=e S0r1n CONGRESS 3 - . . 2n Session 1 5 7 5 8 e e@ Mr. To IN THE ILOUSE OF REPRESENTATIVES Marcu 5, 1968 Sraccers introduced the following bill; which was referred to the Com- mittee on Interstate and Fc oreign Conunerce A BILL amend the Public Health Service Act so as to extend and improve the provisions relating to regional medical programs, to extend the authorization of grants for health of migratory agricultural workers, to provide for specialized facilities for alcoholics and narcotic addicts, and for other purposes. Be it enacted by the Senate and House of Representa- tives of the United States of America in Congress assembled, TITLE I—REGIONAL MEDICAL PROGRAMS : EXTENSION OF REGIONAL MEDICAL PROGRAMS Src. 101. Section 901 (a) of the Public Health 1 Bervise Act (42 U.S.C. 299a) is amended by striking out ‘ “and before “$200,000,000” and by inserting after “Si une ¢ 30, 1968,” the following: “$65,000,000 for the fiscal year ‘onde I 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 2 ing June 30, 1969, and such sums as may be necessary for the next four fiscal years,”. EVALUATION OF REGIONAL MEDICAL PROGRAMS Sec. 102. Section 901 (a) of the Public Health Service Act is further amended by inserting at the end thereof the following new sentence: “For any fiscal year ending after June 30, 1969, such portion of the appropriations pursuant to this section as the Secretary may determine, but not ex- ceeding 1 per centum thereof, shall be available to the Secre- tary for evaluation (directly or by grants or contracts) of the program authorized by this title.” INCLUSION OF TERRITORIES . Sec. 103. Section 902(a) (1) of the Public Health Service Act (42 U.S.C. 299b) is amended by inserting after “States” the following: “ (which for purposes of this title includes the District of Columbia, the Commonwealth of Puerto Rico, the Virgin Islands, Guam, American Samoa, and the Trust Territory of the Pacific Islands)”. COMBINATIONS OF REGIONAL MEDICAL PROGRAM AGENCIES Sec. 104. Section 903 (a) and section 904 (a) of the Public Health Service Act (42 U.S.C. 299¢, 299d). are each amended by. inserting after “other public or nonprofit private _ agencies and institutions’’. the following: “,.and combina- EDP LOEH tions thereof,”. - Su gtpet idee ED he B04 . oe tes ti Meg eer. EYE eA iG oS 10 11 12 13 14 15 16 17 18 19 20 21 22 23 3 ADVISORY COUNCIL MEMBERS Suc. 105. (a) Section 905 (a) of the Public Health Service Act (42 U.S.C. 299e) is amended by striking out “twelve” and inserting in lieu thereof “sixteen”. | (b) Section 905 (b) of such Act is amended by striking out “and four at the end of the third year” and inserting in lieu thereof “four at the end of the third year, and four at the end of the fourth year”. MULTIPROGRAM SERVICES Suc. 106. Title IX of the Public Health Service Act is further amended by adding at the end thereof the following new section: | | “PROJECT GRANTS FOR MULTIPROGRAM SERVICES: “Sno. 910. Funds appropriated under this title shall also be available for -erants: to any public or nonprofit private agency or institution for services needed by or which will be of substantial use to, any ‘two or more régional’ medical programs.” | : | CLARIFYING OR TECHNICAL AMENDMENTS So. 107. (a) Section 901 (c) of ‘the Public Health Service Act is amended by inserting before the’ period at the end thereof “or, where appropriate, a practicing dentist”. (b) Section 901 of such Act is further amended by add- ing at the end thereof the following new subsection: co 10 11 12 13 14 15 16 17 18 19 20 21 4 “(d) Grants under this title to any agency or institu- tion for a regional medical program may be used by it to assist in meeting the cost of participation m stich program by any Federal hospital.” TITLE I[-MIGRATORY WORKERS EXTENSION OF SPECIAL GRANTS FOR HEALTH OF MIGRATORY WORKERS So, 201. Section 310 of the Public Health Service Act (42 U.S.C. 942h) is amended by striking out “and, $9,000,- 000 for the fiscal year ending June 30, 1968” and inserting in liew thereof “$9,000,000 each for the fiscal year ending June 30, 1968, and the next fiscal year, and such sums as may be necessary for the fiscal year ending June 30, 1970”. TITLE II[—ALCOHOLIC AND NARCOTIC ADDICT. REHABILITATION Sg. 300. This title may be cited as the “Alcoholic and. Narcotic Addict Rehabilitation Amendments of 1968”. Parr A—ALCOHOLIC REMABILITATION | Sno. 301. The Community Mental Health Centers Act (42 U.S.C. 2681, et. seq.) B the following new part: ig amended