9-8-8 Implementation Act of 2023
This bill modifies programs and activities that support access to behavioral health services, with a focus on crisis services and the 9-8-8 telecommunication system that provides callers with mental health or suicide crisis support and resources.
For example, the bill establishes a national suicide prevention media campaign and grant programs to support crisis call centers and the behavioral health workforce. It also requires the Department of Health and Human Services to convene a panel to develop recommendations for 9-1-1 dispatchers on how respond to callers experiencing behavioral health crises, including with respect to utilizing the 9-8-8 system.
The bill also expands coverage under Medicare, Medicaid, the Children's Health Insurance Program (CHIP), private insurance, and insurance programs for members of the Armed Forces, veterans, and federal employees to include crisis response services.
[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4851 Introduced in House (IH)]
<DOC>
118th CONGRESS
1st Session
H. R. 4851
To provide for improvements in the implementation of the National
Suicide Prevention Lifeline, and for other purposes.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
July 25, 2023
Mr. Cardenas (for himself, Mr. Fitzpatrick, Ms. Blunt Rochester, Mr.
Moulton, Ms. Matsui, Mrs. Napolitano, Mr. Beyer, Mr. Raskin, Ms.
Strickland, Mr. Gomez, Mr. Pocan, Mr. Tonko, Ms. Moore of Wisconsin,
Ms. Barragan, Ms. Underwood, Ms. Clarke of New York, Mr. Trone, Ms.
Balint, Mr. Lynch, Ms. Schrier, Ms. Craig, and Ms. Jayapal) introduced
the following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committees on Ways and Means, Armed
Services, Veterans' Affairs, and Oversight and Accountability, 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 provide for improvements in the implementation of the National
Suicide Prevention Lifeline, 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.
(a) Short Title.--This Act may be cited as the ``9-8-8
Implementation Act of 2023''.
(b) Table of Contents.--The table of contents for this Act is as
follows:
Sec. 1. Short title.
TITLE I--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
Sec. 101. Regional and local lifeline call center program.
Sec. 102. Mental Health Crisis Response Partnership Pilot Program.
Sec. 103. National suicide prevention media campaign.
TITLE II--HEALTH RESOURCES AND SERVICES ADMINISTRATION
Sec. 201. Health center capital grants.
Sec. 202. Expanding behavioral health workforce training programs.
TITLE III--BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION
Sec. 301. Coverage of crisis response services.
Sec. 302. Incident reporting.
TITLE IV--MEDICAID AMENDMENTS
Sec. 401. Revisions to the State option to provide qualifying
community-based mobile crisis intervention
services and other services under State
plans under the Medicaid program.
Sec. 402. Revisions to the IMD exclusion under Medicaid.
TITLE I--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION
SEC. 101. REGIONAL AND LOCAL LIFELINE CALL CENTER PROGRAM.
Part B of title V of the Public Health Service Act (42 U.S.C. 290bb
et seq.) is amended by inserting after section 520E-4 (42 U.S.C. 290bb-
36d) the following:
``SEC. 520E-5. REGIONAL AND LOCAL LIFELINE CALL CENTER PROGRAM.
``(a) In General.--The Secretary shall award grants to crisis call
centers to--
``(1) purchase or upgrade call center technology;
``(2) provide for training of call center staff;
``(3) improve call center operations; and
``(4) hiring of call center staff.
``(b) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $441,000,000 for fiscal year
2024, to remain available until expended.''.
SEC. 102. MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT PROGRAM.
Section 520F(e) of the Public Health Service Act (42 U.S.C. 290bb-
37(e)) is amended by striking ``section, $10,000,000 for each of fiscal
years 2023 through 2027'' and inserting the following: ``section--
``(1) $10,000,000 for fiscal year 2023; and
``(2) $100,000,000 for each of fiscal years 2024 through
2027''.
SEC. 103. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.
Subpart 3 of part B of title V of the Public Health Service Act (42
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:
``SEC. 5200. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.
