Helping Families in Mental Health Crisis Act of 2016
TITLE I--ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE
(Sec. 101) This bill amends the Public Health Service Act (PHSA) to rename the position of Administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA) to Assistant Secretary for Mental Health and Substance Use. The bill revises the duties under this position, including to require the review and evaluation of programs related to mental illness and substance use disorders.
(Sec. 102) The Office of the Assistant Secretary for Planning and Evaluation must: (1) evaluate programs related to mental illness and substance use disorders, (2) develop an evaluation strategy that identifies priority programs to be evaluated, and (3) make recommendations to improve evaluated programs.
(Sec. 103) SAMHSA's Office of Policy, Planning, and Innovation is renamed the National Mental Health and Substance Use Policy Laboratory. The bill specifies responsibilities for the laboratory, including that the laboratory must: (1) facilitate the implementation of policy changes likely to have a significant effect on mental health; (2) collect information from SAMHSA grantees to evaluate and disseminate information on evidence-based practices; and (3) identify federal activities that are duplicative or that are not evidence-based, effective, or efficient.
(Sec. 104) The Government Accountability Office (GAO) must study peer-support specialist programs that receive funding from SAMHSA to identify best practices for training and credential requirements.
(Sec. 105) This bill amends the Protection and Advocacy for Individuals with Mental Illness Act to prohibit state protection and advocacy systems from using federal funds to lobby.
(Sec. 106) State protection and advocacy systems must publish their annual reports. The Department of Health and Human Services (HHS) must include in its biennial reports detailed accounting for each system.
(Sec. 107) HHS must establish a grievance procedure for clients and potential clients of state protection and advocacy systems.
(Sec. 108) SAMHSA must establish a Center for Behavioral Health Statistics and Quality to: (1) coordinate SAMHSA's integrated data strategy, (2) recommend measurement standards for SAMHSA grant programs, and (3) coordinate efforts to evaluate activities supported by SAMHSA. Every two years, the center must report on the quality of services furnished through SAMHSA grant programs.
(Sec. 109) Every five years, SAMHSA must develop, publish, and carry out a strategic plan.
(Sec. 110) The bill revises provisions regarding SAMHSA's Center for Mental Health Services and Center for Substance Abuse Treatment, including to require the centers to ensure consistent documentation of the application of grant criteria.
(Sec. 111) The bill revises membership requirements for SAMHSA advisory councils.
(Sec. 112) The bill revises membership requirements for SAMHSA peer review groups.
TITLE II--MEDICAID MENTAL HEALTH COVERAGE
(Sec. 201) The bill declares that current law allows a state Medicaid plan to pay for a primary care service and a mental health service furnished to an individual on the same day by providers at the same facility.
(Sec. 202) The bill amends title XIX (Medicaid) of the Social Security Act to provide for federal payment under Medicaid, under specified conditions, for capitated payments to Medicaid managed care organizations or prepaid inpatient health plans for individuals between 21 and 65 years old who are receiving inpatient treatment in institutions for mental diseases.
(Sec. 203) The Centers for Medicare and Medicaid Services (CMS) must report on Medicaid coverage of services provided through Medicaid managed care organizations or prepaid inpatient health plans to certain enrollees receiving treatment in institutions for mental diseases.
(Sec. 204) The CMS must notify state Medicaid programs regarding opportunities to design innovative service delivery systems for individuals with serious mental illness or serious emotional disturbance.
(Sec. 205) The CMS must collect and report specified information from states with Medicaid emergency psychiatric demonstration projects, including the extent to which there is a reduction in spending under demonstration projects.
(Sec. 206) The bill provides for federal payment under Medicaid for early and periodic screening, diagnostic, and treatment services for children in inpatient psychiatric hospitals, effective January 1, 2019.
(Sec. 207) Federal payment under Medicaid for in-home personal care services or home health care services is reduced for states that do not require the use of an electronic visit verification system for such services, effective January 1, 2019. The CMS must pay a specified share of state expenditures attributable to such a system.
HHS must disseminate to states best practices for electronic visit verification systems, including training for users.
TITLE III--INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE
(Sec. 301) HHS must establish the Interdepartmental Serious Mental Illness Coordinating Committee to report on research, evaluate the effect of federal programs, provide a plan to improve outcomes for individuals, and recommend agency actions to better coordinate administration of mental health services.
TITLE IV--COMPASSIONATE COMMUNICATION ON HIPAA
(Sec. 402) After finalizing regulations on the confidentiality of alcohol and drug abuse patient records, HHS must convene stakeholders to determine the effect of the regulations on patient care, health outcomes, and patient privacy.
(Sec. 403) HHS must promulgate regulations clarifying the circumstances under which an entity may disclose protected health information.
(Sec. 404) HHS must develop and disseminate model programs and materials for training: (1) health care providers and legal professionals regarding disclosure of the protected health information of patients with a mental illness, and (2) patients and their families regarding their rights to protect and obtain such information.
TITLE V--INCREASING ACCESS TO TREATMENT FOR SERIOUS MENTAL ILLNESS
(Sec. 501) SAMHSA must award grants for assertive community treatment programs for individuals with serious mental illness. (Patients in assertive community treatment programs receive care in their community from a multidisciplinary team of providers.)
(Sec. 502) SAMHSA must award grants to enhance community-based crisis response systems or for a database of available beds at inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities.
(Sec. 503) This bill amends the Protecting Access to Medicare Act of 2014 to extend through FY2022 a pilot program for assisted outpatient treatment programs for individuals with serious mental illness.
(Sec. 504) A health professional volunteer providing primary health care to an individual at a community health center or through programs or events carried out by a center is deemed to be an employee of the Public Health Service for purposes of any civil action that may arise from providing services to patients. For a volunteer to be covered by this liability protection, HHS must approve the center's application to sponsor the volunteer.
TITLE VI--SUPPORTING INNOVATIVE AND EVIDENCE-BASED PROGRAMS
Subtitle A--Encouraging the Advancement, Incorporation, and Development of Evidence-Based Practices
(Sec. 601) SAMHSA may award grants for the development of evidence-based interventions for mental illness, serious emotional disturbance, substance use disorders, and co-occurring illness or disorders.
(Sec. 602) SAMHSA must review and publish information on evidence-based programs and practices.
Subtitle B--Supporting the State Response to Mental Health Needs
(Sec. 611) The bill revises block grants for community mental health services. States must use at least a specified amount of a block grant to support evidence-based programs for individuals with early serious mental illness. The bill revises the block grant requirement that a state maintain spending on community mental health services.
Subtitle C--Strengthening Mental Health Care for Children and Adolescents
(Sec. 621) The Health Resources and Services Administration must award grants to promote integration of behavioral health with pediatric primary care.
(Sec. 622) HHS must award grants for infant and early childhood mental health promotion, intervention, and treatment programs.
(Sec. 623) The bill revises and extends through FY2021 a grant program to address violence-related stress. The program must support the continued operation of the National Child Traumatic Stress Initiative (NCTSI). The NCTSI coordinating center must report on child treatment and outcomes and facilitate training in evidence-based and trauma-informed treatments, interventions, and practices.
TITLE VII--GRANT PROGRAMS AND PROGRAM REAUTHORIZATION
Subtitle A--Garrett Lee Smith Memorial Act Reauthorization
(Sec. 701) The bill revises and extends through FY2021 a technical assistance resource center to prevent suicides. The center's focus is expanded from youth suicides to suicides among all ages, particularly among groups that are at high risk for suicide.
(Sec. 702) A program to provide support for youth suicide early intervention and prevention strategies is also revised and extended through FY2021.
(Sec. 703) The bill revises and extends through FY2021 SAMHSA grants for mental and behavioral health services at institutions of higher education.
Subtitle B--Other Provisions
(Sec. 711) SAMHSA must maintain the existing National Suicide Prevention Lifeline program.
(Sec. 712) SAMHSA must publish a report on the adult and pediatric mental health and substance use disorder workforce.
(Sec. 713) HHS must maintain a Minority Fellowship Program for mental and substance use treatment professionals to improve services for racial and ethnic minority populations.
(Sec. 714) The bill repeals various expired SAMHSA programs.
(Sec. 715) The Centers for Disease Control and Prevention (CDC) is encouraged to improve the National Violent Death Reporting System.
(Sec. 717) HHS must award grants to develop and sustain behavioral health paraprofessional training and education programs, including through tuition support.
(Sec. 718) Pediatric mental health subspecialists are eligible for National Health Service Corps programs.
(Sec. 719) SAMHSA must award grants for suicide prevention and intervention programs for adults.
(Sec. 720) SAMHSA may award grants to: (1) train first responders to recognize and intervene with individuals with mental illness, and (2) establish collaborative law enforcement and mental health programs to provide services during mental health crises.
(Sec. 721) SAMHSA may award grants to support the recruitment and training of health services psychology students, interns, and postdoctoral residents in community mental health settings.
(Sec. 722) The bill extends through FY2022 a loan repayment program for health professionals who provide pediatric specialty care to underserved areas or populations.
(Sec. 723) The bill reduces the authorization of appropriations for CDC facilities.
TITLE VIII--MENTAL HEALTH PARITY
(Sec. 801) HHS, the Department of Labor, and the Department of the Treasury must: (1) issue guidance to improve the compliance of group health plans and health insurance coverage with requirements for parity between mental health and substance use disorder benefits and medical and surgical benefits, and (2) audit the plan documents of group health plans and health insurers that repeatedly violate parity requirements.
The bill amends the PHSA, the Employee Retirement Income Security Act of 1974 (ERISA), and the Internal Revenue Code to require health plan administrators to make available information, including the criteria used to make medical necessity determinations, to demonstrate compliance with parity requirements.
(Sec. 802) HHS must convene stakeholders to produce an action plan for improved federal and state coordination regarding enforcement of parity requirements.
(Sec. 803) The Employee Benefits Security Administration must report on closed federal investigations that found serious violations of parity requirements.
(Sec. 804) The GAO must report on the extent to which group health plans, health insurance coverage, Medicaid managed care plans, and Children's Health Insurance Program (CHIP) health plans comply with parity requirements.
(Sec. 805) HHS may: (1) update published information on eating disorders, (2) incorporate public resources into its obesity prevention programs, and (3) advance public awareness of eating disorders.
(Sec. 806) HHS may facilitate the identification of programs to educate and train health professionals regarding eating disorders.
(Sec. 807) The GAO must report on federal oversight of group health plans, health insurance coverage, and Medicaid managed care plans regarding compliance with parity requirements.
(Sec. 808) Eating disorder benefits under group health plans and health insurance coverage must be consistent with parity requirements.
[Congressional Bills 114th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2646 Introduced in House (IH)]
114th CONGRESS
1st Session
H. R. 2646
To make available needed psychiatric, psychological, and supportive
services for individuals with mental illness and families in mental
health crisis, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
June 4, 2015
Mr. Murphy of Pennsylvania (for himself, Ms. Eddie Bernice Johnson of
Texas, Mr. Buchanan, Mr. Diaz-Balart, Mr. Bilirakis, Mr. Dold, Mr.
Guinta, Mrs. Mimi Walters of California, Mr. Brendan F. Boyle of
Pennsylvania, Mrs. Ellmers of North Carolina, Mr. Denham, Mr. Vargas,
Mrs. Miller of Michigan, Mr. Hastings, Mr. Calvert, Mr. Nunes, Mr.
Hunter, Mr. Blumenauer, and Ms. Sinema) introduced the following bill;
which was referred to the Committee on Energy and Commerce, and in
addition to the Committees on Ways and Means and Education and the
Workforce, for a period to be subsequently determined by the Speaker,
in each case for consideration of such provisions as fall within the
jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To make available needed psychiatric, psychological, and supportive
services for individuals with mental illness and families in mental
health crisis, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE; TABLE OF CONTENTS.
(a) Short Title.--This Act may be cited as the ``Helping Families
in Mental Health Crisis Act of 2015''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title; table of contents.
Sec. 2. Definitions.
TITLE I--ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE
DISORDERS
Sec. 101. Assistant Secretary for Mental Health and Substance Use
Disorders.
Sec. 102. Transfer of SAMHSA authorities.
Sec. 103. Reports.
Sec. 104. Advisory Council on Graduate Medical Education.
TITLE II--GRANT REFORM AND RESTRUCTURING
Sec. 201. National mental health policy laboratory.
Sec. 202. Innovation grants.
Sec. 203. Demonstration grants.
Sec. 204. Early childhood intervention and treatment.
Sec. 205. Extension of assisted outpatient treatment grant program for
individuals with serious mental illness.
Sec. 206. Block grants.
Sec. 207. Workforce development.
Sec. 208. Authorized grants and programs.
TITLE III--INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE
Sec. 301. Interagency Serious Mental Illness Coordinating Committee.
TITLE IV--HIPAA AND FERPA CAREGIVERS
Sec. 401. Promoting appropriate treatment for mentally ill individuals
by treating their caregivers as personal
representatives for purposes of HIPAA
privacy regulations.
Sec. 402. Caregivers permitted access to certain education records
under FERPA.
Sec. 403. Confidentiality of records.
TITLE V--MEDICARE AND MEDICAID REFORMS
Sec. 501. Enhanced Medicaid coverage relating to certain mental health
services.
Sec. 502. Access to mental health prescription drugs under Medicare and
Medicaid.
Sec. 503. Elimination of 190-day lifetime limit on coverage of
inpatient psychiatric hospital services
under Medicare.
Sec. 504. Modifications to Medicare discharge planning requirements.
Sec. 505. Demonstration programs to improve community mental health
services.
TITLE VI--RESEARCH BY NATIONAL INSTITUTE OF MENTAL HEALTH
Sec. 601. Increase in funding for certain research.
TITLE VII--BEHAVIORAL HEALTH INFORMATION TECHNOLOGY
Sec. 701. Extension of health information technology assistance for
behavioral and mental health and substance
abuse.
Sec. 702. Extension of eligibility for Medicare and Medicaid health
information technology implementation
assistance.
TITLE VIII--SAMHSA REAUTHORIZATION AND REFORMS
Subtitle A--Organization and General Authorities
Sec. 801. In general.
Sec. 802. Advisory councils.
Sec. 803. Peer review.
Subtitle B--Protection and Advocacy for Individuals With Mental Illness
Sec. 811. Prohibition against lobbying by systems accepting Federal
funds to protect and advocate the rights of
individuals with mental illness.
Sec. 812. Ensuring that caregivers of individuals with serious mental
illness have access to the protected health
information of such individuals.
Sec. 813. Protection and advocacy activities to focus exclusively on
safeguarding rights to be free from abuse
and neglect.
Sec. 814. Reporting.
Sec. 815. Grievance procedure.
Sec. 816. Evidence-based treatment for individuals with serious mental
illness.
TITLE IX--REPORTING
Sec. 901. GAO study on preventing discriminatory coverage limitations
for individuals with serious mental illness
and substance use disorders.
SEC. 2. DEFINITIONS.
In this Act:
(1) Except as inconsistent with the provisions of this Act,
the term ``Assistant Secretary'' means the Assistant Secretary
for Mental Health and Substance Use Disorders.
(2) The term ``evidence-based'' means the conscientious,
systematic, explicit, and judicious appraisal and use of
external, current, reliable, and valid research findings as the
basis for making decisions about the effectiveness and efficacy
of a program, intervention, or treatment.
TITLE I--ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE
DISORDERS
SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH AND SUBSTANCE USE
DISORDERS.
(a) In General.--There shall be in the Department of Health and
Human Services an official to be known as the Assistant Secretary for
Mental Health and Substance Use Disorders, who shall--
(1) report directly to the Secretary;
(2) be appointed by the Secretary of Health and Human
Services, by and with the advice and consent of the Senate; and
(3) be selected from among individuals who--
(A)(i) have a doctoral degree in medicine or
osteopathic medicine and clinical and research
experience in psychiatry;
(ii) graduated from an Accreditation Council for
Graduate Medical Education-accredited psychiatric
residency program; and
(iii) have an understanding of biological,
psychosocial, and pharmaceutical treatments of mental
illness and substance use disorders; or
(B) have a doctoral degree in psychology with--
(i) clinical and research experience
regarding mental illness and substance use
disorders; and
(ii) an understanding of biological,
psychosocial, and pharmaceutical treatments of
mental illness and substance use disorders.
(b) Duties.--The Assistant Secretary shall--
(1) promote, evaluate, organize, integrate, and coordinate
research, treatment, and services across departments, agencies,
organizations, and individuals with respect to the problems of
individuals suffering from substance use disorders or mental
illness;
(2) carry out any functions within the Department of Health
and Human Services--
(A) to improve the treatment of, and related
services to, individuals with respect to substance use
disorders or mental illness;
(B) to improve secondary prevention or tertiary
prevention services for such individuals;
(C) to ensure access to effective, evidence-based
treatment for individuals with mental illnesses and
individuals with a substance use disorder;
(D) to ensure that grant programs of the Department
adhere to scientific standards with an emphasis on
secondary prevention and tertiary prevention for
individuals with serious mental illness or substance
use disorders; and
(E) to develop and implement initiatives to
encourage individuals to pursue careers (especially in
underserved areas and populations) as psychiatrists,
psychologists, psychiatric nurse practitioners,
clinical social workers, and other licensed mental
health professionals specializing in the diagnosis,
evaluation, and treatment of individuals with severe
mental illness, including individuals--
(i) who are vulnerable to crises, psychotic
episodes, or suicidal rumination;
(ii) whose deterioration can be rapid; or
(iii) who require more frequent contact or
integration of a variety of services by the
treating mental health professional;
(3) carry out the administrative and financial management,
policy development and planning, evaluation, knowledge
dissemination, and public information functions that are
required for the implementation of mental health programs,
including block grants, treatments, and data collection;
(4) conduct and coordinate demonstration projects,
evaluations, and service system assessments and other
activities necessary to improve the availability and quality of
treatment, prevention, and related services related to
substance use disorders and mental illness;
(5) within the Department of Health and Human Services,
oversee and coordinate all programs and activities relating
to--
(A) the prevention of, or treatment or
rehabilitation for, mental health or substance use
disorders;
(B) parity in health insurance benefits and
conditions relating to mental health and substance use
disorder; or
(C) the reduction of homelessness among individuals
with mental illness;
(6) across the Federal Government, in conjunction with the
Interagency Serious Mental Illness Coordinating Committee under
section 501A--
(A) review all programs and activities relating to
the prevention of, or treatment or rehabilitation for,
mental illness or substance use disorders;
(B) identify any such programs and activities that
are duplicative;
(C) identify any such programs and activities that
are not evidence-based, effective, or efficient; and
(D) formulate recommendations for expanding,
coordinating, eliminating, and improving programs and
activities identified pursuant to subparagraph (B) or
(C) and merging such programs and activities into
other, successful programs and activities;
(7) identify evidence-based best practices across the
Federal Government for treatment and services for those with
mental health and substance use disorders by reviewing
practices for efficiency, effectiveness, quality, coordination,
and cost effectiveness;
(8) be the head of and supervise the National Mental Health
Policy Laboratory; and
(9) not later than one year after the date of enactment of
the Helping Families in Mental Health Crisis Act of 2015,
submit to the Congress a report containing a nationwide
strategy to increase the psychiatric workforce and recruit
medical professionals for the treatment of individuals with
serious mental illness and substance use disorders.
(c) Nationwide Strategy.--The Assistant Secretary shall ensure that
the nationwide strategy in the report under subsection (b)(9) is
designed--
(1) to encourage and incentivize students enrolled in an
accredited medical or osteopathic medical school to enter the
specialty of psychiatry;
(2) to promote greater research-oriented psychiatrist
residency training on evidence-based service delivery models
for individuals with serious mental illness or substance use
disorders;
(3) to promote appropriate Federal administrative and
fiscal mechanisms that support--
(A) evidence-based collaborative care models; and
(B) the necessary psychiatric workforce capacity
for these models, including psychiatrists (including
child and adolescent psychiatrists), psychologists,
psychiatric nurse practitioners, clinical social
workers, and mental health, peer-support specialists;
(4) to increase access to child and adolescent psychiatric
services in order to promote early intervention for prevention
and mitigation of mental illness; and
(5) to identify populations and locations that are the most
underserved by mental health professionals and the most in need
of psychiatrists (including child and adolescent
psychiatrists), psychologists, psychiatric nurse practitioners,
clinical social workers, and mental health, peer-support
specialists.
