit private entities to develop and implement model
substance abuse prevention programs to provide early intervention
and substance abuse prevention services for individuals of highrisk families and the communities in which such individuals reside.
‘‘(b) PRIORITY.—In awarding grants under subsection (a), the
Secretary shall give priority to applicants that—
‘‘(1) have proven experience in preventing substance abuse
by individuals of high-risk families and reducing substance
abuse in communities of such individuals;
‘‘(2) have demonstrated the capacity to implement community-based partnership initiatives that are sensitive to the
diverse backgrounds of individuals of high-risk families and
the communities of such individuals;
‘‘(3) have experience in providing technical assistance to
support substance abuse prevention programs that are community-based;
‘‘(4) have demonstrated the capacity to implement researchbased substance abuse prevention strategies; and
‘‘(5) have implemented programs that involve families, residents, community agencies, and institutions in the implementation and design of such programs.
‘‘(c) DURATION OF GRANTS.—The Secretary shall award grants
under subsection (a) for a period not to exceed 5 years.
‘‘(d) USE OF FUNDS.—An applicant that is awarded a grant
under subsection (a) shall—
‘‘(1) in the first fiscal year that such funds are received
under the grant, use such funds to develop a model substance
abuse prevention program; and
‘‘(2) in the fiscal year following the first fiscal year that
such funds are received, use such funds to implement the
program developed under paragraph (1) to provide early intervention and substance abuse prevention services to—
‘‘(A) strengthen the environment of children of high
risk families by targeting interventions at the families
of such children and the communities in which such children reside;
‘‘(B) strengthen protective factors, such as—
‘‘(i) positive adult role models;
‘‘(ii) messages that oppose substance abuse;
‘‘(iii) community actions designed to reduce accessibility to and use of illegal substances; and
‘‘(iv) willingness of individuals of families in which
substance abuse occurs to seek treatment for substance
abuse;
‘‘(C) reduce family and community risks, such as family
violence, alcohol or drug abuse, crime, and other behaviors
that may effect healthy child development and increase
the likelihood of substance abuse; and
‘‘(D) build collaborative and formal partnerships
between community agencies, institutions, and businesses
to ensure that comprehensive high quality services are
provided, such as early childhood education, health care,
family support programs, parent education programs, and
home visits for infants.

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114 STAT. 1182

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(e) APPLICATION.—To be eligible to receive a grant under subsection (a), an applicant shall prepare and submit to the Secretary
an application that—
‘‘(1) describes a model substance abuse prevention program
that such applicant will establish;
‘‘(2) describes the manner in which the services described
in subsection (d)(2) will be provided; and
‘‘(3) describe in as much detail as possible the results
that the entity expects to achieve in implementing such a
program.
‘‘(f ) MATCHING FUNDING.—The Secretary may not make a grant
to a entity under subsection (a) unless that entity agrees that,
with respect to the costs to be incurred by the entity in carrying
out the program for which the grant was awarded, the entity
will make available non-Federal contributions in an amount that
is not less than 40 percent of the amount provided under the
grant.
‘‘(g) REPORT TO SECRETARY.—An applicant that is awarded a
grant under subsection (a) shall prepare and submit to the Secretary
a report in such form and containing such information as the
Secretary may require, including an assessment of the efficacy
of the model substance abuse prevention program implemented
by the applicant and the short, intermediate, and long term results
of such program.
‘‘(h) EVALUATIONS.—The Secretary shall conduct evaluations,
based in part on the reports submitted under subsection (g), to
determine the effectiveness of the programs funded under subsection (a) in reducing substance use in high-risk families and
in making communities in which such families reside in stronger.
The Secretary shall submit such evaluations to the appropriate
committees of Congress.
‘‘(i) HIGH-RISK FAMILIES.—In this section, the term ‘high-risk
family’ means a family in which the individuals of such family
are at a significant risk of using or abusing alcohol or any illegal
substance.
‘‘( j) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section, $3,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.’’.
SEC. 3109. PROGRAMS TO REDUCE UNDERAGE DRINKING.

Subpart 2 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–21 et seq.), as amended by section 3108,
is further amended by adding at the end the following:
42 USC 290bb–
25b.
Grants.
Contracts.

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‘‘SEC. 519B. PROGRAMS TO REDUCE UNDERAGE DRINKING.

‘‘(a) IN GENERAL.—The Secretary shall make awards of grants,
cooperative agreements, or contracts to public and nonprofit private
entities, including Indian tribes and tribal organizations, to enable
such entities to develop plans for and to carry out school-based
(including institutions of higher education) and community-based
programs for the prevention of alcoholic-beverage consumption by
individuals who have not attained the legal drinking age.
‘‘(b) ELIGIBILITY REQUIREMENTS.—To be eligible to receive an
award under subsection (a), an entity shall provide any assurances
to the Secretary which the Secretary may require, including that
the entity will—

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1183

‘‘(1) annually report to the Secretary on the effectiveness
of the prevention approaches implemented by the entity;
‘‘(2) use science based and age appropriate approaches;
and
‘‘(3) involve local public health officials and community
prevention program staff in the planning and implementation
of the program.
‘‘(c) EVALUATION.—The Secretary shall evaluate each project
under subsection (a) and shall disseminate the findings with respect
to each such evaluation to appropriate public and private entities.
‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary shall ensure
that awards will be distributed equitably among the regions of
the country and among urban and rural areas.
‘‘(e) DURATION OF AWARD.—With respect to an award under
subsection (a), the period during which payments under such award
are made to the recipient may not exceed 5 years. The preceding
sentence may not be construed as establishing a limitation on
the number of awards under such subsection that may be made
to the recipient.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
$25,000,000 for fiscal year 2001, and such sums as may be necessary
for each of the fiscal years 2002 and 2003.’’.
SEC. 3110. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.

Subpart 2 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–21 et seq.), as amended by sections 3108
and 3109, is further amended by adding at the end the following:
‘‘SEC. 519C. SERVICES FOR INDIVIDUALS WITH FETAL ALCOHOL SYNDROME.

42 USC 290bb–
25c.

‘‘(a) IN GENERAL.—The Secretary shall make awards of grants,
cooperative agreements, or contracts to public and nonprofit private
entities, including Indian tribes and tribal organizations, to provide
services to individuals diagnosed with fetal alcohol syndrome or
alcohol-related birth defects.
‘‘(b) USE OF FUNDS.—An award under subsection (a) may, subject to subsection (d), be used to—
‘‘(1) screen and test individuals to determine the type and
level of services needed;
‘‘(2) develop a comprehensive plan for providing services
to the individual;
‘‘(3) provide mental health counseling;
‘‘(4) provide substance abuse prevention services and treatment, if needed;
‘‘(5) coordinate services with other social programs
including social services, justice system, educational services,
health services, mental health and substance abuse services,
financial assistance programs, vocational services and housing
assistance programs;
‘‘(6) provide vocational services;
‘‘(7) provide health counseling;
‘‘(8) provide housing assistance;
‘‘(9) parenting skills training;
‘‘(10) overall case management;
‘‘(11) supportive services for families of individuals with
Fetal Alcohol Syndrome; and

Grants.
Contracts.

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114 STAT. 1184

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(12) provide other services and programs, to the extent
authorized by the Secretary after consideration of recommendations made by the National Task Force on Fetal Alcohol Syndrome.
‘‘(c) REQUIREMENTS.—To be eligible to receive an award under
subsection (a), an applicant shall—
‘‘(1) demonstrate that the program will be part of a coordinated, comprehensive system of care for such individuals;
‘‘(2) demonstrate an established communication with other
social programs in the community including social services,
justice system, financial assistance programs, health services,
educational services, mental health and substance abuse services, vocational services and housing assistance services;
‘‘(3) show a history of working with individuals with fetal
alcohol syndrome or alcohol-related birth defects;
‘‘(4) provide assurance that the services will be provided
in a culturally and linguistically appropriate manner; and
‘‘(5) provide assurance that at the end of the 5-year award
period, other mechanisms will be identified to meet the needs
of the individuals and families served under such award.
‘‘(d) RELATIONSHIP TO PAYMENTS UNDER OTHER PROGRAMS.—
An award may be made under subsection (a) only if the applicant
involved agrees that the award will not be expended to pay the
expenses of providing any service under this section to an individual
to the extent that payment has been made, or can reasonably
be expected to be made, with respect to such expenses—
‘‘(1) under any State compensation program, under an
insurance policy, or under any Federal or State health benefits
program; or
‘‘(2) by an entity that provides health services on a prepaid
basis.
‘‘(e) DURATION OF AWARDS.—With respect to an award under
subsection (a), the period during which payments under such award
are made to the recipient may not exceed 5 years.
‘‘(f ) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a) and shall disseminate the findings
with respect to each such evaluation to appropriate public and
private entities.
‘‘(g) FUNDING.—
‘‘(1) AUTHORIZATION OF APPROPRIATIONS.—For the purpose
of carrying out this section, there are authorized to be appropriated $25,000,000 for fiscal year 2001, and such sums as
may be necessary for each of the fiscal years 2002 and 2003.
‘‘(2) ALLOCATION.—Of the amounts appropriated under
paragraph (1) for a fiscal year, not less than $300,000 shall,
for purposes relating to fetal alcohol syndrome and alcoholrelated birth defects, be made available for collaborative, coordinated interagency efforts with the National Institute on Alcohol
Abuse and Alcoholism, the National Institute on Child Health
and Human Development, the Health Resources and Services
Administration, the Agency for Healthcare Research and
Quality, the Centers for Disease Control and Prevention, the
Department of Education, and the Department of Justice.

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Attachment 1B

PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1185

‘‘SEC. 519D. CENTERS OF EXCELLENCE ON SERVICES FOR INDIVIDUALS
WITH FETAL ALCOHOL SYNDROME AND ALCOHOLRELATED BIRTH DEFECTS AND TREATMENT FOR
INDIVIDUALS WITH SUCH CONDITIONS AND THEIR FAMILIES.

42 USC 290bb–
25d.

‘‘(a) IN GENERAL.—The Secretary shall make awards of grants,
cooperative agreements, or contracts to public or nonprofit private
entities for the purposes of establishing not more than four centers
of excellence to study techniques for the prevention of fetal alcohol
syndrome and alcohol-related birth defects and adaptations of
innovative clinical interventions and service delivery improvements
for the provision of comprehensive services to individuals with
fetal alcohol syndrome or alcohol-related birth defects and their
families and for providing training on such conditions.
‘‘(b) USE OF FUNDS.—An award under subsection (a) may be
used to—
‘‘(1) study adaptations of innovative clinical interventions
and service delivery improvements strategies for children and
adults with fetal alcohol syndrome or alcohol-related birth
defects and their families;
‘‘(2) identify communities which have an exemplary comprehensive system of care for such individuals so that they
can provide technical assistance to other communities
attempting to set up such a system of care;
‘‘(3) provide technical assistance to communities who do
not have a comprehensive system of care for such individuals
and their families;
‘‘(4) train community leaders, mental health and substance
abuse professionals, families, law enforcement personnel,
judges, health professionals, persons working in financial assistance programs, social service personnel, child welfare professionals, and other service providers on the implications of fetal
alcohol syndrome and alcohol-related birth defects, the early
identification of and referral for such conditions;
‘‘(5) develop innovative techniques for preventing alcohol
use by women in child bearing years;
‘‘(6) perform other functions, to the extent authorized by
the Secretary after consideration of recommendations made
by the National Task Force on Fetal Alcohol Syndrome.
‘‘(c) REPORT.—
‘‘(1) IN GENERAL.—A recipient of an award under subsection
(a) shall at the end of the period of funding report to the
Secretary on any innovative techniques that have been discovered for preventing alcohol use among women of child bearing
years.
‘‘(2) DISSEMINATION OF FINDINGS.—The Secretary shall
upon receiving a report under paragraph (1) disseminate the
findings to appropriate public and private entities.
‘‘(d) DURATION OF AWARDS.—With respect to an award under
subsection (a), the period during which payments under such award
are made to the recipient may not exceed 5 years.
‘‘(e) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a) and shall disseminate the findings
with respect to each such evaluation to appropriate public and
private entities.
‘‘(f ) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated

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Attachment 1B

114 STAT. 1186

PUBLIC LAW 106–310—OCT. 17, 2000

$5,000,000 for fiscal year 2001, and such sums as may be necessary
for each of the fiscal years 2002 and 2003.’’.
SEC. 3111. SUICIDE PREVENTION.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3107,
is further amended by adding at the end the following:
42 USC 290bb–
36.
Grants.
Contracts.

VerDate 11-MAY-2000

‘‘SEC. 520E. SUICIDE PREVENTION FOR CHILDREN AND ADOLESCENTS.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to States, political subdivisions of States,
Indian tribes, tribal organizations, public organizations, or private
nonprofit organizations to establish programs to reduce suicide
deaths in the United States among children and adolescents.
‘‘(b) COLLABORATION.—In carrying out subsection (a), the Secretary shall ensure that activities under this section are coordinated
among the Substance Abuse and Mental Health Services Administration, the relevant institutes at the National Institutes of Health,
the Centers for Disease Control and Prevention, the Health
Resources and Services Administration, and the Administration
on Children and Families.
‘‘(c) REQUIREMENTS.—A State, political subdivision of a State,
Indian tribe, tribal organization, public organization, or private
nonprofit organization desiring a grant, contract, or cooperative
agreement under this section shall demonstrate that the suicide
prevention program such entity proposes will—
‘‘(1) provide for the timely assessment, treatment, or
referral for mental health or substance abuse services of children and adolescents at risk for suicide;
‘‘(2) be based on best evidence-based, suicide prevention
practices and strategies that are adapted to the local community;
‘‘(3) integrate its suicide prevention program into the
existing health care system in the community including primary
health care, mental health services, and substance abuse services;
‘‘(4) be integrated into other systems in the community
that address the needs of children and adolescents including
the educational system, juvenile justice system, welfare and
child protection systems, and community youth support
organizations;
‘‘(5) use primary prevention methods to educate and raise
awareness in the local community by disseminating evidencebased information about suicide prevention;
‘‘(6) include suicide prevention, mental health, and related
information and services for the families and friends of those
who completed suicide, as needed;
‘‘(7) provide linguistically appropriate and culturally competent services, as needed;
‘‘(8) provide a plan for the evaluation of outcomes and
activities at the local level, according to standards established
by the Secretary, and agree to participate in a national evaluation; and
‘‘(9) ensure that staff used in the program are trained
in suicide prevention and that professionals involved in the
system of care have received training in identifying persons
at risk of suicide.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1187

‘‘(d) USE OF FUNDS.—Amounts provided under grants, contracts,
or cooperative agreements under subsection (a) shall be used to
supplement and not supplant other Federal, State, and local public
funds that are expended to provide services for eligible individuals.
‘‘(e) CONDITION.—An applicant for a grant, contract, or cooperative agreement under subsection (a) shall demonstrate to the Secretary that the applicant has the support of the local community
and relevant public health officials.
‘‘(f ) SPECIAL POPULATIONS.—In awarding grants, contracts, and
cooperative agreements under subsection (a), the Secretary shall
ensure that such awards are made in a manner that will focus
on the needs of communities or groups that experience high or
rapidly rising rates of suicide.
‘‘(g) APPLICATION.—A State, political subdivision of a State,
Indian tribe, tribal organization, public organization, or private
nonprofit organization receiving a grant, contract, or cooperative
agreement under subsection (a) shall prepare and submit an
application to the Secretary at such time, in such manner, and
containing such information as the Secretary may reasonably
require. Such application shall include a plan for the rigorous
evaluation of activities funded under the grant, contract, or cooperative agreement, including a process and outcome evaluation.
‘‘(h) DISTRIBUTION OF AWARDS.—In awarding grants, contracts,
and cooperative agreements under subsection (a), the Secretary
shall ensure that such awards are distributed among the geographical regions of the United States and between urban and
rural settings.
‘‘(i) EVALUATION.—A State, political subdivision of a State,
Indian tribe, tribal organization, public organization, or private
nonprofit organization receiving a grant, contract, or cooperative
agreement under subsection (a) shall prepare and submit to the
Secretary at the end of the program period, an evaluation of all
activities funded under this section.
‘‘( j) DISSEMINATION AND EDUCATION.—The Secretary shall
ensure that findings derived from activities carried out under this
section are disseminated to State, county and local governmental
agencies and public and private nonprofit organizations active in
promoting suicide prevention and family support activities.
‘‘(k) DURATION OF PROJECTS.—With respect to a grant, contract,
or cooperative agreement awarded under this section, the period
during which payments under such award may be made to the
recipient may not exceed 5 years.
‘‘(l) STUDY.—Within 1 year after the date of the enactment
of this section, the Secretary shall, directly or by grant or contract,
initiate a study to assemble and analyze data to identify—
‘‘(1) unique profiles of children under 13 who attempt or
complete suicide;
‘‘(2) unique profiles of youths between ages 13 and 21
who attempt or complete suicide; and
‘‘(3) a profile of services which might have been available
to these groups and the use of these services by children and
youths from paragraphs (1) and (2).
‘‘(m) AUTHORIZATION OF APPROPRIATION.—
‘‘(1) IN GENERAL.—For purposes of carrying out this section,
there is authorized to be appropriated $75,000,000 for fiscal
year 2001 and such sums as may be necessary for each of
the fiscal years 2002 through 2003.

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Attachment 1B

114 STAT. 1188

PUBLIC LAW 106–310—OCT. 17, 2000
‘‘(2) PROGRAM MANAGEMENT.—In carrying out this section,
the Secretary shall use 1 percent of the amount appropriated
under paragraph (1) for each fiscal year for managing programs
under this section.’’.

SEC. 3112. GENERAL PROVISIONS.

(a) DUTIES OF THE
MENT.—Section 507(b) of

42 USC 290bb–
31.

VerDate 11-MAY-2000

CENTER FOR SUBSTANCE ABUSE TREATthe Public Health Service Act (42 U.S.C.

290bb(b)) is amended—
(1) by redesignating paragraphs (2) through (12) as paragraphs (4) through (14), respectively;
(2) by inserting after paragraph (1), the following:
‘‘(2) ensure that emphasis is placed on children and adolescents in the development of treatment programs;
‘‘(3) collaborate with the Attorney General to develop programs to provide substance abuse treatment services to individuals who have had contact with the Justice system, especially
adolescents;’’;
(3) in paragraph (7) (as so redesignated), by striking ‘‘services, and monitor’’ and all that follows through ‘‘1925’’ and
inserting ‘‘services’’;
(4) in paragraph (13) (as so redesignated), by striking
‘‘treatment, including’’ and all that follows through ‘‘which
shall’’ and inserting ‘‘treatment, which shall’’; and
(5) in paragraph 14 (as so redesignated), by striking ‘‘paragraph (11)’’ and inserting ‘‘paragraph (13)’’.
(b) OFFICE FOR SUBSTANCE ABUSE PREVENTION.—Section 515(b)
of the Public Health Service Act (42 U.S.C. 290bb–21(b)) is
amended—
(1) by redesignating paragraphs (9) and (10) as (10) and
(11);
(2) by inserting after paragraph (8), the following:
‘‘(9) collaborate with the Attorney General of the Department of Justice to develop programs to prevent drug abuse
among high risk youth;’’; and
(3) in paragraph (10) (as so redesignated), by striking
‘‘public concerning’’ and inserting ‘‘public, especially adolescent
audiences, concerning’’.
(c) DUTIES OF THE CENTER FOR MENTAL HEALTH SERVICES.—
Section 520(b) of the Public Health Service Act (42 U.S.C. 290bb–
3(b)) is amended—
(1) by redesignating paragraphs (3) through (14) as paragraphs (4) through (15), respectively;
(2) by inserting after paragraph (2), the following:
‘‘(3) collaborate with the Department of Education and
the Department of Justice to develop programs to assist local
communities in addressing violence among children and adolescents;’’;
(3) in paragraph (8) (as so redesignated), by striking ‘‘programs authorized’’ and all that follows through ‘‘Programs’’
and inserting ‘‘programs under part C’’; and
(4) in paragraph (9) (as so redesignated), by striking ‘‘program and programs’’ and all that follows through ‘‘303’’ and
inserting ‘‘programs’’.

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Attachment 1B

PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1189

TITLE XXXII—PROVISIONS RELATING
TO MENTAL HEALTH
SEC. 3201. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.

(a) IN GENERAL.—Section 520A of the Public Health Service
Act (42 U.S.C. 290bb–32) is amended to read as follows:
‘‘SEC. 520A. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL AND
NATIONAL SIGNIFICANCE.

‘‘(a) PROJECTS.—The Secretary shall address priority mental
health needs of regional and national significance (as determined
under subsection (b)) through the provision of or through assistance
for—
‘‘(1) knowledge development and application projects for
prevention, treatment, and rehabilitation, and the conduct or
support of evaluations of such projects;
‘‘(2) training and technical assistance programs;
‘‘(3) targeted capacity response programs; and
‘‘(4) systems change grants including statewide family network grants and client-oriented and consumer run self-help
activities.
The Secretary may carry out the activities described in this subsection directly or through grants or cooperative agreements with
States, political subdivisions of States, Indian tribes and tribal
organizations, other public or private nonprofit entities.
‘‘(b) PRIORITY MENTAL HEALTH NEEDS.—
‘‘(1) DETERMINATION OF NEEDS.—Priority mental health
needs of regional and national significance shall be determined
by the Secretary in consultation with States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
‘‘(2) SPECIAL CONSIDERATION.—In developing program priorities described in paragraph (1), the Secretary shall give special
consideration to promoting the integration of mental health
services into primary health care systems.
‘‘(c) REQUIREMENTS.—
‘‘(1) IN GENERAL.—Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined appropriate by the Secretary.
‘‘(2) DURATION OF AWARD.—With respect to a grant, contract, or cooperative agreement awarded under this section,
the period during which payments under such award are made
to the recipient may not exceed 5 years.
‘‘(3) MATCHING FUNDS.—The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
this section provide non-Federal matching funds, as determined
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public or private entities and may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.