``(a) National Suicide Prevention Media Campaign.--
``(1) In general.--Not later than the date that is 3 years
after the date of the enactment of this Act, the Secretary, in
consultation with the Assistant Secretary for Mental Health and
Substance Use and the Director of the Centers for Disease
Control and Prevention (referred to in this section as the
`Director'), shall conduct a national suicide prevention media
campaign (referred to in this section as the `national media
campaign'), for purposes of--
``(A) preventing suicide in the United States;
``(B) educating families, friends, and communities
on how to address suicide and suicidal thoughts,
including when to encourage individuals with suicidal
risk to seek help; and
``(C) increasing awareness of suicide prevention
resources of the Centers for Disease Control and
Prevention and the Substance Abuse and Mental Health
Services Administration (including the suicide
prevention hotline maintained under section 520E-3, any
suicide prevention mobile application of the Centers
for Disease Control and Prevention or the Substance
Abuse Mental Health Services Administration, and other
support resources determined appropriate by the
Secretary).
``(2) Additional consultation.--In addition to consulting
with the Assistant Secretary and the Director under this
section, the Secretary shall consult with, as appropriate,
State, local, Tribal, and territorial health departments,
primary health care providers, hospitals with emergency
departments, mental and behavioral health services providers,
crisis response services providers, paramedics, law
enforcement, suicide prevention and mental health
professionals, patient advocacy groups, survivors of suicide
attempts, and representatives of television and social media
platforms in planning the national media campaign to be
conducted under paragraph (1).
``(b) Target Audiences.--
``(1) Tailoring advertisements and other communications.--
In conducting the national media campaign under subsection
(a)(1), the Secretary may tailor culturally competent
advertisements and other communications of the campaign across
all available media for a target audience (such as a particular
geographic location or demographic) across the lifespan.
``(2) Targeting certain local areas.--The Secretary shall,
to the maximum extent practicable, use amounts made available
under subsection (f) for media that targets certain local areas
or populations at disproportionate risk for suicide.
``(c) Use of Funds.--
``(1) Required uses.--
``(A) In general.--The Secretary shall, if
reasonably feasible with the funds made available under
subsection (f), carry out the following, with respect
to the national media campaign:
``(i) Testing and evaluation of
advertising.
``(ii) Evaluation of the effectiveness of
the national media campaign.
``(iii) Operational and management
expenses.
``(iv) The creation of an educational
toolkit for television and social media
platforms to use in discussing suicide and
raising awareness about how to prevent suicide.
``(B) Specific requirements.--
``(i) Testing and evaluation of
advertising.--In testing and evaluating
advertising under subparagraph (A)(i), the
Secretary shall test all advertisements after
use in the national media campaign to evaluate
the extent to which such advertisements have
been effective in carrying out the purposes of
the national media campaign.
``(ii) Evaluation of effectiveness of
national media campaign.--In evaluating the
effectiveness of the national media campaign
under subparagraph (A)(ii), the Secretary
shall--
``(I) take into account the number
of unique calls that are made to the
suicide prevention hotline maintained
under section 520E-3 and assess whether
there are any State and regional
variations with respect to the capacity
to answer such calls;
``(II) take into account the number
of unique encounters with suicide
prevention and support resources of the
Centers for Disease Control and
Prevention and the Substance Abuse and
Mental Health Services Administration
and assess engagement with such suicide
prevention and support resources;
``(III) assess whether the national
media campaign has contributed to
increased awareness that suicidal
individuals should be engaged, rather
than ignored; and
``(IV) take into account such other
measures of evaluation as the Secretary
determines are appropriate.
``(2) Optional uses.--The Secretary may use amounts made
available under subsection (f) for the following, with respect
to the national media campaign:
``(A) Partnerships with professional and civic
groups, community-based organizations, including faith-
based organizations, and Federal agencies or Tribal
organizations that the Secretary determines have
experience in suicide prevention, including the
Substance Abuse and Mental Health Services
Administration and the Centers for Disease Control and
Prevention.