(d) Prioritization of Integration of Services, Early Diagnosis,
Intervention, and Workforce Development.--In carrying out the duties
described in subsection (b), the Assistant Secretary shall prioritize--
(1) the integration of mental health, substance use, and
physical health services for the purpose of diagnosing,
preventing, treating, or providing rehabilitation for mental
illness or substance use disorders, including any such services
provided through the justice system (including departments of
correction) or other entities other than the Department of
Health and Human Services;
(2) crisis intervention for, early diagnosis and
intervention services for the prevention of, and treatment and
rehabilitation for, serious mental illness or substance use
disorders; and
(3) workforce development for--
(A) appropriate treatment of serious mental illness
or substance use disorders; and
(B) research activities that advance scientific and
clinical understandings of these disorders, including
the development and implementation of a continuing
nationwide strategy to increase the psychiatric
workforce with psychiatrists, child and adolescent
psychiatrists, psychologists, psychiatric nurse
practitioners, clinical social workers, and mental
health peer support specialists.
(e) Requirements and Restrictions on Authority To Award Grants.--In
awarding any grant or financial assistance, the Assistant Secretary,
and any agency or official within the Office of the Assistant
Secretary, shall comply with the following:
(1) The grant or financial assistance shall be for
activities consisting of, or based upon, applied scientific
research.
(2) Any program to be funded shall be demonstrated--
(A) in the case of an ongoing program, to be
effective; and
(B) in the case of a new program, to have the
prospect of being effective.
(3) The programs and activities to be funded shall use
evidence-based best practices or emerging evidence-based best
practices that are translational and can be expanded or
replicated to other States, local communities, agencies, or
through the Medicaid program under title XIX of the Social
Security Act.
(4) An application for the grant or financial assistance
shall include, as applicable, a scientific justification based
on previously demonstrated models, the number of individuals to
be served, the population to be targeted, what objective
outcomes measures will be used, and details on how the program
or activity to be funded can be replicated and by whom.
(5) Applicants shall be evaluated and selected through a
blind, peer-review process by expert mental health care
providers with professional experience in mental health
research or treatment and where appropriate or necessary
professional experience related to substance abuse and other
areas of expertise appropriate to the grant or other financial
assistance.
(6) No member of a peer-review group conducting a blind,
peer-review process, as required by paragraph (5), may be
related to anyone who may be applying for the type of award
being reviewed, may be a current grant applicant, or may have a
financial or employment interested in selecting whom to receive
the award.
(7) Award recipients may be periodically reviewed and
audited at the discretion of the Inspector General of the
Department of Health and Human Services or the Comptroller
General of the United States to ensure that--
(A) the best scientific method for both services
and data collection is being followed; and
(B) Federal funds are being used as required by the
conditions of the award and by applicable guidelines of
the NMHPL.
(8) Award recipients that fail an audit or fail to provide
information pursuant to an audit shall have their awards
terminated.
(f) Definitions.--In this section:
(1) The term ``secondary prevention'' means prevention that
is designed to prevent a disease or condition from occurring
among individuals or a subpopulation determined to be at risk
for the disease or condition.
(2) The term ``tertiary prevention'' means prevention that
is designed to reduce or minimize the consequences of a disease
or condition among individuals showing symptoms of the disease
or condition.
SEC. 102. TRANSFER OF SAMHSA AUTHORITIES.
(a) In General.--The Secretary of Health and Human Services shall
delegate to the Assistant Secretary all duties and authorities that--
(1) as of the day before the date of enactment of this Act,
were vested in the Administrator of the Substance Abuse and
Mental Health Services Administration; and
(2) are not terminated by this Act.
(b) Transition.--This section and the amendments made by this
section apply beginning on the day that is 6 months after the date of
enactment of this Act. As of such day, the Secretary of Health and
Human Services shall provide for the transfer of the personnel, assets,
and obligations of the Substance Abuse and Mental Health Services
Administration to the Office of the Assistant Secretary.
(c) Conforming Amendments.--Title V of the Public Health Service
Act (42 U.S.C. 290aa et seq.) is amended--
(1) in the title heading, by striking ``SUBSTANCE ABUSE AND
MENTAL HEALTH SERVICES ADMINISTRATION'' and inserting ``MENTAL
HEALTH AND SUBSTANCE USE DISORDERS'';
(2) by amending section 501(a) to read as follows:
``(a) Assistant Secretary.--The Assistant Secretary for Mental
Health and Substance Use Disorders shall have the duties and
authorities vested in the Assistant Secretary by this title in addition
to the duties and authorities vested in the Assistant Secretary by
section 501 of the Helping Families in Mental Health Crisis Act of 2015
and other provisions of law.'';
(3) by amending section 501(c) to read as follows:
``(c) Deputy Assistant Secretary.--The Assistant Secretary, with
the approval of the Secretary, may appoint a Deputy Assistant Secretary
and may employ and prescribe the functions of such officers and
employees, including attorneys, as are necessary to administer the
activities to be carried out under this title.'';
(4) by striking subsection (o) (relating to authorization
of appropriations);
(5) by striking ``Administrator of the Substance Abuse and
Mental Health Services Administration'' each place it appears
and inserting ``Assistant Secretary for Mental Health and
Substance Use Disorders'';
(6) by striking ``Administrator'' each place it appears and
inserting ``Assistant Secretary'', except where the term
``Administrator'' appears within the term--
(A) Associate Administrator;
(B) Administrator of the Health Resources and
Services Administration;
(C) Administrator of the Centers for Medicare &
Medicaid Services; or
(D) Administrator of the Office of Juvenile Justice
and Delinquency Prevention;
(7) by striking ``Substance Abuse and Mental Health
Services Administration'' each place it appears and inserting
``Office of the Assistant Secretary'';
(8) in section 502, by striking ``Administration or
Center'' each place it appears and inserting ``Office or
Center'';
(9) in section 502, by striking ``Administration's'' and
inserting ``Office of the Assistant Secretary's''; and
(10) by striking the term ``Administration'' each place it
appears and inserting ``Office of the Assistant Secretary'',
except in the heading of section 520G(b) and where the term
``Administration'' appears with the term--
(A) Health Resources and Services Administration;
or
(B) National Highway Traffic Safety Administration.
(d) References.--After executing subsection (a), subsection (b),
and the amendments made by subsection (c)--
(1) any reference in statute, regulation, or guidance to
the Administrator of the Substance Abuse and Mental Health
Services Administration shall be construed to be a reference to
the Assistant Secretary for Mental Health and Substance Use
Disorders; and
(2) any reference in statute, regulation, or guidance to
the Substance Abuse and Mental Health Services Administration
shall be construed to be a reference to the Office of the
Assistant Secretary.
SEC. 103. REPORTS.
(a) Report on Investigations Regarding Parity in Mental Health and
Substance Use Disorder Benefits.--
(1) In general.--Not later than 180 days after the
enactment of this Act, and annually thereafter, the
Administrator of the Centers for Medicare & Medicaid Services,
in collaboration with the Assistant Secretary of Labor of the
Employee Benefits Security Administration and the Secretary of
the Treasury, and in consultation with the Assistant Secretary
for Mental Health and Substance Use Disorders, shall submit to
the Congress a report--
(A) identifying Federal investigations conducted or
completed during the preceding 12-month period
regarding compliance with parity in mental health and
substance use disorder benefits, including benefits
provided to persons with serious mental illness and
substance use disorders, under the Paul Wellstone and
Pete Domenici Mental Health Parity and Addiction Equity
Act of 2008 (subtitle B of title V of division C of
Public Law 110-343); and
(B) summarizing the results of such investigations.
(2) Contents.--Subject to paragraph (3), each report under
paragraph (1) shall include the following information:
(A) The number of investigations opened and closed
during the covered reporting period.
(B) The benefit classification or classifications
examined by each investigation.
(C) The subject matter or subject matters of each
investigation, including quantitative and
nonquantitative treatment limitations.
(D) A summary of the basis of the final decision
rendered for each investigation.
(3) Limitation.--Individually identifiable information
shall be excluded from reports under paragraph (1) consistent
with Federal privacy protections.
(b) Report on Best Practices for Peer-Support Specialist Programs,
Training, and Certification.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, and biannually thereafter, the Assistant
Secretary shall submit to the Congress and make publicly
available a report on best practices and professional standards
in States for--
(A) establishing and operating health care programs
using peer-support specialists; and
(B) training and certifying peer-support
specialists.
(2) Peer-support specialist defined.--In this subsection,
the term ``peer-support specialist'' means an individual who--
(A) uses his or her lived experience of recovery
from mental illness or substance abuse, plus skills
learned in formal training, to facilitate support
groups, and to work on a one-on-one basis, with
individuals with a serious mental illness or a
substance use disorder, in consultation with and under
the supervision of a licensed mental health or
substance use treatment professional;
(B) has been an active participant in mental health
or substance use treatment for at least the preceding 2
years;
(C) does not provide direct medical services; and
(D) does not perform services outside of his or her
area of training, expertise, competence, or scope of
practice.
(3) Contents.--Each report under this subsection shall
include information on best practices and standards with regard
to the following:
(A) Hours of formal work or volunteer experience
related to mental health and substance use issues.
(B) Types of peer specialist exams required.
(C) Code of ethics.
(D) Additional training required prior to
certification, including in areas such as--
(i) psychopharmacology;
(ii) integrating physical medicine and
mental health supportive services;
(iii) ethics;
(iv) scope of practice;
(v) crisis intervention;
(vi) identification and treatment of mental
health disorders;
(vii) State confidentiality laws;
(viii) Federal privacy protections,
including under the Health Insurance
Portability and Accountability Act of 1996; and
(ix) other areas as determined by the
Assistant Secretary.
(E) Requirements to explain what, where, when, and
how to accurately complete all required documentation
activities.
(F) Required or recommended skill sets, including--
(i) identifying consumer risk indicators,
including individual stressors, triggers, and
indicators of escalating symptoms;
(ii) explaining basic de-escalation
techniques;
(iii) explaining basic suicide prevention
concepts and techniques;
(iv) identifying indicators that the
consumer may be experiencing abuse or neglect;
(v) identifying and responding
appropriately to personal stressors, triggers,
and indicators;
(vi) identifying the consumer's current
stage of change or recovery;
(vii) explaining the typical process that
should be followed to access or participate in
community mental health and related services;
and
(viii) identifying circumstances when it is
appropriate to request assistance from other
professionals to help meet the consumer's
recovery goals.
(G) Requirements for continuing education credits
annually.
(c) Report on the State of the States in Mental Health and
Substance Use Treatment.--
(1) In general.--Not later than 1 year after the date of
enactment of this Act, and not less than every 2 years
thereafter, the Assistant Secretary shall submit to the
Congress and make available to the public a report on the state
of the States in mental health and substance use treatment,
including the following:
(A) A detailed report on how Federal mental health
and substance use treatment funds are used in each
State including:
(i) The numbers of individuals with serious
mental illness or substance use disorders who
are served with Federal funds.
(ii) The types of programs made available
to individuals with serious mental illness or
substance use disorders.
(B) A summary of best practice models in the States
highlighting programs that are cost effective, provide
evidence-based care, increase access to care, integrate
physical, psychiatric, psychological, and behavioral
medicine, and improve outcomes for individuals with
mental illness or substance use disorders.
(C) A statistical report of outcome measures in
each State, including--
(i) rates of suicide, suicide attempts,
substance abuse, overdose, overdose deaths,
emergency psychiatric hospitalizations, and
emergency room boarding; and
(ii) for those with mental illness,
arrests, incarcerations, victimization,
homelessness, joblessness, employment, and
enrollment in educational or vocational
programs.
(D) Outcome measures on State-assisted outpatient
treatment programs, including--
(i) rates of keeping treatment appointments
and compliance with prescribed medications;
(ii) participants' perceived effectiveness
of the program;
(iii) rates of the programs helping those
with serious mental illness gain control over
their lives;
(iv) alcohol and drug abuse rates;
(v) incarceration and arrest rates;
(vi) violence against persons or property;
(vii) homelessness; and
(viii) total treatment costs for compliance
with the program.
(E) State and counties with assisted outpatient
treatment programs.--For States and counties with
assisted outpatient treatment programs, the information
reported under this subsection shall include a
comparison of the outcomes of individuals with serious
mental illness who participated in the programs versus
the outcomes of individuals who did not participate but
were eligible to do so by nature of their history.
(F) States and counties without aot programs.--For
States and counties without assisted outpatient
treatment programs, the information reported under this
subsection shall include data on individuals with
mental illness who--
(i) have a history of violence,
incarceration, and arrests;
(ii) have a history of emergency
psychiatric hospitalizations;
(iii) are substantially unlikely to
participate in treatment on their own;
(iv) may be unable for reasons other than
indigence, to provide for any of their basic
needs such as food, clothing, shelter, health
or safety;
(v) have a history of mental illness or
condition that is likely to substantially
deteriorate if the individual is not provided
with timely treatment; and
(vi) due to their mental illness, have a
lack of capacity to fully understand or lack
judgment, or diminished capacity to make
informed decisions, regarding their need for
treatment, care, or supervision.
(2) Definition.--In this subsection, the term ``emergency
room boarding'' means the practice of admitting patients to an
emergency department and holding them in the department until
inpatient psychiatric beds become available.
(d) Reporting Compliance Study.--
(1) In general.--The Assistant Secretary for Mental Health
and Substance Use Disorders shall enter into an arrangement
with the Institute of Medicine of the National Academies (or,
if the Institute declines, another appropriate entity) under
which, not later than 12 months after the date of enactment of
this Act, the Institute will submit to the appropriate
committees of Congress a report that evaluates the combined
paperwork burden of--
(A) community mental health centers meeting the
criteria specified in section 1913(c) of the Public
Health Service Act (42 U.S.C. 300x-2), including such
centers meeting such criteria as in effect on the day
before the date of enactment of this Act; and
(B) federally qualified community mental health
clinics certified pursuant to section 223 of the
Protecting Access to Medicare Act of 2014 (Public Law
113-93), as amended by section 505.
(2) Scope.--In preparing the report under subsection (a),
the Institute of Medicine (or, if applicable, other appropriate
entity) shall examine licensing, certification, service
definitions, claims payment, billing codes, and financial
auditing requirements used by the Office of Management and
Budget, the Centers for Medicare & Medicaid Services, the
Health Resources and Services Administration, the Substance
Abuse and Mental Health Services Administration, the Office of
the Inspector General of the Department of Health and Human
Services, State Medicaid agencies, State departments of health,
State departments of education, and State and local juvenile
justice and social service agencies to--
(A) establish an estimate of the combined
nationwide cost of complying with such requirements, in
terms of both administrative funding and staff time;
(B) establish an estimate of the per capita cost to
each center or clinic described in subparagraph (A) or
(B) of paragraph (1) to comply with such requirements,
in terms of both administrative funding and staff time;
and
(C) make administrative and statutory
recommendations to Congress (which recommendations may
include a uniform methodology) to reduce the paperwork
burden experienced by centers and clinics described in
subparagraph (A) or (B) of paragraph (1).
SEC. 104. ADVISORY COUNCIL ON GRADUATE MEDICAL EDUCATION.
Section 762(b) of the Public Health Service Act (42 U.S.C. 294o(b))
is amended--
(1) by redesignating paragraphs (4) through (6) as
paragraphs (5) through (7), respectively; and
(2) by inserting after paragraph (3) the following:
``(4) the Assistant Secretary for Mental Health and
Substance Use Disorders;''.
TITLE II--GRANT REFORM AND RESTRUCTURING
SEC. 201. NATIONAL MENTAL HEALTH POLICY LABORATORY.
(a) In General.--
(1) Establishment.--The Assistant Secretary for Mental
Health and Substance Use Disorders shall establish, within the
Office of the Assistant Secretary, the National Mental Health
Policy Laboratory (in this section referred to as the
``NMHPL''), to be headed by a Director.
(2) Duties.--The Director of the NMHPL shall--
(A) identify, coordinate, and implement policy
changes and other trends likely to have the most
significant impact on mental health services and
monitor their impact;
(B) collect information from grantees under
programs established or amended by this Act and under
other mental health programs under the Public Health
Service Act, including grantees that are States
receiving funds under a block grant under part B of
title XIX of the Public Health Service Act (42 U.S.C.
300x et seq.);
(C) evaluate and disseminate to such grantees
evidence-based practices and services delivery models
using the best available science shown to be cost-
effective while enhancing the quality of care furnished
to individuals;
(D) establish standards for the appointment of
scientific peer-review panels to evaluate grant
applications; and
(E) establish standards for grant programs under
subsection (b).
(3) Evidence-based practices and service delivery models.--
In selecting evidence-based best practices and service delivery
models for evaluation and dissemination under paragraph (2)(C),
the Director of the NMHPL--
(A) shall give preference to models that improve--
(i) the coordination between mental health
and physical health providers;
(ii) the coordination among such providers
and the justice and corrections system; and
(iii) the cost effectiveness, quality,
effectiveness, and efficiency of health care
services furnished to individuals with serious
mental illness, in mental health crisis, or at
risk to themselves, their families, and the
general public; and
(B) may include clinical protocols and practices
used in the Recovery After Initial Schizophrenia
Episode (RAISE) project and the North American Prodrome
Longitudinal Study (NAPLS) of the National Institute of
Mental Health.
(4) Deadline for beginning implementation.--The Director of
the NMHPL shall begin implementation of the duties described in
this subsection not later than January 1, 2018.
(5) Consultation.--In carrying out the duties under this
subsection, the Director of the NMHPL shall consult with--
(A) representatives of the National Institute of
Mental Health on organization, hiring decisions, and
operations, initially and on an ongoing basis;
(B) other appropriate Federal agencies;
(C) clinical and analytical experts with expertise
in medicine, psychiatric and clinical psychological
care, health care management, education, corrections
health care, and mental health court systems; and
(D) other individuals and agencies as determined
appropriate by the Assistant Secretary.
(b) Standards for Grant Programs.--
(1) In general.--The Director of the NMHPL shall set
standards for grant programs administered by the Assistant
Secretary, and the Assistant Secretary shall comply with such
standards, including standards for--
(A) the extent to which the grantee must have the
capacity to implement the award;
(B) the extent to which the grant plan submitted by
the grantee as part of its application must explain how
the grantee will help to provide comprehensive
community mental health or substance use services to
adults with serious mental illness and children with
serious emotional disturbances;
(C) the extent to which the grantee must identify
priorities, as well as strategies and performance
indicators to address those priorities for the duration
of the grant;
(D) the extent to which the grantee must submit
statements on the extent to which the grantee is
meeting annual program priorities with quantifiable,
objective, and scientific targets, measures, and
outcomes;
(E) the extent to which grantees are expected to
collaborate with other child-serving systems such as
child welfare, education, juvenile justice, and primary
care systems;
(F) the extent to which the grantee must collect
and report data;
(G) the extent to which the grantee must use
evidence-based practices and the extent to which those
evidence-based practices must be used with respect to a
population similar to the population for which the
evidence-based practices were shown to be effective;
and
(H) the extent to which a grantee, when possible,
must have a control group.
(2) Public disclosure of results.--The Director of the
NMHPL--
(A) shall make the standards under paragraph (1),
and the Director's findings on compliance by the
Assistant Secretary and grantees with such standards,
available to the public in a timely fashion; and
(B) may establish requirements for States and other
entities receiving funds through grants under programs
established or amended by this Act and under other
mental health programs under the Public Health Service
Act, including under a block grant under part B of
title XIX of the Public Health Service Act (42 U.S.C.
300x et seq.), to collect information on evidence-based
best practices and services delivery models selected
under section 101(c)(2), as the Assistant Secretary
determines necessary to monitor and evaluate such
models.
