II 

117TH CONGRESS 

2D SESSION S. 4498 

To expand the availability of mental, emotional, and behavioral health services 

under the Medicaid program, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JUNE 23, 2022 

Mr. CASEY introduced the following bill; which was read twice and referred 

to the Committee on Finance 

A BILL 

To expand the availability of mental, emotional, and behavioral health services under the Medicaid program, and 

for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Kids’ Mental Health 

5 Improvement Act’’. 

6 SEC. 2. TABLE OF CONTENTS. 

7 The table of contents for this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Table of contents. 


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Sec. 3. Guidance to States on supporting mental, emotional, and behavioral 

health services, and on the availability of telehealth under Medicaid. 

Sec. 4. Ensuring children receive timely access to care. 

1 SEC. 3. GUIDANCE TO STATES ON SUPPORTING MENTAL, 

2 EMOTIONAL, AND BEHAVIORAL HEALTH 

3 SERVICES, AND ON THE AVAILABILITY OF 

4 TELEHEALTH UNDER MEDICAID. 

5 (a) MENTAL, EMOTIONAL, AND BEHAVIORAL

6 HEALTH SERVICES.—Not later than 1 year after the date 

7 of enactment of this Act, the Secretary of Health and 

8 Human Services shall issue guidance to States on how to 

9 expand the provision of mental, emotional, and behavioral 

10 health services covered by State plans (or waivers of such 

11 plans) under title XIX of the Social Security Act (42 

12 U.S.C. 1396 et seq.), including a description of best prac13 tices for effective programs, service provision for under14 served communities, recruitment and retention of pro15 viders, and supporting the delivery of such services in 

16 schools and other community settings. 

17 (b) TELEHEALTH SERVICES.—Not later than 1 year 

18 after the date of enactment of this Act, the Secretary of 

19 Health and Human Services shall issue guidance to States 

20 on best practices to sustain and enhance the availability 

21 of telehealth services covered by State plans (or waivers 

22 of such plans) under title XIX of the Social Security Act 

23 (42 U.S.C. 1396 et seq.). 


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1 SEC. 4. ENSURING CHILDREN RECEIVE TIMELY ACCESS TO 

2 CARE. 

3 (a) GUIDANCE TO STATES ON FLEXIBILITIES TO EN4 SURE PROVIDER CAPACITY TO PROVIDE PEDIATRIC MEN5 TAL, EMOTIONAL, AND BEHAVIORAL CRISIS CARE.—Not 

6 later than 1 year after the date of enactment of this Act, 

7 the Secretary of Health and Human Services shall provide 

8 guidance to States on existing flexibilities for hospitals 

9 and other providers under applicable laws, regulations, 

10 and guidance to support children in crisis or in need of 

11 intensive mental, emotional or behavioral health services. 

12 (b) MANDATED REPORT TO CONGRESS REGARDING

13 BARRIERS TO REPURPOSING OF BEDS, SPACE, AND

14 STAFF TO ADDRESS PEDIATRIC BEHAVIORAL HEALTH

15 NEEDS.— 

16 (1) IN GENERAL.—Not later than 120 days 

17 after the date of enactment of this Act, the Sec18 retary of Health and Human Services shall submit 

19 to the Congress a report with respect to regulatory 

20 and legal barriers to care across the crisis con21 tinuum that identifies solutions to facilitate flexi22 bility for children’s hospitals and other providers of 

23 mental, emotional, or behavioral health services. 

24 (2) REQUIREMENTS.—In preparing a report 

25 under this subsection, the Secretary of Health and 

26 Human Services shall include in such report— 


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1 (A) a comprehensive list of laws, regula2 tions, and guidance impacting children’s hos3 pitals’ and other providers’ ability to repurpose 

4 immediately beds, space, and staff for children 

5 in need of mental, emotional, or behavioral 

6 health services, including a description of the 

7 rationale for each policy and corresponding ac8 tions required to repurpose such beds, space, 

9 and staff; and 

10 (B) recommendations on how children’s 

11 hospitals and other providers can immediately 

12 expand access to mental, emotional, and behav13 ioral health services while also ensuring high 

14 quality and safety. 

15 (c) ENSURING CONSISTENT REVIEW AND STATE IM16 PLEMENTATION OF EARLY AND PERIODIC SCREENING, 

17 DIAGNOSTIC, AND TREATMENT SERVICES.—Section 

18 1905(r) of the Social Security Act (42 U.S.C. 1396d(r)) 

19 is amended by adding at the end the following: ‘‘The Sec20 retary shall, not later than July 1, 2022, and not later 

21 than January 1 each year thereafter, review implementa22 tion of the requirements of this subsection by States as 

23 they pertain to behavioral health services for children, in24 cluding services provided by a managed care entity, iden25 tify and disseminate best practices for ensuring comVerDate Sep 11 2014 04:41 Jun 30, 2022 Jkt 029200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S4498.IS S4498

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1 prehensive coverage of services, identify gaps and defi2 ciencies in meeting Federal requirements, and provide 

3 guidance to States on addressing identified gaps and dis4 parities and meeting Federal coverage requirements in 

5 order to ensure children, including children without a 

6 mental health diagnosis, have access to behavioral health 

7 services.’’. 

Æ 


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