``(B) Entertainment industry outreach, interactive
outreach, media projects and activities, the
dissemination of public information, news media
outreach, outreach through television programs, and
corporate sponsorship and participation.
``(d) Prohibitions.--None of the amounts made available under
subsection (f) may be obligated or expended for any of the following:
``(1) To supplant Federal suicide prevention campaigns in
effect as of the date of the enactment of this section.
``(2) For partisan political purposes, or to express
advocacy in support of or to defeat any clearly identified
candidate, clearly identified ballot initiative, or clearly
identified legislative or regulatory proposal.
``(e) Report to Congress.--Not later than 18 months after
implementation of the national media campaign has begun, the Secretary,
in coordination with the Assistant Secretary and the Director, shall,
with respect to the first year of the national media campaign, submit
to Congress a report that describes--
``(1) the strategy of the national media campaign and
whether specific objectives of such campaign were accomplished,
including whether such campaign impacted the number of calls
made to lifeline crisis centers and the capacity of such
centers to manage such calls;
``(2) steps taken to ensure that the national media
campaign operates in an effective and efficient manner
consistent with the overall strategy and focus of the national
media campaign;
``(3) plans to purchase advertising time and space;
``(4) policies and practices implemented to ensure that
Federal funds are used responsibly to purchase advertising time
and space and eliminate the potential for waste, fraud, and
abuse; and
``(5) all contracts entered into with a corporation, a
partnership, or an individual working on behalf of the national
media campaign.
``(f) Authorization of Appropriations.--For purposes of carrying
out this section, there is authorized to be appropriated $10,000,000
for each of fiscal years 2024 through 2028.''.
TITLE II--HEALTH RESOURCES AND SERVICES ADMINISTRATION
SEC. 201. HEALTH CENTER CAPITAL GRANTS.
Subpart 1 of part D of title III of the Public Health Service Act
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:
``SEC. 330Q. HEALTH CENTER CAPITAL GRANTS.
``(a) In General.--The Secretary shall award grants to eligible
entities for capital projects.
``(b) Eligible Entity.--In this section, the term `eligible entity'
is an entity that is--
``(1) a health center funded under section 330, or in the
case of a Tribe or Tribal organization, eligible, to be awarded
without regard to the time limitation in subsection (e)(3) and
subsections (e)(6)(A)(iii), (e)(6)(B)(iii), and (r)(2)(B) of
such section; or
``(2) a mental health and substance use crisis receiving
and stabilization program and crisis call center that have a
working relationship with one or more local community mental
health and substance use organizations, community mental health
centers, and certified community behavioral health clinics, or
other local mental health and substance use care providers,
including inpatient and residential treatment settings.
``(c) Use of Funds.--Amounts made available to a recipient of a
grant or cooperative agreement pursuant to subsection (a) shall be used
for crisis response program facility alteration, renovation,
remodeling, expansion, construction, and other capital improvement
costs, including the costs of amortizing the principal of, and paying
interest on, loans for such purposes.
``(d) Authorization of Appropriations.--There are authorized to be
appropriated to carry out this section $1,000,000,000, to remain
available until expended.''.
SEC. 202. EXPANDING BEHAVIORAL HEALTH WORKFORCE TRAINING PROGRAMS.
(a) National Health Service Corps.--Section 331(a)(3)(E)(i) of the
Public Health Service Act (254d(a)(3)(E)(i)) is amended by striking
``and psychiatrists'' and inserting ``psychiatrists and professionals
who provide crisis management services (such as at a crisis call
center, as part of a mobile crisis team, or through crisis receiving
and stabilization program)''.
(b) Minority Fellowship Program.--Section 597(b) of the Public
Health Service Act (42 U.S.C. 290ll(b)) is amended by inserting
``crisis management services (such as at a crisis call center, as part
of a mobile crisis team, or through crisis receiving and stabilization
program),'' after ``mental health counseling,''.