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114 STAT. 1190

42 USC 290bb–
32 note.

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(4) MAINTENANCE OF EFFORT.—With respect to activities
for which a grant, contract or cooperative agreement is awarded
under this section, the Secretary may require that recipients
for specific projects under subsection (a) agree to maintain
expenditures of non-Federal amounts for such activities at a
level that is not less than the level of such expenditures maintained by the entity for the fiscal year preceding the fiscal
year for which the entity receives such a grant, contract, or
cooperative agreement.
‘‘(d) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a)(1) and shall disseminate the
findings with respect to each such evaluation to appropriate public
and private entities.
‘‘(e) INFORMATION AND EDUCATION.—
‘‘(1) IN GENERAL.—The Secretary shall establish information and education programs to disseminate and apply the
findings of the knowledge development and application,
training, and technical assistance programs, and targeted
capacity response programs, under this section to the general
public, to health care professionals, and to interested groups.
The Secretary shall make every effort to provide linkages
between the findings of supported projects and State agencies
responsible for carrying out mental health services.
‘‘(2) RURAL AND UNDERSERVED AREAS.—In disseminating
information on evidence-based practices in the provision of children’s mental health services under this subsection, the Secretary shall ensure that such information is distributed to
rural and medically underserved areas.
‘‘(f ) AUTHORIZATION OF APPROPRIATION.—
‘‘(1) IN GENERAL.—There are authorized to be appropriated
to carry out this section, $300,000,000 for fiscal year 2001,
and such sums as may be necessary for each of the fiscal
years 2002 and 2003.
‘‘(2) DATA INFRASTRUCTURE.—If amounts are not appropriated for a fiscal year to carry out section 1971 with respect
to mental health, then the Secretary shall make available,
from the amounts appropriated for such fiscal year under paragraph (1), an amount equal to the sum of $6,000,000 and
10 percent of all amounts appropriated for such fiscal year
under such paragraph in excess of $100,000,000, to carry out
such section 1971.’’.
(b) CONFORMING AMENDMENTS.—
(1) Section 303 of the Public Health Service Act (42 U.S.C.
242a) is repealed.
(2) Section 520B of the Public Health Service Act (42 U.S.C.
290bb–33) is repealed.
(3) Section 612 of the Stewart B. McKinney Homeless
Assistance Act (42 U.S.C. 290aa–3 note) is repealed.
SEC. 3202. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.

Section 506 of the Public Health Service Act (42 U.S.C. 290aa–
5) is amended to read as follows:
‘‘SEC. 506. GRANTS FOR THE BENEFIT OF HOMELESS INDIVIDUALS.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts
and cooperative agreements to community-based public and private
nonprofit entities for the purposes of providing mental health and
substance abuse services for homeless individuals. In carrying out

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114 STAT. 1191

this section, the Secretary shall consult with the Interagency
Council on the Homeless, established under section 201 of the
Stewart B. McKinney Homeless Assistance Act (42 U.S.C. 11311).
‘‘(b) PREFERENCES.—In awarding grants, contracts, and cooperative agreements under subsection (a), the Secretary shall give a
preference to—
‘‘(1) entities that provide integrated primary health, substance abuse, and mental health services to homeless individuals;
‘‘(2) entities that demonstrate effectiveness in serving runaway, homeless, and street youth;
‘‘(3) entities that have experience in providing substance
abuse and mental health services to homeless individuals;
‘‘(4) entities that demonstrate experience in providing
housing for individuals in treatment for or in recovery from
mental illness or substance abuse; and
‘‘(5) entities that demonstrate effectiveness in serving
homeless veterans.
‘‘(c) SERVICES FOR CERTAIN INDIVIDUALS.—In awarding grants,
contracts, and cooperative agreements under subsection (a), the
Secretary shall not—
‘‘(1) prohibit the provision of services under such subsection
to homeless individuals who are suffering from a substance
abuse disorder and are not suffering from a mental health
disorder; and
‘‘(2) make payments under subsection (a) to any entity
that has a policy of—
‘‘(A) excluding individuals from mental health services
due to the existence or suspicion of substance abuse; or
‘‘(B) has a policy of excluding individuals from substance abuse services due to the existence or suspicion
of mental illness.
‘‘(d) TERM OF THE AWARDS.—No entity may receive a grant,
contract, or cooperative agreement under subsection (a) for more
than 5 years.
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section, $50,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.’’.
SEC.

3203.

PROJECTS FOR ASSISTANCE
HOMELESSNESS.

IN

TRANSITION

FROM

(a) WAIVERS FOR TERRITORIES.—Section 522 of the Public
Health Service Act (42 U.S.C. 290cc–22) is amended by adding
at the end the following:
‘‘(i) WAIVER FOR TERRITORIES.—With respect to the United
States Virgin Islands, Guam, American Samoa, Palau, the Marshall
Islands, and the Commonwealth of the Northern Mariana Islands,
the Secretary may waive the provisions of this part that the Secretary determines to be appropriate.’’.
(b) AUTHORIZATION OF APPROPRIATION.—Section 535(a) of the
Public Health Service Act (42 U.S.C. 290cc–35(a)) is amended by
striking ‘‘1991 through 1994’’ and inserting ‘‘2001 through 2003’’.

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114 STAT. 1192

PUBLIC LAW 106–310—OCT. 17, 2000

SEC. 3204. COMMUNITY MENTAL HEALTH SERVICES PERFORMANCE
PARTNERSHIP BLOCK GRANT.
42 USC 300x–1.

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(a) CRITERIA FOR PLAN.—Section 1912(b) of the Public Health
Service Act (42 U.S.C. 300x–2(b)) is amended by striking paragraphs
(1) through (12) and inserting the following:
‘‘(1) COMPREHENSIVE COMMUNITY-BASED MENTAL HEALTH
SYSTEMS.—The plan provides for an organized community-based
system of care for individuals with mental illness and describes
available services and resources in a comprehensive system
of care, including services for dually diagnosed individuals.
The description of the system of care shall include health
and mental health services, rehabilitation services, employment
services, housing services, educational services, substance abuse
services, medical and dental care, and other support services
to be provided to individuals with Federal, State and local
public and private resources to enable such individuals to function outside of inpatient or residential institutions to the maximum extent of their capabilities, including services to be provided by local school systems under the Individuals with
Disabilities Education Act. The plan shall include a separate
description of case management services and provide for activities leading to reduction of hospitalization.
‘‘(2) MENTAL HEALTH SYSTEM DATA AND EPIDEMIOLOGY.—
The plan contains an estimate of the incidence and prevalence
in the State of serious mental illness among adults and serious
emotional disturbance among children and presents quantitative targets to be achieved in the implementation of the
system described in paragraph (1).
‘‘(3) CHILDREN’S SERVICES.—In the case of children with
serious emotional disturbance, the plan—
‘‘(A) subject to subparagraph (B), provides for a system
of integrated social services, educational services, juvenile
services, and substance abuse services that, together with
health and mental health services, will be provided in
order for such children to receive care appropriate for their
multiple needs (such system to include services provided
under the Individuals with Disabilities Education Act);
‘‘(B) provides that the grant under section 1911 for
the fiscal year involved will not be expended to provide
any service under such system other than comprehensive
community mental health services; and
‘‘(C) provides for the establishment of a defined
geographic area for the provision of the services of such
system.
‘‘(4) TARGETED SERVICES TO RURAL AND HOMELESS POPULATIONS.—The plan describes the State’s outreach to and services for individuals who are homeless and how communitybased services will be provided to individuals residing in rural
areas.
‘‘(5) MANAGEMENT SYSTEMS.—The plan describes the financial resources, staffing and training for mental health providers
that is necessary to implement the plan, and provides for
the training of providers of emergency health services regarding
mental health. The plan further describes the manner in which
the State intends to expend the grant under section 1911 for
the fiscal year involved.

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114 STAT. 1193

Except as provided for in paragraph (3), the State plan shall contain
the information required under this subsection with respect to
both adults with serious mental illness and children with serious
emotional disturbance.’’.
(b) REVIEW OF PLANNING COUNCIL OF STATE’S REPORT.—Section
1915(a) of the Public Health Service Act (42 U.S.C. 300x–4(a))
is amended—
(1) in paragraph (1), by inserting ‘‘and the report of the
State under section 1942(a) concerning the preceding fiscal
year’’ after ‘‘to the grant’’; and
(2) in paragraph (2), by inserting before the period ‘‘and
any comments concerning the annual report’’.
(c) MAINTENANCE OF EFFORT.—Section 1915(b) of the Public
Health Service Act (42 U.S.C. 300x–4(b)) is amended—
(1) by redesignating paragraphs (2) and (3) as paragraphs
(3) and (4), respectively; and
(2) by inserting after paragraph (1), the following:
‘‘(2) EXCLUSION OF CERTAIN FUNDS.—The Secretary may
exclude from the aggregate State expenditures under subsection
(a), funds appropriated to the principle agency for authorized
activities which are of a non-recurring nature and for a specific
purpose.’’.
(d) APPLICATION FOR GRANTS.—Section 1917(a)(1) of the Public
Health Service Act (42 U.S.C. 300x–6(a)(1)) is amended to read
as follows:
‘‘(1) the plan is received by the Secretary not later than
September 1 of the fiscal year prior to the fiscal year for
which a State is seeking funds, and the report from the previous
fiscal year as required under section 1941 is received by
December 1 of the fiscal year of the grant;’’.
(e) WAIVERS FOR TERRITORIES.—Section 1917(b) of the Public
Health Service Act (42 U.S.C. 300x–6(b)) is amended by striking
‘‘whose allotment under section 1911 for the fiscal year is the
amount specified in section 1918(c)(2)(B)’’ and inserting in its place
‘‘except Puerto Rico’’.
(f ) AUTHORIZATION OF APPROPRIATION.—Section 1920 of the
Public Health Service Act (42 U.S.C. 300x–9) is amended—
(1) in subsection (a), by striking ‘‘$450,000,000’’ and all
that follows through the end and inserting ‘‘$450,000,000 for
fiscal year 2001, and such sums as may be necessary for each
of the fiscal years 2002 and 2003.’’; and
(2) in subsection (b)(2), by striking ‘‘section 505’’ and
inserting ‘‘sections 505 and 1971’’.
SEC. 3205. DETERMINATION OF ALLOTMENT.

Section 1918(b) of the Public Health Service Act (42 U.S.C.
300x–7(b)) is amended to read as follows:
‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—With respect to fiscal
year 2000, and subsequent fiscal years, the amount of the allotment
of a State under section 1911 shall not be less than the amount
the State received under such section for fiscal year 1998.’’.
SEC. 3206. PROTECTION AND ADVOCACY FOR MENTALLY ILL INDIVIDUALS ACT OF 1986.

(a) SHORT TITLE.—The first section of the Protection and
Advocacy for Mentally Ill Individuals Act of 1986 (Public Law
99–319) is amended to read as follows:

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114 STAT. 1194
42 USC 10801
note.

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PUBLIC LAW 106–310—OCT. 17, 2000

‘‘SECTION 1. SHORT TITLE.

‘‘This Act may be cited as the ‘Protection and Advocacy for
Individuals with Mental Illness Act’.’’.
(b) DEFINITIONS.—Section 102 of the Protection and Advocacy
for Individuals with Mental Illness Act (as amended by subsection
(a)) (42 U.S.C. 10802) is amended—
(1) in paragraph (4)—
(A) in the matter preceding subparagraph (A), by
inserting ‘‘, except as provided in section 104(d),’’ after
‘‘means’’;
(B) in subparagraph (B)—
(i) by striking ‘‘(i)’’ who’’ and inserting ‘‘(i)(I) who’’;
(ii) by redesignating clauses (ii) and (iii) as subclauses (II) and (III);
(iii) in subclause (III) (as so redesignated), by
striking the period and inserting ‘‘; or’’; and
(iv) by adding at the end the following:
‘‘(ii) who satisfies the requirements of subparagraph
(A) and lives in a community setting, including their own
home.’’; and
(2) by adding at the end the following:
‘‘(8) The term ‘American Indian consortium’ means a
consortium established under part C of the Developmental
Disabilities Assistance and Bill of Rights Act (42 U.S.C. 6042
et seq.).’’.
(c) USE OF ALLOTMENTS.—Section 104 of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended by
subsection (a)) (42 U.S.C. 10804) is amended by adding at the
end the following:
‘‘(d) The definition of ‘individual with a mental illness’ contained
in section 102(4)(B)(iii) shall apply, and thus an eligible system
may use its allotment under this title to provide representation
to such individuals, only if the total allotment under this title
for any fiscal year is $30,000,000 or more, and in such case, an
eligible system must give priority to representing persons with
mental illness as defined in subparagraphs (A) and (B)(i) of section
102(4).’’.
(d) MINIMUM AMOUNT.—Paragraph (2) of section 112(a) of the
Protection and Advocacy for Individuals with Mental Illness Act
(as amended by subsection (a)) (42 U.S.C. 10822(a)(2)) is amended
to read as follows:
‘‘(2)(A) The minimum amount of the allotment of an eligible
system shall be the product (rounded to the nearest $100)
of the appropriate base amount determined under subparagraph (B) and the factor specified in subparagraph (C).
‘‘(B) For purposes of subparagraph (A), the appropriate
base amount—
‘‘(i) for American Samoa, Guam, the Marshall Islands,
the Federated States of Micronesia, the Commonwealth
of the Northern Mariana Islands, the Republic of Palau,
and the Virgin Islands, is $139,300; and
‘‘(ii) for any other State, is $260,000.
‘‘(C) The factor specified in this subparagraph is the ratio
of the amount appropriated under section 117 for the fiscal
year for which the allotment is being made to the amount
appropriated under such section for fiscal year 1995.

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1195

‘‘(D) If the total amount appropriated for a fiscal year
is at least $25,000,000, the Secretary shall make an allotment
in accordance with subparagraph (A) to the eligible system
serving the American Indian consortium.’’.
(e) TECHNICAL AMENDMENTS.—Section 112(a) of the Protection
and Advocacy for Individuals with Mental Illness Act (as amended
by subsection (a)) (42 U.S.C. 10822(a)) is amended—
(1) in paragraph (1)(B), by striking ‘‘Trust Territory of
the Pacific Islands’’ and inserting ‘‘Marshall Islands, the Federated States of Micronesia, the Republic of Palau’’; and
(2) by striking paragraph (3).
(f ) REAUTHORIZATION.—Section 117 of the Protection and
Advocacy for Individuals with Mental Illness Act (as amended by
subsection (a)) (42 U.S.C. 10827) is amended by striking ‘‘1995’’
and inserting ‘‘2003’’.
SEC. 3207. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS
OF CERTAIN FACILITIES.

Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.) is amended by adding at the end the following:

‘‘PART H—REQUIREMENT RELATING TO THE
RIGHTS OF RESIDENTS OF CERTAIN FACILITIES
‘‘SEC. 591. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS
OF CERTAIN FACILITIES.

42 USC 290ii.

‘‘(a) IN GENERAL.—A public or private general hospital, nursing
facility, intermediate care facility, or other health care facility,
that receives support in any form from any program supported
in whole or in part with funds appropriated to any Federal department or agency shall protect and promote the rights of each resident
of the facility, including the right to be free from physical or
mental abuse, corporal punishment, and any restraints or involuntary seclusions imposed for purposes of discipline or convenience.
‘‘(b) REQUIREMENTS.—Restraints and seclusion may only be
imposed on a resident of a facility described in subsection (a)
if—
‘‘(1) the restraints or seclusion are imposed to ensure the
physical safety of the resident, a staff member, or others; and
‘‘(2) the restraints or seclusion are imposed only upon the
written order of a physician, or other licensed practitioner
permitted by the State and the facility to order such restraint
or seclusion, that specifies the duration and circumstances
under which the restraints are to be used (except in emergency
circumstances specified by the Secretary until such an order
could reasonably be obtained).
‘‘(c) CURRENT LAW.—This part shall not be construed to affect
or impede any Federal or State law or regulations that provide
greater protections than this part regarding seclusion and restraint.
‘‘(d) DEFINITIONS.—In this section:
‘‘(1) RESTRAINTS.—The term ‘restraints’ means—
‘‘(A) any physical restraint that is a mechanical or
personal restriction that immobilizes or reduces the ability
of an individual to move his or her arms, legs, or head

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114 STAT. 1196

PUBLIC LAW 106–310—OCT. 17, 2000
freely, not including devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective
helmets, or any other methods that involves the physical
holding of a resident for the purpose of conducting routine
physical examinations or tests or to protect the resident
from falling out of bed or to permit the resident to participate in activities without the risk of physical harm to
the resident (such term does not include a physical escort);
and
‘‘(B) a drug or medication that is used as a restraint
to control behavior or restrict the resident’s freedom of
movement that is not a standard treatment for the resident’s medical or psychiatric condition.
‘‘(2) SECLUSION.—The term ‘seclusion’ means a behavior
control technique involving locked isolation. Such term does
not include a time out.
‘‘(3) PHYSICAL ESCORT.—The term ‘physical escort’ means
the temporary touching or holding of the hand, wrist, arm,
shoulder or back for the purpose of inducing a resident who
is acting out to walk to a safe location.
‘‘(4) TIME OUT.—The term ‘time out’ means a behavior
management technique that is part of an approved treatment
program and may involve the separation of the resident from
the group, in a non-locked setting, for the purpose of calming.
Time out is not seclusion.

42 USC 290ii–1.

‘‘SEC. 592. REPORTING REQUIREMENT.

‘‘(a) IN GENERAL.—Each facility to which the Protection and
Advocacy for Mentally Ill Individuals Act of 1986 applies shall
notify the appropriate agency, as determined by the Secretary,
of each death that occurs at each such facility while a patient
is restrained or in seclusion, of each death occurring within 24
hours after the patient has been removed from restraints and
seclusion, or where it is reasonable to assume that a patient’s
death is a result of such seclusion or restraint. A notification
under this section shall include the name of the resident and
shall be provided not later than 7 days after the date of the
death of the individual involved.
‘‘(b) FACILITY.—In this section, the term ‘facility’ has the
meaning given the term ‘facilities’ in section 102(3) of the Protection
and Advocacy for Mentally Ill Individuals Act of 1986 (42 U.S.C.
10802(3)).’’.
42 USC 290ii–2.

‘‘SEC. 593. REGULATIONS AND ENFORCEMENT.

Deadline.

‘‘(a) TRAINING.—Not later than 1 year after the date of the
enactment of this part, the Secretary, after consultation with appropriate State and local protection and advocacy organizations, physicians, facilities, and other health care professionals and patients,
shall promulgate regulations that require facilities to which the
Protection and Advocacy for Mentally Ill Individuals Act of 1986
(42 U.S.C. 10801 et seq.) applies, to meet the requirements of
subsection (b).
‘‘(b) REQUIREMENTS.—The regulations promulgated under subsection (a) shall require that—
‘‘(1) facilities described in subsection (a) ensure that there
is an adequate number of qualified professional and supportive
staff to evaluate patients, formulate written individualized,

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114 STAT. 1197

comprehensive treatment plans, and to provide active treatment
measures;
‘‘(2) appropriate training be provided for the staff of such
facilities in the use of restraints and any alternatives to the
use of restraints; and
‘‘(3) such facilities provide complete and accurate notification of deaths, as required under section 592(a).
‘‘(c) ENFORCEMENT.—A facility to which this part applies that
fails to comply with any requirement of this part, including a
failure to provide appropriate training, shall not be eligible for
participation in any program supported in whole or in part by
funds appropriated to any Federal department or agency.’’.
SEC. 3208. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS
OF CERTAIN NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH.

Title V of the Public Health Service Act (42 U.S.C. 290aa
et seq.), as amended by section 3207, is further amended by adding
at the end the following:

‘‘PART I—REQUIREMENT RELATING TO THE
RIGHTS OF RESIDENTS OF CERTAIN NONMEDICAL, COMMUNITY-BASED FACILITIES
FOR CHILDREN AND YOUTH
‘‘SEC. 595. REQUIREMENT RELATING TO THE RIGHTS OF RESIDENTS
OF CERTAIN NON-MEDICAL, COMMUNITY-BASED FACILITIES FOR CHILDREN AND YOUTH.

