ADAMHA Reorganization Act

ADAMHA Reorganization Act - Title I: Reorganization of Administration and Institutes - Subtitle A: Administration - Amends the Public Health Service Act to replace provisions relating to the Alcohol, Drug Abuse, and Mental Health Administration, the National Institute on Alcohol Abuse and Alcoholism, the National Institute on Drug Abuse, and the National Institute of Mental Health with provisions declaring that the Substance Abuse and Mental Health Services Administration (the Administration) is an agency of the Public Health Service and that the Center for Substance Abuse Treatment, the Center for Substance Abuse Prevention, and the Center for Mental Health Services (the Centers) are agencies of the Administration. Mandates an Administrator, authorizes a Deputy Administrator, sets forth the Administration's general authorities, and requires an Associate Administrator for Alcohol Prevention and Treatment Policy. Mandates an Associate Administrator for Women's Services and establishment of the Advisory Committee for Women's Services. Requires a study on the extent to which women are represented among senior personnel at the Administration. Requires a biennial report to specified congressional committees on Administration activities. Authorizes appropriations for grants, cooperative agreements, and contracts under these provisions. Replaces provisions relating to advisory councils with provisions establishing advisory councils for the Administration and each of the Centers. Replaces provisions relating to peer review with provisions requiring peer review of grants, cooperative agreements, and contracts administered through the Centers. Replaces provisions relating to alcohol abuse and alcoholism demonstration projects with provisions authorizing grants, contracts, and cooperative agreements to develop and expand mental health and substance abuse treatment services for homeless individuals. Authorizes appropriations. Establishes the Center for Substance Abuse Treatment. Mandates grants, cooperative agreements, or contracts for providing to pregnant and postpartum women residential treatment for substance abuse. Allows minor children of the women to reside in the treatment facilities. Authorizes appropriations. Requires grants for outpatient treatment of substance abuse among pregnant and postpartum women and, where appropriate, their infants. Mandates grants for demonstration projects to improve the provision of treatment services for substance abuse, including: (1) treatment to adolescents, female addicts and their children, racial and ethnic minorities, or individuals in rural areas; (2) treatment in exchange for public service; (3) treatment services operated by migrant or community health centers or programs providing health services for the homeless; (4) 'treatment campus' projects; (5) projects in large metropolitan areas to improve the availability and delivery of services; and (6) outreach to drug abusers at risk of HIV infection. Authorizes appropriations. Requires grants for substance abuse treatment for individuals under criminal justice supervision. Authorizes appropriations. Mandates grants to increase the number of substance abuse treatment professionals and the number of health professionals providing treatment services. Authorizes appropriations. Redesignates the National Institute on Drug Abuse as the Center for Drug Abuse Treatment. Modifies the duties of the Director of the Center for (originally established as the Office for) Substance Abuse Prevention. Replaces provisions authorizing appropriations for the Center with provisions establishing a national data base on programs for substance abuse prevention. Replaces provisions establishing an alcohol and drug abuse clearinghouse with provisions mandating: (1) assistance to communities to develop comprehensive long-term substance abuse prevention strategies; and (2) evaluation of different community approaches to prevention. Authorizes appropriations. Requires that demonstration projects for the prevention, treatment, and rehabilitation of drug and alcohol abuse among high risk youth include strategies for reducing the use of alcoholic and tobacco products by individuals to whom it is unlawful to sell or distribute the products. Authorizes appropriations to carry out the demonstration projects. Establishes the Center for Mental Health Services (Mental Health Center) and sets forth its duties, including carrying out provisions relating to clinical training and instruction and clinical traineeships. (Current law authorizes the Surgeon General to carry out those provisions.) Directs the Secretary of Health and Human Services to carry out provisions establishing grant programs for demonstration projects through the Mental Health Center (currently, through the National Institute of Mental Health), increases the limitation on the duration of grants, and authorizes appropriations. Repeals provisions establishing a National Mental Health Education Program. Authorizes appropriations to carry out provisions relating to counseling and mental health treatment for individuals infected with the etiologic agent for acquired immune deficiency syndrome and others who experience serious psychological reactions as a result of such infection of that individual. Mandates grants to public entities for comprehensive community mental health services to children under 22 years old with a serious emotional disturbance. Requires grantees to enter into understandings with providers of non-mental health services (such as medical, educational, and vocational services) to facilitate the availability of those services, but prohibits the use of grant funds or non-Federal contributions made with respect to the grant for those services. Mandates case management and individualized service plans. Allows grant funds to be used for related training. Requires the grantee public entity to have an approved plan for a jurisdiction-wide care system for community-based services for such children. Authorizes appropriations. Removes provisions relating to research on public health emergencies, animals in research, reduction in the waiting period for drug abuse treatment, model projects for pregnant and postpartum women and their infants, and drug abuse demonstration projects of national significance. Subtitle B: Institutes - Adds the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH) to the list of national research institutes. Rewords provisions relating to NIAAA's general purposes and research program, authorizes appropriations, and mandates an Associate Director for Prevention. Creates a subpart on NIDA, including authorizing appropriations for NIDA. Mandates an Associate Director for Prevention. Authorizes the designation of National Drug Abuse Research Centers for interdisciplinary research. Mandates annual grants to any such designated centers. Establishes: (1) an Office on AIDS (acquired immune deficiency syndrome); and (2) a Medication Development Program regarding medications to treat drug addictions. Authorizes appropriations for the Medication Program. Repeals provisions relating to drug abuse research. Creates a new subpart on NIMH. Mandates: (1) collection and publication of information on suicide and suicide prevention; and (2) an Associate Director for Special Populations to deal with policies and programs regarding women, minorities, and discrimination. Authorizes appropriations for NIMH. Mandates an Associate Director for Prevention. Establishes the Office of Rural Mental Health Research and the Office on AIDS. Subtitle C: Miscellaneous Provisions Relating to Substance Abuse and Mental Health - Replaces provisions relating generally to alcohol abuse and alcoholism and drug abuse with provisions making the Secretary responsible for fostering substance abuse prevention and treatment programs and services in State and local governments and in private industry. Mandates development of a variety of model programs suitable for replication on a cost-effective basis in different types of businesses and governmental entities. Prohibits, subject to exception, denial or deprivation of Federal civilian employment, license, or right