(c) Behavioral Health Workforce Education and Training.--Section
756 of the Public Health Service Act (42 U.S.C. 294e-1) is amended--
(1) in subsection (a)--
(A) in paragraph (1), by inserting ``crisis
management (such as at a crisis call center, as part of
a mobile crisis team, or through crisis receiving and
stabilization program),'' after ``occupational
therapy,'';
(B) in paragraph (2), by inserting ``and providing
crisis management services (such as at a crisis call
center, as part of a mobile crisis team, or through
crisis receiving and stabilization program)'' after
``treatment services,'';
(C) in paragraph (3), by inserting ``and providing
crisis management services (such as at a crisis call
center, as part of a mobile crisis team, or through
crisis receiving and stabilization program),'' after
``behavioral health services''; and
(D) in paragraph (4), by inserting ``including for
the provision of crisis management services (such as at
a crisis call center, as part of a mobile crisis team,
or through crisis receiving and stabilization
program),'' after ``paraprofessional field'';
(2) in subsection (d)(2), by inserting ``or that emphasize
training in crisis management and meeting the crisis needs of
diverse populations specified in (b)(2), including effective
outreach and engagement'' after ``partnerships''; and
(3) by adding at the end the following:
``(g) Additional Funding.--
``(1) In general.--For each of fiscal years 2024 through
2028, in addition to funding made available under subsection
(f), there are authorized to be appropriated $15,000,000 for
workforce development for crisis management, as specified in
paragraphs (1) through (4) of subsection (a).
``(2) Priority.--In making grants for the purpose specified
in paragraph (1), the Secretary shall give priority to programs
demonstrating effective recruitment and retention efforts for
individuals and groups from different racial, ethnic, cultural,
geographic, religious, linguistic, and class backgrounds, and
different genders and sexual orientations, as specified in
subsection (b)(2).''.
TITLE III--BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION
SEC. 301. COVERAGE OF CRISIS RESPONSE SERVICES.
(a) Coverage Under the Medicare Program.--
(1) In general.--Section 1861(s)(2) of the Social Security
Act (42 U.S.C. 1395x(s)(2)) is amended--
(A) in subparagraph (II), by striking ``and'' at
the end;
(B) in subparagraph (JJ), by striking the period at
the end and inserting ``; and''; and
(C) by adding at the end the following new
subparagraph:
``(KK) crisis response services as defined in
subsection (nnn);''.
(2) Crisis response services defined.--Section 1861 of the
Social Security Act (42 U.S.C. 1395x) is amended by adding at
the end the following new subsection:
``(nnn) Crisis Response Services.--The term `crisis response
services' means mental health or substance use services that are
furnished by a mobile crisis response team, a crisis receiving and
stabilization facility, mental health or substance use urgent care
facility, or other appropriate provider, as determined by the
Secretary, to an individual, including children and adolescents,
experiencing a mental health or substance use crisis.''.
(3) Payment.--
(A) In general.--Section 1833(a)(1) of the Social
Security Act (42 U.S.C. 1395l(a)(1)) is amended--
(i) by striking ``and (HH)'' and inserting
``(HH)''; and
(ii) by inserting before the semicolon at
the end the following: ``and (II) with respect
to crisis response services described in
section 1861(s)(2)(KK), the amounts paid shall
be 80 percent of the lesser of the actual
charge for the service or the amount determined
under the payment basis established under
section 1834(aa)''.
(B) Establishment of payment basis.--Section 1834
of the Social Security Act (42 U.S.C. 1395m) is amended
by adding at the end the following new subsection:
``(aa) Payment for Crisis Response Services.--The Secretary shall
establish a payment basis determined appropriate by the Secretary with
respect to crisis response services (as defined in section 1861(nnn))
furnished by a provider of services or supplier.''.
(4) Ambulance transport of individuals in crisis.--
(A) In general.--Section 1834(l) of the Social
Security Act (42 U.S.C. 1395m(l)) is amended by adding
at the end the following new paragraph:
``(18) Transportation of individuals in crisis.--With
respect to ambulance services furnished on or after the date
that is 3 years after the date of the enactment of the
Behavioral Health Crisis Services Expansion Act, the
regulations described in section 1861(s)(7) shall provide
coverage under such section for ambulance and other qualified
emergency transport services to transport an individual
experiencing a mental health or substance crisis to an
appropriate facility, such as a community mental health center
(as defined in section 1861(ff)(3)(B)) or other facility or
provider identified by the Secretary, as appropriate, for
crisis response services described in section
1861(s)(2)(KK).''.
