;z ;I I i i I i * 1.11 0 i I i 0 90TIT CONGP,,ES@S 2D SrSqIO-,\- He R* 15758 IN T]ILE IIOUSE OF riEPRESENTATIVES MAP,Cll 5,1968 NI.r. STAGGErs introcl'ticed the following bill; whicli ,vas referred to the Com- mittee on Interstate and Foreign Coniiiierce A BILL To amend the Public Ilealth Service Act so as to extend and improve the provisions relating to reOioii,,il medical programs, to extend the authorization of grants for health of migratory agricultural Ni-orkers, to provide for specialized facilities for alcoholics and narcotic addicts, and for'other purposes. I Be it enacted bY the Senate and Hottse of Representa- 2 tives of the United States of America in Congress assembled, 3 TITLE I-REGIONAL.INIEDICAL PROGr-,Ailis 4 riXTENSION OF REGIONAL ATEDICAL PROGRA-AIS 5 Sicc. 101. Section 901 (a) of the Public Health Service 6 Act (42 U.S.C. 299a) is amended by striking "'and" 7 before "$200,000,000" and by inserting after "Jun e 30, 8 1968@" the following: "$65,000,000 for the fiscal 2 1 ilig June 30, 1969, and such sums as may be necessary for 2 the next four fiscal years,". 3 Ei VAL-UATION OF REGIONAL AIEDICAL PROGRAMS 4 SEC. 102. Section 901 (a) of the Public :Flealth Service 5 Act is further amended by inserting at the end thereof the, 6 following new sentence: "For any fiscal year ending after 7 June 30, 1969, such portion of the appropriations pursuant 8 to this section as the Secretary may determine, but not ex- 9 ceeding 1 per centiun thereof, shall be available to the Secre- 10 tary for evaluation (directly or by grants or contracts) of the 11 progTam authorized by this title." 12 INCLTJSION OF TERRITORIES 13 SEC. 103. Section 902 (a) (1) of the Public IF[ealth 14 Service Act (42 TJ.S.C. 299b) is amended by inserting 15 after "States" the following: (which for purposes of this 16 title includes the District of Colul-nl)ia, the Commonwealth 17 of Puerto. Rico, the Airgin Islands, Guam, American,Samoa 18 and the Trust Territory of the Pacific Islands) :L9 CO-LNIBINATIOT-\'S OF REGIONAL MEDICAL PROGRAM AGENCIES 20 SEC. 104. Section 903,(a,) and section 904 (a) of the 21 Public Health Service Act (42 U.S.C. 299c. 299d) are each @2 a-mended by,inserting after "other -ptibEc or nonprofit -private 23 agencies and institutions". the following:, @.,@@d combina- 24 tions thereof,",. 3 1 ADVISORY COUNCIL MBilfllEl?S 2 SEC. 105. (a) Section 90 5 (a) of the Public Hea-Ith t i I ut 3 Service Act (42 U.S.C. 299e) g is aniended by s r'kng o 4 "tNielve," itiid inserting in lieu thereof "sixteen".' 5 (b) Section 905 (b) of stich'Act is airteitcl'e'd by strikino, 6 out "aiiid foui- at the end of the third yeai-" ajid'imerting in 7 lieu thereof "fotii- at the ei:id of the: third yeai-, and four at 8 the end of the fourth yeai-". 9 MULTIPROGRAM SERVICES 10 SEC. 106. Title 1X of the Public H@lth Service Act is 11 further aniended by addirio- at the end thereof the following 12 new section: 13 9c PROJECT GRANTS FOR 3,IULTIPROGRAM SERV .ICES' 14 "SEC. 91 0. Funds appropriated iuider this title -shall als @o' 15 be available for -grants to any ubee or nonprofit private' p 16 ill be, agency or institution for services 'needed bv.o'r' which w 17 of substantial use to, any two or rnore regional inbdic,,tl 18 programs." 19 CLARIFYING OR TECHNICAL AMENDMENTS 20 SEC. 107. (a) Section 901 (c)@ of the Pu"'bli@c @llealth 21 Service Act is amended by inserting before ine pence a't' 22 the end thereof "or, where appropriate, a practicing dentist". 23 (b) Section 901 of such Act is further amended by add- 24 ing at the end thereof the following new subsection: 4 Cy or institti- 1 (d) Grants tinder this title to 2 tion for a regional me(Ecal program may be used by it to 3,tssist in nieeting the cost of particil),,ttion in @ticli program 4by anv Federal hospital." 