42 USC 290jj.

‘‘(a) PROTECTION OF RIGHTS.—
‘‘(1) IN GENERAL.—A public or private non-medical, community-based facility for children and youth (as defined in regulations to be promulgated by the Secretary) that receives support
in any form from any program supported in whole or in part
with funds appropriated under this Act shall protect and promote the rights of each resident of the facility, including the
right to be free from physical or mental abuse, corporal punishment, and any restraints or involuntary seclusions imposed
for purposes of discipline or convenience.
‘‘(2) NONAPPLICABILITY.—Notwithstanding this part, a
facility that provides inpatient psychiatric treatment services
for individuals under the age of 21, as authorized and defined
in subsections (a)(16) and (h) of section 1905 of the Social
Security Act, shall comply with the requirements of part H.
‘‘(3) APPLICABILITY OF MEDICAID PROVISIONS.—A non-medical, community-based facility for children and youth funded
under the Medicaid program under title XIX of the Social
Security Act shall continue to meet all existing requirements
for participation in such program that are not affected by
this part.
‘‘(b) REQUIREMENTS.—
‘‘(1) IN GENERAL.—Physical restraints and seclusion may
only be imposed on a resident of a facility described in subsection (a) if—
‘‘(A) the restraints or seclusion are imposed only in
emergency circumstances and only to ensure the immediate
physical safety of the resident, a staff member, or others

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PUBLIC LAW 106–310—OCT. 17, 2000
and less restrictive interventions have been determined
to be ineffective; and
‘‘(B) the restraints or seclusion are imposed only by
an individual trained and certified, by a State-recognized
body (as defined in regulation promulgated by the Secretary) and pursuant to a process determined appropriate
by the State and approved by the Secretary, in the prevention and use of physical restraint and seclusion, including
the needs and behaviors of the population served, relationship building, alternatives to restraint and seclusion, deescalation methods, avoiding power struggles, thresholds
for restraints and seclusion, the physiological and psychological impact of restraint and seclusion, monitoring physical signs of distress and obtaining medical assistance,
legal issues, position asphyxia, escape and evasion techniques, time limits, the process for obtaining approval for
continued restraints, procedures to address problematic
restraints, documentation, processing with children, and
follow-up with staff, and investigation of injuries and complaints.
‘‘(2) INTERIM PROCEDURES RELATING TO TRAINING AND CERTIFICATION.—
‘‘(A) IN GENERAL.—Until such time as the State
develops a process to assure the proper training and certification of facility personnel in the skills and competencies
referred in paragraph (1)(B), the facility involved shall
develop and implement an interim procedure that meets
the requirements of subparagraph (B).
‘‘(B) REQUIREMENTS.—A procedure developed under
subparagraph (A) shall—
‘‘(i) ensure that a supervisory or senior staff person
with training in restraint and seclusion who is competent to conduct a face-to-face assessment (as defined
in regulations promulgated by the Secretary), will
assess the mental and physical well-being of the child
or youth being restrained or secluded and assure that
the restraint or seclusion is being done in a safe
manner;
‘‘(ii) ensure that the assessment required under
clause (i) take place as soon as practicable, but in
no case later than 1 hour after the initiation of the
restraint or seclusion; and
‘‘(iii) ensure that the supervisory or senior staff
person continues to monitor the situation for the duration of the restraint and seclusion.
‘‘(3) LIMITATIONS.—
‘‘(A) IN GENERAL.—The use of a drug or medication
that is used as a restraint to control behavior or restrict
the resident’s freedom of movement that is not a standard
treatment for the resident’s medical or psychiatric condition
in nonmedical community-based facilities for children and
youth described in subsection (a)(1) is prohibited.
‘‘(B) PROHIBITION.—The use of mechanical restraints
in non-medical, community-based facilities for children and
youth described in subsection (a)(1) is prohibited.
‘‘(C) LIMITATION.—A non-medical, community-based
facility for children and youth described in subsection (a)(1)

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114 STAT. 1199

may only use seclusion when a staff member is continuously
face-to-face monitoring the resident and when strong
licensing or accreditation and internal controls are in place.
‘‘(c) RULE OF CONSTRUCTION.—
‘‘(1) IN GENERAL.—Nothing in this section shall be construed as prohibiting the use of restraints for medical immobilization, adaptive support, or medical protection.
‘‘(2) CURRENT LAW.—This part shall not be construed to
affect or impede any Federal or State law or regulations that
provide greater protections than this part regarding seclusion
and restraint.
‘‘(d) DEFINITIONS.—In this section:
‘‘(1) MECHANICAL RESTRAINT.—The term ‘mechanical
restraint’ means the use of devices as a means of restricting
a resident’s freedom of movement.
‘‘(2) PHYSICAL ESCORT.—The term ‘physical escort’ means
the temporary touching or holding of the hand, wrist, arm,
shoulder or back for the purpose of inducing a resident who
is acting out to walk to a safe location.
‘‘(3) PHYSICAL RESTRAINT.—The term ‘physical restraint’
means a personal restriction that immobilizes or reduces the
ability of an individual to move his or her arms, legs, or
head freely. Such term does not include a physical escort.
‘‘(4) SECLUSION.—The term ‘seclusion’ means a behavior
control technique involving locked isolation. Such term does
not include a time out.
‘‘(5) TIME OUT.—The term ‘time out’ means a behavior
management technique that is part of an approved treatment
program and may involve the separation of the resident from
the group, in a non-locked setting, for the purpose of calming.
Time out is not seclusion.
‘‘SEC. 595A. REPORTING REQUIREMENT.

42 USC 290jj–1.

‘‘Each facility to which this part applies shall notify the appropriate State licensing or regulatory agency, as determined by the
Secretary—
‘‘(1) of each death that occurs at each such facility. A
notification under this section shall include the name of the
resident and shall be provided not later than 24 hours after
the time of the individuals death; and
‘‘(2) of the use of seclusion or restraints in accordance
with regulations promulgated by the Secretary, in consultation
with the States.
‘‘SEC. 595B. REGULATIONS AND ENFORCEMENT.

42 USC 290jj–2.

‘‘(a) TRAINING.—Not later than 6 months after the date of
the enactment of this part, the Secretary, after consultation with
appropriate State, local, public and private protection and advocacy
organizations, health care professionals, social workers, facilities,
and patients, shall promulgate regulations that—
‘‘(1) require States that license non-medical, communitybased residential facilities for children and youth to develop
licensing rules and monitoring requirements concerning
behavior management practice that will ensure compliance with
Federal regulations and to meet the requirements of subsection
(b);
‘‘(2) require States to develop and implement such licensing
rules and monitoring requirements within 1 year after the

Deadline.

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PUBLIC LAW 106–310—OCT. 17, 2000

promulgation of the regulations referred to in the matter preceding paragraph (1); and
‘‘(3) support the development of national guidelines and
standards on the quality, quantity, orientation and training,
required under this part, as well as the certification or licensure
of those staff responsible for the implementation of behavioral
intervention concepts and techniques.
‘‘(b) REQUIREMENTS.—The regulations promulgated under subsection (a) shall require—
‘‘(1) that facilities described in subsection (a) ensure that
there is an adequate number of qualified professional and supportive staff to evaluate residents, formulate written individualized, comprehensive treatment plans, and to provide active
treatment measures;
‘‘(2) the provision of appropriate training and certification
of the staff of such facilities in the prevention and use of
physical restraint and seclusion, including the needs and behaviors of the population served, relationship building, alternatives
to restraint, de-escalation methods, avoiding power struggles,
thresholds for restraints, the physiological impact of restraint
and seclusion, monitoring physical signs of distress and
obtaining medical assistance, legal issues, position asphyxia,
escape and evasion techniques, time limits for the use of
restraint and seclusion, the process for obtaining approval for
continued restraints and seclusion, procedures to address
problematic restraints, documentation, processing with children, and follow-up with staff, and investigation of injuries
and complaints; and
‘‘(3) that such facilities provide complete and accurate
notification of deaths, as required under section 595A(1).
‘‘(c) ENFORCEMENT.—A State to which this part applies that
fails to comply with any requirement of this part, including a
failure to provide appropriate training and certification, shall not
be eligible for participation in any program supported in whole
or in part by funds appropriated under this Act.’’.
SEC. 3209. EMERGENCY MENTAL HEALTH CENTERS.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3111,
is further amended by adding at the end the following:
42 USC 290bb–
37.

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‘‘SEC. 520F. GRANTS FOR EMERGENCY MENTAL HEALTH CENTERS.

‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall award grants
to States, political subdivisions of States, Indian tribes, and tribal
organizations to support the designation of hospitals and health
centers as Emergency Mental Health Centers.
‘‘(b) HEALTH CENTER.—In this section, the term ‘health center’
has the meaning given such term in section 330, and includes
community health centers and community mental health centers.
‘‘(c) DISTRIBUTION OF AWARDS.—The Secretary shall ensure that
such grants awarded under subsection (a) are equitably distributed
among the geographical regions of the United States, between urban
and rural populations, and between different settings of care
including health centers, mental health centers, hospitals, and other
psychiatric units or facilities.
‘‘(d) APPLICATION.—A State, political subdivision of a State,
Indian tribe, or tribal organization that desires a grant under
subsection (a) shall submit an application to the Secretary at such

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114 STAT. 1201

time, in such manner, and containing such information as the
Secretary may require, including a plan for the rigorous evaluation
of activities carried out with funds received under this section.
‘‘(e) USE OF FUNDS.—
‘‘(1) IN GENERAL.—A State, political subdivision of a State,
Indian tribe, or tribal organization receiving a grant under
subsection (a) shall use funds from such grant to establish
or designate hospitals and health centers as Emergency Mental
Health Centers.
‘‘(2) EMERGENCY MENTAL HEALTH CENTERS.—Such Emergency Mental Health Centers described in paragraph (1)—
‘‘(A) shall—
‘‘(i) serve as a central receiving point in the
community for individuals who may be in need of emergency mental health services;
‘‘(ii) purchase, if needed, any equipment necessary
to evaluate, diagnose and stabilize an individual with
a mental illness;
‘‘(iii) provide training, if needed, to the medical
personnel staffing the Emergency Mental Health
Center to evaluate, diagnose, stabilize, and treat an
individual with a mental illness; and
‘‘(iv) provide any treatment that is necessary for
an individual with a mental illness or a referral for
such individual to another facility where such treatment may be received; and
‘‘(B) may establish and train a mobile crisis intervention team to respond to mental health emergencies within
the community.
‘‘(f ) EVALUATION.—A State, political subdivision of a State,
Indian tribe, or tribal organization that receives a grant under
subsection (a) shall prepare and submit an evaluation to the Secretary at such time, in such manner, and containing such information as the Secretary may reasonably require, including an evaluation of activities carried out with funds received under this section
and a process and outcomes evaluation.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section, $25,000,000 for fiscal
year 2001 and such sums as may be necessary for each of the
fiscal years 2002 through 2003.’’.
SEC. 3210. GRANTS FOR JAIL DIVERSION PROGRAMS.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3209,
is further amended by adding at the end the following:
‘‘SEC. 520G. GRANTS FOR JAIL DIVERSION PROGRAMS.

‘‘(a) PROGRAM AUTHORIZED.—The Secretary shall make up to
125 grants to States, political subdivisions of States, Indian tribes,
and tribal organizations, acting directly or through agreements
with other public or nonprofit entities, to develop and implement
programs to divert individuals with a mental illness from the
criminal justice system to community-based services.
‘‘(b) ADMINISTRATION.—
‘‘(1) CONSULTATION.—The Secretary shall consult with the
Attorney General and any other appropriate officials in carrying
out this section.

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PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(2) REGULATORY AUTHORITY.—The Secretary shall issue
regulations and guidelines necessary to carry out this section,
including methodologies and outcome measures for evaluating
programs carried out by States, political subdivisions of States,
Indian tribes, and tribal organizations receiving grants under
subsection (a).
‘‘(c) APPLICATIONS.—
‘‘(1) IN GENERAL.—To receive a grant under subsection (a),
the chief executive of a State, chief executive of a subdivision
of a State, Indian tribe or tribal organization shall prepare
and submit an application to the Secretary at such time, in
such manner, and containing such information as the Secretary
shall reasonably require.
‘‘(2) CONTENT.—Such application shall—
‘‘(A) contain an assurance that—
‘‘(i) community-based mental health services will
be available for the individuals who are diverted from
the criminal justice system, and that such services
are based on the best known practices, reflect current
research findings, include case management, assertive
community treatment, medication management and
access, integrated mental health and co-occurring substance abuse treatment, and psychiatric rehabilitation,
and will be coordinated with social services, including
life skills training, housing placement, vocational
training, education job placement, and health care;
‘‘(ii) there has been relevant interagency collaboration between the appropriate criminal justice, mental
health, and substance abuse systems; and
‘‘(iii) the Federal support provided will be used
to supplement, and not supplant, State, local, Indian
tribe, or tribal organization sources of funding that
would otherwise be available;
‘‘(B) demonstrate that the diversion program will be
integrated with an existing system of care for those with
mental illness;
‘‘(C) explain the applicant’s inability to fund the program adequately without Federal assistance;
‘‘(D) specify plans for obtaining necessary support and
continuing the proposed program following the conclusion
of Federal support; and
‘‘(E) describe methodology and outcome measures that
will be used in evaluating the program.
‘‘(d) USE OF FUNDS.—A State, political subdivision of a State,
Indian tribe, or tribal organization that receives a grant under
subsection (a) may use funds received under such grant to—
‘‘(1) integrate the diversion program into the existing
system of care;
‘‘(2) create or expand community-based mental health and
co-occurring mental illness and substance abuse services to
accommodate the diversion program;
‘‘(3) train professionals involved in the system of care,
and law enforcement officers, attorneys, and judges; and
‘‘(4) provide community outreach and crisis intervention.
‘‘(e) FEDERAL SHARE.—
‘‘(1) IN GENERAL.—The Secretary shall pay to a State, political subdivision of a State, Indian tribe, or tribal organization

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114 STAT. 1203

receiving a grant under subsection (a) the Federal share of
the cost of activities described in the application.
‘‘(2) FEDERAL SHARE.—The Federal share of a grant made
under this section shall not exceed 75 percent of the total
cost of the program carried out by the State, political subdivision of a State, Indian tribe, or tribal organization. Such share
shall be used for new expenses of the program carried out
by such State, political subdivision of a State, Indian tribe,
or tribal organization.
‘‘(3) NON-FEDERAL SHARE.—The non-Federal share of payments made under this section may be made in cash or in
kind fairly evaluated, including planned equipment or services.
The Secretary may waive the requirement of matching contributions.
‘‘(f ) GEOGRAPHIC DISTRIBUTION.—The Secretary shall ensure
that such grants awarded under subsection (a) are equitably distributed among the geographical regions of the United States and
between urban and rural populations.
‘‘(g) TRAINING AND TECHNICAL ASSISTANCE.—Training and technical assistance may be provided by the Secretary to assist a State,
political subdivision of a State, Indian tribe, or tribal organization
receiving a grant under subsection (a) in establishing and operating
a diversion program.
‘‘(h) EVALUATIONS.—The programs described in subsection (a)
shall be evaluated not less than one time in every 12-month period
using the methodology and outcome measures identified in the
grant application.
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section $10,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 through 2003.’’.
SEC. 3211. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS
THROUGH SERVICES INTEGRATION BETWEEN CHILD
WELFARE AND MENTAL HEALTH SERVICES.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3210,
is further amended by adding at the end the following:
‘‘SEC. 520H. IMPROVING OUTCOMES FOR CHILDREN AND ADOLESCENTS THROUGH SERVICES INTEGRATION BETWEEN
CHILD WELFARE AND MENTAL HEALTH SERVICES.

42 USC 290bb–
39.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts
or cooperative agreements to States, political subdivisions of States,
Indian tribes, and tribal organizations to provide integrated child
welfare and mental health services for children and adolescents
under 19 years of age in the child welfare system or at risk for
becoming part of the system, and parents or caregivers with a
mental illness or a mental illness and a co-occurring substance
abuse disorder.
‘‘(b) DURATION.—With respect to a grant, contract or cooperative
agreement awarded under this section, the period during which
payments under such award are made to the recipient may not
exceed 5 years.
‘‘(c) APPLICATION.—
‘‘(1) IN GENERAL.—To be eligible to receive an award under
subsection (a), a State, political subdivision of a State, Indian
tribe, or tribal organization shall submit an application to the

Grants.
Contracts.

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114 STAT. 1204

PUBLIC LAW 106–310—OCT. 17, 2000

Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
‘‘(2) CONTENT.—An application submitted under paragraph
(1) shall—
‘‘(A) describe the program to be funded under the grant,
contract or cooperative agreement;
‘‘(B) explain how such program reflects best practices
in the provision of child welfare and mental health services;
and
‘‘(C) provide assurances that—
‘‘(i) persons providing services under the grant,
contract or cooperative agreement are adequately
trained to provide such services; and
‘‘(ii) the services will be provided in accordance
with subsection (d).
‘‘(d) USE OF FUNDS.—A State, political subdivision of a State,
Indian tribe, or tribal organization that receives a grant, contract,
or cooperative agreement under subsection (a) shall use amounts
made available through such grant, contract or cooperative agreement to—
‘‘(1) provide family-centered, comprehensive, and coordinated child welfare and mental health services, including
prevention, early intervention and treatment services for children and adolescents, and for their parents or caregivers;
‘‘(2) ensure a single point of access for such coordinated
services;
‘‘(3) provide integrated mental health and substance abuse
treatment for children, adolescents, and parents or caregivers
with a mental illness and a co-occurring substance abuse disorder;
‘‘(4) provide training for the child welfare, mental health
and substance abuse professionals who will participate in the
program carried out under this section;
‘‘(5) provide technical assistance to child welfare and mental
health agencies;
‘‘(6) develop cooperative efforts with other service entities
in the community, including education, social services, juvenile
justice, and primary health care agencies;
‘‘(7) coordinate services with services provided under the
Medicaid program and the State Children’s Health Insurance
Program under titles XIX and XXI of the Social Security Act;
‘‘(8) provide linguistically appropriate and culturally competent services; and
‘‘(9) evaluate the effectiveness and cost-efficiency of the
integrated services that measure the level of coordination, outcome measures for parents or caregivers with a mental illness
or a mental illness and a co-occurring substance abuse disorder,
and outcome measures for children.
‘‘(e) DISTRIBUTION OF AWARDS.—The Secretary shall ensure that
grants, contracts, and cooperative agreements awarded under subsection (a) are equitably distributed among the geographical regions
of the United States and between urban and rural populations.
‘‘(f ) EVALUATION.—The Secretary shall evaluate each program
carried out by a State, political subdivision of a State, Indian
tribe, or tribal organization under subsection (a) and shall disseminate the findings with respect to each such evaluation to appropriate
public and private entities.

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114 STAT. 1205

‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section, $10,000,000 for fiscal
year 2001, and such sums as may be necessary for each of fiscal
years 2002 and 2003.’’.
SEC. 3212. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS
MENTAL ILLNESS AND CO-OCCURRING SUBSTANCE
ABUSE.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3211,
is further amended by adding at the end the following:
‘‘SEC. 520I. GRANTS FOR THE INTEGRATED TREATMENT OF SERIOUS
MENTAL ILLNESS AND CO-OCCURRING SUBSTANCE
ABUSE.

42 USC 290bb–
40.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to States, political subdivisions of States,
Indian tribes, tribal organizations, and private nonprofit organizations for the development or expansion of programs to provide
integrated treatment services for individuals with a serious mental
illness and a co-occurring substance abuse disorder.
‘‘(b) PRIORITY.—In awarding grants, contracts, and cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants that emphasize the provision of services for individuals
with a serious mental illness and a co-occurring substance abuse
disorder who—
‘‘(1) have a history of interactions with law enforcement
or the criminal justice system;
‘‘(2) have recently been released from incarceration;
‘‘(3) have a history of unsuccessful treatment in either
an inpatient or outpatient setting;
‘‘(4) have never followed through with outpatient services
despite repeated referrals; or
‘‘(5) are homeless.
‘‘(c) USE OF FUNDS.—A State, political subdivision of a State,
Indian tribe, tribal organization, or private nonprofit organization
that receives a grant, contract, or cooperative agreement under
subsection (a) shall use funds received under such grant—
‘‘(1) to provide fully integrated services rather than serial
or parallel services;
‘‘(2) to employ staff that are cross-trained in the diagnosis
and treatment of both serious mental illness and substance
abuse;
‘‘(3) to provide integrated mental health and substance
abuse services at the same location;
‘‘(4) to provide services that are linguistically appropriate
and culturally competent;
‘‘(5) to provide at least 10 programs for integrated treatment of both mental illness and substance abuse at sites that
previously provided only mental health services or only substance abuse services; and
‘‘(6) to provide services in coordination with other existing
public and private community programs.
‘‘(d) CONDITION.—The Secretary shall ensure that a State, political subdivision of a State, Indian tribe, tribal organization, or
private nonprofit organization that receives a grant, contract, or
cooperative agreement under subsection (a) maintains the level
of effort necessary to sustain existing mental health and substance

Contracts.