solely on the basis of prior substance abuse. Prohibits discrimination against substance abusers suffering from medical conditions in admission or treatment by any hospital or outpatient facility receiving Federal assistance. Provides for records confidentiality regarding any substance abuse patient in connection with a Federally-assisted program. Subtitle D: Transfer Provisions - Provides for transfer and transition of functions, appropriations, personnel, contracts, proceedings and other matters under this Act. Requires that, with respect to fiscal years 1993 through 1996, the peer review systems, advisory councils, and scientific advisory committees used by NIAAA, NIDA, and NIMH be used by those institutes. Prohibits merger of NIAAA, NIDA, or NIMH with any other institute or entity or with each other for five years after enactment of this Act. Requires the NIAAA, NIDA, and NIMH Directors to submit budgets for FY 1994 and 1995 directly to the President. Subtitle E: References and Conforming Amendments - Deems references to the Alcohol, Drug Abuse and Mental Health Administration (ADAMHA) and its Administrator to be references to the Substance Abuse and Mental Health Services Administration and its Administrator. Removes provisions: (1) requiring the Orphan Products Board to evaluate ADAMHA activities regarding rare diseases or conditions; (2) including ADAMHA as one of the agencies among whom the Board must assure coordination regarding drug development; and (3) requiring ADAMHA to report to the Board regarding ADAMHA's rare disease and condition activities. Increases the number of experts or consultants of whom the Director of the National Institutes of Health is authorized to obtain the services. Removes provisions: (1) mandating National Research Service Awards for research at ADAMHA; (2) including ADAMHA institutes in mandatory continuing study of training programs for biomedical and behavioral research personnel; and (3) referring to the ADAMHA Administrator in connection with selection of candidates for certain endowed scientific positions. Amends the Orphan Drug Amendments of 1985 to remove a requirement that the National Commission on Orphan Diseases assess ADAMHA activities regarding rare diseases. Amends the Protection and Advocacy for Mentally Ill Individuals Act of 1986 to require that applications for allotments under existing provisions remain in effect for four (currently, for three) years. Subtitle F: Employee Assistance Programs - Amends the Public Health Service Act to authorize grants to assist business organizations in establishing employee assistance programs to provide substance abuse services. Authorizes appropriations. Title II: Block Grants to States Regarding Mental Health and Substance Abuse - Replaces provisions of the Public Health Service Act relating to alcohol and drug abuse and mental health services block grants with provisions mandating annual grants and allotments to States for comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance. Requires submission by each State and approval by the Secretary of a plan for the services. Requires that services include: (1) outpatient services; (2) 24-hour-a-day services; (3) day treatment or other partial hospitalization services, or psychosocial rehabilitation services; and (4) screening for admission to State mental health facilities. Requires services to be provided, within capacity, to any individual residing or employed in the service area regardless of ability to pay. Requires the State to establish a State mental health planning council. Includes in council duties serving as an advocate for adults and children. Authorizes appropriations. Mandates annual grants and allotments to States for the prevention and treatment of substance abuse. Allocates certain percentages for: (1) prevention and treatment regarding alcohol; (2) prevention and treatment regarding other drugs; (3) education, counseling, and risk reduction for individuals who do not require treatment; and (4) pregnant women and women with dependent children. Requires prenatal and child care for women receiving services. Requires: (1) intravenous drug treatment programs receiving assistance to notify the State on reaching 90 percent of capacity; (2) States to assure admission to such treatment within certain time limits; and (3) outreach for such treatment. Requires substance abuse programs receiving assistance to routinely make available tuberculosis counseling, testing, and treatment. Provides for counseling, testing, and treatment regarding HIV disease (infection with the etiologic agent for acquired immune deficiency syndrome). Requires States to provide for the ongoing operation of a revolving fund to make loans for establishing group homes for individuals recovering from alcohol or drug abuse. Requires that: (1) the loans be repaid by the residents through monthly installments; and (2) the residents establish house policies, including residence application procedures. Conditions a grant on a State having and enforcing a law prohibiting sale or distribution of tobacco products to any individual under 18 years old. Requires giving preference to pregnant women in admission to substance abuse treatment. Requires treatment or interim services to be made available to such a women within a specified time limit. Requires: (1) that States improve the process for referring individuals to treatment facilities that can provide the modality most appropriate for the individual; (2) availability of continuing education for employees; and (3) coordination of treatment activities with other services such as health, social, correctional, educational, vocational rehabilitation, and employment services. Mandates an assessment of need for services in the State. Limits expenditures for treatment services in correctional institutions. Allows grant funds to be used: (1) for inpatient hospital services as treatment for substance abuse only if medically necessary; and (2) with a waiver, for construction of facilities. Authorizes appropriations. Sets forth antidiscrimination provisions, including prohibiting discrimination against a woman because she is pregnant. Provides for the continuation of programs under allotments to the State of Hawaii for comprehensive substance abuse and treatment programs for Native Hawaiians. Authorizes grants to States to increase the number of individuals to whom public and nonprofit private entities are capable of providing substance abuse treatment. Authorizes appropriations. Authorizes methadone programs, if they have more than a specified admission waiting list period, to dispense methadone with only minimum ancillary services while individuals are waiting for admission for comprehensive treatment, providing the programs provide counseling regarding preventing exposure to or the transmission of HIV disease. Regulates the transition from the provisions deleted by this Act to the new provisions enacted by this Act, including specifying the dollar amount to be allotted to each named State from FY 1992 allotments not paid to States before a specified date. Sets aside a specified percentage of certain funds for programs, as enacted by this Act, for pregnant and postpartum women. Title III: Model Comprehensive Program for Treatment of Substance Abuse - Mandates a demonstration grant for a model comprehensive substance abuse treatment program in the national capital area. Earmarks certain funds appropriated for the Department of Health and Human Services to carry out the program. Title IV: Children of Substance Abusers - Mandates grants to identify and provide certain services to children of substance abusers and their families. Lists included services such as health and mental health care and referrals. Requires peer review of grant applications. Authorizes appropriations. Authorizes use of a specified amount of such appropriations for related training of health care professionals. Title V: Home Visiting Services for At-Risk Families - Mandates grants for the Federal share of the costs of services to families in which a member is: (1) a pregnant woman at risk of delivering an infant with a health or developmental complication; or (2) a child under three years old who has or is at risk of a health or developmental complication, child abuse, or neglect, or who was exposed to prenatal maternal substance abuse. Includes in those services: (1) prenatal and postnatal health care; (2) primary health care for the children; (3) infant care and child development education for the parents and other care givers; (4) education concerning behaviors that adversely affect health; and (5) help in obtaining other assistance. Considers a pregnant woman at such risk if she: (1) lacks access to or information about early and routine prenatal care; (2) lacks transportation to gain access to program services; (3) lacks appropriate child care assistance; (4) is fearful of accessing substance abuse services or child and family support services; or (5) is a low-income minor. Requires that home visiting services provided under the grants be delivered according to a case management model. Mandates outreach, case finding, and peer review. Authorizes appropriations. Title VI: Trauma Centers and Drug-Related Violence - Authorizes grants for the operating expenses of trauma centers that have incurred substantial uncompensated costs in providing trauma care in geographic areas with a significant incidence of violence arising directly or indirectly from illicit trafficking in drugs. Sets forth grant qualifications and preferences. Requires recipients to operate trauma registries. Authorizes appropriations. Title VII: Studies - Mandates studies regarding: (1) the role of the private sector in the development of anti-addiction medications; (2) the process by which such medications receive Food and Drug Administration marketing approval; (3) other matters regarding pharmacotherapeutic treatments for drug addiction. Declares that it is the sense of the Senate that the Medications Development Division of the National Institute on Drug Abuse shall devote special attention and adequate resources to achieve the development of: (1) medications in addition to methadone; (2) a long-acting narcotic antagonist; (3) agents for the treatment of cocaine abuse and dependency; (4) medications to treat addiction to drugs that are becoming increasingly prevalent; (5) medications to treat safely pregnant addicts and their fetuses; and (6) medications to treat the offspring of addicted mothers. Requires submission to the appropriate congressional committees of a report on the most effective methods for providing mental health services to individuals in contact with the criminal justice system. Mandates studies regarding: (1) insurance coverage for the treatment of mental illness and substance abuse; (2) fetal alcohol effect and fetal alcohol syndrome; (3) distribution of hypodermic needles and bleach to reduce the risk of contracting acquired immune deficiency syndrome; and (4) the statutory formulae under which funds are allocated among the States and territories under specified block grant provisions of the Public Health Service Act. Requires the Substance Abuse and Mental Health Services Administration to report directly to specified congressional committees regarding specified aspects of substance abuse and mental health services, including regarding related insurance. Title VIII: General Provisions - Sets forth the effective dates of this Act.

Community Mental Health and Substance Abuse Services Improvement Act of 1992 - Title I: Block Grants to States Regarding Mental Health and Substance Abuse - Amends title XIX (Block Grants) of the Public Health Service Act (the Act) to direct the Secretary of Health and Human Services (the Secretary) to make an annual allotment, in accordance with a specified formula, to each State with an approved application for providing comprehensive community mental health services to adults with a serious mental illness and to children with a serious emotional disturbance. Sets forth criteria for State plans and mental health centers. Requires monitoring of any entities which have remaining obligations under the Community Mental Health Centers Act, as such Act was in effect before its repeal in 1981. Requires a State, in order to receive a grant, to maintain a State mental health planning council. Authorizes appropriations. Directs the Secretary to make an annual allotment to each State making specified agreements for the purpose of planning, carrying out, and evaluating activities to prevent and treat the abuse of alcohol and other drugs. Gives priority to communities with the highest prevalence of substance abuse or the greatest treatment need. Specifies the percentages a State must use regarding: (1) alcohol vs. other drugs; (2) prevention programs; and (3) treatment for pregnant women and women with dependent children. Requires States to make child care and prenatal care available to women receiving services. Requires that: (1) States continue assistance to entities which received grants for reducing the waiting period for drug abuse treatment; and (2) a specified percentage be expended for intravenous drug abuse programs with priority given to programs treating individuals with the etiologic agent for acquired immune deficiency syndrome. Requires States to ensure that each individual who requests and is in need of intravenous drug abuse treatment is admitted to a treatment program within seven days of the request. Requires outreach activities. Mandates that States require drug treatment programs receiving assistance from the grants to offer (but not require) early intervention services for human immunodeficiency virus (HIV) disease. Requires a grant recipient State to: (1) provide for a revolving fund to make loans to establish group homes for recovering substance abusers; and (2) have in effect and enforce a law prohibiting the sale of tobacco products to any individual under the age of 18. Requires that the State ensure that treatment services are available to each pregnant woman in the State who seeks or is referred for and would benefit from the services. Sets forth additional provisions concerning a State's responsibilities, application, and plan. Authorizes appropriations. Adds a new subtitle to title XIX of the Act which sets forth new provisions regarding block grants, including provisions concerning: (1) the submission of the description of the intended use of a block grant; (2) reports and audits by States; (3) disposition of funds appropriated for allotments; (4) failure to comply with agreements required as a condition of receiving payments; and (5) nondiscrimination. Directs the Secretary to make grants to public entities for the purpose of providing comprehensive community mental health services to children (not over 21 years old) with a serious emotional disturbance. Sets forth requirements for receiving grants, including: (1) matching fund requirements; and (2) requirements concerning the provision of services. Permits charges for such services if: (1) the charges are adjusted to reflect the income of the child's family; and (2) no charges are imposed on families with income and resources below the official poverty line. Prohibits the period during which grant payments may be made from exceeding five years. Authorizes appropriations. Authorizes the Secretary to make grants to States for the purpose of increasing the maximum number of individuals to whom public and nonprofit private entities are capable of providing effective treatment for substance abuse. Requires that priority in making grants be given to States that: (1) give priority to pregnant women in the provision of residential treatment; and (2) more than meet their matching funds requirement. Sets forth requirements for receiving a grant. Authorizes appropriations. Title II: Other Programs of Alcohol, Drug Abuse, and Mental Health Administration - Requires that at least 15 percent of the amounts appropriated under the Act for conducting or supporting research regarding mental health be made available for research on community-based treatment programs. Authorizes appropriations for such research. Establishes within the National Institute of Mental Health the Office of Rural Mental Health. Requires the Director of such Office to coordinate various activities