(c) Staffing.--
(1) Composition.--In selecting the staff of the NMHPL, the
Director of the NMHPL, in consultation with the Director of the
National Institute of Mental Health, shall ensure the
following:
(A) At least 20 percent of the staff shall--
(i) have a doctoral degree in medicine or
osteopathic medicine and clinical and research
experience in psychiatry;
(ii) have graduated from an Accreditation
Council for Graduate Medical Education-
accredited psychiatric residency program; and
(iii) have an understanding of biological,
psychosocial, and pharmaceutical treatments of
mental illness and substance use disorders.
(B) At least 20 percent of the staff shall have a
doctoral degree in psychology with--
(i) clinical and research experience
regarding mental illness and substance use
disorders; and
(ii) an understanding of biological,
psychosocial, and pharmaceutical treatments of
mental illness and substance use disorders.
(C) At least 20 percent of the staff shall be
professionals or academics with clinical or research
expertise in substance use disorders and treatment.
(D) At least 20 percent of the staff shall be
professionals or academics with expertise in research
design and methodologies.
(2) Congressional appointments.--At least 20 percent, or
two, whichever is greater, of the members of the staff of the
NMHPL shall be appointed by Congress.
(d) Report on Quality of Care.--Not later than 1 year after the
date of enactment of this Act, and every 2 years thereafter, the
Director of the NMHPL shall submit to the Congress a report on the
quality of care furnished through grant programs administered by the
Assistant Secretary under the respective services delivery models,
including measurement of patient-level outcomes and public health
outcomes such as--
(1) reduced rates of suicide, suicide attempts, substance
abuse, overdose, overdose deaths, emergency psychiatric
hospitalizations, emergency room boarding, incarceration,
crime, arrest, victimization, homelessness, and joblessness;
(2) rates of employment and enrollment in educational and
vocational programs; and
(3) such other criteria as the Director may determine.
(e) Definition.--In this section, the term ``emergency room
boarding'' means the practice of admitting patients to an emergency
department and holding them in the department until inpatient
psychiatric beds become available.
SEC. 202. INNOVATION GRANTS.
(a) In General.--The Assistant Secretary shall award grants to
State and local governments, educational institutions, and nonprofit
organizations for expanding a model that has been scientifically
demonstrated to show promise, but would benefit from further applied
research, for--
(1) enhancing the screening, diagnosis, and treatment of
mental illness and serious mental illness; or
(2) integrating or coordinating physical, mental health,
and substance use services.
(b) Duration.--A grant under this section shall be for a period of
not more than 2 years.
(c) Limitations.--Of the amounts made available for carrying out
this section for a fiscal year--
(1) not more than one-third shall be awarded for use for
primary prevention; and
(2) not less than one-third shall be awarded for screening,
diagnosis, treatment, or services, as described in subsection
(a), for individuals (or subpopulations of individuals) who are
below the age of 18 when activities funded through the grant
award are initiated.
(d) Guidelines.--As a condition on receipt of an award under this
section, an applicant shall agree to adhere to guidelines issued by the
National Mental Health Policy Laboratory on research designs and data
collection.
(e) Termination.--The Assistant Secretary may terminate any award
under this section upon a determination that--
(1) the recipient is not providing information requested by
the National Mental Health Policy Laboratory or the Assistant
Secretary in connection with the award; or
(2) there is a clear failure in the effectiveness of the
recipient's programs or activities funded through the award.
(f) Reporting.--As a condition on receipt of an award under this
section, an applicant shall agree--
(1) to report to the National Mental Health Policy
Laboratory and the Assistant Secretary the results of programs
and activities funded through the award; and
(2) to include in such reporting any relevant data
requested by the National Mental Health Policy Laboratory and
the Assistant Secretary.
(g) Definition.--In this section, the term ``primary prevention''
means prevention that is designed to prevent a disease or condition
from occurring among the general population without regard to
identifying the presence of risk factors or symptoms in the population.
(h) Funding.--Of the amounts made available to carry out sections
501, 509, 516, and 520A of the Public Health Service Act for a fiscal
year, 5 percent of such amounts are authorized to be used to carry out
this section.
SEC. 203. DEMONSTRATION GRANTS.
(a) Grants.--The Assistant Secretary shall award grants to States,
counties, local governments, educational institutions, and private
nonprofit organizations for the expansion, replication, or scaling of
evidence-based programs across a wider area to enhance effective
screening, early diagnosis, intervention, and treatment with respect to
mental illness and serious mental illness, primarily by--
(1) applied delivery of care, including training staff in
effective evidence-based treatment; and
(2) integrating models of care across specialties and
jurisdictions.
(b) Duration.--A grant under this section shall be for a period of
not less than 2 years and not more than 5 years.
(c) Limitations.--Of the amounts made available for carrying out
this section for a fiscal year--
(1) not less than half shall be awarded for screening,
diagnosis, intervention, and treatment, as described in
subsection (a), for individuals (or subpopulations of
individuals) who are below the age of 26 when activities funded
through the grant award are initiated;
(2) no amounts shall be made available for any program or
project that is not evidence-based;
(3) no amounts shall be made available for primary
prevention; and
(4) no amounts shall be made available solely for the
purpose of expanding facilities or increasing staff at an
existing program.
(d) Guidelines.--As a condition on receipt of an award under this
section, an applicant shall agree to adhere to guidelines issued by the
National Mental Health Policy Laboratory on research designs and data
collection.
(e) Termination.--The Assistant Secretary may terminate any award
under this section upon a determination that--
(1) the recipient is not providing information requested by
the National Mental Health Policy Laboratory or the Assistant
Secretary in connection with the award; or
(2) there is a clear failure in the effectiveness of the
recipient's programs or activities funded through the award.
(f) Reporting.--As a condition on receipt of an award under this
section, an applicant shall agree--
(1) to report to the National Mental Health Policy
Laboratory and the Assistant Secretary the results of programs
and activities funded through the award; and
(2) to include in such reporting any relevant data
requested by the National Mental Health Policy Laboratory and
the Assistant Secretary.
(g) Funding.--Of the amounts made available to carry out sections
501, 509, 516, and 520A of the Public Health Service Act for a fiscal
year, 10 percent of such amounts are authorized to be used to carry out
this section.
SEC. 204. EARLY CHILDHOOD INTERVENTION AND TREATMENT.
(a) Grants.--The Director of the National Mental Health Policy
Laboratory (in this section referred to as the ``NMHPL'') shall award--
(1) grants to eligible entities to initiate and undertake,
for eligible children, early childhood intervention and
treatment programs, and specialized preschool and elementary
school programs, with the goal of preventing chronic and
serious mental illness;
(2) grants to not more than 3 eligible entities for
studying the longitudinal outcomes of programs funded under
paragraph (1) on eligible children who were treated 5 or more
years prior to the enactment of this Act; and
(3) ensure that programs and activities funded through
grants under this subsection are based on a sound scientific
model that shows evidence and promise and can be replicated in
other settings.
(b) Eligible Entities and Children.--In this section:
(1) Eligible entity.--The term ``eligible entity'' means a
nonprofit institution that--
(A) is duly accredited by State mental health and
education agencies, as applicable, for the treatment
and education of children from 1 to 10 years of age;
and
(B) provides services that include early childhood
intervention and specialized preschool and elementary
school programs focused on children whose primary need
is a social or emotional disability (in addition to any
learning disability).
(2) Eligible child.--The term ``eligible child'' means a
child who is at least 0 years old and not more than 12 years
old--
(A) whose primary need is a social and emotional
disability (in addition to any learning disability);
(B) who is at risk of developing serious mental
illness and/or may show early signs of mental illness;
and
(C) who could benefit from early childhood
intervention and specialized preschool or elementary
school programs with the goal of preventing or treating
chronic and serious mental illness.
(c) Application.--An eligible entity seeking a grant under
subsection (a) shall submit to the Secretary an application at such
time, in such manner, and containing such information as the Secretary
may require.
(d) Use of Funds for Early Childhood Intervention and Treatment
Programs.--An eligible entity shall use amounts awarded under a grant
under subsection (a)(1) to carry out the following activities:
(1) Deliver (or facilitate) for eligible children treatment
and education, early childhood intervention, and specialized
preschool and elementary school programs, including the
provision of medically based child care and early education
services.
(2) Treat and educate eligible children, including startup,
curricula development, operating and capital needs, staff and
equipment, assessment and intervention services, administration
and medication requirements, enrollment costs, collaboration
with primary care physicians and psychiatrists, other related
services to meet emergency needs of children, and communication
with families and medical professionals concerning the
children.
(3) Develop and implement other strategies to address
identified treatment and educational needs of eligible children
that have reliable and valid evaluation modalities built into
assess outcomes based on sound scientific metrics as determined
by the NMHPL.
(e) Use of Funds for Longitudinal Study.--In conducting a study on
longitudinal outcomes through a grant under subsection (a)(2), an
eligible entity shall include an analysis of--
(1) the individuals treated and educated;
(2) the success of such treatment and education in avoiding
the onset of serious mental illness or the preparation of such
children for the care and management of serious mental illness;
(3) any evidence-based best practices generally applicable
as a result of such treatment and educational techniques used
with such children; and
(4) the ability of programs to be replicated as a best
practice model of intervention.
(f) Requirements.--In carrying out this section, the Secretary
shall ensure that each entity receiving a grant under subsection (a)
maintains a written agreement with the Secretary, and provides regular
written reports, as required by the Secretary, regarding the quality,
efficiency, and effectiveness of intervention and treatment for
eligible children preventing or treating the development and onset of
serious mental illness.
(g) Amount of Awards.--
(1) Amounts for early childhood intervention and treatment
programs.--The amount of an award to an eligible entity under
subsection (a)(1) shall be not more than $600,000 per fiscal
year.
(2) Amounts for longitudinal study.--The total amount of an
award to an eligible entity under subsection (a)(2) (for one or
more fiscal years) shall be not less than $1,000,000 and not
greater than $2,000,000.
(h) Project Terms.--The period of a grant--
(1) for awards under subsection (a)(1), shall be not less
than 3 fiscal years and not more than 10 fiscal years; and
(2) for awards under subsection (a)(2), shall be not more
than 5 fiscal years.
(i) Matching Funds.--The Director of the NMHPL may not award a
grant under this section to an eligible entity unless the eligible
entity agrees, with respect to the costs to be incurred by the eligible
entity in carrying out the activities described in subparagraph (D), to
make available non-Federal contributions (in cash or in kind) toward
such costs in an amount equal to not less than 10 percent of Federal
funds provided in the grant.
(j) Definitions.--In this section:
(1) The term ``emergency room boarding'' means the practice
of admitting patients to an emergency department and holding
them in the department until inpatient psychiatric beds become
available.
(2) The term ``primary prevention'' means prevention that
is designed to prevent a disease or condition from occurring
among the general population without regard to identifying the
presence of risk factors or symptoms in the population.
(k) Funding.--Of the amounts made available to carry out part E of
title V of the Public Health Service Act (42 U.S.C. 290ff et seq.) for
each of fiscal years 2016 through 2021, not more than 5 percent of such
amounts are authorized to be appropriated to carry out this section.
SEC. 205. EXTENSION OF ASSISTED OUTPATIENT TREATMENT GRANT PROGRAM FOR
INDIVIDUALS WITH SERIOUS MENTAL ILLNESS.
Section 224 of the Protecting Access to Medicare Act of 2014 (42
U.S.C. 290aa note) is amended--
(1) in subsection (e), by striking ``and 2018'' and
inserting ``2018, 2019, and 2020''; and
(2) in subsection (g)--
(A) in paragraph (1), by striking ``2018'' and
inserting ``2020'';
(B) in paragraph (2)--
(i) by striking ``$15,000,000'' and
inserting ``$20,000,000''; and
(ii) by striking ``2018'' and inserting
``2020''; and
(C) by adding at the end the following:
``(3) Allocation.--Of the funds made available to carry out
this section for a fiscal year, the Secretary shall allocate--
``(A) 20 percent of such funds for existing
assisted outpatient treatment programs; and
``(B) 80 percent of such funds for new assisted
outpatient treatment programs.''.
SEC. 206. BLOCK GRANTS.
(a) Best Practices in Clinical Care Models.--Section 1920 of the
Public Health Service Act (42 U.S.C. 300x-9) is amended by adding at
the end the following:
``(c) Best Practices in Clinical Care Models.--The Secretary,
acting through the Director of the National Institute of Mental Health,
shall obligate 5 percent of the amounts appropriated for a fiscal year
under subsection (a) for translating evidence-based (as defined in
section 2 of the Helping Families in Mental Health Crisis Act of 2015)
interventions and best available science into systems of care, such as
through models including--
``(1) the Recovery After an Initial Schizophrenia Episode
research project of the National Institute of Mental Health;
and
``(2) the North American Prodrome Longitudinal Study.''.
(b) Administration of Block Grants by Assistant Secretary.--Section
1911(a) of the Public Health Service Act (42 U.S.C. 300x) is amended by
striking ``acting through the Director of the Center for Mental Health
Services'' and inserting ``acting through the Assistant Secretary for
Mental Health and Substance Use Disorders''.
(c) Additional Program Requirements.--
(1) Integrated services.--Subsection (b)(1) of section 1912
of the Public Health Service Act (42 U.S.C. 300x-1(b)(1)) is
amended--
(A) by striking ``The plan provides'' and
inserting:
``(A) The plan provides'';
(B) in the subparagraph (A) inserted by paragraph
(1), in the second sentence, by striking ``health and
mental health services'' and inserting ``integrated
physical and mental health services'';
(C) in such subparagraph (A), by striking ``The
plan shall include'' through the period at the end and
inserting ``The plan shall integrate and coordinate
services to maximize the efficiency, effectiveness,
quality, coordination, and cost effectiveness of those
services and programs to produce the best possible
outcomes for those with serious mental illness.''; and
(D) by adding at the end the following new
subparagraph:
``(B) The plan shall include a separate description
of case management services and provide for activities
leading to reduction of rates of suicides, suicide
attempts, substance abuse, overdose deaths, emergency
hospitalizations, incarceration, crimes, arrest,
victimization, homelessness, joblessness, medication
nonadherence, and education and vocational programs
drop outs. The plan must also include a detailed list
of services available for eligible patients (as defined
in subsection (d)(3)) in each county or county
equivalent, including assisted outpatient treatment.''.
(2) Data collection system.--Subsection (b)(2) of section
1912 of the Public Health Service Act (42 U.S.C. 300x-1(b)(2))
is amended--
(A) by striking ``The plan contains an estimate
of'' and inserting the following: ``The plan contains--
``(A) an estimate of'';
(B) in subparagraph (A), as inserted by paragraph
(1), by inserting ``, including reductions in
homelessness, emergency hospitalization, incarceration,
and unemployment for eligible patients (as defined in
subsection (d)(3)),'' after ``targets'';
(C) in such subparagraph, by striking the period at
the end and inserting ``; and''; and
(D) by adding at the end the following new
subparagraph:
``(B) an agreement by the State to report to the
National Mental Health Policy Laboratory such data as
may be required by the Secretary concerning--
``(i) comprehensive community mental health
services in the State; and
``(ii) public health outcomes for persons
with serious mental illness in the State,
including rates of suicides, suicide attempts,
substance abuse, overdose deaths, emergency
hospitalizations, incarceration, crimes,
arrest, victimization, homelessness,
joblessness, medication non-adherence, and
education and vocational programs drop outs.''.
(3) Implementation of plan.--Subsection (d) of section 1912
of the Public Health Service Act (42 U.S.C. 300x-1(d)) is
amended--
(A) in paragraph (1)--
(i) by striking ``Except as provided'' and
inserting:
``(A) Except as provided''; and
(ii) by adding at the end the following new
subparagraph:
``(B) For eligible patients receiving treatment
through funds awarded under a grant under section 1911,
a State shall include in the State plan for the first
year beginning after the date of the enactment of this
subparagraph and each subsequent year, a de-
individualized report, containing information that is
open source and de-identified, on the services provided
to those individuals, including--
``(i) outcomes and the overall cost of such
treatment provided; and
``(ii) county or county equivalent level
data on such patient population, including
overall costs and raw number data on rates of
involuntary inpatient and outpatient commitment
orders, suicides, suicide attempts, substance
abuse, overdose deaths, emergency
hospitalizations, incarceration, crimes,
arrest, victimization, homelessness,
joblessness, medication non-adherence, and
education and vocational programs drop outs.'';
and
(B) by adding at the end the following new
paragraph:
``(3) Definition.--In this subsection, the term `eligible
patient' means an adult mentally ill person who--
``(A) may have a history of violence,
incarceration, or medically unnecessary
hospitalizations;
``(B) without supervision and treatment, may be a
danger to self or others in the community;
``(C) is substantially unlikely to voluntarily
participate in treatment;
``(D) may be unable, for reasons other than
indigence, to provide for any of the basic needs of
such person, such as food, clothing, shelter, health,
or safety;
``(E) with a history of mental illness or condition
that is likely to substantially deteriorate if the
person is not provided with timely treatment;
``(F) due to mental illness, lacks capacity to
fully understand or lacks judgment to make informed
decisions regarding his or her need for treatment,
care, or supervision; and
``(G) is likely to improve in mental health and
reduce the symptoms of serious mental illness when in
treatment.''.
(4) Treatment under state law.--
(A) In general.--Section 1912 of the Public Health
Service Act (42 U.S.C. 300x-1) is amended by adding at
the end the following new subsections:
``(e) Assisted Outpatient Treatment Under State Law.--
``(1) In general.--A funding agreement for a grant under
section 1911 is that the State involved has in effect a law
under which a State court may order a treatment plan for an
eligible patient that--
``(A) requires such patient to obtain outpatient
mental health treatment while the patient is living in
a community; and
``(B) is designed to improve access and adherence
by such patient to intensive behavioral health services
in order to--
``(i) avert relapse, repeated
hospitalizations, arrest, incarceration,
suicide, property destruction, and violent
behavior; and
``(ii) provide such patient with the
opportunity to live in a less restrictive
alternative to incarceration or involuntary
hospitalization.
``(2) Certification of state compliance.--A funding
agreement described in paragraph (1) is effective only if the
Assistant Secretary for Mental Health and Substance Use
Disorders reviews the State law and certifies that it satisfies
the criteria specified in such paragraph.
``(f) Treatment Standard Under State Law.--
``(1) In general.--A funding agreement for a grant under
section 1911 is that--
``(A) the State involved has in effect a law under
which, if a State court finds by clear and convincing
evidence that an individual, as a result of mental
illness, is a danger to self, is a danger to others, is
persistently or acutely disabled, or is gravely
disabled and in need of treatment, and is either
unwilling or unable to accept voluntary treatment, the
court must order the individual to undergo inpatient or
outpatient treatment; or
``(B) the State involved has in effect a law under
which a State court must order an individual with a
mental illness to undergo inpatient or outpatient
treatment, the law was in effect on the date of
enactment of the Helping Families in Mental Health
Crisis Act of 2015, and the Secretary finds that the
law requires a State court to order such treatment
across all or a sufficient range of the type of
circumstances described in subparagraph (A).
``(2) Definition.--For purposes of paragraph (1), the term
`persistently or acutely disabled' refers to a serious mental
illness that meets all the following criteria:
``(A) If not treated, the illness has a substantial
probability of causing the individual to suffer or
continue to suffer severe and abnormal mental,
emotional, or physical harm that significantly impairs
judgment, reason, behavior, or capacity to recognize
reality.
``(B) The illness substantially impairs the
individual's capacity to make an informed decision
regarding treatment, and this impairment causes the
individual to be incapable of understanding and
expressing an understanding of the advantages and
disadvantages of accepting treatment and understanding
and expressing an understanding of the alternatives to
the particular treatment offered after the advantages,
disadvantages, and alternatives are explained to that
individual.
``(C) The illness has a reasonable prospect of
being treatable by outpatient, inpatient, or combined
inpatient and outpatient treatment.''.
