II 

118TH CONGRESS 

2D SESSION S. 4312 

To establish a United States Senate Commission on Mental Health for the 

purpose of providing to Congress and the President independent, expert 

policy recommendations to improve access to and affordability of mental 

health care services. 

IN THE SENATE OF THE UNITED STATES 

MAY 9, 2024 

Mr. FETTERMAN (for himself and Ms. SMITH) introduced the following bill; 

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

A BILL 

To establish a United States Senate Commission on Mental 

Health for the purpose of providing to Congress and 

the President independent, expert policy recommendations to improve access to and affordability of mental 

health care services. 

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 ‘‘United States Senate 

5 Commission on Mental Health Act of 2024’’. 

6 SEC. 2. PURPOSES. 

7 The purposes of this section are as follows: 


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1 (1) To establish the United States Senate Com2 mission on Mental Health to review available data, 

3 research, policies, and other pertinent information 

4 regarding mental health care services and delivery. 

5 (2) To facilitate discussion among relevant 

6 stakeholders, including Federal agencies, to under7 stand what policies have successfully improved men8 tal health care services and delivery and to develop 

9 recommendations for congressional and executive ac10 tion to improve access to, and affordability of, men11 tal health care services. 

12 SEC. 3. ESTABLISHMENT OF UNITED STATES SENATE COM13 MISSION ON MENTAL HEALTH. 

14 (a) ESTABLISHMENT.—There is established a United 

15 States Senate Commission on Mental Health (referred to 

16 in this Act as the ‘‘Commission’’). 

17 (b) PURPOSES.—The purpose of the Commission is 

18 to provide Congress and the President independent, expert 

19 policy recommendations to improve mental health care 

20 services, including improving equitable access and afford21 ability. 

22 (c) MEMBERSHIP.— 

23 (1) IN GENERAL.—The Commission shall be 

24 composed of 8 members, as follows: 


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1 (A) Six shall be Members of the Senate ap2 pointed by the President of the Senate, of 

3 which— 

4 (i) 3 shall be selected, after consulta5 tion with the majority leader of the Senate, 

6 from the majority party; and 

7 (ii) 3 shall be selected, after consulta8 tion with the minority leader of the Senate, 

9 from the minority party. 

10 (B) Two shall be experts with a dem11 onstrated academic and professional back12 ground in mental health care, selected by the 

13 majority leader of the Senate, after consultation 

14 with the minority leader of the Senate. 

15 (2) PERIOD OF APPOINTMENT.—Each member 

16 of the Commission shall be appointed for a term of 

17 2 years. 

18 (3) CHAIR AND VICE CHAIR.—On the com19 mencement of each 2-year period of appointment of 

20 the members of the Commission, the members of the 

21 Commission shall select a Chair from among the 

22 members appointed under paragraph (1)(A)(i), and 

23 a Vice Chair from among the members appointed 

24 under paragraph (1)(A)(ii). 


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1 (4) NO COMPENSATION.—The members of the 

2 Commission shall serve without compensation for 

3 their work on the Commission. 

4 (5) TRAVEL EXPENSES.—A member of the 

5 Commission shall be allowed travel expenses, includ6 ing per diem in lieu of subsistence, at rates author7 ized for employees of agencies under subchapter I of 

8 chapter 57 of title 5, United States Code, while 

9 away from their homes or regular places of business 

10 in the performance of services for the Commission. 

11 (d) RETENTION OF SUPPORT.—The Commission 

12 shall retain and make use of such staff, materials, and 

13 infrastructure of the Senate as is necessary to carry out 

14 the duties of the Commission. 

15 (e) MEETINGS.—The Commission shall conduct 

16 meetings, not less frequently than every 90 days, with rel17 evant stakeholders across the United States, including 

18 mental health care providers (such as physicians, psychia19 trists, psychologists, counselors, and therapists), patients, 

20 and individuals representing advocacy groups, academic 

21 and research institutions, nonprofit organizations, indus22 try, and other relevant stakeholders, as determined by the 

23 Commission. 

24 (f) VACANCIES.—A vacancy in the Commission— 


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1 (1) shall not affect the powers of the Commis2 sion; and 

3 (2) shall be filled in the same manner as the 

4 original appointment. 

5 SEC. 4. DUTIES OF THE COMMISSION. 

6 (a) IN GENERAL.—The Commission shall study rel7 evant issues regarding mental health care services and de8 livery and issue reports, as required under subsection (b). 

9 (b) TOPICS STUDIED.— 

10 (1) IN GENERAL.—Each calendar year, the 

11 Commission shall study specific topics relating to 

12 improving mental health care services and delivery, 

13 including improving equitable access and afford14 ability with respect to such services, in accordance 

15 with paragraphs (2) and (3), including by convening 

16 meetings described in section 3(e). 

17 (2) INITIAL TOPICS.—In the first year following 

18 the establishment of the Commission, the Commis19 sion shall consider the following topics: 

20 (A) Mental health care services coverage, 

21 including mental health parity requirements, 

22 under the Medicare program under title XVIII 

23 of the Social Security Act (42 U.S.C. 1395 et 

24 seq.), the Medicaid program under title XIX of 

25 such Act (42 U.S.C. 1396 et seq.), the State 


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1 Children’s Health Insurance Program under 

2 title XXI of such Act (42 U.S.C. 1397aa et 

3 seq.), and, as the Commission determines ap4 propriate, other health programs administered 

5 by the Federal Government, including— 

6 (i) the extent to which mental health 

7 care services are covered under such pro8 grams; and 

9 (ii) the extent to which mental health 

10 parity requirements applicable to such pro11 grams are effective in meeting the mental 

12 health care needs of patients. 