(B) Conforming amendment.--Section 1861(s)(7) of
such Act (42 U.S.C. 1395x(s)(7)) is amended by striking
``section 1834(l)(14)'' and inserting ``paragraphs (14)
and (18) of section 1834(l)''.
(5) Effective date.--The amendments made by this subsection
shall apply to services furnished on or after the date that is
3 years after the date of the enactment of this Act.
(b) Mandatory Coverage of Crisis Response Services Under the
Medicaid Program.--Title XIX of the Social Security Act (42 U.S.C. 1396
et seq.) is amended--
(1) in section 1902(a)(10)(A), in the matter preceding
clause (i), by striking ``and (30)'' and inserting ``(30), and
(31)''; and
(2) in section 1905--
(A) in subsection (a)--
(i) in paragraph (30), by striking ``;
and'' and inserting a semicolon;
(ii) by redesignating paragraph (31) as
paragraph (32); and
(iii) by inserting the following paragraph
after paragraph (30):
``(31) crisis response services (as defined in section
1861(nnn)); and''.
(3) Presumptive eligibility determination by crisis
response service providers.--Section 1902(a)(47)(B) of the
Social Security Act (42 U.S.C. 1396a(a)(47)(B)) is amended by
inserting ``or provider of crisis response services (as defined
in section 1861(nnn))'' after ``any hospital''.
(4) Effective date.--
(A) In general.--Except as provided in subparagraph
(B), the amendments made by this section shall take
effect on the date that is 3 years after the date of
the enactment of this Act.
(B) Delay permitted if state legislation
required.--In the case of a State plan under title XIX
of the Social Security Act (42 U.S.C. 1396 et seq.)
which the Secretary of Health and Human Services
determines requires State legislation (other than
legislation appropriating funds) in order for the plan
to meet the additional requirements imposed by the
amendments made by this section, the State plan shall
not be regarded as failing to comply with the
requirements of such title solely on the basis of the
failure of the plan to meet such additional
requirements 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 Act. For purposes of the
previous sentence, in the case of a State that has a 2-
year legislative session, each year of such session
shall be deemed to be a separate regular session of the
State legislature.
(c) Essential Health Benefits.--Section 1302(b)(1)(E) of the
Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)(E))
is amended by inserting ``and crisis response services (as defined in
section 1861(nnn) of the Social Security Act)'' before the period.
(d) Group Health Plans and Health Insurance Issuers.--
(1) In general.--Section 2707 of the Public Health Service
Act (42 U.S.C. 300gg-6) is amended by adding at the end the
following:
``(e) Crisis Response Services.--A group health plan or a health
insurance issuer offering group or individual health insurance coverage
shall ensure that such coverage includes crisis response services (as
defined in section 1861(nnn) of the Social Security Act).''.
(2) Application to grandfathered plans.--Section
1251(a)(4)(A) of the Public Health Service Act (42 U.S.C.
18011(a)(4)(A)) is amended by adding at the end the following
new clause:
``(v) Section 2707(e) (relating to coverage
of crisis response services).''.
(e) Tricare Coverage.--
(1) In general.--The Secretary of Defense shall provide
coverage under the TRICARE program for crisis response
services, as defined in section 1861(nnn) of the Social
Security Act (42 U.S.C. 1395x).
(2) Tricare program defined.--In this section, the term
``TRICARE program'' has the meaning given the term in section
1072 of title 10, United States Code.
(f) Reimbursement for Crisis Response Services for Veterans.--
Section 1725(f)(1) of title 38, United States Code, is amended, in the
matter preceding subparagraph (A), by inserting ``, including crisis
response services (as defined in subsection (nnn) of section 1861 of
the Social Security Act (42 U.S.C. 1395x)),'' after ``services''.