concerning mental health in rural areas. Authorizes the Director, directly and through grants, cooperative agreements, or contracts, to conduct research and carry out demonstration projects. Mandates grants for demonstration projects in rural areas to improve the availability of mental health services. Earmarks certain funds to carry out these provisions. Establishes, in the Alcohol, Drug Abuse, and Mental Health Administration, an Office for Treatment Improvement. Requires the Director of such Office, with respect to the treatment of substance abuse, to carry out specified duties, including: (1) collaborating efforts with other similar agencies; (2) providing technical assistance to entities providing treatment services; and (3) providing grants for the purpose of establishing demonstration projects that will improve the provision of treatment services for substance abuse. Authorizes appropriations for such grants. Requires the establishment of a demonstration program for providing, within the national capital area, comprehensive treatment services for substance abuse. Removes provisions authorizing appropriations for the Office for Substance Abuse Prevention (Prevention Office). Requires the Prevention Office Director to establish a national data base on programs for the prevention of substance abuse. Authorizes appropriations for the Prevention Office to assist communities in developing long-term strategies for the prevention of substance abuse and to evaluate the success of different approaches. Authorizes appropriations under the Act for prevention, treatment, and rehabilitation model projects for high risk youth. Replaces current provisions providing grants to establish projects for pregnant and postpartum women having substance abuse problems with provisions providing grants for residential treatment programs for such women. Sets forth program requirements, including that minor children of such women be allowed to live with the women during treatment. Authorizes appropriations. Provides for grants to establish projects for prevention and education activities and outpatient treatment regarding the effects of drug and alcohol abuse on pregnant and postpartum women and their infants. Requires the Director of the Prevention Office, through awarding grants, to develop programs to increase the number of full-time substance abuse treatment professionals and the number of professionals providing treatment services. Authorizes appropriations. Authorizes appropriations for research on alcohol abuse, alcoholism, and drug abuse. Mandates studies concerning: (1) programs that provide sterile hypodermic needles and bleach to individuals at risk of contracting acquired immune deficiency syndrome; (2) the barriers to insurance coverage for substance abuse treatment; and (3) fetal alcohol effect and fetal alcohol syndrome. Mandates grants for services to children and families of substance abusers. Authorizes appropriations. Authorizes appropriations for grants to entities for the acquisition of small instrumentation necessary for research on mental health and substance abuse. Title III: Trauma Centers and Drug-Related Violence - Authorizes the Secretary to make grants for the purpose of providing for the operating expenses of trauma centers that have incurred substantial uncompensated costs in providing trauma care in geographic areas with a significant incidence of violence arising from the abuse of drugs. Sets forth provisions concerning: (1) qualifying for such grants; and (2) preferences in making such grants. Authorizes appropriations. Title IV: National Commission on Alcohol and Tobacco Use By Children - Establishes the National Commission on Alcohol and Tobacco Use By Children. Title V: Miscellaneous - Amends the Anti-Drug Abuse Act of 1988 to consider the position of Deputy Director for Demand Reduction, when occupied by a physician, to be a Government physician for purposes of eligibility for the physicians comparability allowance. Authorizes grants to assist businesses with 500 or fewer employees with the costs of providing alcohol and drug abuse prevention and treatment services to employees and their families. Authorizes appropriations.

Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act of 1991 - Title I: Administration and Institutes - Subtitle A: Restructuring - Amends the Public Health Service Act to remove provisions relating to the administration, institutes, and research of the Alcohol, Drug Abuse, and Mental Health Administration. Establishes, as an agency of the Public Health Service, the Alcohol, Drug Abuse and Mental Health Services Administration (ADAMHSA). Directs the ADAMHSA Administrator to establish a comprehensive program to improve treatment, rehabilitation, and related services to individuals with substance abuse and mental illness and emotional disorders, improve prevention, promote mental health, and protect the rights of the mentally ill and substance abusers. Mandates: (1) grants, cooperative agreements, and contracts for activities relative to the provision of treatment, rehabilitation, prevention, and related services; (2) the establishment of peer review groups and advisory committees. Sets forth ADAMHSA's general duties. Authorizes appropriations. Mandates: (1) grants to prevent and treat substance abuse among high risk youth; (2) grants for providing pregnant and postpartum women and their children substance abuse prevention, education, and treatment services, including primary health care, comprehensive social services, support services, counseling, housing, and case management; (3) grants to improve the provision of substance abuse treatment services, including through focusing on specified populations, treatment and vocational training in exchange for service, projects operated by community and migrant health centers, and treatment campus projects; (4) grants for drug and alcohol treatment services to individuals under criminal justice supervision; (5) grants, contracts, or cooperative agreements to increase the number of full-time substance abuse treatment and prevention providers and the number of health professionals providing treatment and prevention as a component of primary health care; and (6) grants to States to expand their substance abuse treatment capacity. Authorizes appropriations. Authorizes: (1) grants or contracts for outreach to intravenous drug abusers to prevent exposure to and transmission of the etiologic agent for acquired immune deficiency syndrome; and (2) grants, contracts, and cooperative agreements to develop and expand mental health and substance abuse treatment for homeless individuals. Prohibits using funds provided under these provisions to distribute needles for illegal drug injection. Authorizes appropriations. Authorizes grants to communities for the development of comprehensive long-term strategies for the prevention of substance abuse and evaluation of different community approaches to such prevention. Authorizes appropriations. Authorizes grants for demonstration projects for: (1) community services for seriously mentally ill individuals and their families, seriously emotionally and mentally disturbed children and youth and their families, and seriously mentally ill homeless and elderly individuals; (2) the prevention of youth suicide; (3) recognition, assessment, treatment, and clinical management of depressive disorders; (4) the prevention of sex offenses and treatment and assistance to sex offense victims; (5) mental health services to family violence victims; and (6) prevention services for individuals at risk of developing mental illness. Authorizes appropriations. Requires: (1) the appointment of one or more advisory councils for ADAMHSA; (2) peer review of services grants, cooperative agreements, and contracts administered through ADAMHSA. Requires peer review approval for assistance under, and both peer review and advisory council approval for assistance over, a specified amount. Declares that, for purposes of provisions of the Public Health Service Act relating to alcohol, drug abuse, and mental health programs, Native American governing units and agencies shall be considered public agencies. Mandates