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114 STAT. 1206

PUBLIC LAW 106–310—OCT. 17, 2000

abuse programs for other populations served by mental health
systems in the community.
‘‘(e) DISTRIBUTION OF AWARDS.—The Secretary shall ensure that
grants, contracts, or cooperative agreements awarded under subsection (a) are equitably distributed among the geographical regions
of the United States and between urban and rural populations.
‘‘(f ) DURATION.—The Secretary shall award grants, contract,
or cooperative agreements under this subsection for a period of
not more than 5 years.
‘‘(g) APPLICATION.—A State, political subdivision of a State,
Indian tribe, tribal organization, or private nonprofit organization
that desires a grant, contract, or cooperative agreement under this
subsection shall prepare and submit an application to the Secretary
at such time, in such manner, and containing such information
as the Secretary may require. Such application shall include a
plan for the rigorous evaluation of activities funded with an award
under such subsection, including a process and outcomes evaluation.
‘‘(h) EVALUATION.—A State, political subdivision of a State,
Indian tribe, tribal organization, or private nonprofit organization
that receives a grant, contract, or cooperative agreement under
this subsection shall prepare and submit a plan for the rigorous
evaluation of the program funded under such grant, contract, or
agreement, including both process and outcomes evaluation, and
the submission of an evaluation at the end of the project period.
‘‘(i) AUTHORIZATION OF APPROPRIATION.—There is authorized
to be appropriated to carry out this subsection $40,000,000 for
fiscal year 2001, and such sums as may be necessary for fiscal
years 2002 through 2003.’’.
SEC. 3213. TRAINING GRANTS.

Subpart 3 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb–31 et seq.), as amended by section 3212,
is further amended by adding at the end the following:
42 USC 290bb–
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‘‘SEC. 520J. TRAINING GRANTS.

‘‘(a) IN GENERAL.—The Secretary shall award grants in accordance with the provisions of this section.
‘‘(b) MENTAL ILLNESS AWARENESS TRAINING GRANTS.—
‘‘(1) IN GENERAL.—The Secretary shall award grants to
States, political subdivisions of States, Indian tribes, tribal
organizations, and nonprofit private entities to train teachers
and other relevant school personnel to recognize symptoms
of childhood and adolescent mental disorders, to refer family
members to the appropriate mental health services if necessary,
to train emergency services personnel to identify and appropriately respond to persons with a mental illness, and to provide
education to such teachers and personnel regarding resources
that are available in the community for individuals with a
mental illness.
‘‘(2) EMERGENCY SERVICES PERSONNEL.—In this subsection,
the term ‘emergency services personnel’ includes paramedics,
firefighters, and emergency medical technicians.
‘‘(3) DISTRIBUTION OF AWARDS.—The Secretary shall ensure
that such grants awarded under this subsection are equitably
distributed among the geographical regions of the United States
and between urban and rural populations.
‘‘(4) APPLICATION.—A State, political subdivision of a State,
Indian tribe, tribal organization, or nonprofit private entity

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114 STAT. 1207

that desires a grant under this subsection shall submit an
application to the Secretary at such time, in such manner,
and containing such information as the Secretary may require,
including a plan for the rigorous evaluation of activities that
are carried out with funds received under a grant under this
subsection.
‘‘(5) USE OF FUNDS.—A State, political subdivision of a
State, Indian tribe, tribal organization, or nonprofit private
entity receiving a grant under this subsection shall use funds
from such grant to—
‘‘(A) train teachers and other relevant school personnel
to recognize symptoms of childhood and adolescent mental
disorders and appropriately respond;
‘‘(B) train emergency services personnel to identify and
appropriately respond to persons with a mental illness;
and
‘‘(C) provide education to such teachers and personnel
regarding resources that are available in the community
for individuals with a mental illness.
‘‘(6) EVALUATION.—A State, political subdivision of a State,
Indian tribe, tribal organization, or nonprofit private entity
that receives a grant under this subsection shall prepare and
submit an evaluation to the Secretary at such time, in such
manner, and containing such information as the Secretary may
reasonably require, including an evaluation of activities carried
out with funds received under the grant under this subsection
and a process and outcome evaluation.
‘‘(7) AUTHORIZATION OF APPROPRIATIONS.—There is authorized to be appropriated to carry out this subsection, $25,000,000
for fiscal year 2001 and such sums as may be necessary for
each of fiscal years 2002 through 2003.’’.

TITLE XXXIII—PROVISIONS RELATING
TO SUBSTANCE ABUSE
SEC. 3301. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.

(a) RESIDENTIAL TREATMENT PROGRAMS FOR PREGNANT AND
POSTPARTUM WOMEN.—Section 508(r) of the Public Health Service
Act (42 U.S.C. 290bb–1(r)) is amended to read as follows:
‘‘(r) AUTHORIZATION OF APPROPRIATIONS.—For the purpose of
carrying out this section, there are authorized to be appropriated
such sums as may be necessary to fiscal years 2001 through 2003.’’.
(b) PRIORITY SUBSTANCE ABUSE TREATMENT.—Section 509 of
the Public Health Service Act (42 U.S.C. 290bb–1) is amended
to read as follows:
‘‘SEC. 509. PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.

42 USC 290bb–2.

‘‘(a) PROJECTS.—The Secretary shall address priority substance
abuse treatment needs of regional and national significance (as
determined under subsection (b)) through the provision of or
through assistance for—
‘‘(1) knowledge development and application projects for
treatment and rehabilitation and the conduct or support of
evaluations of such projects;

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PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(2) training and technical assistance; and
‘‘(3) targeted capacity response programs.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal organizations, other public or nonprofit private entities.
‘‘(b) PRIORITY SUBSTANCE ABUSE TREATMENT NEEDS.—
‘‘(1) IN GENERAL.—Priority substance abuse treatment
needs of regional and national significance shall be determined
by the Secretary after consultation with States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
‘‘(2) SPECIAL CONSIDERATION.—In developing program priorities under paragraph (1), the Secretary shall give special
consideration to promoting the integration of substance abuse
treatment services into primary health care systems.
‘‘(c) REQUIREMENTS.—
‘‘(1) IN GENERAL.—Recipients of grants, contracts, or
cooperative agreements under this section shall comply with
information and application requirements determined appropriate by the Secretary.
‘‘(2) DURATION OF AWARD.—With respect to a grant, contract, or cooperative agreement awarded under this section,
the period during which payments under such award are made
to the recipient may not exceed 5 years.
‘‘(3) MATCHING FUNDS.—The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
that project provide non-Federal matching funds, as determined
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public or private entities and may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
‘‘(4) MAINTENANCE OF EFFORT.—With respect to activities
for which a grant, contract, or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree to
maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures
maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant, contract,
or cooperative agreement.
‘‘(d) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a)(1) and shall disseminate the
findings with respect to each such evaluation to appropriate public
and private entities.
‘‘(e) INFORMATION AND EDUCATION.—The Secretary shall establish comprehensive information and education programs to disseminate and apply the findings of the knowledge development and
application, training and technical assistance programs, and targeted capacity response programs under this section to the general
public, to health professionals and other interested groups. The
Secretary shall make every effort to provide linkages between the

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1209

findings of supported projects and State agencies responsible for
carrying out substance abuse prevention and treatment programs.
‘‘(f ) AUTHORIZATION OF APPROPRIATION.—There are authorized
to be appropriated to carry out this section, $300,000,000 for fiscal
year 2001 and such sums as may be necessary for each of the
fiscal years 2002 and 2003.’’.
(c) CONFORMING AMENDMENTS.—The following sections of the
Public Health Service Act are repealed:
(1) Section 510 (42 U.S.C. 290bb–3).
(2) Section 511 (42 U.S.C. 290bb–4).
(3) Section 512 (42 U.S.C. 290bb–5).
(4) Section 571 (42 U.S.C. 290gg).
SEC. 3302. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.

(a) IN GENERAL.—Section 516 of the Public Health Service
Act (42 U.S.C. 290bb–1) is amended to read as follows:
‘‘SEC. 516. PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS OF
REGIONAL AND NATIONAL SIGNIFICANCE.

42 USC 290bb–
22.

‘‘(a) PROJECTS.—The Secretary shall address priority substance
abuse prevention needs of regional and national significance (as
determined under subsection (b)) through the provision of or
through assistance for—
‘‘(1) knowledge development and application projects for
prevention and the conduct or support of evaluations of such
projects;
‘‘(2) training and technical assistance; and
‘‘(3) targeted capacity response programs.
The Secretary may carry out the activities described in this section
directly or through grants or cooperative agreements with States,
political subdivisions of States, Indian tribes and tribal organizations, or other public or nonprofit private entities.
‘‘(b) PRIORITY SUBSTANCE ABUSE PREVENTION NEEDS.—
‘‘(1) IN GENERAL.—Priority substance abuse prevention
needs of regional and national significance shall be determined
by the Secretary in consultation with the States and other
interested groups. The Secretary shall meet with the States
and interested groups on an annual basis to discuss program
priorities.
‘‘(2) SPECIAL CONSIDERATION.—In developing program priorities under paragraph (1), the Secretary shall give special
consideration to—
‘‘(A) applying the most promising strategies and
research-based primary prevention approaches; and
‘‘(B) promoting the integration of substance abuse
prevention information and activities into primary health
care systems.
‘‘(c) REQUIREMENTS.—
‘‘(1) IN GENERAL.—Recipients of grants, contracts, and
cooperative agreements under this section shall comply with
information and application requirements determined appropriate by the Secretary.
‘‘(2) DURATION OF AWARD.—With respect to a grant, contract, or cooperative agreement awarded under this section,
the period during which payments under such award are made
to the recipient may not exceed 5 years.

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114 STAT. 1210

PUBLIC LAW 106–310—OCT. 17, 2000

‘‘(3) MATCHING FUNDS.—The Secretary may, for projects
carried out under subsection (a), require that entities that
apply for grants, contracts, or cooperative agreements under
that project provide non-Federal matching funds, as determined
appropriate by the Secretary, to ensure the institutional
commitment of the entity to the projects funded under the
grant, contract, or cooperative agreement. Such non-Federal
matching funds may be provided directly or through donations
from public or private entities and may be in cash or in kind,
fairly evaluated, including plant, equipment, or services.
‘‘(4) MAINTENANCE OF EFFORT.—With respect to activities
for which a grant, contract, or cooperative agreement is
awarded under this section, the Secretary may require that
recipients for specific projects under subsection (a) agree to
maintain expenditures of non-Federal amounts for such activities at a level that is not less than the level of such expenditures
maintained by the entity for the fiscal year preceding the
fiscal year for which the entity receives such a grant, contract,
or cooperative agreement.
‘‘(d) EVALUATION.—The Secretary shall evaluate each project
carried out under subsection (a)(1) and shall disseminate the
findings with respect to each such evaluation to appropriate public
and private entities.
‘‘(e) INFORMATION AND EDUCATION.—The Secretary shall establish comprehensive information and education programs to disseminate the findings of the knowledge development and application,
training and technical assistance programs, and targeted capacity
response programs under this section to the general public and
to health professionals. The Secretary shall make every effort to
provide linkages between the findings of supported projects and
State agencies responsible for carrying out substance abuse prevention and treatment programs.
‘‘(f ) AUTHORIZATION OF APPROPRIATION.—There are authorized
to be appropriated to carry out this section, $300,000,000 for fiscal
year 2001, and such sums as may be necessary for each of the
fiscal years 2002 and 2003.’’.
(b) CONFORMING AMENDMENTS.—Section 518 of the Public
Health Service Act (42 U.S.C. 290bb–24) is repealed.
SEC.

3303.

SUBSTANCE ABUSE PREVENTION AND TREATMENT
PERFORMANCE PARTNERSHIP BLOCK GRANT.

(a) ALLOCATION REGARDING ALCOHOL AND OTHER DRUGS.—
Section 1922 of the Public Health Service Act (42 U.S.C. 300x–
22) is amended by—
(1) striking subsection (a); and
(2) redesignating subsections (b) and (c) as subsections
(a) and (b).
(b) GROUP HOMES FOR RECOVERING SUBSTANCE ABUSERS.—
Section 1925(a) of the Public Health Service Act (42 U.S.C. 300x–
25(a)) is amended by striking ‘‘For fiscal year 1993’’ and all that
follows through the colon and inserting the following: ‘‘A State,
using funds available under section 1921, may establish and maintain the ongoing operation of a revolving fund in accordance with
this section to support group homes for recovering substance
abusers as follows:’’.
(c) MAINTENANCE OF EFFORT.—Section 1930 of the Public
Health Service Act (42 U.S.C. 300x–30) is amended—

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1211

(1) by redesignating subsections (b) and (c) as subsections
(c) and (d) respectively; and
(2) by inserting after subsection (a), the following:
‘‘(b) EXCLUSION OF CERTAIN FUNDS.—The Secretary may
exclude from the aggregate State expenditures under subsection
(a), funds appropriated to the principle agency for authorized activities which are of a non-recurring nature and for a specific purpose.’’.
(d) APPLICATIONS FOR GRANTS.—Section 1932(a)(1) of the Public
Health Service Act (42 U.S.C. 300x–32(a)(1)) is amended to read
as follows:
‘‘(1) the application is received by the Secretary not later
than October 1 of the fiscal year for which the State is seeking
funds;’’.
(e) WAIVER FOR TERRITORIES.—Section 1932(c) of the Public
Health Service Act (42 U.S.C. 300x–32(c)) is amended by striking
‘‘whose allotment under section 1921 for the fiscal year is the
amount specified in section 1933(c)(2)(B)’’ and inserting ‘‘except
Puerto Rico’’.
(f ) WAIVER AUTHORITY FOR CERTAIN REQUIREMENTS.—
(1) IN GENERAL.—Section 1932 of the Public Health Service
Act (42 U.S.C. 300x–32) is amended by adding at the end
the following:
‘‘(e) WAIVER AUTHORITY FOR CERTAIN REQUIREMENTS.—
‘‘(1) IN GENERAL.—Upon the request of a State, the Secretary may waive the requirements of all or part of the sections
described in paragraph (2) using objective criteria established
by the Secretary by regulation after consultation with the
States and other interested parties including consumers and
providers.
‘‘(2) SECTIONS.—The sections described in paragraph (1)
are sections 1922(c), 1923, 1924 and 1928.
‘‘(3) DATE CERTAIN FOR ACTING UPON REQUEST.—The Secretary shall approve or deny a request for a waiver under
paragraph (1) and inform the State of that decision not later
than 120 days after the date on which the request and all
the information needed to support the request are submitted.
‘‘(4) ANNUAL REPORTING REQUIREMENT.—The Secretary
shall annually report to the general public on the States that
receive a waiver under this subsection.’’.
(2) CONFORMING AMENDMENTS.—Effective upon the publication of the regulations developed in accordance with section
1932(e)(1) of the Public Health Service Act (42 U.S.C. 300x–
32(d))—
(A) section 1922(c) of the Public Health Service Act
(42 U.S.C. 300x–22(c)) is amended by—
(i) striking paragraph (2); and
(ii) redesignating paragraph (3) as paragraph (2);
and
(B) section 1928(d) of the Public Health Service Act
(42 U.S.C. 300x–28(d)) is repealed.
(g) AUTHORIZATION OF APPROPRIATION.—Section 1935 of the
Public Health Service Act (42 U.S.C. 300x–35) is amended—
(1) in subsection (a), by striking ‘‘$1,500,000,000’’ and all
that follows through the end and inserting ‘‘$2,000,000,000
for fiscal year 2001, and such sums as may be necessary for
each of the fiscal years 2002 and 2003.’’;

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114 STAT. 1212

PUBLIC LAW 106–310—OCT. 17, 2000
(2) in subsection (b)(1), by striking ‘‘section 505’’ and
inserting ‘‘sections 505 and 1971’’;
(3) in subsection (b)(2), by striking ‘‘1949(a)’’ and inserting
‘‘1948(a)’’; and
(4) in subsection (b), by adding at the end the following:
‘‘(3) CORE DATA SET.—A State that receives a new grant,
contract, or cooperative agreement from amounts available to
the Secretary under paragraph (1), for the purposes of
improving the data collection, analysis and reporting capabilities of the State, shall be required, as a condition of receipt
of funds, to collect, analyze, and report to the Secretary for
each fiscal year subsequent to receiving such funds a core
data set to be determined by the Secretary in conjunction
with the States.’’.

SEC. 3304. DETERMINATION OF ALLOTMENTS.

Section 1933(b) of the Public Health Service Act (42 U.S.C.
300x–33(b)) is amended to read as follows:
‘‘(b) MINIMUM ALLOTMENTS FOR STATES.—
‘‘(1) IN GENERAL.—With respect to fiscal year 2000, and
each subsequent fiscal year, the amount of the allotment of
a State under section 1921 shall not be less than the amount
the State received under such section for the previous fiscal
year increased by an amount equal to 30.65 percent of the
percentage by which the aggregate amount allotted to all States
for such fiscal year exceeds the aggregate amount allotted
to all States for the previous fiscal year.
‘‘(2) LIMITATIONS.—
‘‘(A) IN GENERAL.—Except as provided in subparagraph
(B), a State shall not receive an allotment under section
1921 for a fiscal year in an amount that is less than
an amount equal to 0.375 percent of the amount appropriated under section 1935(a) for such fiscal year.
‘‘(B) EXCEPTION.—In applying subparagraph (A), the
Secretary shall ensure that no State receives an increase
in its allotment under section 1921 for a fiscal year (as
compared to the amount allotted to the State in the prior
fiscal year) that is in excess of an amount equal to 300
percent of the percentage by which the amount appropriated under section 1935(a) for such fiscal year exceeds
the amount appropriated for the prior fiscal year.
‘‘(3) DECREASE IN OR EQUAL APPROPRIATIONS.—If the
amount appropriated under section 1935(a) for a fiscal year
is equal to or less than the amount appropriated under such
section for the prior fiscal year, the amount of the State allotment under section 1921 shall be equal to the amount that
the State received under section 1921 in the prior fiscal year
decreased by the percentage by which the amount appropriated
for such fiscal year is less than the amount appropriated or
such section for the prior fiscal year.’’.
SEC. 3305. NONDISCRIMINATION AND INSTITUTIONAL SAFEGUARDS
FOR RELIGIOUS PROVIDERS.

Subpart III of part B of title XIX of the Public Health Service
Act (42 U.S.C. 300x–51 et seq.) is amended by adding at the
end the following:

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1213

‘‘SEC. 1955. SERVICES PROVIDED BY NONGOVERNMENTAL ORGANIZATIONS.

42 USC 300x–65.

‘‘(a) PURPOSES.—The purposes of this section are—
‘‘(1) to prohibit discrimination against nongovernmental
organizations and certain individuals on the basis of religion
in the distribution of government funds to provide substance
abuse services under this title and title V, and the receipt
of services under such titles; and
‘‘(2) to allow the organizations to accept the funds to provide
the services to the individuals without impairing the religious
character of the organizations or the religious freedom of the
individuals.
‘‘(b) RELIGIOUS ORGANIZATIONS INCLUDED AS NONGOVERNMENTAL PROVIDERS.—
‘‘(1) IN GENERAL.—A State may administer and provide
substance abuse services under any program under this title
or title V through grants, contracts, or cooperative agreements
to provide assistance to beneficiaries under such titles with
nongovernmental organizations.
‘‘(2) REQUIREMENT.—A State that elects to utilize nongovernmental organizations as provided for under paragraph
(1) shall consider, on the same basis as other nongovernmental
organizations, religious organizations to provide services under
substance abuse programs under this title or title V, so long
as the programs under such titles are implemented in a manner
consistent with the Establishment Clause of the first amendment to the Constitution. Neither the Federal Government
nor a State or local government receiving funds under such
programs shall discriminate against an organization that provides services under, or applies to provide services under, such
programs, on the basis that the organization has a religious
character.
‘‘(c) RELIGIOUS CHARACTER AND INDEPENDENCE.—
‘‘(1) IN GENERAL.—A religious organization that provides
services under any substance abuse program under this title
or title V shall retain its independence from Federal, State,
and local governments, including such organization’s control
over the definition, development, practice, and expression of
its religious beliefs.
‘‘(2) ADDITIONAL SAFEGUARDS.—Neither the Federal
Government nor a State or local government shall require
a religious organization—
‘‘(A) to alter its form of internal governance; or
‘‘(B) to remove religious art, icons, scripture, or other
symbols,
in order to be eligible to provide services under any substance
abuse program under this title or title V.
‘‘(d) EMPLOYMENT PRACTICES.—
‘‘(1) SUBSTANCE ABUSE.—A religious organization that provides services under any substance abuse program under this
title or title V may require that its employees providing services
under such program adhere to rules forbidding the use of
drugs or alcohol.
‘‘(2) TITLE VII EXEMPTION.—The exemption of a religious
organization provided under section 702 or 703(e)(2) of the
Civil Rights Act of 1964 (42 U.S.C. 2000e–1, 2000e–2(e)(2))
regarding employment practices shall not be affected by the

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114 STAT. 1214

PUBLIC LAW 106–310—OCT. 17, 2000

religious organization’s provision of services under, or receipt
of funds from, any substance abuse program under this title
or title V.
‘‘(e) RIGHTS OF BENEFICIARIES OF ASSISTANCE.—
‘‘(1) IN GENERAL.—If an individual described in paragraph
(3) has an objection to the religious character of the organization
from which the individual receives, or would receive, services
funded under any substance abuse program under this title
or title V, the appropriate Federal, State, or local governmental
entity shall provide to such individual (if otherwise eligible
for such services) within a reasonable period of time after
the date of such objection, services that—
‘‘(A) are from an alternative provider that is accessible
to the individual; and
‘‘(B) have a value that is not less than the value
of the services that the individual would have received
from such organization.
‘‘(2) NOTICE.—The appropriate Federal, State, or local
governmental entity shall ensure that notice is provided to
individuals described in paragraph (3) of the rights of such
individuals under this section.
‘‘(3) INDIVIDUAL DESCRIBED.—An individual described in
this paragraph is an individual who receives or applies for
services under any substance abuse program under this title
or title V.
‘‘(f ) NONDISCRIMINATION AGAINST BENEFICIARIES.—A religious
organization providing services through a grant, contract, or
cooperative agreement under any substance abuse program under
this title or title V shall not discriminate, in carrying out such
program, against an individual described in subsection (e)(3) on
the basis of religion, a religious belief, a refusal to hold a religious
belief, or a refusal to actively participate in a religious practice.
‘‘(g) FISCAL ACCOUNTABILITY.—
‘‘(1) IN GENERAL.—Except as provided in paragraph (2),
any religious organization providing services under any substance abuse program under this title or title V shall be subject
to the same regulations as other nongovernmental organizations to account in accord with generally accepted accounting
principles for the use of such funds provided under such program.
‘‘(2) LIMITED AUDIT.—Such organization shall segregate
government funds provided under such substance abuse program into a separate account. Only the government funds shall
be subject to audit by the government.
‘‘(h) COMPLIANCE.—Any party that seeks to enforce such party’s
rights under this section may assert a civil action for injunctive
relief exclusively in an appropriate Federal or State court against
the entity, agency or official that allegedly commits such violation.
‘‘(i) LIMITATIONS ON USE OF FUNDS FOR CERTAIN PURPOSES.—
No funds provided through a grant or contract to a religious
organization to provide services under any substance abuse program
under this title or title V shall be expended for sectarian worship,
instruction, or proselytization.
‘‘( j) EFFECT ON STATE AND LOCAL FUNDS.—If a State or local
government contributes State or local funds to carry out any substance abuse program under this title or title V, the State or
local government may segregate the State or local funds from the

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1215

Federal funds provided to carry out the program or may commingle
the State or local funds with the Federal funds. If the State or
local government commingles the State or local funds, the provisions
of this section shall apply to the commingled funds in the same
manner, and to the same extent, as the provisions apply to the
Federal funds.
‘‘(k) TREATMENT OF INTERMEDIATE CONTRACTORS.—If a nongovernmental organization (referred to in this subsection as an
‘intermediate organization’), acting under a contract or other agreement with the Federal Government or a State or local government,
is given the authority under the contract or agreement to select
nongovernmental organizations to provide services under any substance abuse program under this title or title V, the intermediate
organization shall have the same duties under this section as the
government but shall retain all other rights of a nongovernmental
organization under this section.’’.
SEC. 3306. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES FOR INDIANS AND NATIVE ALASKANS.