(B) Funding increase.--Section 1918 of the Public
Health Service Act (42 U.S.C. 300x-7) is amended--
(i) in subsection (a)(1), by striking
``subsection (b)'' and inserting ``subsections
(b) and (d)''; and
(ii) by adding at the end the following new
subsection:
``(d) Increase for Certain States.--With respect to fiscal year
2016 and each subsequent fiscal year, in the case of a State that has
in effect a law described in subsection (e)(1) or subparagraph (A) or
(B) of subsection (f)(1), the amount of the allotment of a State under
section 1911 shall be for such fiscal year the amount that would
otherwise be determined, without application of this subsection, for
such State for such fiscal year, increased by 2 percent.''.
(5) Evidence-based services delivery models.--Section 1912
of the Public Health Service Act (42 U.S.C. 300x-1), as amended
by paragraph (4), is further amended by adding at the end the
following new subsection:
``(g) Expansion of Models.--
``(1) In general.--Taking into account the results of
evaluations under section 201(a)(2)(C) of the Helping Families
in Mental Health Crisis Act of 2015, the Assistant Secretary
may, by rule, as part of the program of block grants under this
subpart, provide for expanded use across the Nation of
evidence-based service delivery models by providers funded
under such block grants, so long as--
``(A) the Assistant Secretary for Mental Health and
Substance Use Disorders (in this subsection referred to
as the `Assistant Secretary') determines that such
expansion will--
``(i) result in more effective use of funds
under such block grants without reducing the
quality of care; or
``(ii) improve the quality of patient care
without significantly increasing spending;
``(B) the Director of the National Institute of
Mental Health determines that such expansion would
improve the quality of patient care; and
``(C) the Assistant Secretary determines that the
change will--
``(i) significantly reduce severity and
duration of symptoms of mental illness;
``(ii) reduce rates of suicide, suicide
attempts, substance abuse, overdose, emergency
hospitalizations, emergency room boarding,
incarceration, crime, arrest, victimization,
homelessness, or joblessness; or
``(iii) significantly improve the quality
of patient care and mental health crisis
outcomes without significantly increasing
spending.
``(2) Congressional review.--Any rule promulgated pursuant
to paragraph (1) is deemed to be a major rule subject to
congressional review and disapproval under chapter 8 of title
5, United States Code.
``(3) Definition.--In this subsection, the term `emergency
room boarding' means the practice of admitting patients to an
emergency department and holding them in the department until
inpatient psychiatric beds become available.''.
(d) Period for Expenditure of Grant Funds.--Section 1913 of the
Public Health Service Act (42 U.S.C. 300x-2), as amended, is further
amended by adding at the end the following:
``(d) Period for Expenditure of Grant Funds.--In implementing a
plan submitted under section 1912(a), a State receiving grant funds
under section 1911 may make such funds available to providers of
services described in subsection (b) for the provision of services
without fiscal year limitation.''.
(e) Active Outreach and Engagement.--Section 1915 of the Public
Health Service Act (42 U.S.C. 300x-4) is amended by adding at the end
of the following:
``(c) Active Outreach and Engagement to Persons With Serious Mental
Illness.--A funding agreement for a grant under section 1911 is that
the State involved has in effect active programs, including assisted
outpatient treatment, to engage persons with serious mental illness who
are substantially unlikely to voluntarily seek treatment, in
comprehensive services in order to avert relapse, repeated
hospitalizations, arrest, incarceration, and suicide to provide the
patient with the opportunity to live in the community through evidence-
based (as defined in section 2 of the Helping Families in Mental Health
Crisis Act of 2015) assertive outreach and engagement services
targeting individuals that are homeless, have co-occurring disorders,
or have a history of treatment failure. The Assistant Secretary for
Mental Health and Substance Use Disorders shall work with the Director
of the National Institute of Mental Health to develop a list of such
evidence-based (as defined in section 2 of the Helping Families in
Mental Health Crisis Act of 2015) assertive outreach and engagement
services, as well as criteria to be used to assess the scope and
effectiveness of such approaches. These programs may include assistant
outpatient treatment programs under State law where State courts may
order a treatment plan for an eligible patient that requires--
``(1) such patient to obtain outpatient mental health
treatment while the patient is living in the community; and
``(2) a design to improve access and adherence by such
patient to intensive mental health services.''.
SEC. 207. WORKFORCE DEVELOPMENT.
(a) Telepsychiatry and Primary Care Physician Training Grant
Program.--
(1) In general.--The Assistant Secretary of Mental Health
and Substance Use Disorders (in this subsection referred to as
the ``Assistant Secretary'') shall establish a grant program
(in this subsection referred to as the ``grant program'') under
which the Assistant Secretary shall award to 10 eligible States
(as described in paragraph (5)) grants for carrying out all of
the purposes described in paragraphs (2), (3), and (4).
(2) Training program for certain primary care physicians.--
For purposes of paragraph (1), the purpose described in this
paragraph, with respect to a grant awarded to a State under the
grant program, is for the State to establish a training program
to train primary care physicians in--
(A) valid and reliable behavioral-health screening
tools for violence and suicide risk, early signs of
serious mental illness, and untreated substance abuse,
including any standardized behavioral-health screening
tools that are determined appropriate by the Assistant
Secretary;
(B) implementing the use of behavioral-health
screening tools in their practices;
(C) establishment of recommended intervention and
treatment protocols for individuals in mental health
crisis, especially for individuals whose illness makes
them less receptive to mental health services; and
(D) implementing the evidence-based collaborative
care model of integrated medical-behavioral health care
in their practices.
(3) Payments for mental health services provided by certain
primary care physicians.--
(A) In general.--For purposes of paragraph (1), the
purpose described in this paragraph, with respect to a
grant awarded to a State under the grant program, is
for the State to provide, in accordance with this
paragraph, in the case of a primary care physician who
participates in the training program of the State
establish pursuant to paragraph (2), payments to the
primary care physician for services furnished by the
primary care physician.
(B) Considerations.--The Assistant Secretary, in
determining the structure, quality, and form of payment
under subparagraph (A) shall seek to find innovative
payment systems which may take into account--
(i) the nature and quality of services
rendered;
(ii) the patients' health outcome;
(iii) the geographical location where
services were provided;
(iv) the acuteness of the patient's medical
condition;
(v) the duration of services provided;
(vi) the feasibility of replicating the
payment model in other locations nationwide;
and
(vii) proper triage and enduring linkage to
appropriate treatment provider for subspecialty
care in child or forensic issues; family crisis
intervention; drug or alcohol rehabilitation;
management of suicidal or violent behavior
risk, and treatment for serious mental illness.
(4) Telehealth services for mental health disorders.--
(A) In general.--For purposes of paragraph (1), the
purpose described in this paragraph, with respect to a
grant awarded to a State under the grant program, is
for the State to provide, in the case of an individual
furnished items and services by a primary care
physician during an office visit, for payment for a
consultation provided by a psychiatrist or psychologist
to such physician with respect to such individual
through the use of qualified telehealth technology for
the identification, diagnosis, mitigation, or treatment
of a mental health disorder if such consultation occurs
not later than the first business day that follows such
visit.
(B) Qualified telehealth technology.--For purposes
of subparagraph (A), the term ``qualified telehealth
technology'', with respect to the provision of items
and services to a patient by a health care provider,
includes the use of interactive audio, audio-only
telephone conversation, video, or other
telecommunications technology by a health care provider
to deliver health care services within the scope of the
provider's practice at a site other than the site where
the patient is located, including the use of electronic
media for consultation relating to the health care
diagnosis or treatment of the patient.
(5) Eligible state.--
(A) In general.--For purposes of this subsection,
an eligible State is a State that has submitted to the
Assistant Secretary an application under subparagraph
(B) and has been selected under subparagraph (D).
(B) Application.--A State seeking to participate in
the grant program under this subsection shall submit to
the Assistant Secretary, at such time and in such
format as the Assistant Secretary requires, an
application that includes such information, provisions,
and assurances as the Assistant Secretary may require.
(C) Matching requirement.--The Assistant Secretary
may not make a grant under the grant program unless the
State involved agrees, with respect to the costs to be
incurred by the State in carrying out the purposes
described in this subsection, to make available non-
Federal contributions (in cash or in kind) toward such
costs in an amount equal to not less than 20 percent of
Federal funds provided in the grant.
(D) Selection.--A State shall be determined
eligible for the grant program by the Assistant
Secretary on a competitive basis among States with
applications meeting the requirements of subparagraphs
(B) and (C). In selecting State applications for the
grant program, the Secretary shall seek to achieve an
appropriate national balance in the geographic
distribution of grants awarded under the grant program.
(6) Target population.--In seeking a grant under this
subsection, a State shall demonstrate how the grant will
improve care for individuals with co-occurring behavioral
health and physical health conditions, vulnerable populations,
socially isolated populations, rural populations, and other
populations who have limited access to qualified mental health
providers.
(7) Length of grant program.--The grant program under this
subsection shall be conducted for a period of 3 consecutive
years.
(8) Public availability of findings and conclusions.--
Subject to Federal privacy protections with respect to
individually identifiable information, the Assistant Secretary
shall make the findings and conclusions resulting from the
grant program under this subsection available to the public.
(9) Authorization of appropriations.--Out of any funds in
the Treasury not otherwise appropriated, there is authorized to
be appropriated to carry out this subsection, $3,000,000 for
each of the fiscal years 2016 through 2020.
(10) Reports.--
(A) Reports.--For each fiscal year that grants are
awarded under this subsection, the Assistant Secretary
and the National Mental Health Policy Laboratory shall
conduct a study on the results of the grants and submit
to the Congress a report on such results that includes
the following:
(i) An evaluation of the grant program
outcomes, including a summary of activities
carried out with the grant and the results
achieved through those activities.
(ii) Recommendations on how to improve
access to mental health services at grantee
locations.
(iii) An assessment of access to mental
health services under the program.
(iv) An assessment of the impact of the
demonstration project on the costs of the full
range of mental health services (including
inpatient, emergency and ambulatory care).
(v) Recommendations on congressional action
to improve the grant.
(vi) Recommendations to improve training of
primary care physicians.
(B) Report.--Not later than December 31, 2018, the
Assistant Secretary and the National Mental Health
Policy Laboratory shall submit to Congress and make
available to the public a report on the findings of the
evaluation under subparagraph (A) and also a policy
outline on how Congress can expand the grant program to
the national level.
(b) Liability Protections for Health Care Professional Volunteers
at Community Health Centers and Federally Qualified Community
Behavioral Health Clinics.--Section 224 of the Public Health Service
Act (42 U.S.C. 233) is amended by adding at the end the following:
``(q)(1) In this subsection, the term `federally qualified
community behavioral health clinic' means--
``(A) a federally qualified community behavioral health
clinic with a certification in effect under section 223 of the
Protecting Access to Medicare Act of 2014; or
``(B) a community mental health center meeting the criteria
specified in section 1913(c) of this Act.
``(2) For purposes of this section, a health care professional
volunteer at an entity described in subsection (g)(4) or a federally
qualified community behavioral health clinic shall, in providing health
care services eligible for funding under section 330 or subpart I of
part B of title XIX to an individual, be deemed to be an employee of
the Public Health Service for a calendar year that begins during a
fiscal year for which a transfer was made under paragraph (5)(C). The
preceding sentence is subject to the provisions of this subsection.
``(3) In providing a health care service to an individual, a health
care professional shall for purposes of this subsection be considered
to be a health professional volunteer at an entity described in
subsection (g)(4) or at a federally qualified community behavioral
health clinic if the following conditions are met:
``(A) The service is provided to the individual at the
facilities of an entity described in subsection (g)(4), at a
federally qualified community behavioral health clinic, or
through offsite programs or events carried out by the center.
``(B) The center or entity is sponsoring the health care
professional volunteer pursuant to paragraph (4)(B).
``(C) The health care professional does not receive any
compensation for the service from the individual or from any
third-party payer (including reimbursement under any insurance
policy or health plan, or under any Federal or State health
benefits program), except that the health care professional may
receive repayment from the entity described in subsection
(g)(4) or the center for reasonable expenses incurred by the
health care professional in the provision of the service to the
individual.
``(D) Before the service is provided, the health care
professional or the center or entity described in subsection
(g)(4) posts a clear and conspicuous notice at the site where
the service is provided of the extent to which the legal
liability of the health care professional is limited pursuant
to this subsection.
``(E) At the time the service is provided, the health care
professional is licensed or certified in accordance with
applicable law regarding the provision of the service.
``(4) Subsection (g) (other than paragraphs (3) and (5)) and
subsections (h), (i), and (l) apply to a health care professional for
purposes of this subsection to the same extent and in the same manner
as such subsections apply to an officer, governing board member,
employee, or contractor of an entity described in subsection (g)(4),
subject to paragraph (5) and subject to the following:
``(A) The first sentence of paragraph (2) applies in lieu
of the first sentence of subsection (g)(1)(A).
``(B) With respect to an entity described in subsection
(g)(4) or a federally qualified community behavioral health
clinic, a health care professional is not a health professional
volunteer at such center unless the center sponsors the health
care professional. For purposes of this subsection, the center
shall be considered to be sponsoring the health care
professional if--
``(i) with respect to the health care professional,
the center submits to the Secretary an application
meeting the requirements of subsection (g)(1)(D); and
``(ii) the Secretary, pursuant to subsection
(g)(1)(E), determines that the health care professional
is deemed to be an employee of the Public Health
Service.
``(C) In the case of a health care professional who is
determined by the Secretary pursuant to subsection (g)(1)(E) to
be a health professional volunteer at such center, this
subsection applies to the health care professional (with
respect to services described in paragraph (2)) for any cause
of action arising from an act or omission of the health care
professional occurring on or after the date on which the
Secretary makes such determination.
``(D) Subsection (g)(1)(F) applies to a health professional
volunteer for purposes of this subsection only to the extent
that, in providing health services to an individual, each of
the conditions specified in paragraph (3) is met.
``(5)(A) Amounts in the fund established under subsection (k)(2)
shall be available for transfer under subparagraph (C) for purposes of
carrying out this subsection for health professional volunteers at
entities described in subsection (g)(4).
``(B) Not later than May 1 of each fiscal year, the Attorney
General, in consultation with the Secretary, shall submit to the
Congress a report providing an estimate of the amount of claims
(together with related fees and expenses of witnesses) that, by reason
of the acts or omissions of health care professional volunteers, will
be paid pursuant to this subsection during the calendar year that
begins in the following fiscal year. Subsection (k)(1)(B) applies to
the estimate under the preceding sentence regarding health care
professional volunteers to the same extent and in the same manner as
such subsection applies to the estimate under such subsection regarding
officers, governing board members, employees, and contractors of
entities described in subsection (g)(4).
``(C) Not later than December 31 of each fiscal year, the Secretary
shall transfer from the fund under subsection (k)(2) to the appropriate
accounts in the Treasury an amount equal to the estimate made under
subparagraph (B) for the calendar year beginning in such fiscal year,
subject to the extent of amounts in the fund.
``(6)(A) This subsection takes effect on October 1, 2017, except as
provided in subparagraph (B).
``(B) Effective on the date of the enactment of this subsection--
``(i) the Secretary may issue regulations for carrying out
this subsection, and the Secretary may accept and consider
applications submitted pursuant to paragraph (4)(B); and
``(ii) reports under paragraph (5)(B) may be submitted to
the Congress.''.
(c) Minority Fellowship Program.--Title V of the Public Health
Service Act (42 U.S.C. 290aa et seq.), as amended, is further amended
by adding at the end the following:
``PART K--MINORITY FELLOWSHIP PROGRAM
``SEC. 597. FELLOWSHIPS.
``(a) In General.--The Secretary shall maintain a program, to be
known as the Minority Fellowship Program, under which the Secretary
awards fellowships, which may include stipends, for the purposes of--
``(1) increasing behavioral health practitioners' knowledge
of issues related to prevention, treatment, and recovery
support for mental and substance use disorders among racial and
ethnic minority populations;
``(2) improving the quality of mental and substance use
disorder prevention and treatment delivered to ethnic
minorities; and
``(3) increasing the number of culturally competent
behavioral health professionals who teach, administer, conduct
services research, and provide direct mental health or
substance use services to underserved minority populations.
``(b) Training Covered.--The fellowships under subsection (a) shall
be for postbaccalaureate training (including for master's and doctoral
degrees) for mental health professionals, including in the fields of
psychiatry, nursing, social work, psychology, marriage and family
therapy, and substance use and addiction counseling.
``(c) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $6,000,000 for each of fiscal
years 2016 through 2020.''.
(d) National Health Service Corps.--
(1) Definitions.--
(A) Primary health services.--Section 331(a)(3)(D)
of the Public Health Service Act (42 U.S.C. 254d(a)(3))
is amended by inserting ``(including pediatric mental
health subspecialty services)'' after ``pediatrics''.
(B) Behavioral and mental health professionals.--
Clause (i) of section 331(a)(3)(E)(i) of the Public
Health Service Act (42 U.S.C. 254d(a)(3)(E)(i)) is
amended by inserting ``(and pediatric subspecialists
thereof)'' before the period at the end.
(C) Health professional shortage area.--Section
332(a)(1) of the Public Health Service Act is amended
by inserting ``(including children and adolescents)''
after ``population group''.
(D) Medical facility.--Section 332(a)(2)(A) of the
Public Health Service Act is amended by inserting
``medical residency or fellowship training site for
training in child and adolescent psychiatry,'' before
``facility operated by a city or county health
department,''.
(2) Eligibility to participate in loan repayment program.--
Section 338A(b)(1)(B) of the Public Health Service Act (42
U.S.C. 254l-1(b)(1)(B)) is amended by inserting ``, including
any physician child and adolescent psychiatry residency or
fellowship training program'' after ``be enrolled in an
approved graduate training program in medicine, osteopathic
medicine, dentistry, behavioral and mental health, or other
health profession''.
(e) Crisis Intervention Grants for Police Officers and First
Responders.--
(1) Grants.--The Assistant Secretary may award grants to
provide specialized training to law enforcement officers,
corrections officers, paramedics, emergency medical services
workers, and other first responders (including village public
safety officers (as defined in section 247 of the Indian Arts
and Crafts Amendments Act of 2010 (42 U.S.C. 3796dd note)))--
(A) to recognize individuals who have mental
illness and how to properly intervene with individuals
with mental illness; and
(B) to establish programs that enhance the ability
of law enforcement agencies to address the mental
health, behavioral, and substance use problems of
individuals encountered in the line of duty.
(2) Funding.--Of the amounts made available to carry out
sections 501, 509, 516, and 520A of the Public Health Service
Act for a fiscal year, 5 percent of such amounts are authorized
to be used to carry out this subsection.
SEC. 208. AUTHORIZED GRANTS AND PROGRAMS.
(a) Children's Recovery From Trauma.--Section 582 of the Public
Health Service Act (42 U.S.C. 290hh-1) is amended--
(1) in subsection (a), by striking ``developing programs''
and all that follows and inserting the following: ``developing
and maintaining programs that provide for--
``(1) the continued operation of the National Child
Traumatic Stress Initiative (referred to in this section as the
`NCTSI'), which includes a coordinating center, that focuses on
the mental, behavioral, and biological aspects of psychological
trauma response; and
``(2) the development of knowledge with regard to evidence-
based (as defined in section 2 of the Helping Families in
Mental Health Crisis Act of 2015) practices for identifying and
treating mental, behavioral, and biological disorders of
children and youth resulting from witnessing or experiencing a
traumatic event.'';
(2) in subsection (b)--
(A) by striking ``subsection (a) related'' and
inserting ``subsection (a)(2) (related'';
(B) by striking ``treating disorders associated
with psychological trauma'' and inserting ``treating
mental, behavioral, and biological disorders associated
with psychological trauma)''; and
(C) by striking ``mental health agencies and
programs that have established clinical and basic
research'' and inserting ``universities, hospitals,
mental health agencies, and other programs that have
established clinical expertise and research'';
(3) by redesignating subsections (c) through (g) as
subsections (g) through (k), respectively;
(4) by inserting after subsection (b), the following:
``(c) Child Outcome Data.--The NCTSI coordinating center shall
collect, analyze, and report NCTSI-wide child treatment process and
outcome data regarding the early identification and delivery of
evidence-based (as defined in section 2 of the Helping Families in
Mental Health Crisis Act of 2015) treatment and services for children
and families served by the NCTSI grantees.