5 TITLE 11-AIIGRATORY WORKER@S 6 l@',XTENSION OF SPEI CIAL GRAINTS FOR HEALTH OF 7 -AITGIZATORY IVORI@r.1-Es 8 SEC. 201. Section 310 of the Public Health Service Act 9(42 U.S.C. 242h) is a'niended by strikino, out "and, $9.000,- 1-0 000 for the fiscal year endino, June ')O, 1968" and inserting 11 in lieu thereof "$9,000,000 each for the fiscal year endino, 12 June 30, 1968, and the next ),ear, ,i.-nd such stinis ,is 13 nlay be necessary for the fiscal i@ea,i- ending June 30, 1970 14 TITLE 111-ALCOHOLIC AND NARCOTIC ADDICT. 15 REHABILITATION 16 -SEC. 300. This title may be cited as the "Alcoholic,,and. 17 Narcotic Ad(lict Rehabilitation Ameiidnients of 1968". PA-RT A-ALCOI-TOLIC Rr,,I-IABTL-ITATION . 19 SEC. 301. The @Commtinity )Ieiit,,il Health Centers Act 20 (42 -U.S.C. 2681, et. seq.) is amei-ided by adding after part 21- B the folloi6lio, new part: -PART C@ALCOI-IOLISIII TIOIN. GRANTS COITSTP,,TJC "SEc. 241. (a.) Grants from appropriations tinder see 3 -n, 4, tion 261 for construction of any facilities I ty be made Only 5to a public or nonprOfit private agency or organization and 6Only upon all application (1) which meets the requirements 7for approval under clauses (1) through (5) and clause (A) 8of section 205 (,a) , (2) which is for construction of a fa-cility 9for tl-ie prevention and treatment of alcoholism, and (3) 10 which contains- a sho,\Niny of the need, in the area to be 12 by the applicant, for special facilities for the @served 1 13 inpatient or outpatient treatment, or both, of ,ilcoholis'm; 14 (B) satisfactoi:v assurance that the services for 15 prevention and control of alcoholism to be, provided 16 through the facility to be constructed, alone or in con- 17 junction with other facilities owned or operated by the applicant or ,tffiliated or associated or hav iliu ,in a,'-r,tnge- is zn 19 ment with the ,,ipplicaiit, will include, or be part of a 20 program providing, principally for persons residing in 21 or near the particular community or communitiesm . 6 which sue 1 h facility is sittiated, at least those essential ele- 2 ments of comprehensive mental health services and serv- 3 ices for the prevention and treatment of alcoholism, 4 including p6stinstittitioiial aftercare and rehi,])ihtation, 5 that are prescribed by the Secretal.), - (C) satisfa6toi-y asstir iice that the tl)pli(,tition has 6 a 7 been approved and recommended bv the single State 8 agency designated bNT the State a,, being the igeiicv pii- 9 maiilv responsible for care ,iiid t@reitinent of alcoholics in 10 the State, and, in case this ti@gen(-,iT is different front the 11 agency designated pursuant to section 1 204 (a) (1) , a 12 showing that tbe-applicatioii has also been approved and 13 recommended by the ,to-enev designated pursuant to 14 section 204 (a) (1) '15. (D) a showing that the project is entitled to prior- 16@ ity over other projects for treatment 'of alcoholism,' if 17@ an , -%itbin the State in a(,,eordaiice' -"ith regulations of y 18 the SecretaiT. as to general ni,,i.iiiier of deteimmng @19 pnoi ty, and is in accordance with sti6h criteiia, includ- ,20. ing the willin and ability to provide satisfactory -e, as the Secretary may deter- ,21 alternatives to custodial cai 22 mine to be appropriate for purposes of -this section; and 23 (E) a showing tha.t adequate provision has been 24 made for fmi@g needed services for persons unable 25 to pay therefor in accordance N-,ith regulations of the 7 -id f cbmpl'a with Secretary under section 203 ai or 1 nce n e. 2 State standards for operations and mainto anc (b) The amount of an s ch ant @ with ke y u gr spect to 4 any projects shall be 'Such @ereenta e @of the cost thereof, 9 but not in excess of per centum, as the Secretary may 6 determine. 