(g) Coverage Under FEHB.--
(1) In general.--Section 8902 of title 5, United States
Code, is amended by adding at the end the following:
``(p) Each contract for a plan under this chapter shall require the
carrier to provide coverage for crisis response services, as that term
is defined in subsection (nnn) of section 1861 of the Social Security
Act (42 U.S.C. 1395x).''.
(2) Effective date.--The amendment made by paragraph (1)
shall apply beginning with respect to the third contract year
for chapter 89 of title 5, United States Code, that begins on
or after the date that is 3 years after the date of enactment
of this Act.
(h) Coverage Under CHIP.--Section 2103(c)(5) of the Social Security
Act (42 U.S.C. 1397cc(c)(5)) is amended--
(1) in subparagraph (A), by striking ``and'' at the end;
(2) in subparagraph (B), by striking the period and
inserting ``; and''; and
(3) by adding at the end the following new subparagraph:
``(C) beginning on the date that is 3 years after
the date of the enactment of this subparagraph, crisis
response services (as defined in section 1861(nnn)).''.
SEC. 302. INCIDENT REPORTING.
(a) Establishment of Protocol Panel.--The Secretary of Health and
Human Services (referred to in this section as the ``Secretary''), in
consultation with the Attorney General, shall convene a panel for the
purposes of making recommendations for training and protocol for 9-1-1
dispatchers to respond appropriately to individuals experiencing a
behavioral health crisis based on the characteristics of the incident
and the needs of the caller.
(b) Panelists.--The Secretary shall appoint individuals to serve
staggered 10-year terms on the panel established under subsection (a).
Such individuals shall include--
(1) psychiatrists;
(2) paramedics and other emergency medical services
personnel;
(3) law enforcement officers and 9-1-1 dispatchers;
(4) representatives from each segment of the crisis
response continuum, including 9-8-8 dispatchers;
(5) members of underserved communities including ethnic and
racial minority groups and sexual orientation and gender
minority groups;
(6) representatives from Tribes or Tribal organizations;
and
(7) other individuals, as the Secretary determines
appropriate.
(c) Recommendations.--
(1) Topics.--In issuing recommendations under this section,
the panel shall consider--
(A) connecting 9-1-1 callers to crisis care
services instead of responding with law enforcement
officers;
(B) integrating the 9-8-8 system into the 9-1-1
system, or transferring calls from the 9-1-1 system to
the 9-8-8 system as appropriate; and
(C) a process for identifying 9-1-1 callers who may
be experiencing psychiatric symptoms or a mental health
crisis, substance use crisis, or co-occurring crisis
and evaluating the level of need of such callers, as
defined by relevant, standardized assessment tools such
as the Level of Care Utilization System (LOCUS), the
Child and Adolescent Level of Care Utilization System
(CALOCUS), and the American Society of Addiction
Medicine (ASAM) Criteria.
(2) Updates.--The panel shall update recommendations issued
under this section not less frequently than every 5 years.
TITLE IV--MEDICAID AMENDMENTS
SEC. 401. REVISIONS TO THE STATE OPTION TO PROVIDE QUALIFYING
COMMUNITY-BASED MOBILE CRISIS INTERVENTION SERVICES AND
OTHER SERVICES UNDER STATE PLANS UNDER THE MEDICAID
PROGRAM.
(a) In General.--Section 1947 of the Social Security Act (42 U.S.C.