by adding after part. mw wr w ov cari -) “PART C— ALCOHOLISM “CONSTRUCTION. GRANTS “Suc, 241. (a) Grants from appropriations under sec- tion 261 for construction of any facilities may be made only to a public or nonprofit private agency or organization and only upon an application (1) which meets the requirements for approval under clauses (1) through (5) and clause (A) of section 205 (a), (2) which is for construction of a facility for the prevention and treatment of alcoholism, and (3) which contains— “(A) a showing of the need, in the area to be served by the applicant, for special facilities for the inpatient or outpatient tveatment, or both, of alcoholism ; “(B) satisfactory assurance that the services for prevention and control of alcoholism to be provided through the facility to be constructed, alone or in con- junction with other facilities owned or operated by the applicant or affiliated or associated or having an arrange- ment with the applicant, will include, or be part of a program providing, principally for persons residing in or near the particular community or communities in IPSS rm ae nee 10 li. 12 ~~ 13 | W4 0-5 15... 16... AT os 18... 19. 20- Bs 22 23 24 25 "6 which such facility is situated, at least those essential ele- ments of comprehensive mental health services and serv- ices for the prevention and treatment of alcoholism, including postinstitutional aftercare and rehabilitation, - that are prescribed by the Secretary; “(C) satisfactory assurance that the application has been approved and recommended by the single State agency designated by the State as being the agency pri- marily responsible for care aud treatment of alcoholics in the State, and, in case this agency is different from the . agency designated pursuant to section 204 (a) (1), a showing that the-application has also been approved and recommended by the agency designated pursuant. to section 204 (a) (1) ; “(D) a showing that the project is entitled to prior- ~- ity over other projects for treatment of alcoholism, if any, within the State + aceordance with regulations of the Secretary. as to general manner of determining .. priority, and is in accordance with such criteria, includ- “ing the willingness and ability to provide satisfactory _ alternatives to custodial care, as the Secretary may deter- mine to be appropriate for purposes of this section; and “(B) a showing that adequate provision has been made for furnishing needed services for persons unable to pay therefor in accordance with regulations of the fa bo 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 7 * » Seeretary undéx' section 203 (4) and for compliance with State standards for operation and maintenance. . “S ©(b)- The amount of any such grant’ with respect to any project: shall be ‘such percentage ‘of the cost thereof, but not in excess of 662 per centum, as the Secretary may determine. © ~ “STAFFING, OPERATION, AND MAINTENANCE GRANTS “Spc, 242. (a) Grants from appropriations under sec- tion 261 may he made to any public or nonprofit private agencies ‘and organizations to assist them in projects for the operation, staffing, and maintenance of new facilities for pre- vention and treatment of alcoholism or of new services in facilities for prevention and treatment thereof. “(b) Grants under this section may be made only upon an application which meets the requirements for approval under part B. In making such grants, the Secretary shall take into account the relative needs of the several States for alcoholism programs and the relative financial need of the applicants and the relative population of area to be served by the applicants. In the case of any project the application for which is approved under this section, the maximum. per- centage of the cost of the project with respect to which a grant is made hereunder shall be 90 per centum thereof for the first year following the first day of the first month for 16 17 18 8 which a grant is made, 80 per centum thereof for the second year thereafter; 70 per centum for the third year thereafter ; 60 per centum for the fourth year thereafter; and 50 per centum for each of the next six years thereafter. “SPHOIALIZED FACILITIES “Src, 248, (a) Grants from appropriations under sec- tion 261 may also be made for projects for construction, operation, staffing, and maintenance of specialized residential ‘and other facilities, such as halfway houses, day-care cen- ters, and hostels, for treatment of homeless alcoholics requiring care