a process to respond to misconduct in projects receiving funds under specified provisions. Authorizes and regulates the use of experts and consultants. Establishes within ADAMHSA the Office for Special Populations to take specified actions with regard to adolescents, children, individuals with disabilities, minority populations (including Native Americans), and the elderly. Establishes in the Office of the ADAMHSA Administrator the Office of Women's Health Services (Office) to ensure that services for women's health and mental health conditions are identified and addressed by the Alcohol, Drug Abuse, and Mental Health Administration. Defines women's health and mental health conditions to include only those conditions relating to alcohol, drug abuse, or mental health or for which ADAMHSA is authorized, by provisions other than these, to provide services. Establishes in the Office the Coordinating Committee for Research on Women's Health and the Advisory Committee for Women's Health Services. Requires the Administrator to establish a single data system for the collection, analysis, and dissemination of information regarding women's health and mental health research, including a registry of clinical trials of experimental treatments. Requires the Administrator to establish and operate a program to provide information on women's health and mental health services. Mandates a biennial report to the Congress on women's health and mental health services. Authorizes appropriations to carry out these provisions relating to the Office and women's health and mental health conditions and services. Establishes in the National Institutes of Health the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH) to conduct and support research, research training, and information dissemination. Authorizes appropriations. Authorizes grants, cooperative agreements, and contracts through NIAAA, NIDA, and NIMH relating to research and demonstrations relative to the cause, diagnosis, treatment, control, epidemiology and prevention of mental illness and substance abuse. Directs the Secretary of Health and Human Services to establish, through NIAAA, NIDA, and NIMH, National Health and Substance Abuse Education Programs to disseminate information on improved treatment and facility assistance methods and to support training. Authorizes the Secretary, through NIAAA and NIDA, to designate National Substance Abuse Research Centers for interdisciplinary research on substance abuse and other biomedical, behavioral, and social issues. Mandates annual grants to Centers. Establishes in NIDA the Medication Development Program to take specified steps regarding: (1) medication to treat the symptoms and disease of drug abuse and addiction; and (2) support of training in such areas. Mandates related grants or contracts and cooperative agreements. Subtitle B: Miscellaneous Provisions - Replaces provisions titled "Miscellaneous Provisions Relating to Substance Abuse and Mental Health" with provisions directing the Secretary, through the ADAMHSA Administrator, as feasible, and on request of a State, to make technical assistance available for specified purposes, including: (1) program management and evaluation; (2) accreditation or licensure of facilities and personnel; and (3) improving the scope of mental health and substance abuse health insurance offered in the State. Makes the Secretary, through the Administrator, responsible for fostering substance abuse prevention and treatment programs and services in State and local governments and private industry. Mandates: (1) development of model programs suitable for replication on a cost-effective basis in different types of businesses and governmental entities; and (2) dissemination of information on the model programs. Prohibits denial or deprivation of Federal civilian employment or a Federal professional or other license or right solely on the grounds of prior substance abuse, except for employment in specified Federal agencies, any other Federal department or agency designated for purposes of national security by the President, or any Federal position determined to be sensitive. Prohibits discrimination against substance abusers who are suffering from medical conditions in admission or treatment, solely because of their substance abuse, by any private or public general hospital, or outpatient facility receiving any Federal support. Prohibits disclosure of patient information maintained in connection with substance abuse prevention, training, treatment, or research which is conducted or assisted by any Federal department or agency, subject to specified exceptions. Provides for monetary penalties. Mandates: (1) data collection on the national incidence and prevalence of the various forms of mental illness and substance abuse; and (2) competitive grants for epidemiological and longitudinal studies of infants and the families of infants with fetal cocaine and fetal alcohol syndromes. Authorizes appropriations. Provides, if the Secretary determines that a disease or disorder within the jurisdiction of ADAMHSA constitutes a public health emergency, for: (1) expediting peer and advisory committee review; (2) waiving advertising requirements for proposals for contracts; (3) increasing existing grants and contracts; and (4) disseminating information. Subtitle C: Transfer Provisions - Provides for the transfer from the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) to: (1) ADAMHSA of authorities, responsibilities, services, personnel, assets, liabilities, orders, regulations, legal actions, and other matters; and (2) the appropriate Directors of NIAAA, NIDA, and NIMH all research related functions of ADAMHA. Subtitle D: Conforming Amendments - Amends specified provisions of the Public Health Service Act relating to projects for assistance in transition from homelessness and provisions relating to alternative utilization of military facilities to substitute references to the Administrator of ADAMHSA for references to: (1) the Director of the National Institute of Mental Health; and (2) the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse. Directs the Secretary to carry out provisions relating to alcohol and drug abuse and mental health services block grants through the Administrator. Subtitle E: Miscellaneous Provisions - Directs the Secretary to try to get alternative Federal funding for grantees receiving assistance under the community youth activity program under the Anti-Drug Abuse Act of 1988. Requires that the peer review systems, advisory councils, and scientific advisory committees used by NIAAA, NIDA, and NIMH before the transfer of those Institutes of NIH be used by those Institutes after the transfer. Declares that the Directors of NIAAA, NIDA, and NIMH shall have independent authority to formulate the budgets of their institutes to the same extent as the director of the National Cancer Institute. Removes provisions requiring the recommendation of the National Advisory Mental Health Council in order to make grants for research and demonstrations regarding methods of diagnosing mental illness and of care, treatment, and rehabilitation of the mentally ill. Affords the Secretary of Health and Human Services the same authority regarding substance abuse as the Secretary has regarding mental health under specified provisions. Extends the authorization of appropriations for grants for demonstration projects to provide counseling and mental health treatment for individuals who test positive for the etiologic agent for acquired immune deficiency syndrome. Trauma Center Revitalization Act - Amends the Public Health Service Act to authorize the Secretary of Health and Human Services to make grants for the operating expenses of hospital trauma centers with substantial uncompensated costs. Gives priority to: (1) centers receiving State or political subdivision support not connected to any Federal program or centers in areas where a trauma center has ceased participation, or because of uncompensated costs will be unable to participate, in the trauma care system; and (2) centers that are developing long term strategies to survive the impact of providing uncompensated care. Limits