PROGRAMS FOR PREGNANT AND POSTPARTUM WOMEN.

SEC. 108. PROGRAMS FOR PREGNANT AND POSTPARTUM WOMEN. (a) In General.—Subpart 1 of part B of title V (as added by section 107) is amended by adding at the end thereof the following new sections: “residential treatment programs for pregnant and postpartum women “Sec. 508. (a) In General.—The Director of the Center for Substance Abuse Treatment shall provide awards of grants, cooperative agreement, or contracts to public and nonprofit private entities for the purpose of providing to pregnant and postpartum women treatment for substance abuse through programs in which, during the course of receiving treatment— “(1) the women reside in facilities provided by the programs; “(2) the minor children of the women reside with the women in such facilities, if the women so request; and 106 STAT. 337 “(3) the services described in subsection (d) are available to or on behalf of the women. “(b) Availability of Services for Each Participant.—A funding agreement for an award under subsection (a) for an applicant is that, in the program operated pursuant to such subsection— “(1) treatment services and each supplemental service will be available through the applicant, either directly or through agreements with other public or nonprofit private entities; and “(2) the services will be made available to each woman admitted to the program. “(c) Individualized Plan of Services.—A funding agreement for an award under subsection (a) for an applicant is that— “(1) in providing authorized services for an eligible woman pursuant to such subsection, the applicant will, in consultation with the women, prepare an individualized plan for the provision to the woman of the services; and “(2) treatment services under the plan will include— “(A) individual, group, and family counseling, as appropriate, regarding substance abuse; and “(B) follow-up services to assist the woman in preventing a relapse into such abuse. “(d) Required Supplemental Services.—In the case of an eligible woman, the services referred to in subsection (a)(3) are as follows: “(1) Prenatal and postpartum health care. “(2) Referrals for necessary hospital services. “(3) For the infants and children of the woman— “(A) pediatric health care, including treatment for any perinatal effects of maternal substance abuse and including screenings regarding the physical and mental development of the infants and children; “(B) counseling and other mental health services, in the case of children; and “(C) comprehensive social services. “(4) Providing supervision of children during periods in which the woman is engaged in therapy or in other necessary health or rehabilitative activities. “(5) Training in parenting. “(6) Counseling on the human immunodeficiency virus and on acquired immune deficiency syndrome. “(7) Counseling on domestic violence and sexual abuse. “(8) Counseling on obtaining employment, including the importance of graduating from a secondary school. “(9) Reasonable efforts to preserve and support the family units of the women, including promoting the appropriate involvement of parents and others, and counseling the children of the women. “(10) Planning for and counseling to assist reentry into society, both before and after discharge, including referrals to any public or nonprofit private entities in the community involved that provide services appropriate for the women and the children of the women. “(11) Case management services, including— “(A) assessing the extent to which authorized services are appropriate for the women and their children; 106 STAT. 338 “(B) in the case of the services that are appropriate, ensuring that the services are provided in a coordinated manner; and “(C) assistance in establishing eligibility for assistance under Federal, State, and local programs providing health services, mental health services, housing services, employment services, educational services, or social services. “(e) Minimum Qualifications For Receipt of Award.— “(1) Certification by relevant state agency.—With respect to the principal agency of the State involved that administers programs relating to substance abuse, the Director may make an award under subsection (a) to an applicant only if the agency has certified to the Director that— “(A) the applicant has the capacity to carry out a program described in subsection (a); “(B) the plans of the applicant for such a program are consistent with the policies of such agency regarding the treatment of substance abuse; and “(C) the applicant, or any entity through which the applicant will provide authorized services, meets all applicable State licensure or certification requirements regarding the provision of the services involved. “(2) Status as medicaid provider.