Collaborate in an Orderly and Cohesive Manner Act
This bill requires the Department of Health and Human Services (HHS) to award grants for implementing and evaluating specified models of care that integrate the delivery of behavioral health and primary care services.
Specifically, HHS must award grants to primary care providers for the initial costs (e.g., hiring staff) of implementing such models. In awarding the grants, HHS must prioritize recipients that provide care to medically underserved populations and in areas where the prevalence of behavioral health conditions exceeds the national average. HHS must also provide additional incentive payments to recipients that use appropriate billing codes and quality measures for behavioral health services.
In addition, HHS must award grants to national and regional organizations for providing technical assistance to health care providers and systems to improve implementation of integrated behavioral health and primary care models.
Furthermore, HHS may direct its agencies to expand efforts to evaluate current and emerging integrated behavioral health and primary care models.
[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5218 Introduced in House (IH)]
<DOC>
117th CONGRESS
1st Session
H. R. 5218
To amend the Public Health Service Act to increase uptake of the
Collaborative Care Model.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
September 10, 2021
Mrs. Fletcher (for herself and Ms. Herrera Beutler) introduced the
following bill; which was referred to the Committee on Energy and
Commerce
_______________________________________________________________________
A BILL
To amend the Public Health Service Act to increase uptake of the
Collaborative Care Model.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Collaborate in an Orderly and
Cohesive Manner Act''.
SEC. 2. INCREASING UPTAKE OF THE COLLABORATIVE CARE MODEL.
(a) In General.--Subpart XII of part D of title III of the Public
Health Service Act (42 U.S.C. 256i et seq.) is amended--
(1) in the subpart heading, by striking ``Community-based
Collaborative-Care Network Program'' and inserting
``Collaborative Care''; and
(2) by adding at the end the following new sections:
``SEC. 340J. INCENTIVIZING PRIMARY CARE UPTAKE OF THE COLLABORATIVE
CARE MODEL.
``(a) Grants.--The Secretary shall make grants to primary health
care physicians and primary health care practices to meet the initial
costs of establishing and delivering behavioral health integration
services through the collaborative care model or a combined approach of
the collaborative care model and primary care behavioral health
integration models.
``(b) Use of Grants.--A primary health care physician or primary
health care practice that receives a grant under this section shall use
funds received through the grant--
``(1) to hire staff;
``(2) to identify and formalize contractual relationships
with other health care providers, including providers who will
function as psychiatric consultants and behavioral health care
managers in providing behavioral health integration services
through the collaborative care model;
``(3) to purchase or upgrade software and other resources
needed to appropriately provide behavioral health integration
services through the collaborative care model, including
resources needed to establish a patient registry and implement
measurement-based care; and
``(4) for other such purposes that the Secretary may
determine to be necessary.
``(c) Priority.--In making grants under this section, the Secretary
shall give priority to primary health care physicians and primary
health care practices--
``(1) providing services to any medically underserved
population; and
``(2) are located in areas with a prevalence of mental
illnesses or substance use disorders that are higher than the
national average.
``(d) Consideration.--If, in reviewing applications for grants
under this section, the Secretary determines that more than one primary
health care physician or a primary health care practice submitting such
an application meets the criteria to be given priority under subsection
(c), the Secretary shall give a preference to the primary health care
physician or primary health care practice (that meets such criteria)
that has the least existing capacity and resources to use grant funds
as described in subsection (b).
``(e) Incentive Payments.--
``(1) In general.--The Secretary shall provide to primary
health care physicians and primary health care practices
receiving a grant under this section that meet the criteria
specified in paragraph (3), additional payments.
``(2) Methodology and timing.--The amount and timing of
payments made under this subsection shall be determined using a
methodology and disbursement schedule established by the
Secretary.
``(3) Criteria.--Criteria described in this paragraph are
such criteria as the Secretary may specify, in consultation
with stakeholders, including physicians in the primary care
community and in the field of mental health and substance use
disorder treatment. Such criteria shall include whether--
``(A) a primary health care physician or primary
health care practice participates in an alternative
payment model that bills for the collaborative care
model using the appropriate common procedural
terminology billing codes; and
``(B) a primary health care physician or primary
health care practice uses of validated quality
measures, including, but not limited to, those related
to depression screening, patient follow up, and symptom
remission.