``(d) Training.--The NCTSI coordinating center shall facilitate the
coordination of training initiatives in evidence-based (as defined in
section 2 of the Helping Families in Mental Health Crisis Act of 2015)
and trauma-informed treatments, interventions, and practices offered to
NCTSI grantees, providers, and partners.
``(e) Dissemination.--The NCTSI coordinating center shall, as
appropriate, collaborate with the Secretary in the dissemination of
evidence-based and trauma-informed interventions, treatments, products,
and other resources to appropriate stakeholders.
``(f) Review.--The Secretary shall, consistent with the peer-review
process, ensure that NCTSI applications are reviewed by appropriate
experts in the field as part of a consensus review process. The
Secretary shall include review criteria related to expertise and
experience in child trauma and evidence-based (as defined in section 2
of the Helping Families in Mental Health Crisis Act of 2015)
practices.'';
(5) in subsection (g) (as so redesignated), by striking
``with respect to centers of excellence are distributed
equitably among the regions of the country'' and inserting
``are distributed equitably among the regions of the United
States'';
(6) in subsection (i) (as so redesignated), by striking
``recipient may not exceed 5 years'' and inserting ``recipient
shall not be less than 4 years, but shall not exceed 5 years'';
and
(7) in subsection (j) (as so redesignated), by striking
``$50,000,000'' and all that follows through ``2006'' and
inserting ``$45,713,000 for each of fiscal years 2014 through
2018''.
(b) Reducing the Stigma of Serious Mental Illness.--
(1) In general.--The Secretary of Education, along with the
Assistant Secretary for Mental Health and Substance Use
Disorders, shall organize a national awareness campaign
involving public health organizations, advocacy groups for
persons with serious mental illness, and social media companies
to assist secondary school students and postsecondary students
in--
(A) reducing the stigma associated with serious
mental illness;
(B) understanding how to assist an individual who
is demonstrating signs of a serious mental illness; and
(C) understanding the importance of seeking
treatment from a physician, clinical psychologist, or
licensed mental health professional when a student
believes the student may be suffering from a serious
mental illness or behavioral health disorder.
(2) Data collection.--The Secretary of Education shall--
(A) evaluate the program under subsection (a) on
public health to determine whether the program has made
an impact on public health, including mortality rates
of persons with serious mental illness, prevalence of
serious mental illness, physician and clinical
psychological visits, emergency room visits; and
(B) submit a report on the evaluation to the
National Mental Health Policy Laboratory created by
title I of this Act.
(3) Secondary school defined.--For purposes of this
section, the term ``secondary school'' has the meaning given
the term in section 9101 of the Elementary and Secondary
Education Act of 1965 (20 U.S.C. 7801).
(c) Garrett Lee Smith Reauthorization.--
(1) Suicide prevention technical assistance center.--
Section 520C of the Public Health Service Act (42 U.S.C. 290bb-
34) is amended to read as follows:
``SEC. 520C. SUICIDE PREVENTION TECHNICAL ASSISTANCE CENTER.
``(a) Program Authorized.--The Assistant Secretary for Mental
Health and Substance Use Disorders shall award a grant for the
operation and maintenance of a research, training, and technical
assistance resource center to provide appropriate information,
training, and technical assistance to States, political subdivisions of
States, federally recognized Indian tribes, tribal organizations,
institutions of higher education, public organizations, or private
nonprofit organizations concerning the prevention of suicide among all
ages, particularly among groups that are at high risk for suicide.
``(b) Responsibilities of the Center.--The center operated and
maintained under subsection (a) shall--
``(1) assist in the development or continuation of
statewide and tribal suicide early intervention and prevention
strategies for all ages, particularly among groups that are at
high risk for suicide;
``(2) ensure the surveillance of suicide early intervention
and prevention strategies for all ages, particularly among
groups that are at high risk for suicide;
``(3) study the costs and effectiveness of statewide and
tribal suicide early intervention and prevention strategies in
order to provide information concerning relevant issues of
importance to State, tribal, and national policymakers;
``(4) further identify and understand causes and associated
risk factors for suicide for all ages, particularly among
groups that are at high risk for suicide;
``(5) analyze the efficacy of new and existing suicide
early intervention and prevention techniques and technology for
all ages, particularly among groups that are at high risk for
suicide;
``(6) ensure the surveillance of suicidal behaviors and
nonfatal suicidal attempts;
``(7) study the effectiveness of State-sponsored statewide
and tribal suicide early intervention and prevention strategies
for all ages particularly among groups that are at high risk
for suicide on the overall wellness and health promotion
strategies related to suicide attempts;
``(8) promote the sharing of data regarding suicide with
Federal agencies involved with suicide early intervention and
prevention, and State-sponsored statewide and tribal suicide
early intervention and prevention strategies for the purpose of
identifying previously unknown mental health causes and
associated risk factors for suicide among all ages particularly
among groups that are at high risk for suicide;
``(9) evaluate and disseminate outcomes and best practices
of mental health and substance use disorder services at
institutions of higher education; and
``(10) conduct other activities determined appropriate by
the Secretary.
``(c) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $4,957,000
for each of the fiscal years 2016 through 2020.''.
(2) Youth suicide intervention and prevention strategies.--
Section 520E of the Public Health Service Act (42 U.S.C. 290bb-
36) is amended to read as follows:
``SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND PREVENTION
STRATEGIES.
``(a) In General.--The Secretary, acting through the Assistant
Secretary, shall award grants or cooperative agreements to eligible
entities to--
``(1) develop and implement State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies in schools, educational institutions, juvenile
justice systems, substance use disorder programs, mental health
programs, foster care systems, and other child and youth
support organizations;
``(2) support public organizations and private nonprofit
organizations actively involved in State-sponsored statewide or
tribal youth suicide early intervention and prevention
strategies and in the development and continuation of State-
sponsored statewide youth suicide early intervention and
prevention strategies;
``(3) provide grants to institutions of higher education to
coordinate the implementation of State-sponsored or tribal
youth suicide early intervention and prevention strategies;
``(4) collect and analyze data on State-sponsored statewide
or tribal youth suicide early intervention and prevention
services that can be used to monitor the effectiveness of such
services and for research, technical assistance, and policy
development; and
``(5) assist eligible entities, through State-sponsored
statewide or tribal youth suicide early intervention and
prevention strategies, in achieving targets for youth suicide
reductions under title V of the Social Security Act.
``(b) Eligible Entity.--
``(1) Definition.--In this section, the term `eligible
entity' means--
``(A) a State;
``(B) a public organization or private nonprofit
organization designated by a State to develop or direct
the State-sponsored statewide youth suicide early
intervention and prevention strategy; or
``(C) a federally recognized Indian tribe or tribal
organization (as defined in the Indian Self-
Determination and Education Assistance Act) or an urban
Indian organization (as defined in the Indian Health
Care Improvement Act) that is actively involved in the
development and continuation of a tribal youth suicide
early intervention and prevention strategy.
``(2) Limitation.--In carrying out this section, the
Secretary shall ensure that a State does not receive more than
one grant or cooperative agreement under this section at any
one time. For purposes of the preceding sentence, a State shall
be considered to have received a grant or cooperative agreement
if the eligible entity involved is the State or an entity
designated by the State under paragraph (1)(B). Nothing in this
paragraph shall be construed to apply to entities described in
paragraph (1)(C).
``(c) Preference.--In providing assistance under a grant or
cooperative agreement under this section, an eligible entity shall give
preference to public organizations, private nonprofit organizations,
political subdivisions, institutions of higher education, and tribal
organizations actively involved with the State-sponsored statewide or
tribal youth suicide early intervention and prevention strategy that--
``(1) provide early intervention and assessment services,
including screening programs, to youth who are at risk for
mental or emotional disorders that may lead to a suicide
attempt, and that are integrated with school systems,
educational institutions, juvenile justice systems, substance
use disorder programs, mental health programs, foster care
systems, and other child and youth support organizations;
``(2) demonstrate collaboration among early intervention
and prevention services or certify that entities will engage in
future collaboration;
``(3) employ or include in their applications a commitment
to evaluate youth suicide early intervention and prevention
practices and strategies adapted to the local community;
``(4) provide timely referrals for appropriate community-
based mental health care and treatment of youth who are at risk
for suicide in child-serving settings and agencies;
``(5) provide immediate support and information resources
to families of youth who are at risk for suicide;
``(6) offer access to services and care to youth with
diverse linguistic and cultural backgrounds;
``(7) offer appropriate postsuicide intervention services,
care, and information to families, friends, schools,
educational institutions, juvenile justice systems, substance
use disorder programs, mental health programs, foster care
systems, and other child and youth support organizations of
youth who recently completed suicide;
``(8) offer continuous and up-to-date information and
awareness campaigns that target parents, family members, child
care professionals, community care providers, and the general
public and highlight the risk factors associated with youth
suicide and the life-saving help and care available from early
intervention and prevention services;
``(9) ensure that information and awareness campaigns on
youth suicide risk factors, and early intervention and
prevention services, use effective communication mechanisms
that are targeted to and reach youth, families, schools,
educational institutions, and youth organizations;
``(10) provide a timely response system to ensure that
child-serving professionals and providers are properly trained
in youth suicide early intervention and prevention strategies
and that child-serving professionals and providers involved in
early intervention and prevention services are properly trained
in effectively identifying youth who are at risk for suicide;
``(11) provide continuous training activities for child
care professionals and community care providers on the latest
youth suicide early intervention and prevention services
practices and strategies;
``(12) conduct annual self-evaluations of outcomes and
activities, including consulting with interested families and
advocacy organizations;
``(13) provide services in areas or regions with rates of
youth suicide that exceed the national average as determined by
the Centers for Disease Control and Prevention; and
``(14) obtain informed written consent from a parent or
legal guardian of an at-risk child before involving the child
in a youth suicide early intervention and prevention program.
``(d) Requirement for Direct Services.--Not less than 85 percent of
grant funds received under this section shall be used to provide direct
services, of which not less than 5 percent shall be used for activities
authorized under subsection (a)(3).
``(e) Consultation and Policy Development.--
``(1) In general.--In carrying out this section, the
Secretary shall collaborate with the Secretary of Education and
relevant Federal agencies and suicide working groups
responsible for early intervention and prevention services
relating to youth suicide.
``(2) Consultation.--In carrying out this section, the
Secretary shall consult with--
``(A) State and local agencies, including agencies
responsible for early intervention and prevention
services under title XIX of the Social Security Act,
the State Children's Health Insurance Program under
title XXI of the Social Security Act, and programs
funded by grants under title V of the Social Security
Act;
``(B) local and national organizations that serve
youth at risk for suicide and their families;
``(C) relevant national medical and other health
and education specialty organizations;
``(D) youth who are at risk for suicide, who have
survived suicide attempts, or who are currently
receiving care from early intervention services;
``(E) families and friends of youth who are at risk
for suicide, who have survived suicide attempts, who
are currently receiving care from early intervention
and prevention services, or who have completed suicide;
``(F) qualified professionals who possess the
specialized knowledge, skills, experience, and relevant
attributes needed to serve youth at risk for suicide
and their families; and
``(G) third-party payers, managed care
organizations, and related commercial industries.
``(3) Policy development.--In carrying out this section,
the Secretary shall--
``(A) coordinate and collaborate on policy
development at the Federal level with the relevant
Department of Health and Human Services agencies and
suicide working groups; and
``(B) consult on policy development at the Federal
level with the private sector, including consumer,
medical, suicide prevention advocacy groups, and other
health and education professional-based organizations,
with respect to State-sponsored statewide or tribal
youth suicide early intervention and prevention
strategies.
``(f) Rule of Construction; Religious and Moral Accommodation.--
Nothing in this section shall be construed to require suicide
assessment, early intervention, or treatment services for youth whose
parents or legal guardians object based on the parents' or legal
guardians' religious beliefs or moral objections.
``(g) Evaluations and Report.--
``(1) Evaluations by eligible entities.--Not later than 18
months after receiving a grant or cooperative agreement under
this section, an eligible entity shall submit to the Secretary
the results of an evaluation to be conducted by the entity
concerning the effectiveness of the activities carried out
under the grant or agreement.
``(2) Report.--Not later than 2 years after the date of
enactment of this section, the Secretary shall submit to the
appropriate committees of Congress a report concerning the
results of--
``(A) the evaluations conducted under paragraph
(1); and
``(B) an evaluation conducted by the Secretary to
analyze the effectiveness and efficacy of the
activities conducted with grants, collaborations, and
consultations under this section.
``(h) Rule of Construction; Student Medication.--Nothing in this
section shall be construed to allow school personnel to require that a
student obtain any medication as a condition of attending school or
receiving services.
``(i) Prohibition.--Funds appropriated to carry out this section,
section 527, or section 529 shall not be used to pay for or refer for
abortion.
``(j) Parental Consent.--States and entities receiving funding
under this section shall obtain prior written, informed consent from
the child's parent or legal guardian for assessment services, school-
sponsored programs, and treatment involving medication related to youth
suicide conducted in elementary and secondary schools. The requirement
of the preceding sentence does not apply in the following cases:
``(1) In an emergency, where it is necessary to protect the
immediate health and safety of the student or other students.
``(2) Other instances, as defined by the State, where
parental consent cannot reasonably be obtained.
``(k) Relation to Education Provisions.--Nothing in this section
shall be construed to supersede section 444 of the General Education
Provisions Act, including the requirement of prior parental consent for
the disclosure of any education records. Nothing in this section shall
be construed to modify or affect parental notification requirements for
programs authorized under the Elementary and Secondary Education Act of
1965 (as amended by the No Child Left Behind Act of 2001; Public Law
107-110).
``(l) Definitions.--In this section:
``(1) Early intervention.--The term `early intervention'
means a strategy or approach that is intended to prevent an
outcome or to alter the course of an existing condition.
``(2) Educational institution; institution of higher
education; school.--The term--
``(A) `educational institution' means a school or
institution of higher education;
``(B) `institution of higher education' has the
meaning given such term in section 101 of the Higher
Education Act of 1965; and
``(C) `school' means an elementary or secondary
school (as such terms are defined in section 9101 of
the Elementary and Secondary Education Act of 1965).
``(3) Prevention.--The term `prevention' means a strategy
or approach that reduces the likelihood or risk of onset, or
delays the onset, of adverse health problems that have been
known to lead to suicide.
``(4) Youth.--The term `youth' means individuals who are
between 10 and 26 years of age.
``(m) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $29,738,000
for each of the fiscal years 2016 through 2020.''.
(3) Suicide prevention for youth.--Section 520E-1 of the
Public Health Service Act (42 U.S.C. 290bb-36a) is amended--
(A) by amending the section heading to read as
follows: ``suicide prevention for youth''; and
(B) by striking subsection (n) and inserting the
following:
``(n) Authorization of Appropriations.--For the purpose of carrying
out this section, there is authorized to be appropriated such sums as
may be necessary for each of fiscal years 2016 through 2020.''.
(4) Mental health and substance use disorders services and
outreach on campus.--Section 520E-2 of the Public Health
Service Act (42 U.S.C. 290bb-36b) is amended to read as
follows:
``SEC. 520E-2. MENTAL HEALTH AND SUBSTANCE USE DISORDERS SERVICES ON
CAMPUS.
``(a) In General.--The Secretary, acting through the Director of
the Center for Mental Health Services and in consultation with the
Secretary of Education, shall award grants on a competitive basis to
institutions of higher education to enhance services for students with
mental health or substance use disorders and to develop best practices
for the delivery of such services.
``(b) Uses of Funds.--Amounts received under a grant under this
section shall be used for 1 or more of the following activities:
``(1) The provision of mental health and substance use
disorder services to students, including prevention, promotion
of mental health, voluntary screening, early intervention,
voluntary assessment, treatment, and management of mental
health and substance use disorder issues.
``(2) The provision of outreach services to notify students
about the existence of mental health and substance use disorder
services.
``(3) Educating students, families, faculty, staff, and
communities to increase awareness of mental health and
substance use disorders.
``(4) The employment of appropriately trained staff,
including administrative staff.
``(5) The provision of training to students, faculty, and
staff to respond effectively to students with mental health and
substance use disorders.
``(6) The creation of a networking infrastructure to link
colleges and universities with providers who can treat mental
health and substance use disorders.
``(7) Developing, supporting, evaluating, and disseminating
evidence-based and emerging best practices.
``(c) Implementation of Activities Using Grant Funds.--An
institution of higher education that receives a grant under this
section may carry out activities under the grant through--
``(1) college counseling centers;
``(2) college and university psychological service centers;
``(3) mental health centers;
``(4) psychology training clinics;
``(5) institution of higher education supported, evidence-
based, mental health and substance use disorder programs; or
``(6) any other entity that provides mental health and
substance use disorder services at an institution of higher
education.
``(d) Application.--To be eligible to receive a grant under this
section, an institution of higher education shall prepare and submit to
the Secretary an application at such time and in such manner as the
Secretary may require. At a minimum, such application shall include the
following:
``(1) A description of identified mental health and
substance use disorder needs of students at the institution of
higher education.
``(2) A description of Federal, State, local, private, and
institutional resources currently available to address the
needs described in paragraph (1) at the institution of higher
education.
``(3) A description of the outreach strategies of the
institution of higher education for promoting access to
services, including a proposed plan for reaching those students
most in need of mental health services.
``(4) A plan, when applicable, to meet the specific mental
health and substance use disorder needs of veterans attending
institutions of higher education.
``(5) A plan to seek input from community mental health
providers, when available, community groups and other public
and private entities in carrying out the program under the
grant.
``(6) A plan to evaluate program outcomes, including a
description of the proposed use of funds, the program
objectives, and how the objectives will be met.
``(7) An assurance that the institution will submit a
report to the Secretary each fiscal year concerning the
activities carried out with the grant and the results achieved
through those activities.
``(e) Special Considerations.--In awarding grants under this
section, the Secretary shall give special consideration to applications
that describe programs to be carried out under the grant that--
``(1) demonstrate the greatest need for new or additional
mental and substance use disorder services, in part by
providing information on current ratios of students to mental
health and substance use disorder health professionals; and
``(2) demonstrate the greatest potential for replication.
``(f) Requirement of Matching Funds.--
``(1) In general.--The Secretary may make a grant under
this section to an institution of higher education only if the
institution agrees to make available (directly or through
donations from public or private entities) non-Federal
contributions in an amount that is not less than $1 for each $1
of Federal funds provided under the grant, toward the costs of
activities carried out with the grant (as described in
subsection (b)) and other activities by the institution to
reduce student mental health and substance use disorders.
``(2) Determination of amount contributed.--Non-Federal
contributions required under paragraph (1) may be in cash or in
kind. 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.
``(3) Waiver.--The Secretary may waive the application of
paragraph (1) with respect to an institution of higher
education if the Secretary determines that extraordinary need
at the institution justifies the waiver.
``(g) Reports.--For each fiscal year that grants are awarded under
this section, the Secretary shall conduct a study on the results of the
grants and submit to the Congress a report on such results that
includes the following:
``(1) An evaluation of the grant program outcomes,
including a summary of activities carried out with the grant
and the results achieved through those activities.
``(2) Recommendations on how to improve access to mental
health and substance use disorder services at institutions of
higher education, including efforts to reduce the incidence of
suicide and substance use disorders.
``(h) Definitions.--In this section:
``(1) The term `evidence-based' has the meaning given to
such term in section 2 of the Helping Families in Mental Health
Crisis Act of 2015.
``(2) The term `institution of higher education' has the
meaning given such term in section 101 of the Higher Education
Act of 1965.
``(i) Authorization of Appropriations.--For the purpose of carrying
out this section, there are authorized to be appropriated $4,975,000
for each of fiscal years 2016 through 2020.''.
(5) Suicide lifeline.--Subpart 3 of part B of title V of
the Public Health Service Act is amended by inserting after
section 520E-2 of such Act (42 U.S.C. 290bb-36b), as amended,
the following:
``SEC. 520E-3. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.