in such facilities. “(p) Such grants may be made only with respect to facilities which (1) are affiliated with a community mental health center providing at least those essential elements of compresensive community mental health services which are prescribed by the Secretary, or (2) are not so affiliated but with respect to which satisfactory provision (as deter- mined by the Secretary) has been made for appropriate utilization of existing community resources needed for an adequate program of prevention and treatment of alcoholism. “DROJECTS ELIGIBLE UNDER REGULAR PROGRAM “Qn0, 244, Nothing in this part shall be construed-to preclude approval under parts A and B of a grant for a-proj- 10 11 12 13 14 16 1 18 19 20 9 ect for:a facility ‘or initial staffing thereof for the treatment of alcoholics but in determining the amount of any such grant under such part there shall be excluded from the cost of the project an amount equal to the sum of (1). the amount of any other Federal grant which the applicant has obtained, or is assured of obtaining, with respect to the project which . is to be financed in part by a grant or grants under this part. and (2) the amount of any non-Federal funds required to he expended as a condition of such other Federal grant. “PAYMENTS “Src. 245. Payments of grants under this part may be made in advance or by way of reimbursement, and on such terms and conditions and in such installments, as the Secre- tary may determine. “SHORT TITLE “Suc. 246. This part may be cited as the ‘Alcoholic Rehabilitation Act of 1968’.” Part B—Narcoric ADDICTION Src. 302. The Community Mental Health Centers Act (42 U.S.C. 2681, et seq.) is further amended by inserting after part C (added by section 101 of this Act) the follow- ing new part: Bo es a 10 11 12 13 . 14 15 16. 17 18 ‘19 20 22 23 24. 25 10 -. “Part D—Narcotic AppICT REHABILITATION -“PROGRAM OF TREATMENT “Sno: 251. (a) Sums appropriated pursuant to section 961 shall be available for grants to any public or nonprofit private agencies and organizations to assist them in projects for constructing, operating, staffing, and maintaining treat- ment centers and facilities (including posthospitalization treatment centers and facilities) for narcotic addicts within the States. | “(b) The grant program authorized by subsection (a) shall, insofar a$ it: deals with the kind of activities authorized by parts A and’B of this title, be carried: out consistently with the grant programs under such parts A and B except to the extent, in the judgment of the Secretary, special con- sideration make differeiices appropriate. . + | “—PRATNING AND EVALUATION | “Sno, 252. The Secretary is authorized; during the pe- riod beginning. July 1, 1968, and ending with the close of June 30, 1970, to make grants to any public or nonprofit - private agencies'and organizations to cover part or all of the 21 ‘gost of (A) developing specialized training ‘programs or materials relating to the provision of public‘health ° services for the prevention and treatment of narcotic addiction, or developing in-service training or short-term or refresher courses with respect to the provision of such services; (B) 10 il 12 13 14 15 16 18 19 20 21 22 23 24 11 training personnel to operate, supervise, and administer such services; and.: (C) :conducting surveys -and field trials -to evaluate the adequacy of the programs for the prevention and treatment of narcotic addiction within the several States with a view to determining ways and means of jmproving, eX- tending, and expanding such programs. “PROJECTS ELIGIBLE UNDER REGULAR PROGRAM “onc, 253. Nothing in this part shall be construed. ‘to preclude approval under parts A and B of a grant fora project for a facility or initial staffing thereof for the treat- ment of narcotic addicts, but in determining the amount of any such grant under such part there shall be excluded from the cost of the project an amount equal to the sum of (1) the ‘amount of any other Federal grant which the applicant has obtained, or is assured of obtaining, with respect to the project which is to be financed in part by a grant or grants under this part, and (2) the amount of any non-Federal funds required to be expended as a condition of such other Federal grant. “PAYMENTS “nc, 254. Payments under this part may be made in advance or by way of reimbursement, and on such terms and conditions and in such installments, as the Secretary may determine.” me wo nD ee a co oe ‘I 10. 11 12 13 14 16 17 18 19 20 21 22. 