7 "STAFFINC,, OPEI?,ATION, AND ATAINTENANCE GPANTS @9 "SFc. 242. (a) Grants from ap r6piiations under see- p 9 tion 261 may be made to any public or'nonprofit private 10 ageiicies'and organizations to assist them in projects for the jl operation, staffing, and mainteiian@ce of new facilities for pre- 12 vention' and treatment of alcoholism or of new services in 13 facilities for prevention and treatment thereof. 14 (b) Grants tuider this section may be made only upon 15 an application which meets the requirements for approval 16 under part B. In making such orants, the Secretary shall 17 tgl-e into account the relative needs of the several States for 18 alcoholism programs and the relative financial need of the 19 applicants and the relative population of area to be served by 20 the applicants. In the case of any project the application for 21 which is approved under this section, the in aximum per- 22 centage of the .cost of the project with @ie@pect to -which a. 23 grant is made heretmder shall be 90 per centum thereof for 24 the first year following the first day of the first month for 8 1 Nvhicli ,i, grant is made, 80 per ceiitui-n thereof for the second 2 year thereafter; 70 per ceiitum for the third year thereafter; 60 per centum for the fourth year thereafter; and 50 per 4 centum for each of the next six years thereafter. 5 SPECIALIZED FACILITIES 6 "SEC. 243. (a) Grants from appropriations under sec- 7 tion 261 may also be made for projects for consti-actioia, S operation, staffing, and maintenance of specialized residential 9 and other facilities, such as halfway houses, day-care cen- 10 ters, and hostels, for treatment of homeless alcoholics 11 requiring care in such facilities. 12 " (b) Such grants may be made only with respect to 13 facilities which (1) are affiliated with a community mental 1-1 health center providing at least those essential elements 15 of compresensive community mental health services which 16 are ' rescribed b tbe Secretary, or (2) are not so affiliated p y 17 but -with respect to which satisfactory provision (as deter- 18 mined by the Secretary) has been made for'appropriate 19 utilization of existing community resources needed for an 20 adeqtiate,prooram of prevention and treatment of alcoholism. 21 "PROTECTS BLIGIBLE UNDER RR,,GULAR PROGIZAM ,22 "SEC. 1244. Nothing in this part shall be construed,-to 23 preclude approval under parts A and B of a. orant for a@pro' :9 1 ect for@ a facility- !or initial staffing thereof for the, treatment 2 of alcoholics, but in determining the amount of any such 3 grant.undersuch@partthereshallbeexcludedfromthecost 4 of the project an amount equal to the sum of - (1). the amount 5 of any other Federal grant which the applicant has obtained, 6 or is assured of obtaining, with respect to the project which 7 is to be financed in part by a grant or grants under this part. 8 and (2) the amount of any iion-Federal funds required to be 9 expended as a condition of such other Federal grant. 10 c cPAYMENTS 11 "SEC. 245. Payments of grants under this part may be 12 made in advance or by ivay of reimbursement, and oil such 13 terms and conditions and in such installments, -us the Secre- 14 t.,,iry may determine. 15 S]IORT TITliE 16 "SEC.- 246. This part may be cited as the 'Alcoholic iri- Rehabilitation Act of 1968'." 18 PAP.T B-I\TA2COTic ADDICTION 19 SEC. D'02.. The Community mental I-lealth Centers Act 20 (42 TJ.S.C. 2681, et seq.) is further amended by inserting 2i after part C (added by section 101 of this Act) the follow- .2 ing new part: to "@T 11)@iNAPCOTic ADDICT REHABILITATION 2 PROGRAM OF TREATIVIENT 3 "Sr,,C'.. 