1396w-6) is amended--
(1) in subsection (a)--
(A) by striking ``for qualifying community-based
mobile crisis intervention services'' and inserting
``for--
``(1) qualifying community-based mobile crisis intervention
services;
``(2) regional and local lifeline call center operations;
and
``(3) programs for the purpose receiving and stabilization
individuals (including beds in homes and facilities for such
purpose).''; and
(B) by striking ``during the 5-year period'';
(2) in subsection (c)--
(A) by striking ``85 percent.'' and inserting the
following: ``85 percent, and for medical assistance for
items described in paragraphs (2) and (3) of subsection
(a) furnished during such quarter shall be equal to 85
percent.''; and
(B) by striking ``occurring during the period
described in subsection (a) that a State'' and
inserting ``in which a State provides medical
assistance for qualifying community-based mobile crisis
intervention services under this section and'';
(3) in subsection (e), by adding at the end at the
following new sentence: ``There is appropriated, out of any
funds in the Treasury not otherwise appropriated, $5,000,000 to
the Secretary for the purposes described in the preceding
sentence to remain available until expended.''; and
(4) in subsection (d)(2)--
(A) in subparagraph (A), by striking ``for the
fiscal year preceding the first fiscal quarter
occurring during the period described in subsection
(a)'' and inserting ``for the fiscal year preceding the
first fiscal quarter in which the State provides
medical assistance for qualifying community-based
mobile crisis intervention services under this
section''; and
(B) in subparagraph (B), by striking ``occurring
during the period described in subsection (a)'' and
inserting ``occurring during a fiscal quarter''.
(b) Effective Date.--The amendments made by subsection (a) shall
take effect as if included in the enactment of the American Rescue Plan
Act of 2021 (Public Law 117-2).
SEC. 402. REVISIONS TO THE IMD EXCLUSION UNDER MEDICAID.
(a) Shrinking of the IMD Exclusion Under Medicaid.--Section
1905(a)(1) of the Social Security Act (42 U.S.C. 1396d(a)(1)) is
amended by inserting ``, except for, services that, beginning the day
after the date of the enactment of the 9-8-8 National Suicide
Prevention Lifeline Implementation Act of 2022, are furnished in
psychiatric acute care crisis beds administered by community behavioral
health organizations certified under section 223 of the Protecting
Access to Medicare Act of 2014, mental health centers that meet the
criteria of section 1913(c) of the Public Health Service Act, crisis
receiving and stabilization facilities, and the mental health and
substance use urgent care facilities''.
(b) Guidance Relating to IMD Exclusion.--Not later than 180 days
after the date of the enactment of this Act, the Secretary of Health
and Human Services shall issue guidance that crisis stabilization units
(as described in section 1905(a)(1) of the Social Security Act (42
U.S.C. 1396d(a)(1)) are excluded from the prohibition specified in the
parenthetical of paragraph (1) of section 1905(a) (relating to services
in an institution for mental diseases), including the following
facilities and services:
(1) Subacute crisis receiving in inpatient or other
facilities specified by the Secretary that provide short-term
observation for all referrals to individuals in severe
distress, as further defined by the Secretary, with up to 23
consecutive hours of supervised care to assist with
deescalating the severity of a mental health or substance use
crisis or need for urgent care in a sub-acute inpatient
setting.
(2) Short term crisis stabilization services assisting with
deescalating the severity of individuals in severe distress, as
defined by the Secretary, or need for urgent care associated
with a substance use or mental health disorder in an inpatient
or residential setting with reimbursement limited to 72 hours.
(c) Reports on Crisis Stabilization Utilization.--Not later than 1
year after the date of the enactment of this Act, the Secretary shall
submit to the appropriate congressional committees of jurisdiction a
report addressing the utilization of facility-based crisis services,
including the number of patients served, type and duration of facility-
based services, linkage to community-based resources, and information
on the total number of law enforcement drop-offs and other data
relevant for diverting mental health and substance use disorder
emergencies from law enforcement response.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Armed Services, Veterans' Affairs, and Oversight and Accountability, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Armed Services, Veterans' Affairs, and Oversight and Accountability, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Armed Services, Veterans' Affairs, and Oversight and Accountability, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Armed Services, Veterans' Affairs, and Oversight and Accountability, 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.
Referred to the Committee on Energy and Commerce, and in addition to the Committees on Ways and Means, Armed Services, Veterans' Affairs, and Oversight and Accountability, 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.
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Referred to the Subcommittee on Health.
Referred to the Subcommittee on Health.