— “(A) Subject to subparagraphs (B) and (C), the Director may make an award under subsection (a) only if, in the case of any authorized service that is available pursuant to the State plan approved under title XIX of the Social Security Act for the State involved— “(i) the applicant for the award will provide the service directly, and the applicant has entered into a participation agreement under the State plan and is qualified to receive payments under such plan; or “(ii) the applicant will enter into an agreement with a public or nonprofit private entity under which the entity will provide the service, and the entity has entered into such a participation agreement plan and is qualified to receive such payments. “(B)(i) In the case of an entity making an agreement pursuant to subparagraph (A)(ii) regarding the provision of services, the requirement established in such subparagraph regarding a participation agreement shall be waived by the Director if the entity does not, in providing health care services, impose a charge or accept reimbursement available from any third-party payor, including reimbursement under any insurance policy or under any Federal or State health benefits plan. “(ii) A determination by the Director of whether an entity referred to in clause (i) meets the criteria for a waiver under such clause shall be made without regard to whether the entity accepts voluntary donations regarding the provision of services to the public. “(C) With respect to any authorized service that is available pursuant to the State plan described in subparagraph (A), the requirements established in such subparagraph shall not apply to the provision of any such service by an institution for mental diseases to an individual who has attained 21 years of age and who has not attained 106 STAT. 33965 years of age. For purposes of the preceding sentence, the term ‘institution for mental diseases’ has the meaning given such term in section 1905(i) of the Social Security Act. “(f) Requirement of Matching Funds.— “(1) In general.— With respect to the costs of the program to be carried out by an applicant pursuant to subsection (a), a funding agreement for an award under such subsection is that the applicant will make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that— “(A) for the first fiscal year for which the applicant receives payments under an award under such subsection, is not less than $1 for each $9 of Federal funds provided in the award; “(B) for any second such fiscal year, is not less than $1 for each $9 of Federal funds provided in the award; and “(C) for any subsequent such fiscal year, is not less than $1 for each $3 of Federal funds provided in the award. “(2) Determination of amount contributed.—Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions. “(g) Outreach.—A funding agreement for an award under sub-section (a) for an applicant is that the applicant will provide out-reach services in the community involved to identify women who are engaging in substance abuse and to encourage the women to undergo treatment for such abuse. “(h) Accessibility of Program; Cultural Context of Services.—A funding agreement for an award under subsection (a) for an applicant is that— “(1) the program operated pursuant to such subsection will be operated at a location that is accessible to low-income pregnant and postpartum women; and “(2) authorized services will be provided in the language and the cultural context that is most appropriate. “(i) Continuing Education.—A funding agreement for an award under subsection (a) is that the applicant involved will provide for continuing education in treatment services for the individuals who will provide treatment in the program to be operated by the applicant pursuant to such subsection. “(j) Imposition of Charges.—a funding agreement for an award under subsection (a) for an applicant is that, if a charge is imposed for the provision of authorized services to on behalf of an eligible woman, such charge— “(1) will be made according to a schedule of charges that is made available to the public; “(2) will be adjusted to reflect the income of the woman involved; and “(3) will not be imposed on any such woman with an income of less than 185 percent of the official poverty line, as established by the Director of the Office for Management and Budget 106 STAT. 340and revised by the Secretary in accordance with section 673(2) of the Omnibus Budget Reconciliation Act of 1981. “(k) Reports to Director.—A funding agreement for an award under subsection (a) is that the applicant involved will submit to the Director a report— “(1) describing the utilization and costs of services provided under the award; “(2) specifying the number of women served, the number of infants served, and the type and costs of services provided; and “(3) providing such other information as the Director determines to be appropriate. “(l) Requirement of Application.—The Director may make an award under subsection (a) only if an application for the award is submitted to the Director containing such agreements, and the application is in such form, is made in such manner, and contains such other agreements and such assurances and information as the Director determines to be necessary to carry out this section. “(m) Equitable Allocation of Awards.—In making awards under subsection (a), the Director shall ensure that the awards are equitably allocated among the principal geographic regions of the United States, subject to the availability of qualified applicants for the awards. “(n) Duration of Award.