II 

116TH CONGRESS 

2D SESSION S. 4282 

To amend the Community Mental Health Service Block Grant to authorize 

a set-aside for crisis care services, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

JULY 22, 2020 

Mr. MANCHIN (for himself and Mr. GARDNER) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend the Community Mental Health Service Block 

Grant to authorize a set-aside for crisis care services, 

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 ‘‘Crisis Care Improve5 ment and Suicide Prevention Act of 2020’’. 

6 SEC. 2. FINDINGS AND SENSE OF CONGRESS. 

7 (a) FINDINGS.—Congress finds the following: 

8 (1) Fragmentation of mental health services 

9 and limited access to crisis services complicates and 


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1 elongates mental health patient stays in emergency 

2 departments and under the custody of law enforce3 ment. 

4 (2) Emergency departments and the criminal 

5 justice system do not have the capacity with existing 

6 resources and health care professional shortages to 

7 address the needs of the rapidly growing number of 

8 individuals with mental health conditions, increasing 

9 the risk of adverse patient outcomes. 

10 (3) In 2017, 150,000 individuals in the United 

11 States died from alcohol and drug-induced fatalities 

and suicides. Nearly 1 12 ⁄3, or more than 47,000 were 

13 suicides. 

(4) From 2016 to 2018, more than 1 14 ⁄4 of hos15 pital emergency department ‘‘frequent users’’ in Illi16 nois were patients with presenting or underlying 

17 mental health conditions, underscoring the need for 

18 additional funding, continued access to real-time 

19 care and connection to long-term treatment options. 

20 (5) Fifteen percent of men and 30 percent of 

21 women in custody of county jails have severe mental 

22 illnesses. 

23 (6) Use of appropriate crisis facilities and inter24 ventions in Maricopa County, Arizona, have saved 

25 emergency departments an estimated $37,000,000 in 


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1 2016 and saved the equivalent of 37 police officer 

2 full-time equivalent salaries. 

3 (b) SENSE OF CONGRESS.—It is the sense of Con4 gress that— 

5 (1) for patients with mental health issues, co6 ordination of physical and mental health services 

7 and cooperation with law enforcement are essential 

8 to ensure timely, appropriate care; and 

9 (2) crisis care networks established at State 

10 and local levels have saved resources and shown im11 proved outcomes for patients in crisis. 

12 SEC. 3. EVIDENCE-BASED CRISIS CARE PROGRAMS. 

13 (a) IN GENERAL.—Section 1912(b)(1) of the Public 

14 Health Service Act (42 U.S.C. 300x–1(b)(1))— 

15 (1) in subparagraph (A)— 

16 (A) by redesignating clauses (vi) and (vii) 

17 as clauses (vii) and (viii), respectively; and 

18 (B) by inserting after clause (v), the fol19 lowing: 

20 ‘‘(vi) include a description of how the 

21 State supports evidenced-based programs 

22 that address the crisis care needs of indi23 viduals with serious mental disorders, and 

24 children with serious mental and emotional 

25 disturbances, that include at least one of 


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1 the core components specified in subpara2 graph (F); ’’; and 

3 (2) by adding at the end the following: 

4 ‘‘(F) CORE COMPONENTS FOR CRISIS CARE

5 SERVICES.—The core components of a program 

6 referred to in subparagraph (A)(vi) include the 

7 following: 

8 ‘‘(i) Crisis call centers. 

9 ‘‘(ii) 24/7 mobile crisis services. 

10 ‘‘(iii) Crisis stabilization programs of11 fering acute care or sub-acute care in a 

12 hospital or appropriately licensed facility, 

13 with referrals to inpatient or outpatient 

14 care, as determined by the Assistant Sec15 retary for Mental Health and Substance 

16 Use.’’. 

17 (b) SET-ASIDE FOR EVIDENCE-BASED CRISIS CARE

18 SERVICES.—Section 1920 of the Public Health Service 

19 Act (42 U.S.C. 300x–9) is amended by adding at the end 

20 the following: 

21 ‘‘(d) CRISIS CARE.— 

22 ‘‘(1) IN GENERAL.—Except as provided in para23 graph (3), a State shall expend at least 5 percent of 

24 the allotment of the State pursuant to a funding 

25 agreement under section 1911 for each fiscal year to 


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1 support programs described in section 

2 1912(b)(1)(A)(vi). 

3 ‘‘(2) STATE FLEXIBILITY.—In lieu of expending 

4 5 percent of the State’s allotment for a fiscal year 

5 as required by paragraph (1), a State may elect to 

6 expend not less than 10 percent of such amount by 

7 the end of 2 consecutive fiscal years. 

8 ‘‘(3) FUNDING CONTINGENCY.—Paragraph (1) 

9 shall not apply with respect to a fiscal year unless 

10 the amount made available to carry out this section 

11 for that fiscal year exceeds the amount appropriated 

12 to carry out this section for fiscal year 2020 by at 

13 least $35,000,000.’’. 

Æ 


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