``(a) In General.--The Secretary shall maintain the National
Suicide Prevention Lifeline program, including by--
``(1) coordinating a network of crisis centers across the
United States for providing suicide prevention and crisis
intervention services to individuals seeking help at any time,
day or night;
``(2) maintaining a suicide prevention hotline to link
callers to local emergency, mental health, and social services
resources; and
``(3) consulting with the Secretary of Veterans Affairs to
ensure that veterans calling the suicide prevention hotline
have access to a specialized veterans' suicide prevention
hotline.
``(b) Authorization of Appropriations.--To carry out this section,
there are authorized to be appropriated $8,000,000 for each of fiscal
years 2016 through 2020.''.
TITLE III--INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE
SEC. 301. INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.
Title V of the Public Health Service Act, as amended by section
101, is further amended by inserting after section 501 of such Act the
following:
``SEC. 501A. INTERAGENCY SERIOUS MENTAL ILLNESS COORDINATING COMMITTEE.
``(a) Establishment.--The Assistant Secretary for Mental Health and
Substance Use Disorders (in this section referred to as the `Assistant
Secretary') shall establish a committee, to be known as the Interagency
Serious Mental Illness Coordinating Committee (in this section referred
to as the `Committee'), to assist the Assistant Secretary in carrying
out the Assistant Secretary's duties.
``(b) Responsibilities.--The Committee shall--
``(1) develop and annually update a summary of advances in
serious mental illness research related to causes, prevention,
treatment, early screening, diagnosis or rule out,
intervention, and access to services and supports for
individuals with serious mental illness;
``(2) monitor Federal activities with respect to serious
mental illness;
``(3) make recommendations to the Assistant Secretary
regarding any appropriate changes to such activities, including
recommendations to the Director of NIH with respect to the
strategic plan developed under paragraph (5);
``(4) make recommendations to the Assistant Secretary
regarding public participation in decisions relating to serious
mental illness;
``(5) develop and annually update a strategic plan for
advancing--
``(A) public utilization of effective mental health
services; and
``(B) compliance with treatment;
``(6) develop and annually update a strategic plan for the
conduct of, and support for, serious mental illness research,
including proposed budgetary requirements; and
``(7) submit to the Congress such strategic plan and any
updates to such plan.
``(c) Membership.--
``(1) In general.--The Committee shall be composed of--
``(A) the Assistant Secretary for Mental Health and
Substance Use Disorders (or the Assistant Secretary's
designee), who shall serve as the Chair of the
Committee;
``(B) the Director of the National Institute of
Mental Health (or the Director's designee);
``(C) the Attorney General of the United States (or
the Attorney General's designee);
``(D) the Director of the Centers for Disease
Control and Prevention (or the Director's designee);
``(E) the Director of the National Institutes of
Health (or the Director's designee);
``(F) the directors of such national research
institutes of the National Institutes of Health as the
Assistant Secretary for Mental Health and Substance Use
Disorders determines appropriate (or their designees);
``(G) a member of the United States Interagency
Council on Homelessness;
``(H) representatives, appointed by the Assistant
Secretary, of Federal agencies that are outside of the
Department of Health and Human Services and serve
individuals with serious mental illness, including
representatives of the Bureau of Indian Affairs, the
Department of Defense, the Department of Education, the
Department of Housing and Urban Development, the
Department of Labor, the Department of Veterans
Affairs, and the Social Security Administration;
``(I) 4 members, of which--
``(i) 1 shall be appointed by the Speaker
of the House of Representatives;
``(ii) 1 shall be appointed by the minority
leader of the House of Representatives;
``(iii) 1 shall be appointed by the
majority leader of the Senate; and
``(iv) 1 shall be appointed by the minority
leader of the Senate; and
``(J) the additional members appointed under
paragraph (2).
``(2) Additional members.--Not fewer than 14 members of the
Committee, or \1/3\ of the total membership of the Committee,
whichever is greater, shall be composed of non-Federal public
members to be appointed by the Assistant Secretary, of which--
``(A) at least one such member shall be an
individual in recovery from a diagnosis of serious
mental illness who has benefitted from and is receiving
medical treatment under the care of a licensed mental
health professional;
``(B) at least one such member shall be a parent or
legal guardian of an individual with a history of
serious mental illness who has either attempted suicide
or is incarcerated for violence committed while
experiencing a serious mental illness;
``(C) at least one such member shall be a
representative of a leading research, advocacy, and
service organization for individuals with serious
mental illness;
``(D) at least one such member shall be--
``(i) a licensed psychiatrist with
experience treating serious mental illness; or
``(ii) a licensed clinical psychologist
with experience treating serious mental
illness;
``(E) at least one member shall be a licensed
mental health counselor or psychotherapist;
``(F) at least one member shall be a licensed
clinical social worker;
``(G) at least one member shall be a licensed
psychiatric nurse or nurse practitioner;
``(H) at least one member shall be a mental health
professional with a significant focus in his or her
practice working with children and adolescents;
``(I) at least one member shall be a mental health
professional who spends a significant concentration of
his or her professional time or leadership practicing
community mental health;
``(J) at least one member shall be a mental health
professional with substantial experience working with
mentally ill individuals who have a history of violence
or suicide;
``(K) at least one such member shall be a State
certified mental health peer specialist;
``(L) at least one member shall be a judge with
experiences applying assisted outpatient treatment;
``(M) at least one member shall be a law
enforcement officer with extensive experience in
interfacing with psychiatric and psychological
disorders or individuals in mental health crisis; and
``(N) at least one member shall be a corrections
officer.
``(d) Reports to Congress.--Not later than 1 year after the date of
enactment of this Act, and every 2 years thereafter, the Committee
shall submit a report to the Congress--
``(1) analyzing the efficiency, effectiveness, quality,
coordination, and cost effectiveness of Federal programs and
activities relating to the prevention of, or treatment or
rehabilitation for, mental health or substance use disorders,
including an accounting of the costs of such programs and
activities, with administrative costs disaggregated from the
costs of services and care provided;
``(2) evaluating the impact on public health of projects
addressing priority mental health needs of regional and
national significance under sections 501, 509, 516, and 520A
including measurement of public health outcomes such as--
``(A) reduced rates of suicide, suicide attempts,
substance abuse, overdose, overdose deaths, emergency
hospitalizations, emergency room boarding,
incarceration, crime, arrest, victimization,
homelessness, and joblessness;
``(B) increased rates of employment and enrollment
in educational and vocational programs; and
``(C) such other criteria as may be determined by
the Assistant Secretary;
``(3) formulating recommendations for the coordination and
improvement of Federal programs and activities described in
paragraph (2);
``(4) identifying any such programs and activities that are
duplicative; and
``(5) summarizing all recommendations made, activities
carried out, and results achieved pursuant to the workforce
development strategy under section 501(b)(9) of the Public
Health Service Act, as amended by section 101.
``(e) Administrative Support; Terms of Service; Other Provisions.--
The following provisions shall apply with respect to the Committee:
``(1) The Assistant Secretary shall provide such
administrative support to the Committee as may be necessary for
the Committee to carry out its responsibilities.
``(2) Members of the Committee appointed under subsection
(c)(2) shall serve for a term of 4 years, and may be
reappointed for one or more additional 4-year terms. Any member
appointed to fill a vacancy for an unexpired term shall be
appointed for the remainder of such term. A member may serve
after the expiration of the member's term until a successor has
taken office.
``(3) The Committee shall meet at the call of the chair or
upon the request of the Assistant Secretary. The Committee
shall meet not fewer than 2 times each year.
``(4) All meetings of the Committee shall be public and
shall include appropriate time periods for questions and
presentations by the public.
``(f) Subcommittees; Establishment and Membership.--In carrying out
its functions, the Committee may establish subcommittees and convene
workshops and conferences. Such subcommittees shall be composed of
Committee members and may hold such meetings as are necessary to enable
the subcommittees to carry out their duties.''.
TITLE IV--HIPAA AND FERPA CAREGIVERS
SEC. 401. PROMOTING APPROPRIATE TREATMENT FOR MENTALLY ILL INDIVIDUALS
BY TREATING THEIR CAREGIVERS AS PERSONAL REPRESENTATIVES
FOR PURPOSES OF HIPAA PRIVACY REGULATIONS.
(a) Caregiver Access to Information.--In applying section
164.502(g) of title 45, Code of Federal Regulations, to an individual
with serious mental illness an exception for disclosure of specific
limited protected health information shall be provided if all of the
following criteria are met for the disclosure by a physician (as
defined in paragraphs (1) and (2) of section 1861(r) of the Social
Security Act (42 U.S.C. 1395x(r))) or other licensed mental health or
health care professional to an identified responsible caregiver:
(1) Such disclosure is for information limited to the
diagnoses, treatment plans, appointment scheduling,
medications, and medication-related instructions, but not
including any personal psychotherapy notes.
(2) Such disclosure is necessary to protect the health,
safety, or welfare of the individual or general public.
(3) The information to be disclosed will be beneficial to
the treatment of the individual if that individual has a co-
occurring acute or chronic medical illness.
(4) The information to be disclosed is necessary for the
continuity of treatment of the medical condition or mental
illness of the individual.
(5) The absence of such information or treatment will
contribute to a worsening prognosis or an acute medical
condition.
(6) The individual by nature of the severe mental illness
has or has had a diminished capacity to fully understand or
follow a treatment plan for their medical condition or may
become gravely disabled in absence of treatment.
(b) Training.--In applying section 164.530 of title 45, Code of
Federal Regulations, the training described in paragraph (b)(1) of such
section shall include training with respect to the disclosure of
information to a caregiver of an individual pursuant to subsection (a).
(c) Age of Majority.--In applying section 164.502(g) of title 45,
Code of Federal Regulations, notwithstanding any other provision of
law, an unemancipated minor shall be an individual under the age of 18
years.
(d) Provider Access to Information.--Health care providers may
listen to information or review medical history provided by family
members or other caregivers who may have concerns about the health and
well-being of the patient, so the health care provider can factor that
information into the patient's care.
(e) Definitions.--For purposes of this section:
(1) Covered entity.--The term ``covered entity'' has the
meaning given such term in section 106.103 of title 45, Code of
Federal Regulations.
(2) Protected health information.--The term ``protected
health information'' has the meaning given such term in section
106.103 of title 45, Code of Federal Regulations.
(3) Caregiver.--The term ``caregiver'' means, with respect
to an individual with a serious mental illness--
(A) an immediate family member of such individual;
(B) an individual who assumes primary
responsibility for providing a basic need of such
individual;
(C) a personal representative of the individual as
determined by the law of the State in which such
individual resides;
(D) can establish a longstanding involvement and is
responsible with the individual with a serious mental
illness and the health care of the individual; and
(E) excludes an individual with a documented
history of abuse.
(4) Individual with a serious mental illness.--The term
``individual with a serious mental illness'' means, with
respect to the disclosure to a caregiver of protected health
information of an individual, an individual who--
(A) is 18 years of age or older; and
(B) has, within one year before the date of the
disclosure, been evaluated, diagnosed, or treated for a
mental, behavioral, or emotional disorder that--
(i) is determined by a physician to be of
sufficient duration to meet diagnostic criteria
specified within the Diagnostic and Statistical
Manual of Mental Disorders; and
(ii) results in functional impairment of
the individual that substantially interferes
with or limits one or more major life
activities of the individual.
Such term includes an individual with autism spectrum
disorder or other developmental disability if such
individual has a co-occurring mental illness.
SEC. 402. CAREGIVERS PERMITTED ACCESS TO CERTAIN EDUCATION RECORDS
UNDER FERPA.
Section 444 of the General Education Provisions Act (20 U.S.C.
1232g) is amended by adding at the end the following new subsection:
``(k) Disclosures to Caregivers.--
``(1) In general.--With respect to a student who is 18
years of age or older, an educational agency or institution may
disclose to the caregiver of the student, without regard to
whether the student has explicitly provided consent to the
agency or institution for the disclosure of the student's
education record, the education record of such student if a
physician (as defined in paragraphs (1) and (2) of section
1861(r) of the Social Security Act), psychologist, or other
recognized mental health professional or paraprofessional
acting in his or her professional or paraprofessional capacity,
or assisting in that capacity reasonably believes such
disclosure to the caregiver is necessary to protect the health,
safety, or welfare of such student or the safety of one or more
other individuals.
``(2) Definitions.--In this subsection:
``(A) Caregiver.--The term `caregiver' means, with
respect to a student, a family member or immediate past
legal guardian who assumes a primary responsibility for
providing a basic need of such student (such as a
family member or past legal guardian of the student who
has assumed the responsibility of co-signing a loan
with the student).
``(B) Education record.--Notwithstanding subsection
(a)(4)(B), the term `education record' shall include a
record described in clause (iv) of such subsection.''.
SEC. 403. CONFIDENTIALITY OF RECORDS.
Section 543(e) of the Public Health Service Act (42 U.S.C. 290dd-
2(e)) is amended--
(1) in paragraph (1), by striking ``; or'' and inserting a
semicolon;
(2) in paragraph (2), by striking the period and inserting
``; or''; and
(3) after paragraph (2), by inserting the following:
``(3) within accountable care organizations described in
section 1899 of the Social Security Act (42 U.S.C. 1395jjj),
health information exchanges (as defined for purposes of
section 3013), health homes (as defined in section 1945(h)(3)
of such Act 42 U.S.C. 1396w-4(h)(3)), or other integrated care
arrangements (in existence before, on, or after the date of the
enactment of this paragraph) involving the interchange of
electronic health records (as defined in section 13400 of
division A of Public Law 111-5) (42 U.S.C. 17921(5)) containing
information described in subsection (a) for purposes of
attaining interoperability, improving care coordination,
reducing health care costs, and securing or providing patient
safety.''.
TITLE V--MEDICARE AND MEDICAID REFORMS
SEC. 501. ENHANCED MEDICAID COVERAGE RELATING TO CERTAIN MENTAL HEALTH
SERVICES.
(a) Medicaid Coverage of Mental Health Services and Primary Care
Services Furnished on the Same Day.--
(1) In general.--Section 1902(a) of the Social Security Act
(42 U.S.C. 1396a(a)) is amended by inserting after paragraph
(77) the following new paragraph:
``(78) not prohibit payment under the plan for a mental
health service or primary care service furnished to an
individual at a community mental health center meeting the
criteria specified in section 1913(c) of the Public Health
Service Act or a federally qualified health center (as defined
in section 1861(aa)(3)) for which payment would otherwise be
payable under the plan, with respect to such individual, if
such service were not a same-day qualifying service (as defined
in subsection (ll));''.
(2) Same-day qualifying services defined.--Section 1902 of
the Social Security Act (42 U.S.C. 1396a) is amended by adding
at the end the following new subsection:
``(ll) Same-Day Qualifying Services Defined.--For purposes of
subsection (a)(78), the term `same-day qualifying service' means--
``(1) a primary care service furnished to an individual by
a provider at a facility on the same day a mental health
service is furnished to such individual by such provider (or
another provider) at the facility; and
``(2) a mental health service furnished to an individual by
a provider at a facility on the same day a primary care service
is furnished to such individual by such provider (or another
provider) at the facility.''.
(b) State Option To Provide Medical Assistance for Certain
Inpatient Psychiatric Services to Nonelderly Adults.--Section 1905 of
the Social Security Act (42 U.S.C. 1396d) is amended--
(1) in subsection (a)--
(A) in paragraph (16)--
(i) by striking ``effective'' and inserting
``(A) effective''; and
(ii) by inserting before the semicolon at
the end the following: ``, (B) qualified
inpatient psychiatric hospital services (as
defined in subsection (h)(3)) for individuals
over 21 years of age and under 65 years of age,
and (C) psychiatric residential treatment
facility services (as defined in subsection
(h)(4)) for individuals over 21 years of age
and under 65 years of age''; and
(B) in the subdivision (B) that follows paragraph
(29), by inserting ``(other than services described in
subparagraphs (B) and (C) of paragraph (16) for
individuals described in such subparagraphs)'' after
``patient in an institution for mental diseases''; and
(2) in subsection (h), by adding at the end the following
new paragraphs:
``(3) For purposes of subsection (a)(16)(B), the term `qualified
inpatient psychiatric hospital services' means, with respect to
individuals described in such subsection, services described in
subparagraphs (A) and (B) of paragraph (1) that are furnished in an
acute care psychiatric unit in a State-operated psychiatric hospital or
a psychiatric hospital (as defined section 1861(f)) if such unit or
hospital, as applicable, has a facilitywide average (determined on an
annual basis) length of stay of less than 30 days.
``(4) For purposes of subsection (a)(16)(C), the term `psychiatric
residential treatment facility services' means, with respect to
individuals described in such subsection, services described in
subparagraphs (A) and (B) of paragraph (1) that are furnished in a
psychiatric residential treatment facility (as defined in section
484.353 of title 42, Code of Federal Regulations, as in effect on
December 9, 2013).''.
(c) Report.--
(1) In general.--The Assistant Secretary for Mental Health
and Substance Use Disorders shall report on the impact of the
amendments made by subsection (b) on the funds made available
by States for inpatient psychiatric hospital care and for
community-based mental health services. Such study shall
include an assessment of each of the following:
(A) The amount of funds expended annually by States
on short-term, acute inpatient psychiatric hospital
care.
(B) The amount of funds expended annually on short-
term, acute inpatient psychiatric hospital care through
disproportionate share hospital payments under section
1923 of the Social Security Act (42 U.S.C. 1396r-4).
(C) The reduction in the amount of funds described
in subparagraph (A) that is attributable to the
amendments made by subsection (b).
(D) The reduction in the amount of funds described
in subparagraph (B) that is attributable to the
amendment made by such subsection.
(E) The total amount of the reductions described in
subparagraphs (C) and (D).
(2) Definition of short-term, acute inpatient psychiatric
hospital care.--For purposes of paragraph (1), the term
``short-term, acute inpatient psychiatric hospital care'' means
care that is provided in either--
(A) an acute-care psychiatric unit with an average
annual length of stay of fewer than 30 days that is
operated within a psychiatric hospital operated by a
State; or
(B) a psychiatric hospital with an average annual
length of stay of fewer than 30 days.
(3) Report.--Not later than two years after the date of the
enactment of this Act, such Assistant Secretary shall submit a
report to Congress on the results of the study described in
paragraph (1), including recommendations with respect to
strategies that can be used to reinvest in community-based
mental health services funds equal to the total amount of the
reductions described in paragraph (1)(E).
(d) Effective Date.--
(1) In general.--Subject to paragraphs (2) and (3), the
amendments made by this section shall apply to items and
services furnished after the first day of the first calendar
year that begins after the date of the enactment of this
section.
(2) Certification of no increased spending.--The amendments
made by this section shall not be effective unless the Chief
Actuary of the Centers for Medicare & Medicaid Services
certifies that the inclusion of qualified inpatient psychiatric
hospital services and psychiatric residential treatment
facility services (as those terms are defined in section
1905(h) of the Social Security Act (42 U.S.C. 1396d(h)))
furnished to nonelderly adults as medical assistance under
section 1905(a) of the Social Security Act (42 U.S.C.
1396d(a)), as amended by subsection (a), would not result in
any increase in net program spending under title XIX of such
Act.
(3) Exception for state legislation.--In the case of a
State plan under title XIX of the Social Security Act, which
the Secretary of Health and Human Services determines requires
State legislation in order for the respective plan to meet any
requirement imposed by amendments made by this section, the
respective plan shall not be regarded as failing to comply with
the requirements of such title solely on the basis of its
failure to meet such an additional requirement before the first
day of the first calendar quarter beginning after the close of
the first regular session of the State legislature that begins
after the date of enactment of this section. For purposes of
the previous sentence, in the case of a State that has a 2-year
legislative session, each year of the session shall be
considered to be a separate regular session of the State
legislature.
SEC. 502. ACCESS TO MENTAL HEALTH PRESCRIPTION DRUGS UNDER MEDICARE AND
MEDICAID.