support for a center to: (1) three years, subject to extension by the Secretary for one additional year; and (2) a specified dollar amount. Authorizes the centers, notwithstanding any other provision of law, to cooperate, collaborate, or coordinate with other trauma centers to improve services. Authorizes appropriations. Amends the Federal Food, Drug, and Cosmetic Act to establish a drug salvager compensation program. Requires the Commissioner of Food and Drugs to contract for: (1) salvagers to return products to manufacturers or, if the manufacturer cannot be determined, to destroy the products; and (2) reimbursement of salvagers' expenses. Declares that it is the sense of the Senate that the Secretary of Health and Human Services should ensure that reports required by the Office of Treatment Improvement under specified provisions of the Public Health Service Act are not redundant, unnecessary, or overly burdensome on the States. Title II: Reauthorization and Improvement of Alcohol and Drug Abuse and Mental Health Service Block Grant Program - Authorizes appropriations for the alcohol and drug abuse and mental health services block grant provisions of the Public Health Service Act. Revises the formula for determining the amount of block grant allotments. Requires that unobligated block grant funds remain available to a State if the Secretary finds that the funds were obligated but subsequently unobligated due to the State's diligence in carrying out the purposes of such provisions. Directs (currently, authorizes) the Secretary to waive a requirement (to spend at least 50 percent of specified funds reserved to carry out certain drug abuse activities) if the Secretary determines that the incidence of intravenous drug abuse in a State does not require that level of funding. Allows block grant allotments to be used: (1) for grants to community health centers for services relating to seriously (currently, chronically) mentally ill individuals; (2) for grants to underserved populations of mentally ill individuals in local jails and detention facilities; (3) for renovation that makes land or a facility suitable for use under such block grant provisions, including removing hazards or making the land or facility accessible to disabled persons; (4) upon waiver by the Secretary, for rehabilitation of an existing facility; and (5) programs of treatment for adult and juvenile substance abusers in State and local criminal and juvenile justice systems. Allows the Secretary to waive or reduce matching funds requirements relating to existing provisions allowing a waiver of a prohibition of using block grant funds for construction of a new facility. Replaces provisions prohibiting the use of block grant funds for the distribution of needles or bleach in connection with the use of illegal drugs with a provision prohibiting the use of such funds for any program prohibited by specified provisions (relating to needle or syringe distribution) of the Health Omnibus Programs Extension of 1988. Amends provisions limiting the percentage of block grant funds a State may use for administration to prohibit including in administrative expenses reasonable expenses incurred for training. Prohibits substance abuse treatment facilities and mental health treatment facilities receiving assistance under Public Health Service Act block grant provisions from discriminating against mentally ill substance abusers. Requires a State to maintain spending levels for alcohol and drug abuse and community mental health services at least at the level (currently, the average level) the State maintained during the previous two years. Removes a provision allowing waiver of that requirement due to extraordinary economic conditions in the State. Adds a requirement that the State mental health planning council comment on the State plan required under specified provisions. Requires a State, on request of the council, to submit the comments to the Secretary with the State plan. Requires development and implementation by a State, and annual approval by the Secretary, of a statewide Substance Abuse Prevention and Treatment Plan. Repeals provisions providing for: (1) evaluations of alcohol and drug abuse treatment programs; and (2) evaluations of, and the establishment of research centers and model plans relating to, community mental health programs. Directs the Secretary, in making grants under existing provisions for the development of State comprehensive mental health services plans, act through the Administrator of ADAMHSA. Title III: Children of Substance Abusers - Children of Substance Abusers Act - Subtitle A: Services for Children of Substance Abusers - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, through the Administrator of the Health Resources and Services Administration, to make grants for the Federal share of the cost of community outreach services and services for children of substance abusers. Sets forth program requirements, including providing comprehensive services for the entire family. Sets forth requirements regarding: (1) the distribution of grants among specified types of entities; and (2) information and assurances which must be included in grant applications. Directs the Secretary: (1) to establish a review panel; and (2) in awarding grants, to rely on the recommendations of the panel. Sets the Federal share at 90 percent. Authorizes appropriations. Mandates a study and a report to specified congressional committees on coordination of Department of Health and Human Services regarding such children and their parents. Provides for grants for the training of professionals and other staff who provide services to, or come in contact with, children and families of substance abusers. Requires the Administrator to identify the training needs of such professionals and other staff and develop a strategy for satisfying the needs. Prescribes the uses of the grant funds. Authorizes appropriations. Subtitle B: Grants for Home-Visiting Services for At-Risk Families - Healthy Beginnings Act of 1991 - Directs the Secretary to make competitive three- to five-year grants for the Federal share of the costs of home visiting services to eligible families. Defines "home visiting services" to include health care, health and child care education, and help in obtaining health and social services. Defines "eligible family" to mean a family that includes: (1) a pregnant women at risk of delivering an infant with a health or developmental complication, or other poor birth outcome; or (2) a child under three years old who has experienced, or is at risk for, a health or developmental complication, or child maltreatment. Sets forth priorities and considerations in awarding grants. Requires: (1) delivery of the home visiting services according to a case management model; and (2) development of a family service plan. Sets forth information and assurances which must be included in grant applications. Sets the Federal share at 90 percent. Requires, in accordance with State law, confidentiality regarding the services provided. Authorizes appropriations. Title IV: Childhood Mental Health - Children's and Communities' Mental Health Systems Improvement Act of 1991 - Amends the Public Health Service Act to direct the Secretary of Health and Human Services, through the Administrator of the Alcohol, Drug Abuse, and Mental Health Administration, to make grants to States for comprehensive community mental health services to children with serious emotional disturbance. Prohibits the Secretary from making a grant to a State unless the State is receiving payments under alcohol and drug abuse and mental health services block grant provisions. Requires non-Federal contributions in specified percentages. Requires State grantees to: (1) establish and operate one or more systems, through grants or contracts, to provide specified types of mental health services to children under 22 years of age; (2) enter into a memorandum of understanding with providers of medical, educational, vocational counseling and vocational rehabilitation, and protection and advocacy services to facilitate the provision of such services without use of grant funds or non-Federal contributions