13 (B) Reimbursement rates for mental 

14 health care services with respect to mental 

15 health care providers, including— 

16 (i) the extent to which reimbursement 

17 rates under the programs described in sub18 paragraph (A)(i), impact the affordability, 

19 accessibility, and availability of mental 

20 health care services; 

21 (ii) how reimbursement rates for all 

22 mental health care services differ from re23 imbursement rates for physical health care 

24 services under such programs; and 


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1 (iii) the probable impact of increasing 

2 the rates of mental health reimbursement 

3 rates under such programs, including the 

4 cost to the Federal Government and the 

5 number of providers and patients who 

6 would be impacted. 

7 (C) Workforce challenges with respect to 

8 mental health care providers, including— 

9 (i) challenges and barriers that pre10 vent individuals, including students, from 

11 entering mental health care professions; 

12 (ii) challenges and barriers that stu13 dents enrolled in mental health care pro14 fessional training programs face while pur15 suing their degrees; 

16 (iii) the challenges and barriers pro17 fessors and staff in such training programs 

18 face; 

19 (iv) challenges and barriers mental 

20 health care providers face; and 

21 (v) factors that contribute to mental 

22 health care providers leaving the field. 

23 (3) TOPICS IN SUBSEQUENT YEARS.—After the 

24 submission of the first report under subsection (c) 

25 that addresses the topics described in paragraph (2), 


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1 the Commission shall consider such topics each year 

2 as the Commission determines appropriate. 

3 (4) DEFINITION.—In this subsection, the term 

4 ‘‘mental health parity’’ means— 

5 (A) with respect to the Medicare program 

6 under title XVIII of the Social Security Act (42 

7 U.S.C. 1395 et seq.), and other applicable plans 

8 administered by the Federal Government, ef9 forts to ensure that reimbursement rates for 

10 mental health care services are equivalent to re11 imbursement rates for physical health care serv12 ices under such program or such plans; and 

13 (B) with respect to the Medicaid program 

14 under title XIX of such Act (42 U.S.C. 1396 et 

15 seq.) and the State Children’s Health Insurance 

16 Program under title XXI of such Act (42 

17 U.S.C. 1397aa et seq.), the requirements set 

18 forth in the rule titled ‘‘Medicaid and Children’s 

19 Health Insurance Programs; Mental Health 

20 Parity and Addiction Equity Act of 2008; the 

21 Application of Mental Health Parity Require22 ments to Coverage Offered by Medicaid Man23 aged Care Organizations, the Children’s Health 

24 Insurance Program (CHIP), and Alternative 

25 Benefit Plans’’ (81 Fed. Reg. 18390). 


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1 (c) ANNUAL REPORT.— 

2 (1) IN GENERAL.—Not later than January 1 

3 each year, beginning with the first year that begins 

4 at least 2 years after the date of enactment of this 

5 Act, the Commission shall submit to Congress, the 

6 Secretary of Health and Human Services, and, as 

7 appropriate, the heads of other relevant Federal 

8 agencies a report, based on the studies carried out 

9 under subsection (b), regarding the state of mental 

10 health care services and delivery, including a needs 

11 and gap assessment across the continuum of mental 

12 health care. Each report shall include— 

13 (A) an analysis of the current barriers to 

14 accessing affordable and equitable mental 

15 health care services, challenges facing the men16 tal health care workforce, and successful efforts 

17 by State, local, or Tribal entities to improve 

18 mental health care services and delivery; and 

19 (B) policy recommendations for legislative 

20 and administrative actions to address issues 

21 identified through the report. 

22 (2) CONTENTS OF REPORT.—Each report sub23 mitted under paragraph (1) shall include a discus24 sion of the topics considered under subsection (b) for 

25 the applicable year and the following: 


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1 (A) The most current and comprehensive 

2 data and research on the state of mental health 

3 care in the United States, including barriers to 

4 accessing mental health care. 

5 (B) A comprehensive needs and gap as6 sessment across the continuum of mental health 

7 care services, using disaggregated data, for— 

8 (i) different age groups, such as for 

9 children, adolescents, adults, and older 

10 adults; 

11 (ii) student status, for each of the pri12 mary, secondary, and postsecondary levels; 

13 (iii) people with disabilities; 

14 (iv) individuals with co-morbidities, 

15 including substance use; 

16 (v) racial and ethnic minorities; 

17 (vi) LGBTQ+ individuals; 

18 (vii) individuals residing in rural com19 munities; and 

20 (viii) members of Tribal communities. 

21 (C) Prioritizing health equity through 

22 building and maintaining a culturally competent 

23 and diverse mental health care workforce across 

24 the continuum of care. 


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1 SEC. 5. TERMINATION OF COMMISSION. 

2 The Commission shall terminate 10 years after the 

3 date of enactment of this Act. 

4 SEC. 6. AUTHORIZATION OF APPROPRIATIONS. 

5 To carry out this Act, there is authorized to be appro6 priated such sums as may be necessary for each of fiscal 

7 years 2025 through 2034. 

Æ 


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