(a) Coverage of Prescription Drugs Used To Treat Mental Health
Disorders Under Medicare.--Section 1860D-4(b)(3)(G) of the Social
Security Act (42 U.S.C. 1395w-104(b)(3)(G)) is amended--
(1) in clause (i)(I), by striking ``in the categories'' and
inserting ``in the categories and classes of drugs specified in
subclauses (II) and (IV) of clause (iv) and in other
categories'';
(2) in clause (i)(II), by inserting ``, for categories and
classes of drugs other than the categories and classes of drugs
specified in subclauses (II) and (IV) of clause (iv),'' before
``exceptions'';
(3) in clause (ii)(I), by inserting at the end the
following new sentence: ``For purposes of the previous
sentence, the categories and classes of drugs specified in
subclauses (II) and (IV) of clause (iv) shall be deemed to be
of clinical concern.''; and
(4) in clause (iv), in the matter preceding subclause (I),
by inserting ``(and in the case of categories and classes of
drugs specified in subclauses (II) and (IV), before, on, and
after the Secretary establishes such criteria)'' after ``clause
(ii)(II)''.
(b) Coverage of Prescription Drugs Used To Treat Mental Health
Disorders Under Medicaid.--
(1) In general.--Section 1927(d) of the Social Security Act
(42 U.S.C. 1396r-8(d)) is amended by adding at the end the
following new paragraph:
``(8) Access to mental health drugs.--With respect to
covered outpatient drugs used for the treatment of a mental
health disorder, including major depression, bipolar (manic-
depressive) disorder, panic disorder, obsessive-compulsive
disorder, schizophrenia, and schizoaffective disorder, a State
shall not exclude from coverage or otherwise restrict access to
such drugs other than pursuant to a prior authorization program
that is consistent with paragraph (5).''.
(2) Medicaid managed care organizations.--Section 1932(b)
of the Social Security Act (42 U.S.C. 1396u-2(b)) is amended by
adding at the end the following new paragraph:
``(9) Coverage of prescription drugs used to treat mental
health disorders.--Each contract with a managed care entity
under section 1903(m) or under section 1905(t)(3) shall require
coverage of all covered outpatient drugs used for the treatment
of a mental health disorder, in accordance with section
1927(d)(8).''.
SEC. 503. ELIMINATION OF 190-DAY LIFETIME LIMIT ON COVERAGE OF
INPATIENT PSYCHIATRIC HOSPITAL SERVICES UNDER MEDICARE.
(a) In General.--Section 1812 of the Social Security Act (42 U.S.C.
1395d) is amended--
(1) in subsection (b)--
(A) in paragraph (1), by adding ``or'' at the end;
(B) in paragraph (2), by striking ``; or'' at the
end and inserting a period; and
(C) by striking paragraph (3); and
(2) in subsection (c), by striking ``or in determining the
190-day limit under subsection (b)(3)''.
(b) Effective Date; Certification of No Increased Spending.--
(1) In general.--Subject to paragraph (2), the amendments
made by subsection (a) shall apply to items and services
furnished on or after January 1, 2016.
(2) Certification of no increased spending.--The amendments
made by subsection (a) shall not be effective unless the Chief
Actuary of the Centers for Medicare & Medicaid Services
certifies that such amendments will not result in any increase
in net Federal expenditures under title XVIII of the Social
Security Act.
SEC. 504. MODIFICATIONS TO MEDICARE DISCHARGE PLANNING REQUIREMENTS.
Section 1861(ee) of the Social Security Act (42 U.S.C. 1395x(ee))
is amended--
(1) in paragraph (1), by inserting ``and, in the case of a
psychiatric hospital or a psychiatric unit (as described in the
matter following clause (v) of section 1886(d)(1)(B)), if it
also meets the guidelines and standards established by the
Secretary under paragraph (3)'' before the period at the end;
and
(2) by adding at the end the following new paragraph:
``(3) The Secretary shall develop guidelines and standards, in
addition to those developed under paragraph (2), for the discharge
planning process of a psychiatric hospital or a psychiatric unit (as
described in the matter following clause (v) of section 1886(d)(1)(B))
in order to ensure a timely and smooth transition to the most
appropriate type of and setting for posthospital or rehabilitative
care. The Secretary shall issue final regulations implementing such
guidelines and standards not later than 24 months after the date of the
enactment of this paragraph. The guidelines and standards shall include
the following:
``(A) The hospital or unit must identify the types of
services needed upon discharge for the patients being treated
by the hospital or unit.
``(B) The hospital or unit must--
``(i) identify organizations that offer community
services to the community that is served by the
hospital or unit and the types of services provided by
the organizations; and
``(ii) must make demonstrated efforts to establish
connections, relationships, and partnerships with such
organizations.
``(C) The hospital or unit must arrange (with the
participation of the patient and of any other individuals
selected by the patient for such purpose) for the development
and implementation of a discharge plan for the patient as part
of the patient's overall treatment plan from admission to
discharge. Such discharge plan shall meet the requirements
described in subparagraphs (G) and (H) of paragraph (2).
``(D) The hospital or unit shall coordinate with the
patient (or assist the patient with) the referral for
posthospital or rehabilitative care and as part of that
referral the hospital or unit shall include transmitting to the
receiving organization, in a timely manner, appropriate
information about the care furnished to the patient by the
hospital or unit and recommendations for posthospital or
rehabilitative care to be furnished to the patient by the
organization.''.
SEC. 505. DEMONSTRATION PROGRAMS TO IMPROVE COMMUNITY MENTAL HEALTH
SERVICES.
Section 223 of the Protecting Access to Medicare Act of 2014
(Public Law 113-93; 128 Stat. 1077) is amended to read as follows:
``SEC. 223. DEMONSTRATION PROGRAMS TO IMPROVE COMMUNITY MENTAL HEALTH
SERVICES.
``(a) Criteria for Certified Community Behavioral Health Clinics To
Participate in Demonstration Programs.--
``(1) Publication.--Not later than September 1, 2015, the
Secretary shall publish criteria for a clinic to be certified
by a State as a certified community behavioral health clinic
for purposes of participating in a demonstration program
conducted under subsection (d).
``(2) Requirements.--The criteria published under this
subsection shall include criteria with respect to the
following:
``(A) Staffing.--Staffing requirements, including
criteria that staff have diverse disciplinary
backgrounds, have necessary State-required license and
accreditation, and are culturally and linguistically
trained to serve the needs of the clinic's patient
population.
``(B) Availability and accessibility of services.--
Availability and accessibility of services, including
crisis management services that are available and
accessible 24 hours a day, the use of a sliding scale
for payment, and no rejection for services or limiting
of services on the basis of a patient's ability to pay
or a place of residence.
``(C) Care coordination.--Care coordination,
including requirements to coordinate care across
settings and providers to ensure seamless transitions
for patients across the full spectrum of health
services including acute, chronic, and behavioral
health needs. Care coordination requirements shall
include partnerships or formal contracts with the
following:
``(i) Federally-qualified health centers
(and as applicable, rural health clinics) to
provide Federally-qualified health center
services (and as applicable, rural health
clinic services) to the extent such services
are not provided directly through the certified
community behavioral health clinic.
``(ii) Inpatient psychiatric facilities and
substance use detoxification, post-
detoxification step-down services, and
residential programs.
``(iii) Other community or regional
services, supports, and providers, including
schools, child welfare agencies, juvenile and
criminal justice agencies and facilities,
Indian Health Service youth regional treatment
centers, State-licensed and nationally
accredited child placing agencies for
therapeutic foster care service, and other
social and human services.
``(iv) Department of Veterans Affairs
medical centers, independent outpatient
clinics, drop-in centers, and other facilities
of the Department as defined in section 1801 of
title 38, United States Code.
``(v) Inpatient acute care hospitals and
hospital outpatient clinics.
``(D) Scope of services.--Provision (in a manner
reflecting person-centered care) of the following
services which, if not available directly through the
certified community behavioral health clinic, are
provided or referred through formal relationships with
other providers:
``(i) Crisis mental health services,
including 24-hour mobile crisis teams,
emergency crisis intervention services, and
crisis stabilization.
``(ii) Screening, assessment, and
diagnosis, including risk assessment.
``(iii) Patient-centered treatment planning
or similar processes, including risk assessment
and crisis planning.
``(iv) Outpatient mental health and
substance use services.
``(v) Outpatient clinic primary care
screening and monitoring of key health
indicators and health risk.
``(vi) Targeted case management.
``(vii) Psychiatric rehabilitation
services.
``(viii) Peer support and counselor
services and family supports.
``(ix) Intensive, community-based mental
health care for members of the Armed Forces and
veterans, particularly those members and
veterans located in rural areas, provided the
care is consistent with minimum clinical mental
health guidelines promulgated by the Veterans
Health Administration including clinical
guidelines contained in the Uniform Mental
Health Services Handbook of such
Administration.
``(E) Quality and other reporting.--Reporting of
encounter data, clinical outcomes data, quality data,
and such other data as the Secretary requires.
``(F) Organizational authority.--Criteria that a
clinic be a non-profit or part of a local government
behavioral health authority or operated under the
authority of the Indian Health Service, an Indian tribe
or tribal organization pursuant to a contract, grant,
cooperative agreement, or compact with the Indian
Health Service pursuant to the Indian Self-
Determination Act (25 U.S.C. 450 et seq.), or an urban
Indian organization pursuant to a grant or contract
with the Indian Health Service under title V of the
Indian Health Care Improvement Act (25 U.S.C. 1601 et
seq.).
``(b) Guidance on Development of Prospective Payment System for
Testing Under Demonstration Programs.--
``(1) In general.--Not later than September 1, 2015, the
Secretary, through the Administrator of the Centers for
Medicare & Medicaid Services, shall issue guidance for the
establishment of a prospective payment system that shall only
apply to medical assistance for mental health services
furnished by a certified community behavioral health clinic
participating in a demonstration program under subsection (d).
``(2) Requirements.--The guidance issued by the Secretary
under paragraph (1) shall provide that--
``(A) no payment shall be made for inpatient care,
residential treatment, room and board expenses, or any
other nonambulatory services, as determined by the
Secretary; and
``(B) no payment shall be made to satellite
facilities of certified community behavioral health
clinics if such facilities are established after the
date of enactment of this Act.
``(c) Planning Grants.--
``(1) In general.--Not later than January 1, 2016, the
Secretary shall award planning grants to States for the purpose
of developing proposals to participate in time-limited
demonstration programs described in subsection (d).
``(2) Use of funds.--A State awarded a planning grant under
this subsection shall--
``(A) solicit input with respect to the development
of such a demonstration program from patients,
providers, and other stakeholders;
``(B) certify clinics as certified community
behavioral health clinics for purposes of participating
in a demonstration program conducted under subsection
(d); and
``(C) establish a prospective payment system for
mental health services furnished by a certified
community behavioral health clinic participating in a
demonstration program under subsection (d) in
accordance with the guidance issued under subsection
(b).
``(d) Demonstration Programs.--
``(1) In general.--Not later than September 1, 2017, the
Secretary shall select States to participate in demonstration
programs that are developed through planning grants awarded
under subsection (c), meet the requirements of this subsection,
and represent a diverse selection of geographic areas,
including rural and underserved areas.
``(2) Application requirements.--
``(A) In general.--The Secretary shall solicit
applications to participate in demonstration programs
under this subsection solely from States awarded
planning grants under subsection (c).
``(B) Required information.--An application for a
demonstration program under this subsection shall
include the following:
``(i) The target Medicaid population to be
served under the demonstration program.
``(ii) A list of participating certified
community behavioral health clinics.
``(iii) Verification that the State has
certified a participating clinic as a certified
community behavioral health clinic in
accordance with the requirements of subsection
(b).
``(iv) A description of the scope of the
mental health services available under the
State Medicaid program that will be paid for
under the prospective payment system tested in
the demonstration program.
``(v) Verification that the State has
agreed to pay for such services at the rate
established under the prospective payment
system.
``(vi) Such other information as the
Secretary may require relating to the
demonstration program including with respect to
determining the soundness of the proposed
prospective payment system.
``(3) Number and length of demonstration programs.--Not
more than 10 States shall be selected for 4-year demonstration
programs under this subsection.
``(4) Requirements for selecting demonstration programs.--
``(A) In general.--The Secretary shall give
preference to selecting demonstration programs where
participating certified community behavioral health
clinics--
``(i) provide the most complete scope of
services described in subsection (a)(2)(D) to
individuals eligible for medical assistance
under the State Medicaid program;
``(ii) will improve availability of, access
to, and participation in, services described in
subsection (a)(2)(D) to individuals eligible
for medical assistance under the State Medicaid
program;
``(iii) will improve availability of,
access to, and participation in assisted
outpatient mental health treatment in the
State; or
``(iv) demonstrate the potential to expand
available mental health services in a
demonstration area and increase the quality of
such services without increasing net Federal
spending.
``(5) Payment for medical assistance for mental health
services provided by certified community behavioral health
clinics.--
``(A) In general.--The Secretary shall pay a State
participating in a demonstration program under this
subsection the Federal matching percentage specified in
subparagraph (B) for amounts expended by the State to
provide medical assistance for mental health services
described in the demonstration program application in
accordance with paragraph (2)(B)(iv) that are provided
by certified community behavioral health clinics to
individuals who are enrolled in the State Medicaid
program. Payments to States made under this paragraph
shall be considered to have been under, and are subject
to the requirements of, section 1903 of the Social
Security Act (42 U.S.C. 1396b).
``(B) Federal matching percentage.--The Federal
matching percentage specified in this subparagraph is
with respect to medical assistance described in
subparagraph (A) that is furnished--
``(i) to a newly eligible individual
described in paragraph (2) of section 1905(y)
of the Social Security Act (42 U.S.C.
1396d(y)), the matching rate applicable under
paragraph (1) of that section; and
``(ii) to an individual who is not a newly
eligible individual (as so described) but who
is eligible for medical assistance under the
State Medicaid program, the enhanced FMAP
applicable to the State.
``(C) Limitations.--
``(i) In general.--Payments shall be made
under this paragraph to a State only for mental
health services--
``(I) that are described in the
demonstration program application in
accordance with paragraph (2)(B)(iv);
``(II) for which payment is
available under the State Medicaid
program; and
``(III) that are provided to an
individual who is eligible for medical
assistance under the State Medicaid
program.
``(ii) Prohibited payments.--No payment
shall be made under this paragraph--
``(I) for inpatient care,
residential treatment, room and board
expenses, or any other nonambulatory
services, as determined by the
Secretary; or
``(II) with respect to payments
made to satellite facilities of
certified community behavioral health
clinics if such facilities are
established after the date of enactment
of this Act.
``(6) Waiver of statewideness requirement.--The Secretary
shall waive section 1902(a)(1) of the Social Security Act (42
U.S.C. 1396a(a)(1)) (relating to statewideness) as may be
necessary to conduct demonstration programs in accordance with
the requirements of this subsection.
``(7) Annual reports.--
``(A) In general.--Not later than 1 year after the
date on which the first State is selected for a
demonstration program under this subsection, and
annually thereafter, the Secretary shall submit to
Congress an annual report on the use of funds provided
under all demonstration programs conducted under this
subsection. Each such report shall include--
``(i) an assessment of access to community-
based mental health services under the Medicaid
program in the area or areas of a State
targeted by a demonstration program compared to
other areas of the State;
``(ii) an assessment of the quality and
scope of services provided by certified
community behavioral health clinics compared to
community-based mental health services provided
in States not participating in a demonstration
program under this subsection and in areas of a
demonstration State that are not participating
in the demonstration program; and
``(iii) an assessment of the impact of the
demonstration programs on the Federal and State
costs of a full range of mental health services
(including inpatient, emergency and ambulatory
services).
``(B) Recommendations.--Not later than December 31,
2021, the Secretary shall submit to Congress
recommendations concerning whether the demonstration
programs under this section should be continued,
expanded, modified, or terminated.
``(e) Definitions.--In this section:
``(1) Federally-qualified health center services;
federally-qualified health center; rural health clinic
services; rural health clinic.--The terms `Federally-qualified
health center services', `Federally-qualified health center',
`rural health clinic services', and `rural health clinic' have
the meanings given those terms in section 1905(l) of the Social
Security Act (42 U.S.C. 1396d(l)).
``(2) Enhanced fmap.--The term `enhanced FMAP' has the
meaning given that term in section 2105(b) of the Social
Security Act (42 U.S.C. 1397dd(b)) but without regard to the
second and third sentences of that section.
``(3) Secretary.--The term `Secretary' means the Secretary
of Health and Human Services.
``(4) State.--The term `State' has the meaning given such
term for purposes of title XIX of the Social Security Act (42
U.S.C. 1396 et seq.).
``(f) Funding.--
``(1) In general.--Out of any funds in the Treasury not
otherwise appropriated, there is appropriated to the
Secretary--
``(A) for purposes of carrying out subsections (a),
(b), and (d)(7), $2,000,000 for fiscal year 2014; and
``(B) for purposes of awarding planning grants
under subsection (c), $25,000,000 for fiscal year 2016.
``(2) Availability.--Funds appropriated under paragraph (1)
shall remain available until expended.''.
TITLE VI--RESEARCH BY NATIONAL INSTITUTE OF MENTAL HEALTH
SEC. 601. INCREASE IN FUNDING FOR CERTAIN RESEARCH.
Section 402A(a) of the Public Health Service Act (42 U.S.C.
282a(a)) is amended by adding at the end the following:
``(3) Funding for the brain initiative at the national
institute of mental health.--
``(A) Funding.--In addition to amounts made
available pursuant to paragraphs (1) and (2), there are
authorized to be appropriated to the National Institute
of Mental Health for the purpose described in
subparagraph (B)(ii) $40,000,000 for each of fiscal
years 2016 through 2020.
``(B) Purposes.--Amounts appropriated pursuant to
subparagraph (A) shall be used exclusively for the
purpose of conducting or supporting--
``(i) research on the determinants of self-
and other directed-violence in mental illness,
including studies directed at reducing the risk
of self harm, suicide, and interpersonal
violence; or
``(ii) brain research through the Brain
Research through Advancing Innovative
Neurotechnologies Initiative.''.
TITLE VII--BEHAVIORAL HEALTH INFORMATION TECHNOLOGY
SEC. 701. EXTENSION OF HEALTH INFORMATION TECHNOLOGY ASSISTANCE FOR
BEHAVIORAL AND MENTAL HEALTH AND SUBSTANCE ABUSE.
Section 3000(3) of the Public Health Service Act (42 U.S.C.
300jj(3)) is amended by inserting before ``and any other category'' the
following: ``behavioral and mental health professionals (as defined in
section 331(a)(3)(E)(i)), a substance abuse professional, a psychiatric
hospital (as defined in section 1861(f) of the Social Security Act), a
community mental health center meeting the criteria specified in
section 1913(c), a residential or outpatient mental health or substance
use treatment facility,''.
SEC. 702. EXTENSION OF ELIGIBILITY FOR MEDICARE AND MEDICAID HEALTH
INFORMATION TECHNOLOGY IMPLEMENTATION ASSISTANCE.
(a) Payment Incentives for Eligible Professionals Under Medicare.--
Section 1848 of the Social Security Act (42 U.S.C. 1395w-4) is
amended--
(1) in subsection (a)(7)--
(A) in subparagraph (E), by adding at the end the
following new clause:
``(iv) Additional eligible professional.--
The term `additional eligible professional'
means a clinical psychologist providing
qualified psychologist services (as defined in
section 1861(ii)).''; and
(B) by adding at the end the following new
subparagraph:
``(F) Application to additional eligible
professionals.--The Secretary shall apply the
provisions of this paragraph with respect to an
additional eligible professional in the same manner as
such provisions apply to an eligible professional,
except in applying subparagraph (A)--
``(i) in clause (i), the reference to 2015
shall be deemed a reference to 2020;
``(ii) in clause (ii), the references to
2015, 2016, and 2017 shall be deemed references
to 2020, 2021, and 2022, respectively; and
``(iii) in clause (iii), the reference to
2018 shall be deemed a reference to 2023.'';
and
(2) in subsection (o)--
(A) in paragraph (5), by adding at the end the
following new subparagraph:
``(D) Additional eligible professional.--The term
`additional eligible professional' means a clinical
psychologist providing qualified psychologist services
(as defined in section 1861(ii)).''; and
(B) by adding at the end the following new
paragraph:
``(6) Application to additional eligible professionals.--
The Secretary shall apply the provisions of this subsection
with respect to an additional eligible professional in the same
manner as such provisions apply to an eligible professional,
except in applying--
``(A) paragraph (1)(A)(ii), the reference to 2016
shall be deemed a reference to 2021;
``(B) paragraph (1)(B)(ii), the references to 2011
and 2012 shall be deemed references to 2016 and 2017,
respectively;
``(C) paragraph (1)(B)(iii), the references to 2013
shall be deemed references to 2018;
``(D) paragraph (1)(B)(v), the references to 2014
shall be deemed references to 2019; and
``(E) paragraph (1)(E), the reference to 2011 shall
be deemed a reference to 2016.''.