23 "to make grants with respect to any project under" part'C or'D 24 25 12 Parr C—GENERAL AUTIIORIZATION OF APPROPRIATIONS FOR REHABILITATION OF ALCOHOLICS AND NARCOTIC ADDICTS Suc. 308. The Community Mental Health Centers Act (42 U.S.C. 2681, et seq.) is further amended by inserting after part D (added by section 201 of this Act) the following new part: “Part E—GENERAL PROVISIONS “AUTHORIZATION OF APPROPRIATIONS FOR REHABILITA- TION OF ALCOHOLICS AND NARCOTIC ADDICTS “Gro, 261. (a) There are authorized to be appropriated for the fiscal year ending June 30, 1969, and the next fiscal year such sums as may be necessary for project grants for construction, operation, staffing, and maintenance of facilities for the prevention and treatment of alcoholism (including specialized residential and other facilities) under part C or the prevention and treatment of narcotic addiction under part D. Sums so appropriated for any fiscal year shall remain available for obligation until the close of the next fiscal year. “(b) There are also authorized to be appropriated for the fiscal year ending June 30, 1971, and each of the next seven fiscal years such sums as may be necessary-to' éontinue for operation, staffing, or maintenance of any facilitiés if such a grant was made thereunder with respect to such project 10. 11. 12 14 15 16 17 18 19 20 24 22 23 24 25 13 © from appropriations under this section for the fiscal year end- ing June 30, 1970, or any prior year, except that grants -inder such part may not be made with respect to any project “after such grants have been made with respect to it from _ such appropriations for eight fiscal years. ‘“pROGRAM EVALUATION “gnc, 262. Such portion of any appropriation under this title for any fiscal year ending after June 30, 1968, as the Secretary may determine, but not. exceeding 1 per centum thereof, shall be available to the Secretary for evaluation (directly or by grants or contracts) of the programs author- ized by this title.” » OPERATION AND MAINTENANCE GRANTS UNDER COM- . MUNITY MENTAL HEALTI CENTERS PROGRAM — Suc. 304. Part B of the Community Mental Health Centers Act 1s amended by adding after section 224. (42 U.S.C. 26884) the following new section: “PACILITIES RELATING TO REHABILITATION OF ALCOHOLICS OR NARCOTIC ADDICTS “Sno, 225. In the case of any community mental health center which includes (to such extent as may be determined in accordance with regulations) facilities for the prevention and treatment of aleoholism or narcotic addiction, the put poses for which the portion of the grant under this part which relates to such facilities may be made, the percentage of the. : i fe . 5 Hi u Py " f + t i : ; bo co 13 14 15 16 17 18 19 20. 21 22° 23, 24 2558, 14 . cost to be met by such portion of the grant, and the duration of such portion of the grant shall, subject to limitations in such regulations, be determined as though the grant is being made for operation, staffing, and maintenance of facilities under part C, in the case of facilities for prevention and treat- ment of alcoholism, or part D, in the case of facilities for the prevention and treatment of narcotic addiction.” USE OF ALLOTMENTS FOR COST OF ADMINISTRATION Sno. 305. Section 403 of the Mental Retardation Facili- ties and Community Mental Health Centers Construction Act of 1968 (42 U.S.C. 2693) is amended by adding at the end thereof the following new subsection: “(c) (1) At the request of any State, a portion of any allotment or allotments of such State under part A of title II shall be available to pay one-half (or such smaller share’ as the State may request) of the expenditures found ‘neces- sary by the Secretary for the proper and efficient administra- tion during such year of the State plan approved under such’ part; except that not more than 2 per centum of the total of the allotments of such State for a year, or $50,000,~ whichever is less, shall be available for such purpose. for such year. Payments -of amounts due under this: paragraph may. be made in advance or by way of reimbursement; rand “+n such installments, ‘as theSecretary may: determine. 1] Be (2) Any amoimnt paid: under parsigriph (1 )s ito. any 15 State for any fiscal year shall be paid on condition that there shall be expended from State sources for such year for administration of the State plan approved under such part A not less than the total amount expended for such purposes from such sources during the fiscal year ending June 30, 1968.”