``(4) Calculation.--A payment received under this
subsection shall not be factored into any determination with
respect to meeting cost reduction targets for purposes of a
model implemented pursuant to section 1115A of the Social
Security Act.
``(f) Accountability.--The recipient of a grant under this section
shall submit to the Secretary, in such time and manner as the Secretary
may specify, a report that measures each recipient's progress toward--
``(1) implementing and appropriately providing behavioral
health integration services through the collaborative care
model;
``(2) improving access to behavioral health integration
services provided through the collaborative care model among
medically underserved populations;
``(3) improving health outcomes for individuals who receive
behavioral health integration services provided through the
collaborative care model; and
``(4) other such purposes that the Secretary may determine
to be necessary.
``(g) Clarification.--
``(1) Reimbursement.--Nothing in this section shall be
construed as preventing a primary health care physician or
primary health care practice that receives a grant under this
section from receiving direct reimbursement for rendering
behavioral health integration services through the
collaborative care model.
``(2) Other programs.--Participation in, or application
for, any other grant or demonstration program administered by
the Secretary by a primary health care physician or primary
health care practice shall not affect the eligibility of such
physician or practice to receive a grant under this section.
``(h) Definitions.--For the purposes of this section:
``(1) Collaborative care model.--The term `collaborative
care model' means the evidence-based, integrated behavioral
health service delivery method described in 81 Federal Register
80230, which includes a formal collaborative arrangement among
a primary care team consisting of a primary care provider, a
care manager, and a psychiatric consultant, and includes the
following elements:
``(A) Care directed by the primary care team.
``(B) Structured care management.
``(C) Regular assessments of clinical status using
developmentally appropriate, validated tools.
``(D) Modification of treatment as appropriate.
``(2) Medically underserved population.--The term
`medically underserved population' means the population of an
urban or rural area designated by the Secretary as an area with
a shortage of mental health or substance use disorder services
or a population group designated by the Secretary as having a
shortage of such services.
``(3) Primary health care physician.--The term `primary
health care physician' means a physician that--
``(A) provides health services related to family
medicine, internal medicine, pediatrics, obstetrics,
gynecology, or geriatrics;
``(B) is a doctor of medicine or osteopathy that is
licensed to practice medicine by the State in which
such physician primarily practices.
``(4) Primary health care practice.--The term `primary
health care practice' means a medical practice of primary
health care physicians, including a practice within a larger
health care system.
``SEC. 340K. ESTABLISHING TECHNICAL ASSISTANCE CENTERS FOR
IMPLEMENTATION OF THE COLLABORATIVE CARE MODEL.
``(a) In General.--The Secretary shall make grants to national and
regional eligible organizations to establish, for purposes of providing
technical assistance and training to health care providers and health
care systems to facilitate and improve implementation of the
collaborative care model--
``(1) a national center, to be known as the National
Collaborative Care Model Training and Technical Assistance
Center (referred to in this section as the `National Center');
and
``(2) regional centers, to be known as Regional
Collaborative Care Model Training and Technical Assistance
Centers (referred to in this section as `Regional Centers').
``(b) Coordination Required.--As a condition on receipt of a grant
under this section to establish the National Center, the eligible
organization receiving such grant shall agree to coordinate with one or
more eligible organizations and the Regional Centers in providing
technical assistance and training referred to in subsection (a).