251. (a) SiLms appropriated pursuant to section 4 261 sha-11 be available for grants to ,tny public or nonprofit a private agencies, and organizations to assist them in projects 6 for constructing, operating, staffing, ,tnd maintaining treat- 7 m'ent 'Centers and facilities (including posfhospitalizatioii 8 treatment centers And facilities) for narcotic addicts within 9 the States -l'O (b) The grant progr,,iiii @iuthofized by subsection (a.) -1-1 shall, insofar @ag @iit deals with the kind of aicti vities authoiize(,t 12 by parts A and -B of this title, be carried, out'coinsistently 13 with the grant progTains-Lu-ider such parts@A and-B except 14 to the extent, in the judgment of the Secretary; special con- 15 sideration make diffetejic6s.a@propriate. 16 TRAINING AND EIVALTJATION 17 "SEC. 252. The Secretary is aut-hoiized,@ during the pe- 1 8 iiod begin@g. July 1, @ 1968,' and ending with -the close of 19 -June 30, 1970,@ to' make grants to any public o'r'nonprofit 20 private agencies-and orgaiiizbtions to cover par jt or all of the 21 st'of (A),' de'vel6ping specialized training 1 programs or @@CO 22 materials relating tc, the provision of publ'ldrh'e@klth'@§6i@ces 23 for the prevention and treatment of narcotic addiction, or 24 developing in-service training or -short-term or refresher 25 courses with respect to the provision of such services; (B) tra@g personnel to erate, supervise, and ,tdminister such 1 CIP 2services; and! t (C) conducting surveys -and field trials 'to 3evaluate the adequacy of the programs for the prevention @iid 4treatment of narcotic addiction within the several States with 5a view to determining ways and means of improving, ex- 6tending, and expanding such programs. 7 41 PRO.TECTS ELIGIBLE UNDER. RR,,GUIAR Pl?,OGIRAm 8 "SFc. 253. Nothing in this'pait shall be consti-aed"to 9 preclude approval under parts A and B of a gra-nt -for, a 10 project for a fa,cilitv or initial staffing thereof for the treat- 11 ment of narcotic addicts, but in determining the, -amount of 12 any such grant under such part there shall be excluded from 13 the cost of the project an amount equal to the sum of (1) 14 the'amount of any other Federal grant which the applicant 15 has obtained, or is assured of obtaining, with respect to the 16 project which is to be financed in part by a grant or grants 17 tinder this part, and (2) the, amount of any non-Federal 18 funds required to be expended as a condition of such other 19 Federal grant. 20 cc PAYMENTS 21 "SEc. 254. Payi-nents under this part may be made in 22 advance or by way of reimbursement, and on such terms 23 and conditions and in such installments, as the Secretary 24 may determine." 12 I PAIZT C-GE.N],',RAT, 2AUTI-IOIZIZATIO-N OF APP-ROPRIA'rlO'L\-S FOR IZEI-IABILITA'RION 3 OF ALCOHOI.JICS ANCD NAIICOTIC AI)DTC'RS 4 SEC. ;OJO'O. The Community illeiit,,il I-lealth Centers Act 5 (42 U.S.C. 2681, et seq.) is furtlici.- amended by inserting 6 after part D (added by section 201- of this Act) the- following 7 new part: 8 "PART E-GENERAL PPON'ISIONS 9 cc A-UTHORIZATION OF APPROPriTATIOLNS FOR REHABILITA- 10 TIOIN OF ALCO]IOLICS AND -N-A-1@GOTIC ADDICTS 11 "SEC. 261. (a) Therea-yeauthoiizedtobeappropriated 12 for the fiscal year ending June 30, 1969, and the next fiscal 13 year such 8unis as may be necessary for'pr-oj'ect grants for 14 construction, operation, staffing, ,tnd maintenance of facilities 15 for the prevention ,ind treatment of alcoholism (including 16 specialized residential and otliei- facilities) -Linder part C or 17 the prevention Itn(I treatment of narcotic @ddictioli under part D. Stims so appropriated for any fiscal year