made with respect to the grant; (3) provide case management; (4) provide services in the cultural context that is most appropriate for the child and effectively communicate, either directly or through interpreters; and (5) establish, for each child, a multidisciplinary team providing services and ensuring the development and implementation of an Individualized Services Plan and either an Individualized Education Program or an Individualized Family Services Plan or both. Describes additional services for which a State system may provide. Requires that parents of children with serious emotional disturbances be included as members of the mental health planning council established under existing provisions. Requires that, if a charge is imposed for services under a grant, the charge be made according to a public schedule, adjusted to reflect the income of the family of the child, and not imposed on any child whose family has income and resources at or below the poverty line. Limits grants to States to five years. Requires that a State, in order to receive grants for the third, fourth, and fifth years: (1) have a plan for achieving long-term financial support for systems for comprehensive care; and (2) be making satisfactory progress in expanding access to such systems in all areas of the State. Directs the Secretary to provide to a State, on request: (1) technical assistance regarding grant applications; and (2) training and technical assistance on the planning, development, and operation of the systems under this Act. Authorizes the Secretary to provide the technical assistance directly or through grants or contracts. Authorizes appropriations, earmarking a specified sum for the technical assistance and training. Limits the number of grants to ten in FY 1992. Title V: Studies - Mandates reports to congressional committees regarding: (1) the role of the private sector in the development of anti-addiction medications, including legislative proposals designed to encourage private sector development of such medications; (2) the process by which anti-addiction medications receive marketing approval. Declares that it is the sense of the Congress that the Medications Development Division of the NIDA shall devote special attention and adequate resources to the development of specified medications relating to drug abuse. Mandates reports to congressional committees regarding: (1) the national strategy for developing pharmacotherapeutic treatment of drug addiction; (2) a uniform definition of "serious mental illness"; (3) standardized methods that may be used by States to estimate the incidence and prevalence of mental illness; (4) the most effective methods for, and the obstacles to, providing mental health services to individuals residing in correctional facilities; (5) the barriers to insurance coverage for substance abuse treatment; (6) the prevalence of, and Federal efforts to combat, fetal alcohol syndrome; and (7) the status of behavioral and services-related research at NIAAA, NIDA, and NIMH. Requires the last report to be submitted annually.

Alcohol, Drug Abuse, and Mental Health Administration Reorganization Act of 1991 - Title I: Administration and Institutes - Subtitle A: Restructuring - Amends the Public Health Service Act to remove provisions relating to the administration, institutes, and research of the Alcohol, Drug Abuse, and Mental Health Administration. Establishes, as an agency of the Public Health Service, the Alcohol, Drug Abuse and Mental Health Services Administration (ADAMHSA). Sets forth its general duties. Authorizes appropriations. Mandates: (1) grants to prevent and treat substance abuse among high risk youth; (2) grants for providing pregnant and postpartum women and their children substance abuse prevention, education, and treatment services, including primary health care, comprehensive social services, support services, counseling, housing, and case management; (3) grants to improve the provision of substance abuse treatment services, including through focusing on specified populations, treatment and vocational training in exchange for service, projects operated by community and migrant health centers, and treatment campus projects; (4) grants for drug and alcohol treatment services to individuals under criminal justice supervision; (5) grants to increase the number of full-time substance abuse treatment and prevention providers and the number of health professionals providing treatment and prevention as a component of primary health care; and (6) grants to States to expand their substance abuse treatment capacity. Authorizes appropriations. Authorizes: (1) grants or contracts for outreach to intravenous drug abusers to prevent exposure to and transmission of the etiologic agent for acquired immune deficiency syndrome; (2) grants, contracts, and cooperative agreements to develop and expand mental health and substance abuse treatment for homeless individuals; and (3) grants to communities for the development of comprehensive long-term strategies for the prevention of substance abuse and evaluation of different community approaches to such prevention. Authorizes appropriations. Authorizes grants for demonstration projects for: (1) community services for seriously mentally ill individuals and their families, seriously emotionally and mentally disturbed children and youth and their families, and seriously mentally ill homeless and elderly individuals; (2) the prevention of youth suicide; (3) recognition, assessment, treatment, and clinical management of depressive disorders; (4) the prevention of sex offenses and treatment and assistance to sex offense victims; (5) mental health services to family violence victims; and (6) prevention services for individuals at risk of developing mental illness. Authorizes appropriations. Requires: (1) the appointment of one or more advisory councils for ADAMHSA; (2) peer review of services grants, cooperative agreements, and contracts administered through ADAMHSA. Requires peer review approval for assistance under, and both peer review and advisory council approval for assistance over, a specified amount. Mandates a process to respond to misconduct in projects receiving funds under specified provisions. Authorizes and regulates the use of experts and consultants. Establishes within ADAMHSA the Office for Special Populations to take specified actions with regard to women, minorities, and the elderly. Establishes in the National Institutes of Health the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the National Institute on Drug Abuse (NIDA), and the National Institute of Mental Health (NIMH), requiring comprehensive research on cause, diagnosis, epidemiology, prevention, and treatment, including services research. Authorizes appropriations. Includes in the purpose of NIMH the study of psychological, social, and legal factors that influence behavior. Authorizes grants, cooperative agreements, and contracts through NIAAA, NIDA, and NIMH relating to research and demonstrations relative to the cause, diagnosis, treatment, control, and prevention of mental illness and substance abuse. Directs the Secretary of Health and Human Services to establish, through NIAAA, NIDA, and NIMH, National Health and Substance Abuse Education Programs to disseminate information on improved treatment and family assistance methods and to support training. Authorizes the Secretary, through NIAAA and NIDA, to designate National Substance Abuse Research Centers for interdisciplinary research on substance abuse and other biomedical, behavioral, and social issues. Mandates annual grants to Centers. Establishes in NIDA the Medication Development Program to take specified steps regarding: (1) medication to treat the symptoms and disease of alcohol and drug abuse and addiction and related mental disorders; and (2) supporting training in such areas. Mandates related grants or contracts and cooperative agreements. Subtitle B: Miscellaneous Provisions - Replaces provisions titled "Miscellaneous Provisions Relating to Substance Abuse and Mental Health" with provisions directing the Secretary, through the ADAMHSA Administrator, as feasible and on request of a