``(c) Technical Assistance and Training.--The technical assistance
and training referred to in subsection (a) shall include--
``(1) developing financial models and budgets for
implementing and maintaining a collaborative care model, based
on practice size;
``(2) developing staffing models for essential staff roles,
including care managers and psychiatric consultants;
``(3) providing strategic advice to assist practices
seeking to utilize other clinicians for additional
psychotherapeutic interventions;
``(4) providing information technology expertise to assist
with building the collaborative care model into electronic
health records, including assistance with care manager tools,
patient registry, ongoing patient monitoring, and patient
records;
``(5) training support for all key staff and operational
consultation to develop practice workflows;
``(6) establishing methods to ensure the sharing of best
practices and operational knowledge among primary health care
physicians and primary health care practices that provide
behavioral health integration services through the
collaborative care model;
``(7) providing guidance and instruction to primary health
care physicians and primary health care practices on developing
and maintaining relationships with community-based mental
health and substance use disorder facilities for referral and
treatment of patients whose clinical presentation or diagnosis
is best suited for treatment at such facilities; and
``(8) other such activities as the Secretary necessary.
``(d) Regional Center Structure.--
``(1) In general.--The Secretary shall issue regulations
establishing the structure of the Regional Centers and the
nature of coordination among the Regional Centers and the
National Center, including--
``(A) the number of Regional Centers, subject to
adjustment as described in paragraph (2);
``(B) the geographic locations for such Regional
Centers, subject to adjustment as described in
paragraph (2);
``(C) the degree to which such National Center may
direct the activities and practices of such Regional
Centers; and
``(D) other such specifications that the Secretary
may deem necessary.
``(2) Adjustments.--The number and geographic location of
the Regional Centers established under paragraph (1) may be
adjusted from time to time as the Secretary determines
necessary so long as, in making such adjustments--
``(A) seeks to establish as many Regional Centers
as is possible and practicable while still maintaining
optimal efficiency and effectiveness; and
``(B) ensures that the distribution of such
geographic locations enables such Regional Centers to
provide training and technical assistance in areas with
medically underserved populations.
``(e) Accountability.--The Secretary shall issue regulations
establishing such criteria as the Secretary determines is necessary to
evaluate the effectiveness of the National Center and Regional Centers
in providing technical assistance and training referred to in
subsection (a), including for monitoring the activities of, collecting
data from, and evaluating the performance of each recipient of a grant
under this section.
``(f) Definitions.--In this section:
``(1) Collaborative care model; medically underserved
population; primary health care physician; primary health care
practice.--The terms `collaborative care model', `primary
health care physician', and `primary health care practice' have
the meaning given such terms in section 340J.
``(2) Eligible organization.--The term `eligible
organization' means a national or regional nonprofit
organization that can provide technical assistance and training
to health care providers and health care systems, and has
special expertise and broad experience in behavioral health
integration services, generally, and in the collaborative care
model, specifically, with preference given to such
organizations that are currently or that have previously
provided training and technical assistance on providing
behavioral health integration services through the
collaborative care model.
``SEC. 340L. RESEARCH ON PROMISING BEHAVIORAL HEALTH INTEGRATION
MODELS.
``The Secretary, in consultation with the Assistant Secretary for
Planning and Evaluation, may direct administrators and directors of the
Department of Health and Human Services, including the Director of the
National Institutes of Health, the Administrator of the Health
Resources and Services Administration, the Director of the Agency for
Healthcare and Research Quality, and the Director of the Center for
Medicare and Medicaid Innovation, as the Secretary determines
appropriate, to expand efforts to evaluate current and emerging
behavioral health integration models, such as the primary care
behavioral health model, and improve the foundation for evidence-based
practice, with a focus on population-based care.
``SEC. 340M. AUTHORIZATION OF APPROPRIATIONS.
``There are authorized to be appropriated to carry out sections
340J, 340K, and 340L, $30,000,000 for each of fiscal years 2022 through
2026.''.
(b) Technical Correction.--Effective as if included in the
enactment of section 301(c) of the Disaster Tax Relief and Airport and
Airway Extension Act of 2017 (Public Law 115-63), such section is
amended, in the matter preceding paragraph (1), by striking ``Part D''
and inserting ``Part D of title III''.
<all>
Introduced in House
Introduced in House
Referred to the House Committee on Energy and Commerce.
Referred to the Subcommittee on Health.
Llama 3.2 · runs locally in your browser
Ask anything about this bill. The AI reads the full text to answer.
Enter to send · Shift+Enter for new line