Part A of title V of the Public Health Service Act (42 U.S.C.
290aa et seq.) is amended by adding at the end the following:
‘‘SEC. 506A. ALCOHOL AND DRUG PREVENTION OR TREATMENT SERVICES FOR INDIANS AND NATIVE ALASKANS.

42 USC 290aa–
5a.

‘‘(a) IN GENERAL.—The Secretary shall award grants, contracts,
or cooperative agreements to public and private nonprofit entities,
including Native Alaskan entities and Indian tribes and tribal
organizations, for the purpose of providing alcohol and drug prevention or treatment services for Indians and Native Alaskans.
‘‘(b) PRIORITY.—In awarding grants, contracts, or cooperative
agreements under subsection (a), the Secretary shall give priority
to applicants that—
‘‘(1) propose to provide alcohol and drug prevention or
treatment services on reservations;
‘‘(2) propose to employ culturally-appropriate approaches,
as determined by the Secretary, in providing such services;
and
‘‘(3) have provided prevention or treatment services to
Native Alaskan entities and Indian tribes and tribal organizations for at least 1 year prior to applying for a grant under
this section.
‘‘(c) DURATION.—The Secretary shall award grants, contracts,
or cooperative agreements under subsection (a) for a period not
to exceed 5 years.
‘‘(d) APPLICATION.—An entity desiring a grant, contract, or
cooperative agreement under subsection (a) shall submit an application to the Secretary at such time, in such manner, and accompanied
by such information as the Secretary may reasonably require.
‘‘(e) EVALUATION.—An entity that receives a grant, contract,
or cooperative agreement under subsection (a) shall submit, in
the application for such grant, a plan for the evaluation of any
project undertaken with funds provided under this section. Such
entity shall provide the Secretary with periodic evaluations of the
progress of such project and such evaluation at the completion
of such project as the Secretary determines to be appropriate.
The final evaluation submitted by such entity shall include a recommendation as to whether such project shall continue.

Grants.
Contracts.

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114 STAT. 1216

PUBLIC LAW 106–310—OCT. 17, 2000

Deadline.

‘‘(f ) REPORT.—Not later than 3 years after the date of the
enactment of this section and annually thereafter, the Secretary
shall prepare and submit, to the Committee on Health, Education,
Labor, and Pensions of the Senate, a report describing the services
provided pursuant to this section.
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated to carry out this section, $15,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 and 2003.’’.

25 USC 1671
note.

SEC. 3307. ESTABLISHMENT OF COMMISSION.

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(a) IN GENERAL.—There is established a commission to be
known as the Commission on Indian and Native Alaskan Health
Care that shall examine the health concerns of Indians and Native
Alaskans who reside on reservations and tribal lands (hereafter
in this section referred to as the ‘‘Commission’’).
(b) MEMBERSHIP.—
(1) IN GENERAL.—The Commission established under subsection (a) shall consist of—
(A) the Secretary;
(B) 15 members who are experts in the health care
field and issues that the Commission is established to
examine; and
(C) the Director of the Indian Health Service and the
Commissioner of Indian Affairs, who shall be nonvoting
members.
(2) APPOINTING AUTHORITY.—Of the 15 members of the
Commission described in paragraph (1)(B)—
(A) two shall be appointed by the Speaker of the House
of Representatives;
(B) two shall be appointed by the Minority Leader
of the House of Representatives;
(C) two shall be appointed by the Majority Leader
of the Senate;
(D) two shall be appointed by the Minority Leader
of the Senate; and
(E) seven shall be appointed by the Secretary.
(3) LIMITATION.—Not fewer than 10 of the members
appointed to the Commission shall be Indians or Native Alaskans.
(4) CHAIRPERSON.—The Secretary shall serve as the Chairperson of the Commission.
(5) EXPERTS.—The Commission may seek the expertise of
any expert in the health care field to carry out its duties.
(c) PERIOD OF APPOINTMENT.—Members shall be appointed for
the life of the Commission. Any vacancy in the Commission shall
not affect its powers, but shall be filed in the same manner as
the original appointment.
(d) DUTIES OF THE COMMISSION.—The Commission shall—
(1) study the health concerns of Indians and Native Alaskans; and
(2) prepare the reports described in subsection (i).
(e) POWERS OF THE COMMISSION.—
(1) HEARINGS.—The Commission may hold such hearings,
including hearings on reservations, sit and act at such times
and places, take such testimony, and receive such information

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1217

as the Commission considers advisable to carry out the purpose
for which the Commission was established.
(2) INFORMATION FROM FEDERAL AGENCIES.—The Commission may secure directly from any Federal department or agency
such information as the Commission considers necessary to
carry out the purpose for which the Commission was established. Upon request of the Chairperson of the Commission,
the head of such department or agency shall furnish such
information to the Commission.
(f ) COMPENSATION OF MEMBERS.—
(1) IN GENERAL.—Except as provided in subparagraph (B),
each member of the Commission may be compensated at a
rate not to exceed the daily equivalent of the annual rate
of basic pay prescribed for level IV of the Executive Schedule
under section 5315 of title 5, United States Code, for each
day (including travel time), during which that member is
engaged in the actual performance of the duties of the Commission.
(2) LIMITATION.—Members of the Commission who are officers or employees of the United States shall receive no additional pay on account of their service on the Commission.
(g) TRAVEL EXPENSES OF MEMBERS.—The members of the
Commission shall be allowed travel expenses, including per diem
in lieu of subsistence, at rates authorized for employees of agencies
under section 5703 of title 5, United States Code, while away
from their homes or regular places of business in the performance
of services for the Commission.
(h) COMMISSION PERSONNEL MATTERS.—
(1) IN GENERAL.—The Secretary, in accordance with rules
established by the Commission, may select and appoint a staff
director and other personnel necessary to enable the Commission to carry out its duties.
(2) COMPENSATION OF PERSONNEL.—The Secretary, in
accordance with rules established by the Commission, may
set the amount of compensation to be paid to the staff director
and any other personnel that serve the Commission.
(3) DETAIL OF GOVERNMENT EMPLOYEES.—Any Federal
Government employee may be detailed to the Commission without reimbursement, and the detail shall be without interruption
or loss of civil service status or privilege.
(4) CONSULTANT SERVICES.—The Chairperson of the
Commission is authorized to procure the temporary and intermittent services of experts and consultants in accordance with
section 3109 of title 5, United States Code, at rates not to
exceed the daily equivalent of the annual rate of basic pay
prescribed for level IV of the Executive Schedule under section
5315 of such title.
(i) REPORT.—
(1) IN GENERAL.—Not later than 3 years after the date
of the enactment of the Youth Drug and Mental Health Services
Act, the Secretary shall prepare and submit, to the Committee
on Health, Education, Labor, and Pensions of the Senate, a
report that shall—
(A) detail the health problems faced by Indians and
Native Alaskans who reside on reservations;
(B) examine and explain the causes of such problems;

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PUBLIC LAW 106–310—OCT. 17, 2000

(C) describe the health care services available to
Indians and Native Alaskans who reside on reservations
and the adequacy of such services;
(D) identify the reasons for the provision of inadequate
health care services for Indians and Native Alaskans who
reside on reservations, including the availability of
resources;
(E) develop measures for tracking the health status
of Indians and Native Americans who reside on reservations; and
(F) make recommendations for improvements in the
health care services provided for Indians and Native Alaskans who reside on reservations, including recommendations for legislative change.
(2) EXCEPTION.—In addition to the report required under
paragraph (1), not later than 2 years after the date of the
enactment of the Youth Drug and Mental Health Services Act,
the Secretary shall prepare and submit, to the Committee on
Health, Education, Labor, and Pensions of the Senate, a report
that describes any alcohol and drug abuse among Indians and
Native Alaskans who reside on reservations.
( j) PERMANENT COMMISSION.—Section 14 of the Federal
Advisory Committee Act (5 U.S.C. App.) shall not apply to the
Commission.
(k) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section $5,000,000 for fiscal
year 2001, and such sums as may be necessary for fiscal years
2002 and 2003.

TITLE XXXIV—PROVISIONS RELATING
TO FLEXIBILITY AND ACCOUNTABILITY
SEC. 3401. GENERAL AUTHORITIES AND PEER REVIEW.

(a) GENERAL AUTHORITIES.—Paragraph (1) of section 501(e)
of the Public Health Service Act (42 U.S.C. 290aa(e)) is amended
to read as follows:
‘‘(1) IN GENERAL.—There may be in the Administration
an Associate Administrator for Alcohol Prevention and Treatment Policy to whom the Administrator may delegate the functions of promoting, monitoring, and evaluating service programs
for the prevention and treatment of alcoholism and alcohol
abuse within the Center for Substance Abuse Prevention, the
Center for Substance Abuse Treatment and the Center for
Mental Health Services, and coordinating such programs among
the Centers, and among the Centers and other public and
private entities. The Associate Administrator also may ensure
that alcohol prevention, education, and policy strategies are
integrated into all programs of the Centers that address substance abuse prevention, education, and policy, and that the
Center for Substance Abuse Prevention addresses the Healthy
People 2010 goals and the National Dietary Guidelines of the
Department of Health and Human Services and the Department
of Agriculture related to alcohol consumption.’’.
(b) PEER REVIEW.—Section 504 of the Public Health Service
(42 U.S.C. 290aa–3) is amended as follows:

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114 STAT. 1219

‘‘SEC. 504. PEER REVIEW.

‘‘(a) IN GENERAL.—The Secretary, after consultation with the
Administrator, shall require appropriate peer review of grants,
cooperative agreements, and contracts to be administered through
the agency which exceed the simple acquisition threshold as defined
in section 4(11) of the Office of Federal Procurement Policy Act.
‘‘(b) MEMBERS.—The members of any peer review group established under subsection (a) shall be individuals who by virtue
of their training or experience are eminently qualified to perform
the review functions of the group. Not more than one-fourth of
the members of any such peer review group shall be officers or
employees of the United States.
‘‘(c) ADVISORY COUNCIL REVIEW.—If the direct cost of a grant
or cooperative agreement (described in subsection (a)) exceeds the
simple acquisition threshold as defined by section 4(11) of the
Office of Federal Procurement Policy Act, the Secretary may make
such a grant or cooperative agreement only if such grant or cooperative agreement is recommended—
‘‘(1) after peer review required under subsection (a); and
‘‘(2) by the appropriate advisory council.
‘‘(d) CONDITIONS.—The Secretary may establish limited exceptions to the limitations contained in this section regarding participation of Federal employees and advisory council approval. The circumstances under which the Secretary may make such an exception
shall be made public.’’.

Grants.
Contracts.

SEC. 3402. ADVISORY COUNCILS.

Section 502(e) of the Public Health Service Act (42 U.S.C.
290aa–1(e)) is amended in the first sentence by striking ‘‘3 times’’
and inserting ‘‘2 times’’.
SEC. 3403. GENERAL PROVISIONS FOR THE PERFORMANCE PARTNERSHIP BLOCK GRANTS.

(a) PLANS FOR PERFORMANCE PARTNERSHIPS.—Section 1949 of
the Public Health Service Act (42 U.S.C. 300x–59) is amended
as follows:
‘‘SEC. 1949. PLANS FOR PERFORMANCE PARTNERSHIPS.

‘‘(a) DEVELOPMENT.—The Secretary in conjunction with States
and other interested groups shall develop separate plans for the
programs authorized under subparts I and II for creating more
flexibility for States and accountability based on outcome and other
performance measures. The plans shall each include—
‘‘(1) a description of the flexibility that would be given
to the States under the plan;
‘‘(2) the common set of performance measures that would
be used for accountability, including measures that would be
used for the program under subpart II for pregnant addicts,
HIV transmission, tuberculosis, and those with a co-occurring
substance abuse and mental disorders, and for programs under
subpart I for children with serious emotional disturbance and
adults with serious mental illness and for individuals with
co-occurring mental health and substance abuse disorders;
‘‘(3) the definitions for the data elements to be used under
the plan;
‘‘(4) the obstacles to implementation of the plan and the
manner in which such obstacles would be resolved;

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‘‘(5) the resources needed to implement the performance
partnerships under the plan; and
‘‘(6) an implementation strategy complete with recommendations for any necessary legislation.
‘‘(b) SUBMISSION.—Not later than 2 years after the date of
the enactment of this Act, the plans developed under subsection
(a) shall be submitted to the Committee on Health, Education,
Labor, and Pensions of the Senate and the Committee on Commerce
of the House of Representatives.
‘‘(c) INFORMATION.—As the elements of the plans described in
subsection (a) are developed, States are encouraged to provide
information to the Secretary on a voluntary basis.
‘‘(d) PARTICIPANTS.—The Secretary shall include among those
interested groups that participate in the development of the plan
consumers of mental health or substance abuse services, providers,
representatives of political divisions of States, and representatives
of racial and ethnic groups including Native Americans.’’.
(b) AVAILABILITY TO STATES OF GRANT PROGRAMS.—Section
1952 of the Public Health Service Act (42 U.S.C. 300x–62) is
amended as follows:
‘‘SEC. 1952. AVAILABILITY TO STATES OF GRANT PAYMENTS.

‘‘Any amounts paid to a State for a fiscal year under section
1911 or 1921 shall be available for obligation and expenditure
until the end of the fiscal year following the fiscal year for which
the amounts were paid.’’.
SEC. 3404. DATA INFRASTRUCTURE PROJECTS.

Part C of title XIX of the Public Health Service Act (42 U.S.C.
300y et seq.) is amended—
(1) by striking the headings for part C and subpart I
and inserting the following:

‘‘PART C—CERTAIN PROGRAMS REGARDING
MENTAL HEALTH AND SUBSTANCE ABUSE
‘‘Subpart I—Data Infrastructure Development’’;
(2) by striking section 1971 (42 U.S.C. 300y) and inserting
the following:
‘‘SEC. 1971. DATA INFRASTRUCTURE DEVELOPMENT.

‘‘(a) IN GENERAL.—The Secretary may make grants to, and
enter into contracts or cooperative agreements with States for the
purpose of developing and operating mental health or substance
abuse data collection, analysis, and reporting systems with regard
to performance measures including capacity, process, and outcomes
measures.
‘‘(b) PROJECTS.—The Secretary shall establish criteria to ensure
that services will be available under this section to States that
have a fundamental basis for the collection, analysis, and reporting
of mental health and substance abuse performance measures and
States that do not have such basis. The Secretary will establish
criteria for determining whether a State has a fundamental basis
for the collection, analysis, and reporting of data.
‘‘(c) CONDITION OF RECEIPT OF FUNDS.—As a condition of the
receipt of an award under this section a State shall agree to collect,
analyze, and report to the Secretary within 2 years of the date

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114 STAT. 1221

of the award on a core set of performance measures to be determined
by the Secretary in conjunction with the States.
‘‘(d) MATCHING REQUIREMENT.—
‘‘(1) IN GENERAL.—With respect to the costs of the program
to be carried out under subsection (a) by a State, the Secretary
may make an award under such subsection only if the applicant
agrees to make available (directly or through donations from
public or private entities) non-Federal contributions toward
such costs in an amount that is not less than 50 percent
of such costs.
‘‘(2) DETERMINATION OF AMOUNT CONTRIBUTED.—Non-Federal contributions under paragraph (1) may be in cash or in
kind, fairly evaluated, including plant, equipment, or services.
Amounts provided by the Federal Government, or services
assisted or subsidized to any significant extent by the Federal
Government, may not be included in determining the amount
of such contributions.
‘‘(e) DURATION OF SUPPORT.—The period during which payments
may be made for a project under subsection (a) may be not less
than 3 years nor more than 5 years.
‘‘(f ) AUTHORIZATION OF APPROPRIATION.—
‘‘(1) IN GENERAL.—For the purpose of carrying out this
section, there are authorized to be appropriated such sums
as may be necessary for each of the fiscal years 2001, 2002
and 2003.
‘‘(2) ALLOCATION.—Of the amounts appropriated under
paragraph (1) for a fiscal year, 50 percent shall be expended
to support data infrastructure development for mental health
and 50 percent shall be expended to support data infrastructure
development for substance abuse.’’.
SEC. 3405. REPEAL OF OBSOLETE ADDICT REFERRAL PROVISIONS.

(a) REPEAL OF OBSOLETE PUBLIC HEALTH SERVICE ACT
AUTHORITIES.—Part E of title III (42 U.S.C. 257 et seq.) is repealed.
(b) REPEAL OF OBSOLETE NARA AUTHORITIES.—Titles III and
IV of the Narcotic Addict Rehabilitation Act of 1966 (Public Law
89–793) are repealed.
(c) REPEAL OF OBSOLETE TITLE 28 AUTHORITIES.—
(1) IN GENERAL.—Chapter 175 of title 28, United States
Code, is repealed.
(2) TABLE OF CONTENTS.—The table of contents to part
VI of title 28, United States Code, is amended by striking
the items relating to chapter 175.

42 USC 3411–
3426, 3441.

28 USC 2901–
2906.

SEC. 3406. INDIVIDUALS WITH CO-OCCURRING DISORDERS.

The Public Health Service Act is amended by inserting after
section 503 (42 U.S.C. 290aa–2) the following:
‘‘SEC. 503A. REPORT ON INDIVIDUALS WITH CO-OCCURRING MENTAL
ILLNESS AND SUBSTANCE ABUSE DISORDERS.

42 USC 290aa–
2a.

‘‘(a) IN GENERAL.—Not later than 2 years after the date of
the enactment of this section, the Secretary shall, after consultation
with organizations representing States, mental health and substance abuse treatment providers, prevention specialists, individuals receiving treatment services, and family members of such
individuals, prepare and submit to the Committee on Health, Education, Labor, and Pensions of the Senate and the Committee on
Commerce of the House of Representatives, a report on prevention

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PUBLIC LAW 106–310—OCT. 17, 2000

and treatment services for individuals who have co-occurring mental
illness and substance abuse disorders.
‘‘(b) REPORT CONTENT.—The report under subsection (a) shall
be based on data collected from existing Federal and State surveys
regarding the treatment of co-occurring mental illness and substance abuse disorders and shall include—
‘‘(1) a summary of the manner in which individuals with
co-occurring disorders are receiving treatment, including the
most up-to-date information available regarding the number
of children and adults with co-occurring mental illness and
substance abuse disorders and the manner in which funds
provided under sections 1911 and 1921 are being utilized,
including the number of such children and adults served with
such funds;
‘‘(2) a summary of improvements necessary to ensure that
individuals with co-occurring mental illness and substance
abuse disorders receive the services they need;
‘‘(3) a summary of practices for preventing substance abuse
among individuals who have a mental illness and are at risk
of having or acquiring a substance abuse disorder; and
‘‘(4) a summary of evidenced-based practices for treating
individuals with co-occurring mental illness and substance
abuse disorders and recommendations for implementing such
practices.
‘‘(c) FUNDS FOR REPORT.—The Secretary may obligate funds
to carry out this section with such appropriations as are available.’’.
SEC. 3407. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.