(b) Eligible Hospitals.--Section 1886 of the Social Security Act
(42 U.S.C. 1395ww) is amended--
(1) in subsection (b)(3)(B)(ix), by adding at the end the
following new subclause:
``(V) The Secretary shall apply the
provisions of this subsection with
respect to an additional eligible
hospital (as defined in subsection
(n)(6)(C)) in the same manner as such
provisions apply to an eligible
hospital, except in applying--
``(aa) subclause (I), the
references to 2015, 2016, and
2017 shall be deemed references
to 2020, 2021, and 2022,
respectively; and
``(bb) subclause (III), the
reference to 2015 shall be
deemed a reference to 2020.'';
and
(2) in subsection (n)--
(A) in paragraph (6), by adding at the end the
following new subparagraph:
``(C) Additional eligible hospital.--The term
`additional eligible hospital' means an inpatient
hospital that is a psychiatric hospital (as defined in
section 1861(f)).''; and
(B) by adding at the end the following new
paragraph:
``(7) Application to additional eligible hospitals.--The
Secretary shall apply the provisions of this subsection with
respect to an additional eligible hospital in the same manner
as such provisions apply to an eligible hospital, except in
applying--
``(A) paragraph (2)(E)(ii), the references to 2013
and 2015 shall be deemed references to 2018 and 2020,
respectively; and
``(B) paragraph (2)(G)(i), the reference to 2011
shall be deemed a reference to 2016.''.
(c) Medicaid Providers.--Section 1903(t) of the Social Security Act
(42 U.S.C. 1396b(t)) is amended--
(1) in paragraph (2)(B)--
(A) in clause (i), by striking ``, or'' at the end
and inserting a semicolon;
(B) in clause (ii), by striking the period at the
end and inserting a semicolon; and
(C) by inserting after clause (ii) the following
new clauses:
``(iii) a public hospital that is principally a
psychiatric hospital (as defined in section 1861(f));
``(iv) a private hospital that is principally a
psychiatric hospital (as defined in section 1861(f))
and that has at least 10 percent of its patient volume
(as estimated in accordance with a methodology
established by the Secretary) attributable to
individuals receiving medical assistance under this
title;
``(v) a community mental health center meeting the
criteria specified in section 1913(c) of the Public
Health Service Act; or
``(vi) a residential or outpatient mental health or
substance use treatment facility that--
``(I) is accredited by the Joint Commission
on Accreditation of Healthcare Organizations,
the Commission on Accreditation of
Rehabilitation Facilities, the Council on
Accreditation, or any other national
accrediting agency recognized by the Secretary;
and
``(II) has at least 10 percent of its
patient volume (as estimated in accordance with
a methodology established by the Secretary)
attributable to individuals receiving medical
assistance under this title.''; and
(2) in paragraph (3)(B)--
(A) in clause (iv), by striking ``; and'' at the
end and inserting a semicolon;
(B) in clause (v), by striking the period at the
end and inserting ``; and''; and
(C) by adding at the end the following new clause:
``(vi) clinical psychologist providing qualified
psychologist services (as defined in section 1861(ii)),
if such clinical psychologist is practicing in an
outpatient clinic that--
``(I) is led by a clinical psychologist;
and
``(II) is not otherwise receiving payment
under paragraph (1) as a Medicaid provider
described in paragraph (2)(B).''.
(d) Medicare Advantage Organizations.--Section 1853 of the Social
Security Act (42 U.S.C. 1395w-23) is amended--
(1) in subsection (l)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
professionals (as described in paragraph (9))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
professionals'' before ``under such sections'';
(B) in paragraph (3)(B)--
(i) in clause (i) in the matter preceding
subclause (I), by inserting ``or an additional
eligible professional described in paragraph
(9)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible professional
described in paragraph (9)'' after
``paragraph (2)''; and
(II) in subclause (I), by inserting
``or an additional eligible
professional, respectively,'' after
``eligible professional'';
(C) in paragraph (3)(C), by inserting ``and
additional eligible professionals'' after ``all
eligible professionals'';
(D) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible professionals of the organization are
meaningful EHR users with respect to an applicable
year, the Secretary shall apply the payment adjustment
under this paragraph based on the proportion of all
such additional eligible professionals of the
organization that are not meaningful EHR users for such
year.'';
(E) in paragraph (6)(A), by inserting ``and, as
applicable, each additional eligible professional
described in paragraph (9)'' after ``paragraph (2)'';
(F) in paragraph (6)(B), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (9)'' after ``subsection (m)(1)'';
(G) in paragraph (7)(A), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(H) in paragraph (7)(B), by inserting ``and, as
applicable, additional eligible professionals'' after
``eligible professionals'';
(I) in paragraph (8)(B), by inserting ``and
additional eligible professionals described in
paragraph (9)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(9) Additional eligible professional described.--With
respect to a qualifying MA organization, an additional eligible
professional described in this paragraph is an additional
eligible professional (as defined for purposes of section
1848(o)) who--
``(A)(i) is employed by the organization; or
``(ii)(I) is employed by, or is a partner of, an
entity that through contract with the organization
furnishes at least 80 percent of the entity's Medicare
patient care services to enrollees of such
organization; and
``(II) furnishes at least 80 percent of the
professional services of the additional eligible
professional covered under this title to enrollees of
the organization; and
``(B) furnishes, on average, at least 20 hours per
week of patient care services.''; and
(2) in subsection (m)--
(A) in paragraph (1)--
(i) by inserting ``or additional eligible
hospitals (as described in paragraph (7))''
after ``paragraph (2)''; and
(ii) by inserting ``and additional eligible
hospitals'' before ``under such sections'';
(B) in paragraph (3)(A)(i), by inserting ``or
additional eligible hospital'' after ``eligible
hospital'';
(C) in paragraph (3)(A)(ii), by inserting ``or an
additional eligible hospital'' after ``eligible
hospital'' in each place it occurs;
(D) in paragraph (3)(B)--
(i) in clause (i), by inserting ``or an
additional eligible hospital described in
paragraph (7)'' after ``paragraph (2)''; and
(ii) in clause (ii)--
(I) in the matter preceding
subclause (I), by inserting ``or an
additional eligible hospital described
in paragraph (7)'' after ``paragraph
(2)''; and
(II) in subclause (I), by inserting
``or an additional eligible hospital,
respectively,'' after ``eligible
hospital'';
(E) in paragraph (4)(A), by inserting ``or one or
more additional eligible hospitals (as defined in
section 1886(n)), as appropriate,'' after ``section
1886(n)(6)(A))'';
(F) in paragraph (4)(D), by adding at the end the
following new sentence: ``In the case that a qualifying
MA organization attests that not all additional
eligible hospitals of the organization are meaningful
EHR users with respect to an applicable period, the
Secretary shall apply the payment adjustment under this
paragraph based on the methodology specified by the
Secretary, taking into account the proportion of such
additional eligible hospitals, or discharges from such
hospitals, that are not meaningful EHR users for such
period.'';
(G) in paragraph (5)(A), by inserting ``and, as
applicable, each additional eligible hospital described
in paragraph (7)'' after ``paragraph (2)'';
(H) in paragraph (5)(B), by inserting ``and
additional eligible hospitals, as applicable,'' after
``eligible hospitals'';
(I) in paragraph (6)(B), by inserting ``and
additional eligible hospitals described in paragraph
(7)'' after ``paragraph (2)''; and
(J) by adding at the end the following new
paragraph:
``(7) Additional eligible hospital described.--With respect
to a qualifying MA organization, an additional eligible
hospital described in this paragraph is an additional eligible
hospital (as defined in section 1886(n)(6)(C)) that is under
common corporate governance with such organization and serves
individuals enrolled under an MA plan offered by such
organization.''.
TITLE VIII--SAMHSA REAUTHORIZATION AND REFORMS
Subtitle A--Organization and General Authorities
SEC. 801. IN GENERAL.
Section 501 of the Public Health Service Act (42 U.S.C. 290aa) is
amended--
(1) in subsection (h), by inserting at the end the
following: ``For any such peer-review group reviewing a
proposal or grant related to mental illness, no fewer than half
of the members of the group shall have a medical degree, or a
corresponding doctoral degree in psychology and clinical
experience.''; and
(2) in subsection (l)--
(A) in paragraph (2), by striking ``and'' at the
end;
(B) in paragraph (3), by striking the period at the
end and inserting ``; and''; and
(C) by adding at the end the following:
``(4) At least 60 days before awarding a grant, cooperative
agreement, or contract, the Assistant Secretary shall give
written notice of the award to the Committee on Energy and
Commerce of the House of Representatives and the Committee on
Health, Education, Labor, and Pensions of the Senate.''.
SEC. 802. ADVISORY COUNCILS.
Paragraph (3) of section 502(b) of the Public Health Service Act
(42 U.S.C. 290aa-1(b)) is amended by adding at the end the following:
``(C) No fewer than half of the members of an
advisory council shall be mental health care providers
with--
``(i) experience in mental health research
or treatment; and
``(ii) expertise in the fields on which
they are advising.
``(D) None of the appointed members may have at any
point been a recipient of any grant, or participated in
any program, about which the members are to advise.
``(E) None of the appointed members may be related
to anyone who has been a recipient of any grant, or
participated in any program, about which the members
are to advise.
``(F) None of the appointed members may have a
financial interest in any grant or program with respect
to which they advise, or receive funding separately
through the Office of Assistant Secretary.
``(G) Each advisory committee must include at least
one member of the National Institute of Mental Health
and one member from any Federal agency that has a
program serving a similar population.''.
SEC. 803. PEER REVIEW.
Section 504 of the Public Health Service Act (42 U.S.C. 290aa-3) is
amended--
(1) by adding at the end of subsection (b) the following:
``At least half of the members of any peer-review group
established under subsection (a) shall have a degree in
medicine, or a corresponding doctoral degree in psychology, or
be a licensed mental health professional. Before awarding a
grant, cooperative agreement, or contract, the Secretary shall
provide a list of the members of the peer-review group
responsible for reviewing the award to the Committee on Energy
and Commerce of the House of Representatives and the Committee
on Health, Education, Labor, and Pensions of the Senate.''; and
(2) by adding at the end the following:
``(e) Scientific Controls and Standards.--Peer review under this
section shall ensure that any research concerning an intervention is
based on scientific controls and standards indicating whether the
intervention reduces symptoms, improves medical or behavioral outcomes,
and improves social functioning.''.
Subtitle B--Protection and Advocacy for Individuals With Mental Illness
SEC. 811. PROHIBITION AGAINST LOBBYING BY SYSTEMS ACCEPTING FEDERAL
FUNDS TO PROTECT AND ADVOCATE THE RIGHTS OF INDIVIDUALS
WITH MENTAL ILLNESS.
Section 105(a) of the Protection and Advocacy for Individuals with
Mental Illness Act (42 U.S.C. 10805(a)) is amended--
(1) in paragraph (9), by striking ``and'' at the end;
(2) in paragraph (10), by striking the period at the end
and inserting a semicolon; and
(3) by adding at the end the following:
``(11) agree to refrain, during any period for which
funding is provided to the system under this part, from--
``(A) lobbying or retaining a lobbyist for the
purpose of influencing a Federal, State, or local
governmental entity or officer; and
``(B) counseling an individual with a serious
mental illness who lacks insight into their condition
on refusing medical treatment or acting against the
wishes of such individual's caregiver;''.
SEC. 812. ENSURING THAT CAREGIVERS OF INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS HAVE ACCESS TO THE PROTECTED HEALTH INFORMATION
OF SUCH INDIVIDUALS.
Section 105(a) of the Protection and Advocacy for Individuals with
Mental Illness Act (42 U.S.C. 10805(a)), as amended by section 811, is
further amended by adding at the end the following:
``(12) ensure that caregivers (as defined in section 201 of
the Helping Families in Mental Health Crisis Act of 2015) of
individuals with serious mental illness (as defined in such
section 201) have access to the protected health information of
such individuals consistent with such section 201;''.
SEC. 813. PROTECTION AND ADVOCACY ACTIVITIES TO FOCUS EXCLUSIVELY ON
SAFEGUARDING RIGHTS TO BE FREE FROM ABUSE AND NEGLECT.
(a) Purposes.--Section 101(b) of the Protection and Advocacy for
Individuals with Mental Illness Act (42 U.S.C. 10801(b)) is amended--
(1) in paragraph (1), by inserting ``to be free from abuse
and neglect'' before ``are protected''; and
(2) in paragraph (2)(A), by inserting ``to be free from
abuse and neglect'' before ``through activities to ensure''.
(b) Allotments.--Section 103(2)(A) of the Protection and Advocacy
for Individuals with Mental Illness Act (42 U.S.C. 10803(2)(A)) is
amended by inserting ``to be free from abuse and neglect'' before the
semicolon.
(c) Use of Allotments.--Section 104(a)(1) of the Protection and
Advocacy for Individuals with Mental Illness Act (42 U.S.C.
10804(a)(1)) is amended--
(1) in subparagraph (A), by striking ``and'' at the end;
(2) in subparagraph (B), by striking the semicolon at the
end and inserting ``to be free from abuse and neglect; and'';
and
(3) by adding at the end the following:
``(C) the protection and advocacy activities of
such an agency or organization shall be exclusively
focused on safeguarding the rights of individuals with
mental illness to be free from abuse and neglect.''.
(d) System Requirements.--Section 105 of the Protection and
Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10805), as
amended by sections 811 and 812, is further amended--
(1) in subsection (a)--
(A) in the matter before paragraph (1), by
inserting ``to be free from abuse and neglect'' before
``shall'';
(B) in paragraph (6)(A), by inserting ``to be free
from abuse and neglect'' before the semicolon; and
(C) by adding at the end the following:
``(13) be exclusively focused on safeguarding the rights of
individuals with mental illness to be free from abuse and
neglect; and''; and
(2) in subsection (c)(1)(A), by inserting ``to be free from
abuse and neglect'' before ``shall have a governing
authority''.
(e) Applications.--Section 111(a) of the Protection and Advocacy
for Individuals with Mental Illness Act (42 U.S.C. 10821(a)) is
amended--
(1) in paragraph (1), by inserting ``to be free from abuse
and neglect'' before the semicolon;
(2) in paragraph (3), by striking ``and'' at the end;
(3) by redesignating paragraph (4) as paragraph (5); and
(4) by inserting after paragraph (3) the following:
``(4) assurances that such system, and any State agency or
nonprofit organization with which such system may enter into a
contract under section 10804(a), will be exclusively focused on
safeguarding the rights of individuals with mental illness to
be free from abuse and neglect; and''.
(f) Reports by Secretary.--Section 114(a) of the Protection and
Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10824(a))
is amended--
(1) in paragraph (1) in the matter before subparagraph (A),
by inserting ``to be free from abuse and neglect'' before
``supported with payments'';
(2) in paragraph (2)(A), by inserting ``to be free from
abuse and neglect'' before ``supported with payments''; and
(3) in paragraph (4), by inserting ``to be free from abuse
and neglect'' before ``and a description''.
SEC. 814. REPORTING.
(a) Public Availability of Reports.--Section 105(a)(7) of the
Protection and Advocacy for Individuals with Mental Illness Act (42
U.S.C. 10805(a)(7)) is amended by striking ``is located a report'' and
inserting ``is located, and make publicly available, a report''.
(b) Detailed Accounting.--Section 114(a) of the Protection and
Advocacy for Individuals with Mental Illness Act (42 U.S.C. 10824(a)),
as amended, is further amended--
(1) in paragraph (3), by striking ``and'' at the end;
(2) in paragraph (4), by striking the period at the end and
inserting ``; and''; and
(3) by adding at the end the following:
``(5) a detailed accounting, for each system funded under
this title, of how funds are spent, disaggregated according to
whether the funds were received from the Federal Government,
the State government, a local government, or a private
entity.''.
SEC. 815. GRIEVANCE PROCEDURE.
Section 105 of the Protection and Advocacy for Individuals with
Mental Illness Act (42 U.S.C. 10805), as amended, is further amended by
adding at the end the following:
``(d) Grievance Procedure.--The Assistant Secretary shall establish
an independent grievance procedure for the types of claims to be
adjudicated, at the request of persons described in subsection (a)(9),
through a system's grievance procedure established under such
subsection.''.
SEC. 816. EVIDENCE-BASED TREATMENT FOR INDIVIDUALS WITH SERIOUS MENTAL
ILLNESS.
Section 105(a) of the Protection and Advocacy for Individuals with
Mental Illness Act (42 U.S.C. 10805(a)), as amended by sections 811,
812, and 813, is further amended by adding at the end the following:
``(14) ensure that individuals with serious mental illness
have access to and can obtain evidence-based treatment for
their serious mental illness.''.
TITLE IX--REPORTING
SEC. 901. GAO STUDY ON PREVENTING DISCRIMINATORY COVERAGE LIMITATIONS
FOR INDIVIDUALS WITH SERIOUS MENTAL ILLNESS AND SUBSTANCE
USE DISORDERS.
Not later than 1 year after the date of the enactment of this Act,
the Comptroller General of the United States, in consultation with the
Assistant Secretary for Mental Health and Substance Use Disorders, the
Secretary of Health and Human Services, the Secretary of Labor, and the
Secretary of the Treasury, shall submit to Congress a report detailing
the extent to which covered group health plans (or health insurance
coverage offered in connection with such plans), including Medicaid
managed care plans under section 1903 of the Social Security Act (42
U.S.C. 1396b), comply with the Paul Wellstone and Pete Domenici Mental
Health Parity and Addiction Equity Act of 2008 (subtitle B of title V
of division C of Public Law 110-343) (in this section referred to as
the ``law''), including--
(1) how nonquantitative treatment limitations, including
medical necessity criteria, of covered group health plans
comply with the law;
(2) how the responsible Federal departments and agencies
ensure that plans comply with the law; and
(3) how proper enforcement, education, and coordination
activities within responsible Federal departments and agencies
can be used to ensure full compliance with the law, including
educational activities directed to State insurance
commissioners.
<all>
Committee Consideration and Mark-up Session Held.
Committee Consideration and Mark-up Session Held.
Ordered to be Reported by the Yeas and Nays: 53 - 0.
Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 114-667, Part I.
Reported (Amended) by the Committee on Energy and Commerce. H. Rept. 114-667, Part I.
Committee on Ways and Means discharged.
Committee on Ways and Means discharged.
Committee on Education and the Workforce discharged.
Committee on Education and the Workforce discharged.
Placed on the Union Calendar, Calendar No. 517.
Mr. Murphy (PA) moved to suspend the rules and pass the bill, as amended.
Considered under suspension of the rules. (consideration: CR H4301-4325)
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DEBATE - The House proceeded with forty minutes of debate on H.R. 2646.
At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
Considered as unfinished business. (consideration: CR H4333-4334)
Passed/agreed to in House: On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 422 - 2 (Roll no. 355).(text: CR H4301-4318)
Roll Call #355 (House)On motion to suspend the rules and pass the bill, as amended Agreed to by the Yeas and Nays: (2/3 required): 422 - 2 (Roll no. 355). (text: CR H4301-4318)
Roll Call #355 (House)Motion to reconsider laid on the table Agreed to without objection.
Received in the Senate.
Read twice and referred to the Committee on Health, Education, Labor, and Pensions.