—The period during which payments are made to an entity from an award under subsection (a) may not exceed 5 years. The provision of such payments shall be subject to annual approval by the Director of the payments and subject to the availability of appropriations for the fiscal year involved to make the payments. This subsection may not be construed to establish a limitation on the number of awards under such sub-section that may be made to an entity. “(o) Evaluations; Dissemination of Findings.—The Director shall, directly or through contract, provide for the conduct of evaluations of programs carried out pursuant to subsection (a). The Director shall disseminate to the States the findings made as a result of the evaluations. “(p) Reports to Congress.—Not later than October 1, 1994, the Director shall submit to the Committee on Energy and Commerce of the House of Representatives, and to the Committee on Labor and Human Resources of the Senate, a report describing programs carried out pursuant to this section. Every 2 years there-after, the Director shall prepare a report describing such programs carried out during the preceding 2 years, and shall submit the report to the Administrator for inclusion in the biennial report under section 501(k). Each report under this subsection shall include a summary of any evaluations conducted under subsection (m) during the period with respect to which the report is prepared. “(q) Definitions.—For purposes of this section: “(1) The term ‘authorized services’ means treatment services and supplemental services. “(2) The term ‘eligible woman’ means a woman who has been admitted to a program operated pursuant to subsection (a). “(3) The term ‘funding agreement under subsection (a)’, with respect to an award under subsection (a), means that the Director may make the award only if the applicant makes the agreement involved. 106 STAT. 341 “(4) The term ‘treatment services’ means treatment for substance abuse, including the counseling and services described in subsection (c)(2). “(5) The term ‘supplemental services’ means the services described in subsection (d). “(r) Authorization of Appropriations.— “(1) In general.—For the purpose of carrying out this section and section 509, there are authorized to be appropriated $100,000,000 for fiscal year 1993, and such sums as may be necessary for fiscal year 1994. “(2) Transfer.—For the purpose described in paragraph (1), in addition to the amounts authorized in such paragraph to be appropriated for a fiscal year, there is authorized to be appropriated for the fiscal year from the special forfeiture fund of the Director of the Office of National Drug Control Policy such sums as may be necessary. “(3) Rule of construction.—The amounts authorized in this subsection to be appropriated are in addition to any other amounts that are authorized to be appropriated and are available for the purpose described in paragraph (1). “outpatient treatment programs for pregnant and postpartum women “Sec. 509. (a) Grants.—The Secretary, acting through the Director of the Treatment Center, shall make grants to establish projects for the outpatient treatment of substance abuse among pregnant and postpartum women, and in the case of conditions arising in the infants of such women as a result of such abuse by the women, the outpatient treatment of the infants for such conditions. “(b) Prevention.—Entities receiving grants under this section shall engage in activities to prevent substance abuse among pregnant and postpartum women. “(c) Evaluation.—The Secretary shall evaluate projects carried out under subsection (a) and shall disseminate to appropriate public and private entities information on effective projects.”. (b) Transitional and Savings Provisions.— (1) Savings provision for completion of current projects.— (A) Subject to paragraph (2), in the case of any project for which a grant under former section 509F was provided for fiscal year 1992, the Secretary of Health and Human Services may continue in effect the grant for fiscal year 1993 and subsequent fiscal years, subject to the duration of any such grant not exceeding the period determined by the Secretary in first approving the grant. Subject to approval by the Administrator, such grants may be administered by the Center for Substance Abuse Prevention. (B) Subparagraph (A) shall apply with respect to a project notwithstanding that the project is not eligible to receive a grant under current section 508 or 509. (2) Limitation on funding for certain projects.—With respect to the amounts appropriated for any fiscal year under current section 508, any such amounts appropriated in excess of the amount appropriated for fiscal year 1992 under former section 509F shall be available only for grants under current section 508. 106 STAT. 342 (3) Definitions.—For purposes of this subsection: (A) The term “former section 509F” means section 509F of the Public Health Service Act, as in effect for fiscal year 1992. (B) The term “current section 508” means section 508 of the Public Health Service Act, as in effect for fiscal year 1993 and subsequent fiscal years. (C) The term “current section 509” means section 509 of the Public Health Service Act, as in effect for fiscal year 1993 and subsequent fiscal years.