Subpart III of part B of title XIX of the Public Health Service
Act (42 U.S.C. 300x–51 et seq.) (as amended by section 3305)
is further amended by adding at the end the following:
42 USC 300x–66.

‘‘SEC. 1956. SERVICES FOR INDIVIDUALS WITH CO-OCCURRING DISORDERS.

‘‘States may use funds available for treatment under sections
1911 and 1921 to treat persons with co-occurring substance abuse
and mental disorders as long as funds available under such sections
are used for the purposes for which they were authorized by law
and can be tracked for accounting purposes.’’.
Drug Addiction
Treatment Act of
2000.

21 USC 801 note.

TITLE XXXV—WAIVER AUTHORITY FOR
PHYSICIANS WHO DISPENSE OR PRESCRIBE CERTAIN NARCOTIC DRUGS
FOR MAINTENANCE TREATMENT OR
DETOXIFICATION TREATMENT
SEC. 3501. SHORT TITLE.

This title may be cited as the ‘‘Drug Addiction Treatment
Act of 2000’’.
SEC. 3502. AMENDMENT TO CONTROLLED SUBSTANCES ACT.

(a) IN GENERAL.—Section 303(g) of the Controlled Substances
Act (21 U.S.C. 823(g)) is amended—

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114 STAT. 1223

(1) in paragraph (2), by striking ‘‘(A) security’’ and inserting
‘‘(i) security’’, and by striking ‘‘(B) the maintenance’’ and
inserting ‘‘(ii) the maintenance’’;
(2) by redesignating paragraphs (1) through (3) as subparagraphs (A) through (C), respectively;
(3) by inserting ‘‘(1)’’ after ‘‘(g)’’;
(4) by striking ‘‘Practitioners who dispense’’ and inserting
‘‘Except as provided in paragraph (2), practitioners who dispense’’; and
(5) by adding at the end the following paragraph:
‘‘(2)(A) Subject to subparagraphs (D) and (J), the requirements
of paragraph (1) are waived in the case of the dispensing (including
the prescribing), by a practitioner, of narcotic drugs in schedule
III, IV, or V or combinations of such drugs if the practitioner
meets the conditions specified in subparagraph (B) and the narcotic
drugs or combinations of such drugs meet the conditions specified
in subparagraph (C).
‘‘(B) For purposes of subparagraph (A), the conditions specified
in this subparagraph with respect to a practitioner are that, before
the initial dispensing of narcotic drugs in schedule III, IV, or
V or combinations of such drugs to patients for maintenance or
detoxification treatment, the practitioner submit to the Secretary
a notification of the intent of the practitioner to begin dispensing
the drugs or combinations for such purpose, and that the notification
contain the following certifications by the practitioner:
‘‘(i) The practitioner is a qualifying physician (as defined
in subparagraph (G)).
‘‘(ii) With respect to patients to whom the practitioner
will provide such drugs or combinations of drugs, the practitioner has the capacity to refer the patients for appropriate
counseling and other appropriate ancillary services.
‘‘(iii) In any case in which the practitioner is not in a
group practice, the total number of such patients of the practitioner at any one time will not exceed the applicable number.
For purposes of this clause, the applicable number is 30, except
that the Secretary may by regulation change such total number.
‘‘(iv) In any case in which the practitioner is in a group
practice, the total number of such patients of the group practice
at any one time will not exceed the applicable number. For
purposes of this clause, the applicable number is 30, except
that the Secretary may by regulation change such total number,
and the Secretary for such purposes may by regulation establish
different categories on the basis of the number of practitioners
in a group practice and establish for the various categories
different numerical limitations on the number of such patients
that the group practice may have.
‘‘(C) For purposes of subparagraph (A), the conditions specified
in this subparagraph with respect to narcotic drugs in schedule
III, IV, or V or combinations of such drugs are as follows:
‘‘(i) The drugs or combinations of drugs have, under the
Federal Food, Drug, and Cosmetic Act or section 351 of the
Public Health Service Act, been approved for use in maintenance or detoxification treatment.
‘‘(ii) The drugs or combinations of drugs have not been
the subject of an adverse determination. For purposes of this
clause, an adverse determination is a determination published

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Deadline.

Expiration date.

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PUBLIC LAW 106–310—OCT. 17, 2000

in the Federal Register and made by the Secretary, after consultation with the Attorney General, that the use of the drugs
or combinations of drugs for maintenance or detoxification
treatment requires additional standards respecting the qualifications of practitioners to provide such treatment, or requires
standards respecting the quantities of the drugs that may be
provided for unsupervised use.
‘‘(D)(i) A waiver under subparagraph (A) with respect to a
practitioner is not in effect unless (in addition to conditions under
subparagraphs (B) and (C)) the following conditions are met:
‘‘(I) The notification under subparagraph (B) is in writing
and states the name of the practitioner.
‘‘(II) The notification identifies the registration issued for
the practitioner pursuant to subsection (f ).
‘‘(III) If the practitioner is a member of a group practice,
the notification states the names of the other practitioners
in the practice and identifies the registrations issued for the
other practitioners pursuant to subsection (f ).
‘‘(ii) Upon receiving a notification under subparagraph (B), the
Attorney General shall assign the practitioner involved an identification number under this paragraph for inclusion with the registration issued for the practitioner pursuant to subsection (f ).
The identification number so assigned shall be appropriate to preserve the confidentiality of patients for whom the practitioner has
dispensed narcotic drugs under a waiver under subparagraph (A).
‘‘(iii) Not later than 45 days after the date on which the Secretary receives a notification under subparagraph (B), the Secretary
shall make a determination of whether the practitioner involved
meets all requirements for a waiver under subparagraph (B). If
the Secretary fails to make such determination by the end of the
such 45-day period, the Attorney General shall assign the physician
an identification number described in clause (ii) at the end of
such period.
‘‘(E)(i) If a practitioner is not registered under paragraph (1)
and, in violation of the conditions specified in subparagraphs (B)
through (D), dispenses narcotic drugs in schedule III, IV, or V
or combinations of such drugs for maintenance treatment or detoxification treatment, the Attorney General may, for purposes of section 304(a)(4), consider the practitioner to have committed an act
that renders the registration of the practitioner pursuant to subsection (f ) to be inconsistent with the public interest.
‘‘(ii)(I) Upon the expiration of 45 days from the date on which
the Secretary receives a notification under subparagraph (B), a
practitioner who in good faith submits a notification under subparagraph (B) and reasonably believes that the conditions specified
in subparagraphs (B) through (D) have been met shall, in dispensing
narcotic drugs in schedule III, IV, or V or combinations of such
drugs for maintenance treatment or detoxification treatment, be
considered to have a waiver under subparagraph (A) until notified
otherwise by the Secretary, except that such a practitioner may
commence to prescribe or dispense such narcotic drugs for such
purposes prior to the expiration of such 45-day period if it facilitates
the treatment of an individual patient and both the Secretary
and the Attorney General are notified by the practitioner of the
intent to commence prescribing or dispensing such narcotic drugs.
‘‘(II) For purposes of subclause (I), the publication in the Federal
Register of an adverse determination by the Secretary pursuant

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114 STAT. 1225

to subparagraph (C)(ii) shall (with respect to the narcotic drug
or combination involved) be considered to be a notification provided
by the Secretary to practitioners, effective upon the expiration
of the 30-day period beginning on the date on which the adverse
determination is so published.
‘‘(F)(i) With respect to the dispensing of narcotic drugs in
schedule III, IV, or V or combinations of such drugs to patients
for maintenance or detoxification treatment, a practitioner may,
in his or her discretion, dispense such drugs or combinations for
such treatment under a registration under paragraph (1) or a
waiver under subparagraph (A) (subject to meeting the applicable
conditions).
‘‘(ii) This paragraph may not be construed as having any legal
effect on the conditions for obtaining a registration under paragraph
(1), including with respect to the number of patients who may
be served under such a registration.
‘‘(G) For purposes of this paragraph:
‘‘(i) The term ‘group practice’ has the meaning given such
term in section 1877(h)(4) of the Social Security Act.
‘‘(ii) The term ‘qualifying physician’ means a physician
who is licensed under State law and who meets one or more
of the following conditions:
‘‘(I) The physician holds a subspecialty board certification in addiction psychiatry from the American Board
of Medical Specialties.
‘‘(II) The physician holds an addiction certification from
the American Society of Addiction Medicine.
‘‘(III) The physician holds a subspecialty board certification in addiction medicine from the American Osteopathic
Association.
‘‘(IV) The physician has, with respect to the treatment
and management of opiate-dependent patients, completed
not less than eight hours of training (through classroom
situations, seminars at professional society meetings, electronic communications, or otherwise) that is provided by
the American Society of Addiction Medicine, the American
Academy of Addiction Psychiatry, the American Medical
Association, the American Osteopathic Association, the
American Psychiatric Association, or any other organization
that the Secretary determines is appropriate for purposes
of this subclause.
‘‘(V) The physician has participated as an investigator
in one or more clinical trials leading to the approval of
a narcotic drug in schedule III, IV, or V for maintenance
or detoxification treatment, as demonstrated by a statement submitted to the Secretary by the sponsor of such
approved drug.
‘‘(VI) The physician has such other training or experience as the State medical licensing board (of the State
in which the physician will provide maintenance or detoxification treatment) considers to demonstrate the ability
of the physician to treat and manage opiate-dependent
patients.
‘‘(VII) The physician has such other training or experience as the Secretary considers to demonstrate the ability
of the physician to treat and manage opiate-dependent
patients. Any criteria of the Secretary under this subclause

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shall be established by regulation. Any such criteria are
effective only for 3 years after the date on which the
criteria are promulgated, but may be extended for such
additional discrete 3-year periods as the Secretary considers appropriate for purposes of this subclause. Such
an extension of criteria may only be effectuated through
a statement published in the Federal Register by the Secretary during the 30-day period preceding the end of the
3-year period involved.
‘‘(H)(i) In consultation with the Administrator of the Drug
Enforcement Administration, the Administrator of the Substance
Abuse and Mental Health Services Administration, the Director
of the National Institute on Drug Abuse, and the Commissioner
of Food and Drugs, the Secretary shall issue regulations (through
notice and comment rulemaking) or issue practice guidelines to
address the following:
‘‘(I) Approval of additional credentialing bodies and the
responsibilities of additional credentialing bodies.
‘‘(II) Additional exemptions from the requirements of this
paragraph and any regulations under this paragraph.
Nothing in such regulations or practice guidelines may authorize
any Federal official or employee to exercise supervision or control
over the practice of medicine or the manner in which medical
services are provided.
‘‘(ii) Not later than 120 days after the date of the enactment
of the Drug Addiction Treatment Act of 2000, the Secretary shall
issue a treatment improvement protocol containing best practice
guidelines for the treatment and maintenance of opiate-dependent
patients. The Secretary shall develop the protocol in consultation
with the Director of the National Institute on Drug Abuse, the
Administrator of the Drug Enforcement Administration, the
Commissioner of Food and Drugs, the Administrator of the Substance Abuse and Mental Health Services Administration and other
substance abuse disorder professionals. The protocol shall be guided
by science.
‘‘(I) During the 3-year period beginning on the date of the
enactment of the Drug Addiction Treatment Act of 2000, a State
may not preclude a practitioner from dispensing or prescribing
drugs in schedule III, IV, or V, or combinations of such drugs,
to patients for maintenance or detoxification treatment in accordance with this paragraph unless, before the expiration of that
3-year period, the State enacts a law prohibiting a practitioner
from dispensing such drugs or combinations of drug.
‘‘(J)(i) This paragraph takes effect on the date of the enactment
of the Drug Addiction Treatment Act of 2000, and remains in
effect thereafter except as provided in clause (iii) (relating to a
decision by the Secretary or the Attorney General that this paragraph should not remain in effect).
‘‘(ii) For purposes relating to clause (iii), the Secretary and
the Attorney General may, during the 3-year period beginning
on the date of the enactment of the Drug Addiction Treatment
Act of 2000, make determinations in accordance with the following:
‘‘(I) The Secretary may make a determination of whether
treatments provided under waivers under subparagraph (A)

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114 STAT. 1227

have been effective forms of maintenance treatment and detoxification treatment in clinical settings; may make a determination of whether such waivers have significantly increased (relative to the beginning of such period) the availability of maintenance treatment and detoxification treatment; and may make
a determination of whether such waivers have adverse consequences for the public health.
‘‘(II) The Attorney General may make a determination of
the extent to which there have been violations of the numerical
limitations established under subparagraph (B) for the number
of individuals to whom a practitioner may provide treatment;
may make a determination of whether waivers under subparagraph (A) have increased (relative to the beginning of such
period) the extent to which narcotic drugs in schedule III,
IV, or V or combinations of such drugs are being dispensed
or possessed in violation of this Act; and may make a determination of whether such waivers have adverse consequences for
the public health.
‘‘(iii) If, before the expiration of the period specified in clause
(ii), the Secretary or the Attorney General publishes in the Federal
Register a decision, made on the basis of determinations under
such clause, that this paragraph should not remain in effect, this
paragraph ceases to be in effect 60 days after the date on which
the decision is so published. The Secretary shall in making any
such decision consult with the Attorney General, and shall in publishing the decision in the Federal Register include any comments
received from the Attorney General for inclusion in the publication.
The Attorney General shall in making any such decision consult
with the Secretary, and shall in publishing the decision in the
Federal Register include any comments received from the Secretary
for inclusion in the publication.’’.
(b) CONFORMING AMENDMENTS.—Section 304 of the Controlled
Substances Act (21 U.S.C. 824) is amended—
(1) in subsection (a), in the matter after and below paragraph (5), by striking ‘‘section 303(g)’’ each place such term
appears and inserting ‘‘section 303(g)(1)’’; and
(2) in subsection (d), by striking ‘‘section 303(g)’’ and
inserting ‘‘section 303(g)(1)’’.
(c) ADDITIONAL AUTHORIZATION OF APPROPRIATIONS.—For the
purpose of assisting the Secretary of Health and Human Services
with the additional duties established for the Secretary pursuant
to the amendments made by this section, there are authorized
to be appropriated, in addition to other authorizations of appropriations that are available for such purpose, such sums as may be
necessary for each of fiscal years 2001 through 2003.

Federal Register,
publication.
Effective date.

TITLE
XXXVI—METHAMPHETAMINE
AND
OTHER
CONTROLLED
SUBSTANCES

Methamphetamine AntiProliferation
Act of 2000.

SEC. 3601. SHORT TITLE.

21 USC 801 note.

This title may be cited as the ‘‘Methamphetamine Anti-Proliferation Act of 2000’’.

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114 STAT. 1228

PUBLIC LAW 106–310—OCT. 17, 2000

Subtitle A—Methamphetamine Production,
Trafficking, and Abuse
PART I—CRIMINAL PENALTIES
28 USC 994 note.

SEC. 3611. ENHANCED PUNISHMENT OF AMPHETAMINE LABORATORY
OPERATORS.

(a) AMENDMENT TO FEDERAL SENTENCING GUIDELINES.—Pursuant to its authority under section 994(p) of title 28, United States
Code, the United States Sentencing Commission shall amend the
Federal sentencing guidelines in accordance with this section with
respect to any offense relating to the manufacture, importation,
exportation, or trafficking in amphetamine (including an attempt
or conspiracy to do any of the foregoing) in violation of—
(1) the Controlled Substances Act (21 U.S.C. 801 et seq.);
(2) the Controlled Substances Import and Export Act (21
U.S.C. 951 et seq.); or
(3) the Maritime Drug Law Enforcement Act (46 U.S.C.
App. 1901 et seq.).
(b) GENERAL REQUIREMENT.—In carrying out this section, the
United States Sentencing Commission shall, with respect to each
offense described in subsection (a) relating to amphetamine—
(1) review and amend its guidelines to provide for increased
penalties such that those penalties are comparable to the base
offense level for methamphetamine; and
(2) take any other action the Commission considers necessary to carry out this subsection.
(c) ADDITIONAL REQUIREMENTS.—In carrying out this section,
the United States Sentencing Commission shall ensure that the
sentencing guidelines for offenders convicted of offenses described
in subsection (a) reflect the heinous nature of such offenses, the
need for aggressive law enforcement action to fight such offenses,
and the extreme dangers associated with unlawful activity involving
amphetamines, including—
(1) the rapidly growing incidence of amphetamine abuse
and the threat to public safety that such abuse poses;
(2) the high risk of amphetamine addiction;
(3) the increased risk of violence associated with amphetamine trafficking and abuse; and
(4) the recent increase in the illegal importation of amphetamine and precursor chemicals.
(d) EMERGENCY AUTHORITY TO SENTENCING COMMISSION.—The
United States Sentencing Commission shall promulgate amendments pursuant to this section as soon as practicable after the
date of the enactment of this Act in accordance with the procedure
set forth in section 21(a) of the Sentencing Act of 1987 (Public
Law 100–182), as though the authority under that Act had not
expired.
28 USC 994 note.

SEC. 3612. ENHANCED PUNISHMENT OF AMPHETAMINE OR METHAMPHETAMINE LABORATORY OPERATORS.

(a) FEDERAL SENTENCING GUIDELINES.—
(1) IN GENERAL.—Pursuant to its authority under section
994(p) of title 28, United States Code, the United States Sentencing Commission shall amend the Federal sentencing guidelines in accordance with paragraph (2) with respect to any

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1229

offense relating to the manufacture, attempt to manufacture,
or conspiracy to manufacture amphetamine or methamphetamine in violation of—
(A) the Controlled Substances Act (21 U.S.C. 801 et
seq.);
(B) the Controlled Substances Import and Export Act
(21 U.S.C. 951 et seq.); or
(C) the Maritime Drug Law Enforcement Act (46 U.S.C.
App. 1901 et seq.).
(2) REQUIREMENTS.—In carrying out this paragraph, the
United States Sentencing Commission shall—
(A) if the offense created a substantial risk of harm
to human life (other than a life described in subparagraph
(B)) or the environment, increase the base offense level
for the offense—
(i) by not less than 3 offense levels above the
applicable level in effect on the date of the enactment
of this Act; or
(ii) if the resulting base offense level after an
increase under clause (i) would be less than level 27,
to not less than level 27; or
(B) if the offense created a substantial risk of harm
to the life of a minor or incompetent, increase the base
offense level for the offense—
(i) by not less than 6 offense levels above the
applicable level in effect on the date of the enactment
of this Act; or
(ii) if the resulting base offense level after an
increase under clause (i) would be less than level 30,
to not less than level 30.
(3) EMERGENCY AUTHORITY TO SENTENCING COMMISSION.—
The United States Sentencing Commission shall promulgate
amendments pursuant to this subsection as soon as practicable
after the date of the enactment of this Act in accordance with
the procedure set forth in section 21(a) of the Sentencing Act
of 1987 (Public Law 100–182), as though the authority under
that Act had not expired.
(b) EFFECTIVE DATE.—The amendments made pursuant to this
section shall apply with respect to any offense occurring on or
after the date that is 60 days after the date of the enactment
of this Act.
SEC. 3613. MANDATORY RESTITUTION FOR VIOLATIONS OF CONTROLLED SUBSTANCES ACT AND CONTROLLED SUBSTANCES IMPORT AND EXPORT ACT RELATING TO
AMPHETAMINE AND METHAMPHETAMINE.

(a) MANDATORY RESTITUTION.—Section 413(q) of the Controlled
Substances Act (21 U.S.C. 853(q)) is amended—
(1) in the matter preceding paragraph (1), by striking ‘‘may’’
and inserting ‘‘shall’’;
(2) by inserting ‘‘amphetamine or’’ before ‘‘methamphetamine’’ each place it appears;
(3) in paragraph (2)—
(A) by inserting ‘‘, the State or local government concerned, or both the United States and the State or local
government concerned’’ after ‘‘United States’’ the first place
it appears; and

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114 STAT. 1230

PUBLIC LAW 106–310—OCT. 17, 2000

(B) by inserting ‘‘or the State or local government
concerned, as the case may be,’’ after ‘‘United States’’ the
second place it appears; and
(4) in paragraph (3), by striking ‘‘section 3663 of title 18,
United States Code’’ and inserting ‘‘section 3663A of title 18,
United States Code’’.
(b) DEPOSIT OF AMOUNTS IN DEPARTMENT OF JUSTICE ASSETS
FORFEITURE FUND.—Section 524(c)(4) of title 28, United States
Code, is amended—
(1) by striking ‘‘and’’ at the end of subparagraph (B);
(2) by striking the period at the end of subparagraph (C)
and inserting ‘‘; and’’; and
(3) by adding at the end the following:
‘‘(D) all amounts collected—
‘‘(i) by the United States pursuant to a reimbursement
order under paragraph (2) of section 413(q) of the Controlled Substances Act (21 U.S.C. 853(q)); and
‘‘(ii) pursuant to a restitution order under paragraph
(1) or (3) of section 413(q) of the Controlled Substances
Act for injuries to the United States.’’.
(c) CLARIFICATION OF CERTAIN ORDERS OF RESTITUTION.—Section 3663(c)(2)(B) of title 18, United States Code, is amended by
inserting ‘‘which may be’’ after ‘‘the fine’’.
(d) EXPANSION OF APPLICABILITY OF MANDATORY RESTITUTION.—Section 3663A(c)(1)(A)(ii) of title 18, United States Code,
is amended by inserting ‘‘or under section 416(a) of the Controlled
Substances Act (21 U.S.C. 856(a)),’’ after ‘‘under this title,’’.
(e) TREATMENT OF ILLICIT SUBSTANCE MANUFACTURING OPERATIONS AS CRIMES AGAINST PROPERTY.—Section 416 of the Controlled Substances Act (21 U.S.C. 856) is amended by adding at
the end the following new subsection:
‘‘(c) A violation of subsection (a) shall be considered an offense
against property for purposes of section 3663A(c)(1)(A)(ii) of title
18, United States Code.’’.
SEC. 3614. METHAMPHETAMINE PARAPHERNALIA.