State, to make technical assistance available for specified purposes, including: (1) program management and evaluation; (2) accreditation or licensure of facilities and personnel; and (3) improving the scope of mental health and substance abuse health insurance offered in the State. Makes the Secretary, through the Administrator, responsible for fostering substance abuse prevention and treatment programs and services in State and local governments and private industry. Mandates: (1) development of model programs suitable for replication on a cost-effective basis in different types of businesses and governmental entities; and (2) dissemination of information on the model programs. Prohibits denial or deprivation of Federal civilian employment or a Federal professional or other license or right solely on the grounds of prior substance abuse, except for employment in specified Federal agencies, any other Federal department or agency designated for purposes of national security by the President, or any Federal position determined to be sensitive. Prohibits discrimination against substance abusers who are suffering from medical conditions in admission or treatment, solely because of their substance abuse, by any private or public general hospital, or outpatient facility receiving any Federal support. Prohibits disclosure of patient information maintained in connection with substance abuse prevention, training, treatment, or research which is conducted or assisted by any Federal department or agency, subject to specified exceptions. Provides for monetary penalties. Mandates: (1) data collection on the national incidence and prevalence of the various forms of mental illness and substance abuse; and (2) competitive grants for epidemiological and longitudinal studies of infants and the families of infants with fetal cocaine and fetal alcohol syndromes. Authorizes appropriations. Provides, if the Secretary determines that a disease or disorder within the jurisdiction of ADAMHSA constitutes a public health emergency, for: (1) expediting peer and advisory committee review; (2) waiving advertising requirements for proposals for contracts; (3) increasing existing grants and contracts; and (4) disseminating information. Subtitle C: Transfer Provisions - Provides for the transfer from the Alcohol, Drug Abuse, and Mental Health Administration (ADAMHA) to: (1) ADAMHSA of authorities, responsibilities, services, personnel, assets, liabilities, orders, regulations, legal actions, and other matters; and (2) the appropriate Directors of NIAAA, NIDA, and NIMH all research related functions of ADAMHA. Subtitle D: Conforming Amendments - Amends specified provisions of the Public Health Service Act relating to projects for assistance in transition from homelessness and provisions relating to alternative utilization of military facilities to substitute references to the Administrator of ADAMHSA for references to: (1) the Director of the National Institute of Mental Health; and (2) the National Institute of Mental Health, the National Institute on Alcohol Abuse and Alcoholism, and the National Institute on Drug Abuse. Directs the Secretary to carry out provisions relating to alcohol and drug abuse and mental health services block grants through the Administrator. Subtitle E: Miscellaneous Provisions - Directs the Secretary to try to get alternative Federal funding for grantees receiving assistance under the community youth activity program under the Anti-Drug Abuse Act of 1988. Requires that the peer review systems, advisory councils, and scientific advisory committees used by NIAAA, NIDA, and NIMH before the transfer of those Institutes to NIH be used by those Institutes after the transfer. Title II: Reauthorization and Improvement of Alcohol and Drug Abuse and Mental Health Service Block Grant Program - Authorizes appropriations for the alcohol and drug abuse and mental health service block grant provisions of the Public Health Service Act. Revises the formula for determining the amount of block grant allotments. Requires that unobligated block grant funds remain available to a State if the Secretary finds that the funds were obligated but subsequently unobligated due to the State's diligence in carrying out the purposes of such provisions. Directs (currently, authorizes) the Secretary to waive a requirement (to spend at least 50 percent of specified funds reserved to carry out certain drug abuse activities) if the Secretary determines that the incidence of intravenous drug abuse in a State does not require that level of funding. Allows block grant allotments to be used for: (1) grants to community health centers for services relating to seriously (currently, chronically) mentally ill individuals; (2) grants to underserved populations of mentally ill individuals in State and local correctional facilities; (3) renovation that makes land or a facility suitable for use under such block grant provisions, including removing hazards or making the land or facility accessible to disabled persons; and (4) programs of treatment for adult and juvenile substance abusers in State and local criminal and juvenile justice systems. Replaces provisions prohibiting the use of block grant funds for the distribution of needles or bleach in connection with the use of illegal drugs with a provision prohibiting the use of such funds for any program prohibited by specified provisions (relating to needle or syringe distribution) of the Health Omnibus Programs Extension of 1988. Amends provisions limiting the percentage of block grant funds a State may use for administration to prohibit including in administrative expenses reasonable expenses incurred for training. Prohibits substance abuse treatment facilities and mental health treatment facilities receiving assistance under Public Health Service Act block grant provisions from discriminating against mentally ill substance abusers. Requires a State to maintain spending levels for alcohol and drug abuse and community mental health services at least at the level (currently, the average level) the State maintained during the previous two years. Removes a provision allowing waiver of that requirement due to extraordinary economic conditions in the State. Adds a requirement that the State mental health planning council comment on the State plan required under specified provisions. Requires a State, on request of the council, to submit the comments to the Secretary with the State plan. Requires development and implementation by a State, and annual approval by the Secretary, of a statewide Substance Abuse Prevention and Treatment Plan. Directs the Secretary, in making grants under existing provisions for the development of State comprehensive mental health services plans, act through the Administrator of ADAMHSA. Title III: Studies - Requires the Director of the NIDA to report to specified congressional committees on the role of the private sector in the development of anti-addiction medications, including legislative proposals designed to encourage private sector development of such medications. Requires the Commissioner of the Food and Drug Administration to report to specified congressional committees on the process by which anti-addiction medications receive marketing approval. Declares that it is the sense of the Congress that the Medications Development Division of the NIDA shall devote special attention and adequate resources to the development of specified medications relating to drug abuse. Requires the Directors of NIAAA, NIDA, and NIMH to establish a panel of independent experts in pharmacotherapeutic treatment of drug addiction to report to the appropriate congressional committees on the national strategy for developing such treatments. Requires the report to be made available to the public. Directs the Secretary to report to the appropriate congressional committees on a uniform definition of "serious mental illness." Requires the ADAMHSA Administrator, acting jointly with the NIMH Director, to report to the appropriate congressional committees on the most effective methods for, and the obstacles to, providing mental health services to individuals residing in correctional facilities.