shall remain 19 available for obligation until the close of the next fiscal year. 20 " (b) There are also authorized to be appropriated f or @21 the fiscal year endino- June 30, 1971 aiid'ea6h of the ile@x't .22 seven fiscal years such stims as may be necessary- 6@contmue ,23 _tomake'gT6,nts@withrespecttoanyprojectii el'r'@'p'@aif,'Cor-D 24 for operation, staffing, or maintenance o any,:,f -a@ ic,ilitie, @sl,if sit 25 a grant was made thereunder with respect to such project 13 iations u der this section for the fiscal year end- Ifrom @ propy ap 2 ing@j,un6 30, 1970 ,tny prior year, except that grants , or 3 such part may not be made ",ith'yes-pect to ,tiny project 4'after such grants have@ been made -with respect to it from 5@@ such appropriations for eight fiscal years. 6 PROGRA@L FVAL-UATION 7 "Sii;c. 262. Such portion of any appropriation tinder this 8 title. for, any fiscal year ending after June 30, 1968, ,is the 9Secretary may detern-u'ne, but not, exceeding, I per centtiin 10 thereof,', shall be available to@ the Secretary for evaluation 11 (directly or by grants or contracts) of the programs author- 12 ized by this title." 13 OPr,,PATIO-N AND --,NfAINTEL\A'-\-CE GRANTS U,-\'DET? COI\R- 14 i\iU-@\ITY'-\IrNTAL IIEALTII CENTEIZ@S PP%OGRAI\L 15 SEC..304. Part B of tl-ie Community Oriental Health 16 Centers Act is amended by addino, after section 224 (42 17 U.S.C. 2688d) the following new section: is- "FACILITIES RELATING TO RE@HABILITATION OF 19 ALCOTIOLICS OR NA-RCOTIC ADDICTS 20 "SEC . 225. In the case of any community mental health 21 center which includes (to such extent as may be determined 22 in accordance with regulations) facilities for the prevention 23 ent of alc (Ection,:the pur- and tyeatni oholism or narcotic ad 24 poses for -which the portion of the zrant tinder this part which 25 of the relatos@to such facilities may be made, the percentage 14 cost to be met by such portion of th o- ant, and the- duration e r 2of such portion of the grant shall, subject to limitations in such regulations, be determined as though the grant is being 4made for operation, staffing, and maintenance of facilities tender part C, in the case of facilities for prevention and treat- 5 6ilient of alcoholism, or part D, in the case of facilities for the 7prevention and treatment of narcotic addiction." Is USE OF ALLOTMENTS FOR COST OF ADMINISTRATION 9 SEC. 305. Section 403 of the Mental Retardation Facili- 10 ties and Community Mental Health Centers 'Construction li Act of 1963 (42 U.S.C. 2693) is amended by adding'at the 1.2 end thereof the following new subsection: (c) (1) At the request of any State, a portion of any 14 ,tllotment or allotments of such State under part A of title i5 II shall be available to pay one-half (or such smaller share' 16 as the State may request) of the expenditures found -neces- 17 sary by the Secretary for the proper and efficient administra- 18 tion during such year of the State plan approved under such 19 part; except that not more than 2 per centwn of the total 20, of the allotments of such State for a year, or $50,000 21 @hichever is less, shall be available for 'such purpose . for' 22 such 1 year. Payment@ , of a"motinfs due u'nder,this.paragiap@: 23, may, be made in, advance or by' way of :reimbursem ent and 24 'in, such installments, as !the Secretary may 'dete@e., 25 Any amoiint; paid under (2) paragraph to-'an'y-- 1 State for any fiscal Year shall be paid on condition that 2 there shall be expended from State sources for such year 3 for administration of the State plan approved under such 4 part A not less than the total amount expended for such 5 purposes from such sources during the fiscal year ending 6 June 30, 1968."