Section 422(d) of the Controlled Substances Act (21 U.S.C.
863(d)) is amended in the matter preceding paragraph (1) by
inserting ‘‘methamphetamine,’’ after ‘‘PCP,’’.

PART II—ENHANCED LAW ENFORCEMENT
SEC. 3621. ENVIRONMENTAL HAZARDS ASSOCIATED WITH ILLEGAL
MANUFACTURE OF AMPHETAMINE AND METHAMPHETAMINE.

(a) USE OF AMOUNTS OR DEPARTMENT OF JUSTICE ASSETS FORFUND.—Section 524(c)(1)(E) of title 28, United States Code,
is amended—
(1) by inserting ‘‘(i) for’’ before ‘‘disbursements’’;
(2) by inserting ‘‘and’’ after the semicolon; and
(3) by adding at the end the following:
‘‘(ii) for payment for—
‘‘(I) costs incurred by or on behalf of the Department
of Justice in connection with the removal, for purposes
of Federal forfeiture and disposition, of any hazardous substance or pollutant or contaminant associated with the
FEITURE

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1231

illegal manufacture of amphetamine or methamphetamine;
and
‘‘(II) costs incurred by or on behalf of a State or local
government in connection with such removal in any case
in which such State or local government has assisted in
a Federal prosecution relating to amphetamine or methamphetamine, to the extent such costs exceed equitable
sharing payments made to such State or local government
in such case;’’.
(b) GRANTS UNDER DRUG CONTROL AND SYSTEM IMPROVEMENT
GRANT PROGRAM.—Section 501(b)(3) of the Omnibus Crime Control
and Safe Streets Act of 1968 (42 U.S.C. 3751(b)(3)) is amended
by inserting before the semicolon the following: ‘‘and to remove
any hazardous substance or pollutant or contaminant associated
with the illegal manufacture of amphetamine or methamphetamine’’.
(c) AMOUNTS SUPPLEMENT AND NOT SUPPLANT.—
(1) ASSETS FORFEITURE FUND.—Any amounts made available from the Department of Justice Assets Forfeiture Fund
in a fiscal year by reason of the amendment made by subsection
(a) shall supplement, and not supplant, any other amounts
made available to the Department of Justice in such fiscal
year from other sources for payment of costs described in section
524(c)(1)(E)(ii) of title 28, United States Code, as so amended.
(2) GRANT PROGRAM.—Any amounts made available in a
fiscal year under the grant program under section 501(b)(3)
of the Omnibus Crime Control and Safe Streets Act of 1968
(42 U.S.C. 3751(b)(3)) for the removal of hazardous substances
or pollutants or contaminants associated with the illegal manufacture of amphetamine or methamphetamine by reason of
the amendment made by subsection (b) shall supplement, and
not supplant, any other amounts made available in such fiscal
year from other sources for such removal.

28 USC 524 note.

42 USC 3751
note.

SEC. 3622. REDUCTION IN RETAIL SALES TRANSACTION THRESHOLD
FOR NON-SAFE HARBOR PRODUCTS CONTAINING
PSEUDOEPHEDRINE OR PHENYLPROPANOLAMINE.

(a) REDUCTION IN TRANSACTION THRESHOLD.—Section
102(39)(A)(iv)(II) of the Controlled Substances Act (21 U.S.C.
802(39)(A)(iv)(II)) is amended—
(1) by striking ‘‘24 grams’’ both places it appears and
inserting ‘‘9 grams’’; and
(2) by inserting before the semicolon at the end the following: ‘‘and sold in package sizes of not more than 3 grams
of pseudoephedrine base or 3 grams of phenylpropanolamine
base’’.
(b) EFFECTIVE DATE.—The amendments made by subsection
(a) shall take effect 1 year after the date of the enactment of
this Act.
SEC. 3623. TRAINING FOR DRUG ENFORCEMENT ADMINISTRATION AND
STATE AND LOCAL LAW ENFORCEMENT PERSONNEL
RELATING TO CLANDESTINE LABORATORIES.

21 USC 802 note.

21 USC 872 note.

(a) IN GENERAL.—
(1) REQUIREMENT.—The Administrator of the Drug Enforcement Administration shall carry out the programs described
in subsection (b) with respect to the law enforcement personnel
of States and localities determined by the Administrator to

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114 STAT. 1232

PUBLIC LAW 106–310—OCT. 17, 2000

have significant levels of methamphetamine-related or amphetamine-related crime or projected by the Administrator to have
the potential for such levels of crime in the future.
(2) DURATION.—The duration of any program under that
subsection may not exceed 3 years.
(b) COVERED PROGRAMS.—The programs described in this subsection are as follows:
(1) ADVANCED MOBILE CLANDESTINE LABORATORY TRAINING
TEAMS.—A program of advanced mobile clandestine laboratory
training teams, which shall provide information and training
to State and local law enforcement personnel in techniques
utilized in conducting undercover investigations and conspiracy
cases, and other information designed to assist in the investigation of the illegal manufacturing and trafficking of amphetamine and methamphetamine.
(2) BASIC CLANDESTINE LABORATORY CERTIFICATION
TRAINING.—A program of basic clandestine laboratory certification training, which shall provide information and training—
(A) to Drug Enforcement Administration personnel and
State and local law enforcement personnel for purposes
of enabling such personnel to meet any certification requirements under law with respect to the handling of wastes
created by illegal amphetamine and methamphetamine laboratories; and
(B) to State and local law enforcement personnel for
purposes of enabling such personnel to provide the information and training covered by subparagraph (A) to other
State and local law enforcement personnel.
(3) CLANDESTINE LABORATORY RECERTIFICATION AND
AWARENESS TRAINING.—A program of clandestine laboratory recertification and awareness training, which shall provide
information and training to State and local law enforcement
personnel for purposes of enabling such personnel to provide
recertification and awareness training relating to clandestine
laboratories to additional State and local law enforcement personnel.
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated for each of fiscal years 2000, 2001, and 2002
amounts as follows:
(1) $1,500,000 to carry out the program described in subsection (b)(1).
(2) $3,000,000 to carry out the program described in subsection (b)(2).
(3) $1,000,000 to carry out the program described in subsection (b)(3).
21 USC 1706
note.

SEC. 3624. COMBATING METHAMPHETAMINE AND AMPHETAMINE IN
HIGH INTENSITY DRUG TRAFFICKING AREAS.

(a) IN GENERAL.—
(1) IN GENERAL.—The Director of National Drug Control
Policy shall use amounts available under this section to combat
the trafficking of methamphetamine and amphetamine in areas
designated by the Director as high intensity drug trafficking
areas.
(2) ACTIVITIES.—In meeting the requirement in paragraph
(1), the Director shall transfer funds to appropriate Federal,
State, and local governmental agencies for employing additional

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1233

Federal law enforcement personnel, or facilitating the employment of additional State and local law enforcement personnel,
including agents, investigators, prosecutors, laboratory technicians, chemists, investigative assistants, and drug-prevention
specialists.
(b) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section—
(1) $15,000,000 for fiscal year 2000; and
(2) such sums as may be necessary for each of fiscal years
2001 through 2004.
(c) APPORTIONMENT OF FUNDS.—
(1) FACTORS IN APPORTIONMENT.—The Director shall apportion amounts appropriated for a fiscal year pursuant to the
authorization of appropriations in subsection (b) for activities
under subsection (a) among and within areas designated by
the Director as high intensity drug trafficking areas based
on the following factors:
(A) The number of methamphetamine manufacturing
facilities and amphetamine manufacturing facilities discovered by Federal, State, or local law enforcement officials
in the previous fiscal year.
(B) The number of methamphetamine prosecutions and
amphetamine prosecutions in Federal, State, or local courts
in the previous fiscal year.
(C) The number of methamphetamine arrests and
amphetamine arrests by Federal, State, or local law
enforcement officials in the previous fiscal year.
(D) The amounts of methamphetamine, amphetamine,
or listed chemicals (as that term is defined in section
102(33) of the Controlled Substances Act (21 U.S.C.
802(33)) seized by Federal, State, or local law enforcement
officials in the previous fiscal year.
(E) Intelligence and predictive data from the Drug
Enforcement Administration and the Department of Health
and Human Services showing patterns and trends in abuse,
trafficking, and transportation in methamphetamine,
amphetamine, and listed chemicals (as that term is so
defined).
(2) CERTIFICATION.—Before the Director apportions any
funds under this subsection to a high intensity drug trafficking
area, the Director shall certify that the law enforcement entities
responsible for clandestine methamphetamine and amphetamine laboratory seizures in that area are providing laboratory
seizure data to the national clandestine laboratory database
at the El Paso Intelligence Center.
(d) LIMITATION ON ADMINISTRATIVE COSTS.—Not more than 5
percent of the amount appropriated in a fiscal year pursuant to
the authorization of appropriations for that fiscal year in subsection
(b) may be available in that fiscal year for administrative costs
associated with activities under subsection (a).
SEC. 3625. COMBATING AMPHETAMINE AND METHAMPHETAMINE
MANUFACTURING AND TRAFFICKING.

21 USC 873 note.

(a) ACTIVITIES.—In order to combat the illegal manufacturing
and trafficking in amphetamine and methamphetamine, the
Administrator of the Drug Enforcement Administration may—

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PUBLIC LAW 106–310—OCT. 17, 2000

(1) assist State and local law enforcement in small and
mid-sized communities in all phases of investigations related
to such manufacturing and trafficking, including assistance
with foreign-language interpretation;
(2) staff additional regional enforcement and mobile
enforcement teams related to such manufacturing and trafficking;
(3) establish additional resident offices and posts of duty
to assist State and local law enforcement in rural areas in
combating such manufacturing and trafficking;
(4) provide the Special Operations Division of the Administration with additional agents and staff to collect, evaluate,
interpret, and disseminate critical intelligence targeting the
command and control operations of major amphetamine and
methamphetamine manufacturing and trafficking organizations;
(5) enhance the investigative and related functions of the
Chemical Control Program of the Administration to implement
more fully the provisions of the Comprehensive Methamphetamine Control Act of 1996 (Public Law 104–237);
(6) design an effective means of requiring an accurate
accounting of the import and export of list I chemicals, and
coordinate investigations relating to the diversion of such
chemicals;
(7) develop a computer infrastructure sufficient to receive,
process, analyze, and redistribute time-sensitive enforcement
information from suspicious order reporting to field offices of
the Administration and other law enforcement and regulatory
agencies, including the continuing development of the Suspicious Order Reporting and Tracking System (SORTS) and
the Chemical Transaction Database (CTRANS) of the Administration;
(8) establish an education, training, and communication
process in order to alert the industry to current trends and
emerging patterns in the illegal manufacturing of amphetamine
and methamphetamine; and
(9) carry out such other activities as the Administrator
considers appropriate.
(b) ADDITIONAL POSITIONS AND PERSONNEL.—
(1) IN GENERAL.—In carrying out activities under subsection (a), the Administrator may establish in the Administration not more than 50 full-time positions, including not more
than 31 special-agent positions, and may appoint personnel
to such positions.
(2) PARTICULAR POSITIONS.—In carrying out activities under
paragraphs (5) through (8) of subsection (a), the Administrator
may establish in the Administration not more than 15 fulltime positions, including not more than 10 diversion investigator positions, and may appoint personnel to such positions.
Any positions established under this paragraph are in addition
to any positions established under paragraph (1).
(c) AUTHORIZATION OF APPROPRIATIONS.—There are authorized
to be appropriated for the Drug Enforcement Administration for
each fiscal year after fiscal year 1999, $9,500,000 for purposes
of carrying out the activities authorized by subsection (a) and
employing personnel in positions established under subsection (b),

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1235

of which $3,000,000 shall be available for activities under paragraphs (5) through (8) of subsection (a) and for employing personnel
in positions established under subsection (b)(2).

PART III—ABUSE PREVENTION AND
TREATMENT
SEC. 3631. EXPANSION OF METHAMPHETAMINE RESEARCH.

Section 464N of the Public Health Service Act (42 U.S.C. 285o–
2) is amended by adding at the end the following:
‘‘(c) METHAMPHETAMINE RESEARCH.—
‘‘(1) GRANTS OR COOPERATIVE AGREEMENTS.—The Director
of the Institute may make grants or enter into cooperative
agreements to expand the current and on-going interdisciplinary research and clinical trials with treatment centers of
the National Drug Abuse Treatment Clinical Trials Network
relating to methamphetamine abuse and addiction and other
biomedical, behavioral, and social issues related to methamphetamine abuse and addiction.
‘‘(2) USE OF FUNDS.—Amounts made available under a
grant or cooperative agreement under paragraph (1) for methamphetamine abuse and addiction may be used for research
and clinical trials relating to—
‘‘(A) the effects of methamphetamine abuse on the
human body, including the brain;
‘‘(B) the addictive nature of methamphetamine and
how such effects differ with respect to different individuals;
‘‘(C) the connection between methamphetamine abuse
and mental health;
‘‘(D) the identification and evaluation of the most effective methods of prevention of methamphetamine abuse and
addiction;
‘‘(E) the identification and development of the most
effective methods of treatment of methamphetamine addiction, including pharmacological treatments;
‘‘(F) risk factors for methamphetamine abuse;
‘‘(G) effects of methamphetamine abuse and addiction
on pregnant women and their fetuses; and
‘‘(H) cultural, social, behavioral, neurological and
psychological reasons that individuals abuse methamphetamine, or refrain from abusing methamphetamine.
‘‘(3) RESEARCH RESULTS.—The Director shall promptly
disseminate research results under this subsection to Federal,
State and local entities involved in combating methamphetamine abuse and addiction.
‘‘(4) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(A) AUTHORIZATION OF APPROPRIATIONS.—There is
authorized to be appropriated to carry out paragraph (1),
such sums as may be necessary for each fiscal year.
‘‘(B) SUPPLEMENT NOT SUPPLANT.—Amounts appropriated pursuant to the authorization of appropriations
in subparagraph (A) for a fiscal year shall supplement
and not supplant any other amounts appropriated in such
fiscal year for research on methamphetamine abuse and
addiction.’’.

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114 STAT. 1236

PUBLIC LAW 106–310—OCT. 17, 2000

SEC. 3632. METHAMPHETAMINE AND AMPHETAMINE TREATMENT INITIATIVE BY CENTER FOR SUBSTANCE ABUSE TREATMENT.

Subpart 1 of part B of title V of the Public Health Service
Act (42 U.S.C. 290bb et seq.) is amended by adding at the end
the following new section:
‘‘METHAMPHETAMINE
42 USC 290bb–9.

AND AMPHETAMINE TREATMENT INITIATIVE

‘‘SEC. 514. (a) GRANTS.—
‘‘(1) AUTHORITY TO MAKE GRANTS.—The Director of the
Center for Substance Abuse Treatment may make grants to
States and Indian tribes recognized by the United States that
have a high rate, or have had a rapid increase, in methamphetamine or amphetamine abuse or addiction in order to permit
such States and Indian tribes to expand activities in connection
with the treatment of methamphetamine or amphetamine
abuser or addiction in the specific geographical areas of such
States or Indian tribes, as the case may be, where there is
such a rate or has been such an increase.
‘‘(2) RECIPIENTS.—Any grants under paragraph (1) shall
be directed to the substance abuse directors of the States,
and of the appropriate tribal government authorities of the
Indian tribes, selected by the Director to receive such grants.
‘‘(3) NATURE OF ACTIVITIES.—Any activities under a grant
under paragraph (1) shall be based on reliable scientific evidence of their efficacy in the treatment of methamphetamine
or amphetamine abuse or addiction.
‘‘(b) GEOGRAPHIC DISTRIBUTION.—The Director shall ensure that
grants under subsection (a) are distributed equitably among the
various regions of the country and among rural, urban, and suburban areas that are affected by methamphetamine or amphetamine
abuse or addiction.
‘‘(c) ADDITIONAL ACTIVITIES.—The Director shall—
‘‘(1) evaluate the activities supported by grants under subsection (a);
‘‘(2) disseminate widely such significant information derived
from the evaluation as the Director considers appropriate to
assist States, Indian tribes, and private providers of treatment
services for methamphetamine or amphetamine abuser or
addiction in the treatment of methamphetamine or amphetamine abuse or addiction; and
‘‘(3) provide States, Indian tribes, and such providers with
technical assistance in connection with the provision of such
treatment.
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—
‘‘(1) IN GENERAL.—There are authorized to be appropriated
to carry out this section $10,000,000 for fiscal year 2000 and
such sums as may be necessary for each of fiscal years 2001
and 2002.
‘‘(2) USE OF CERTAIN FUNDS.—Of the funds appropriated
to carry out this section in any fiscal year, the lesser of 5
percent of such funds or $1,000,000 shall be available to the
Director for purposes of carrying out subsection (c).’’.
SEC. 3633. STUDY OF METHAMPHETAMINE TREATMENT.

(a) STUDY.—

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PUBLIC LAW 106–310—OCT. 17, 2000

114 STAT. 1237

(1) REQUIREMENT.—The Secretary of Health and Human
Services shall, in consultation with the Institute of Medicine
of the National Academy of Sciences, conduct a study on the
development of medications for the treatment of addiction to
amphetamine and methamphetamine.
(2) REPORT.—Not later than 9 months after the date of
the enactment of this Act, the Secretary shall submit to the
Committees on the Judiciary of the Senate and House of Representatives a report on the results of the study conducted
under paragraph (1).
(b) AUTHORIZATION OF APPROPRIATIONS.—There are hereby
authorized to be appropriated for the Department of Health and
Human Services for fiscal year 2000 such sums as may be necessary
to meet the requirements of subsection (a).

Deadline.

PART IV—REPORTS
SEC. 3641. REPORTS ON CONSUMPTION OF METHAMPHETAMINE AND
OTHER ILLICIT DRUGS IN RURAL AREAS, METROPOLITAN
AREAS, AND CONSOLIDATED METROPOLITAN AREAS.

42 USC 290aa–4
note.

The Secretary of Health and Human Services shall include
in each National Household Survey on Drug Abuse appropriate
prevalence data and information on the consumption of methamphetamine and other illicit drugs in rural areas, metropolitan
areas, and consolidated metropolitan areas.
SEC. 3642. REPORT ON DIVERSION OF ORDINARY, OVER-THE-COUNTER
PSEUDOEPHEDRINE
AND
PHENYLPROPANOLAMINE
PRODUCTS.

(a) STUDY.—The Attorney General shall conduct a study of
the use of ordinary, over-the-counter pseudoephedrine and phenylpropanolamine products in the clandestine production of illicit
drugs. Sources of data for the study shall include the following:
(1) Information from Federal, State, and local clandestine
laboratory seizures and related investigations identifying the
source, type, or brand of drug products being utilized and
how they were obtained for the illicit production of methamphetamine and amphetamine.
(2) Information submitted voluntarily from the pharmaceutical and retail industries involved in the manufacture, distribution, and sale of drug products containing ephedrine,
pseudoephedrine, and phenylpropanolamine, including information on changes in the pattern, volume, or both, of sales of
ordinary, over-the-counter pseudoephedrine and phenylpropanolamine products.
(b) REPORT.—
(1) REQUIREMENT.—Not later than 1 year after the date
of the enactment of this Act, the Attorney General shall submit
to Congress a report on the study conducted under subsection
(a).
(2) ELEMENTS.—The report shall include—
(A) the findings of the Attorney General as a result
of the study; and
(B) such recommendations on the need to establish
additional measures to prevent diversion of ordinary, overthe-counter pseudoephedrine and phenylpropanolamine
(such as a threshold on ordinary, over-the-counter

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PUBLIC LAW 106–310—OCT. 17, 2000
pseudoephedrine and phenylpropanolamine products) as
the Attorney General considers appropriate.
(3) MATTERS CONSIDERED.—In preparing the report, the
Attorney General shall consider the comments and recommendations including the comments on the Attorney General’s proposed findings and recommendations, of State and
local law enforcement and regulatory officials and of representatives of the industry described in subsection (a)(2).
(c) REGULATION OF RETAIL SALES.—
(1) IN GENERAL.—Notwithstanding section 401(d) of the
Comprehensive Methamphetamine Control Act of 1996 (21
U.S.C. 802 note) and subject to paragraph (2), the Attorney
General shall establish by regulation a single-transaction limit
of not less than 24 grams of ordinary, over-the-counter
pseudoephedrine or phenylpropanolamine (as the case may be)
for retail distributors, if the Attorney General finds, in the
report under subsection (b), that—
(A) there is a significant number of instances (as set
forth in paragraph (3)(A) of such section 401(d) for purposes
of such section) where ordinary, over-the-counter
pseudoephedrine products, phenylpropanolamine products,
or both such products that were purchased from retail
distributors were widely used in the clandestine production
of illicit drugs; and
(B) the best practical method of preventing such use
is the establishment of single-transaction limits for retail
distributors of either or both of such products.
(2) DUE PROCESS.—The Attorney General shall establish
the single-transaction limit under paragraph (1) only after
notice, comment, and an informal hearing.

Subtitle B—Controlled Substances
Generally
28 USC 994 note.

SEC. 3651. ENHANCED PUNISHMENT FOR TRAFFICKING IN LIST I
CHEMICALS.

(a) AMENDMENTS TO FEDERAL SENTENCING GUIDELINES.—
Pursuant to its authority under section 994(p) of title 28, United
States Code, the United States Sentencing Commission shall amend
the Federal sentencing guidelines in accordance with this section
with respect to any violation of paragraph (1) or (2) of section
401(d) of the Controlled Substances Act (21 U.S.C. 841(d)) involving
a list I chemical and any violation of paragraph (1) or (3) of
section 1010(d) of the Controlled Substance Import and Export
Act (21 U.S.C. 960(d)) involving a list I chemical.
(b)
EPHEDRINE,
PHENYLPROPANOLAMINE,
AND
PSEUDOEPHEDRINE.—
(1) IN GENERAL.—In carrying this section, the United States
Sentencing Commission shall, with respect to each offense
described in subsection (a) involving ephedrine, phenylpropanolamine, or pseudoephedrine (including their salts,
optical isomers, and salts of optical isomers), review and amend
its guidelines to provide for increased penalties such that those
penalties corresponded to the quantity of controlled substance
that could reasonably have been manufactured using the

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114 STAT. 1239

quantity
of
ephedrine,
phenylpropanolamine,
or
pseudoephedrine possessed or distributed.
(2) CONVERSION RATIOS.—For the purposes of the amendments made by this subsection, the quantity of controlled substance that could reasonably have been manufactured shall
be determined by using a table of manufacturing conversion
ratios
for
ephedrine,
phenylpropanolamine,
and
pseudoephedrine, which table shall be established by the Sentencing Commission based on scientific, law enforcement, and
other data the Sentencing Commission considers appropriate.
(c) OTHER LIST I CHEMICALS.—In carrying this section, the
United States Sentencing Commission shall, with respect to each
offense described in subsection (a) involving any list I chemical
other than ephedrine, phenylpropanolamine, or pseudoephedrine,
review and amend its guidelines to provide for increased penalties
such that those penalties reflect the dangerous nature of such
offenses, the need for aggressive law enforcement action to fight
such offenses, and the extreme dangers associated with unlawful
activity involving methamphetamine and amphetamine, including—
(1) the rapidly growing incidence of controlled substance
manufacturing;
(2) the extreme danger inherent in manufacturing controlled substances;
(3) the threat to public safety posed by manufacturing
controlled substances; and
(4) the recent increase in the importation, possession, and
distribution of list I chemicals for the purpose of manufacturing
controlled substances.
(d) EMERGENCY AUTHORITY TO SENTENCING COMMISSION.—The
United States Sentencing Commission shall promulgate amendments pursuant to this section as soon as practicable after the
date of the enactment of this Act in accordance with the procedure
set forth in section 21(a) of the Sentencing Act of 1987 (Public
Law 100–182), as though the authority under that Act had not
expired.
SEC. 3652. MAIL ORDER REQUIREMENTS.

Section 310(b)(3) of the Controlled Substances Act (21 U.S.C.
830(b)(3)) is amended—
(1) by redesignating subparagraphs (A) and (B) as subparagraphs (B) and (C), respectively;
(2) by inserting before subparagraph (B), as so redesignated, the following new subparagraph (A):
‘‘(A) As used in this paragraph:
‘‘(i) The term ‘drug product’ means an active ingredient in dosage form that has been approved or otherwise may be lawfully marketed under the Food, Drug,
and Cosmetic Act for distribution in the United States.
‘‘(ii) The term ‘valid prescription’ means a prescription which is issued for a legitimate medical purpose
by an individual practitioner licensed by law to administer and prescribe the drugs concerned and acting
in the usual course of the practitioner’s professional
practice.’’;
(3) in subparagraph (B), as so redesignated, by inserting
‘‘or who engages in an export transaction’’ after ‘‘nonregulated
person’’; and

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PUBLIC LAW 106–310—OCT. 17, 2000
(4) adding at the end the following:
‘‘(D) Except as provided in subparagraph (E), the following distributions to a nonregulated person, and the
following export transactions, shall not be subject to the
reporting requirement in subparagraph (B):
‘‘(i) Distributions of sample packages of drug products when such packages contain not more than two
solid dosage units or the equivalent of two dosage
units in liquid form, not to exceed 10 milliliters of
liquid per package, and not more than one package
is distributed to an individual or residential address
in any 30-day period.
‘‘(ii) Distributions of drug products by retail
distributors that may not include face-to-face transactions to the extent that such distributions are consistent with the activities authorized for a retail distributor as specified in section 102(46).
‘‘(iii) Distributions of drug products to a resident
of a long term care facility (as that term is defined
in regulations prescribed by the Attorney General) or
distributions of drug products to a long term care
facility for dispensing to or for use by a resident of
that facility.
‘‘(iv) Distributions of drug products pursuant to
a valid prescription.
‘‘(v) Exports which have been reported to the
Attorney General pursuant to section 1004 or 1018
or which are subject to a waiver granted under section
1018(e)(2).
‘‘(vi) Any quantity, method, or type of distribution
or any quantity, method, or type of distribution of
a specific listed chemical (including specific formulations or drug products) or of a group of listed chemicals
(including specific formulations or drug products)
which the Attorney General has excluded by regulation
from such reporting requirement on the basis that
such reporting is not necessary for the enforcement
of this title or title III.
‘‘(E) The Attorney General may revoke any or all of
the exemptions listed in subparagraph (D) for an individual
regulated person if he finds that drug products distributed
by the regulated person are being used in violation of
this title or title III. The regulated person shall be notified
of the revocation, which will be effective upon receipt by
the person of such notice, as provided in section 1018(c)(1),
and shall have the right to an expedited hearing as provided in section 1018(c)(2).’’.

SEC. 3653. THEFT AND TRANSPORTATION OF ANHYDROUS AMMONIA
FOR PURPOSES OF ILLICIT PRODUCTION OF CONTROLLED SUBSTANCES.

(a) IN GENERAL.—Part D of the Controlled Substances Act
(21 U.S.C. 841 et seq.) is amended by adding at the end the
following:
‘‘ANHYDROUS
21 USC 864.

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AMMONIA

‘‘SEC. 423. (a) It is unlawful for any person—

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114 STAT. 1241

‘‘(1) to steal anhydrous ammonia, or
‘‘(2) to transport stolen anhydrous ammonia across State
lines,
knowing, intending, or having reasonable cause to believe that
such anhydrous ammonia will be used to manufacture a controlled
substance in violation of this part.
‘‘(b) Any person who violates subsection (a) shall be imprisoned
or fined, or both, in accordance with section 403(d) as if such
violation were a violation of a provision of section 403.’’.
(b) CLERICAL AMENDMENT.—The table of contents for that Act
is amended by inserting after the item relating to section 421
the following new items:
‘‘Sec. 422. Drug paraphernalia.
‘‘Sec. 423. Anhydrous ammonia.’’.

(c) ASSISTANCE FOR CERTAIN RESEARCH.—
(1) AGREEMENT.—The Administrator of the Drug Enforcement Administration shall seek to enter into an agreement
with Iowa State University in order to permit the University
to continue and expand its current research into the development of inert agents that, when added to anhydrous ammonia,
eliminate the usefulness of anhydrous ammonia as an ingredient in the production of methamphetamine.
(2) REIMBURSABLE PROVISION OF FUNDS.—The agreement
under paragraph (1) may provide for the provision to Iowa
State University, on a reimbursable basis, of $500,000 for purposes the activities specified in that paragraph.
(3) AUTHORIZATION OF APPROPRIATIONS.—There is hereby
authorized to be appropriated for the Drug Enforcement
Administration for fiscal year 2000, $500,000 for purposes of
carrying out the agreement under this subsection.

Subtitle C—Ecstasy AntiProliferationAct of
2000

Ecstasy AntiProliferation
Act of 2000.

SEC. 3661. SHORT TITLE.

42 USC 201 note.

This subtitle may be cited as the ‘‘Ecstasy Anti-Proliferation
Act of 2000’’.
SEC. 3662. FINDINGS.

Congress makes the following findings:
(1) The illegal importation of 3,4-methylenedioxy methamphetamine, commonly referred to as ‘‘MDMA’’ or ‘‘Ecstasy’’
(referred to in this subtitle as ‘‘Ecstasy’’), has increased in
recent years, as evidenced by the fact that Ecstasy seizures
by the United States Customs Service have increased from
less than 500,000 tablets during fiscal year 1997 to more than
9,000,000 tablets during the first 9 months of fiscal year 2000.
(2) Use of Ecstasy can cause long-lasting, and perhaps
permanent, damage to the serotonin system of the brain, which
is fundamental to the integration of information and emotion,
and this damage can cause long-term problems with learning
and memory.
(3) Due to the popularity and marketability of Ecstasy,
there are numerous Internet websites with information on the
effects of Ecstasy, the production of Ecstasy, and the locations
of Ecstasy use (often referred to as ‘‘raves’’). The availability

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PUBLIC LAW 106–310—OCT. 17, 2000
of this information targets the primary users of Ecstasy, who
are most often college students, young professionals, and other
young people from middle- to high-income families.
(4) Greater emphasis needs to be placed on—
(A) penalties associated with the manufacture, distribution, and use of Ecstasy;
(B) the education of young people on the negative
health effects of Ecstasy, since the reputation of Ecstasy
as a ‘‘safe’’ drug is the most dangerous component of
Ecstasy;
(C) the education of State and local law enforcement
agencies regarding the growing problem of Ecstasy trafficking across the United States;
(D) reducing the number of deaths caused by Ecstasy
use and the combined use of Ecstasy with other ‘‘club’’
drugs and alcohol; and
(E) adequate funding for research by the National
Institute on Drug Abuse to—
(i) identify those most vulnerable to using Ecstasy
and develop science-based prevention approaches tailored to the specific needs of individuals at high risk;
(ii) understand how Ecstasy produces its toxic
effects and how to reverse neurotoxic damage;
(iii) develop treatments, including new medications
and behavioral treatment approaches;
(iv) better understand the effects that Ecstasy has
on the developing children and adolescents; and
(v) translate research findings into useful tools
and ensure their effective dissemination.

28 USC 994 note.

SEC. 3663. ENHANCED PUNISHMENT OF ECSTASY TRAFFICKERS.

(a) AMENDMENT TO FEDERAL SENTENCING GUIDELINES.—Pursuant to its authority under section 994(p) of title 28, United States
Code, the United States Sentencing Commission (referred to in
this section as the ‘‘Commission’’) shall amend the Federal sentencing guidelines regarding any offense relating to the manufacture, importation, or exportation of, or trafficking in—
(1) 3,4-methylenedioxy methamphetamine;
(2) 3,4-methylenedioxy amphetamine;
(3) 3,4-methylenedioxy-N-ethylamphetamine;
(4) paramethoxymethamphetamine (PMA); or
(5) any other controlled substance, as determined by the
Commission in consultation with the Attorney General, that
is marketed as Ecstasy and that has either a chemical structure
substantially similar to that of 3,4-methylenedioxy methamphetamine or an effect on the central nervous system
substantially similar to or greater than that of 3,4methylenedioxy methamphetamine,
including an attempt or conspiracy to commit an offense described
in paragraph (1), (2), (3), (4), or (5) in violation of the Controlled
Substances Act (21 U.S.C. 801 et seq.), the Controlled Substances
Import and Export Act (21 U.S.C. 951 et seq.), or the Maritime
Drug Law Enforcement Act (46 U.S.C. 1901 et seq.).
(b) GENERAL REQUIREMENTS.—In carrying out this section, the
Commission shall, with respect to each offense described in subsection (a)—

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114 STAT. 1243

(1) review and amend the Federal sentencing guidelines
to provide for increased penalties such that those penalties
reflect the seriousness of these offenses and the need to deter
them; and
(2) take any other action the Commission considers to
be necessary to carry out this section.
(c) ADDITIONAL REQUIREMENTS.—In carrying out this section,
the Commission shall ensure that the Federal sentencing guidelines
for offenders convicted of offenses described in subsection (a)
reflect—
(1) the need for aggressive law enforcement action with
respect to offenses involving the controlled substances described
in subsection (a); and
(2) the dangers associated with unlawful activity involving
such substances, including—
(A) the rapidly growing incidence of abuse of the controlled substances described in subsection (a) and the threat
to public safety that such abuse poses;
(B) the recent increase in the illegal importation of
the controlled substances described in subsection (a);
(C) the young age at which children are beginning
to use the controlled substances described in subsection
(a);
(D) the fact that the controlled substances described
in subsection (a) are frequently marketed to youth;
(E) the large number of doses per gram of the controlled
substances described in subsection (a); and
(F) any other factor that the Commission determines
to be appropriate.
(d) SENSE OF THE CONGRESS.—It is the sense of the Congress
that—
(1) the base offense levels for Ecstasy are too low, particularly for high-level traffickers, and should be increased, such
that they are comparable to penalties for other drugs of abuse;
and
(2) based on the fact that importation of Ecstasy has surged
in the past few years, the traffickers are targeting the Nation’s
youth, and the use of Ecstasy among youth in the United
States is increasing even as other drug use among this population appears to be leveling off, the base offense levels for
importing and trafficking the controlled substances described
in subsection (a) should be increased.
(e) REPORT.—Not later than 60 days after the amendments
pursuant to this section have been promulgated, the Commission
shall—
(1) prepare a report describing the factors and information
considered by the Commission in promulgating amendments
pursuant to this section; and
(2) submit the report to—
(A) the Committee on the Judiciary, the Committee
on Health, Education, Labor, and Pensions, and the Committee on Appropriations of the Senate; and
(B) the Committee on the Judiciary, the Committee
on Commerce, and the Committee on Appropriations of
the House of Representatives.

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28 USC 994 note.

PUBLIC LAW 106–310—OCT. 17, 2000

SEC. 3664. EMERGENCY AUTHORITY TO UNITED STATES SENTENCING
COMMISSION.

The United States Sentencing Commission shall promulgate
amendments under this subtitle as soon as practicable after the
date of the enactment of this Act in accordance with the procedure
set forth in section 21(a) of the Sentencing Act of 1987 (Public
Law 100–182), as though the authority under that Act had not
expired.
SEC. 3665. EXPANSION OF ECSTASY AND CLUB DRUGS ABUSE PREVENTION EFFORTS.

(a) PUBLIC HEALTH SERVICE ACT.—Part A of title V of the
Public Health Service Act (42 U.S.C. 290aa et seq.), as amended
by section 3306, is further amended by adding at the end the
following:
42 USC 290aa–
5b.

‘‘SEC. 506B. GRANTS FOR ECSTASY AND OTHER CLUB DRUGS ABUSE
PREVENTION.

‘‘(a) AUTHORITY.—The Administrator may make grants to, and
enter into contracts and cooperative agreements with, public and
nonprofit private entities to enable such entities—
‘‘(1) to carry out school-based programs concerning the dangers of the abuse of and addiction to 3,4-methylenedioxy methamphetamine, related drugs, and other drugs commonly
referred to as ‘club drugs’ using methods that are effective
and science-based, including initiatives that give students the
responsibility to create their own anti-drug abuse education
programs for their schools; and
‘‘(2) to carry out community-based abuse and addiction
prevention programs relating to 3,4-methylenedioxy methamphetamine, related drugs, and other club drugs that are
effective and science-based.
‘‘(b) USE OF FUNDS.—Amounts made available under a grant,
contract or cooperative agreement under subsection (a) shall be
used for planning, establishing, or administering prevention programs relating to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs.
‘‘(c) USE OF FUNDS.—
‘‘(1) DISCRETIONARY FUNCTIONS.—Amounts provided to an
entity under this section may be used—
‘‘(A) to carry out school-based programs that are
focused on those districts with high or increasing rates
of abuse and addiction to 3,4-methylenedioxy methamphetamine, related drugs, and other club drugs and targeted
at populations that are most at risk to start abusing these
drugs;
‘‘(B) to carry out community-based prevention programs that are focused on those populations within the
community that are most at-risk for abuse of and addiction
to 3,4-methylenedioxy methamphetamine, related drugs,
and other club drugs;
‘‘(C) to assist local government entities to conduct
appropriate prevention activities relating to 3,4methylenedioxy methamphetamine, related drugs, and
other club drugs;
‘‘(D) to train and educate State and local law enforcement officials, prevention and education officials, health

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114 STAT. 1245

professionals, members of community anti-drug coalitions
and parents on the signs of abuse of and addiction to
3,4-methylenedioxy methamphetamine, related drugs, and
other club drugs and the options for treatment and prevention;
‘‘(E) for planning, administration, and educational
activities related to the prevention of abuse of and addiction
to 3,4-methylenedioxy methamphetamine, related drugs,
and other club drugs;
‘‘(F) for the monitoring and evaluation of prevention
activities relating to 3,4-methylenedioxy methamphetamine, related drugs, and other club drugs and reporting
and disseminating resulting information to the public; and
‘‘(G) for targeted pilot programs with evaluation components to encourage innovation and experimentation with
new methodologies.
‘‘(2) PRIORITY.—The Administrator shall give priority in
awarding grants under this section to rural and urban areas
that are experiencing a high rate or rapid increases in abuse
and addiction to 3,4-methylenedioxy methamphetamine, related
drugs, and other club drugs.
‘‘(d) ALLOCATION AND REPORT.—
‘‘(1) PREVENTION PROGRAM ALLOCATION.—Not less than
$500,000 of the amount appropriated in each fiscal year to
carry out this section shall be made available to the Administrator, acting in consultation with other Federal agencies, to
support and conduct periodic analyses and evaluations of effective prevention programs for abuse of and addiction to 3,4methylenedioxy methamphetamine, related drugs, and other
club drugs and the development of appropriate strategies for
disseminating information about and implementing such programs.
‘‘(2) REPORT.—The Administrator shall annually prepare
and submit to the Committee on Health, Education, Labor,
and Pensions, the Committee on the Judiciary, and the Committee on Appropriations of the Senate, and the Committee
on Commerce, the Committee on the Judiciary, and the Committee on Appropriations of the House of Representatives, a
report containing the results of the analyses and evaluations
conducted under paragraph (1).
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to carry out this section—
‘‘(1) $10,000,000 for fiscal year 2001; and
‘‘(2) such sums as may be necessary for each succeeding
fiscal year.’’.

Subtitle D—Miscellaneous
SEC. 3671. ANTIDRUG MESSAGES ON FEDERAL GOVERNMENT INTERNET WEBSITES.

21 USC 801 note.

Not later than 90 days after the date of the enactment of
this Act, the head of each department, agency, and establishment
of the Federal Government shall, in consultation with the Director

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PUBLIC LAW 106–310—OCT. 17, 2000

of the Office of National Drug Control Policy, place antidrug messages on appropriate Internet websites controlled by such department, agency, or establishment which messages shall, where appropriate, contain an electronic hyperlink to the Internet website,
if any, of the Office.
21 USC 886 note.

SEC. 3672. REIMBURSEMENT BY DRUG ENFORCEMENT ADMINISTRATION OF EXPENSES INCURRED TO REMEDIATE METHAMPHETAMINE LABORATORIES.

(a) REIMBURSEMENT AUTHORIZED.—The Attorney General,
acting through the Administrator of the Drug Enforcement Administration, may reimburse States, units of local government, Indian
tribal governments, other public entities, and multi-jurisdictional
or regional consortia thereof for expenses incurred to clean up
and safely dispose of substances associated with clandestine methamphetamine laboratories which may present a danger to public
health or the environment.
(b) ADDITIONAL DEA PERSONNEL.—From amounts appropriated
or otherwise made available to carry out this section, the Attorney
General may hire not more than five additional Drug Enforcement
Administration personnel to administer this section.
(c) AUTHORIZATION OF APPROPRIATIONS.—There is authorized
to be appropriated to the Attorney General to carry out this section
$20,000,000 for fiscal year 2001.
21 USC 801 note.

SEC. 3673. SEVERABILITY.

Any provision of this title held to be invalid or unenforceable
by its terms, or as applied to any person or circumstance, shall
be construed as to give the maximum effect permitted by law,
unless such provision is held to be utterly invalid or unenforceable,
in which event such provision shall be severed from this title
and shall not affect the applicability of the remainder of this title,
or of such provision, to other persons not similarly situated or
to other, dissimilar circumstances.
Approved October 17, 2000.

LEGISLATIVE HISTORY—H.R. 4365:
CONGRESSIONAL RECORD, Vol. 146 (2000):
May 9, considered and passed House.
Sept. 22, considered and passed Senate, amended.
Sept. 27, House concurred in Senate amendment.
WEEKLY COMPILATION OF PRESIDENTIAL DOCUMENTS, Vol. 36 (2000):
Oct. 17, Presidential statements.

Æ

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