I 

118TH CONGRESS 

2D SESSION H. R. 8543 

To amend the Social Security Act and the Public Health Service Act to 

permanently authorize certified community behavioral health clinics, and 

for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 23, 2024 

Ms. MATSUI (for herself, Mr. BUCSHON, Ms. CRAIG, Mr. MOLINARO, and Mr. 

TONKO) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on 

Ways and Means, 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 amend the Social Security Act and the Public Health 

Service Act to permanently authorize certified community 

behavioral health clinics, 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 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Ensuring Excellence in Mental Health Act’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows: 


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Sec. 1. Short title. 

TITLE I—ENSURING PERMANENCY FOR CERTIFIED COMMUNITY 

BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM 

Sec. 101. Establishing a Medicaid Prospective Payment System for Certified 

Community Behavioral Health Clinics. 

TITLE II—COVERAGE OF CERTIFIED COMMUNITY BEHAVIORAL 

HEALTH CLINIC SERVICES UNDER THE MEDICARE PROGRAM 

Sec. 201. Coverage of certified community behavioral health clinic services 

under the Medicare program. 

TITLE III—COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS 

Sec. 301. Operating grants for community behavioral health clinics. 

1 TITLE I—ENSURING PERMA2 NENCY FOR CERTIFIED COM3 MUNITY BEHAVIORAL 

4 HEALTH CLINICS IN THE 

5 MEDICAID PROGRAM 

6 SEC. 101. ESTABLISHING A MEDICAID PROSPECTIVE PAY7 MENT SYSTEM FOR CERTIFIED COMMUNITY 

8 BEHAVIORAL HEALTH CLINICS. 

9 Section 1902 of the Social Security Act (42 U.S.C. 

10 1396a) is amended by adding at the end the following new 

11 subsection: 

12 ‘‘(uu) PAYMENT FOR SERVICES PROVIDED BY CER13 TIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS.— 

14 ‘‘(1) IN GENERAL.—Beginning with fiscal year 

15 2024, with respect to services furnished on or after 

16 January 1, 2024, and each succeeding fiscal year, a 

17 State may provide under the State plan under this 

18 title (or under a waiver of such plan) for payment 


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1 for services described in section 1905(a)(31) fur2 nished by a certified community behavioral health 

3 clinic (in this subsection referred to as a ‘clinic’) in 

4 accordance with the provisions of this subsection. 

5 ‘‘(2) PAYMENT FOR SERVICES IN INITIAL YEAR

6 AND EVERY THIRD YEAR.—Subject to paragraphs 

7 (4), (5), and (6), for services furnished by a clinic 

8 in the first fiscal year for which a State elects to 

9 provide for payment for services described in section 

10 1905(a)(31) in accordance with the payment option 

11 under paragraph (1), and every third fiscal year 

12 thereafter in which the State makes such an elec13 tion, the State shall provide for payment for such 

14 services in an amount (calculated on the basis of 

15 daily visits or unduplicated monthly visits, at the 

16 State’s election) that is equal to 100 percent of the 

17 average costs of the clinic of furnishing any of the 

18 services described in paragraph (31) of section 

19 1905(a) during the 2 fiscal years preceding the fis20 cal year involved which are reasonable and related to 

21 the costs of furnishing such services; provided that, 

22 in the absence of complete actual cost data rep23 resenting the provision of the full covered benefit in 

24 such preceding fiscal years, certified community be25 havioral health clinics may, at the State’s discretion, 


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1 use estimated or projected data relating to specific 

2 services for which they lack cost experience. The 

3 per-unit rate derived from such cost data shall be 

4 adjusted to take into account any increase or de5 crease in the scope of such services furnished by the 

6 clinic in the fiscal year involved. 

7 ‘‘(3) PAYMENT FOR SERVICES IN SUCCEEDING

8 FISCAL YEARS.—Subject to paragraphs (4), (5), and 

9 (6), for services described in section 1905(a)(31) 

10 furnished by a clinic for which a State elects to pro11 vide for payment for such services in accordance 

12 with the payment option under paragraph (1) and 

13 that are furnished in a fiscal year that is not de14 scribed in paragraph (2), the State plan shall pro15 vide for payment for such services in an amount 

16 (calculated on the basis of daily visits or 

17 unduplicated monthly visits, at the State’s election) 

18 that is equal to the amount calculated under this 

19 subsection for such services and clinic for the pre20 ceding year— 

21 ‘‘(A) increased by the percentage increase 

22 in the inflationary factor described in section 

23 1834(aa)(2)(C); and 

24 ‘‘(B) adjusted to take into account any in25 crease or decrease in the scope of such services 


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1 furnished by the clinic during the fiscal year in2 volved. 

3 ‘‘(4) ESTABLISHMENT OF INITIAL YEAR PAY4 MENT FOR NEW CLINICS.—In any case in which an 

5 entity first qualifies as a certified community behav6 ioral health clinic after the first fiscal year in which 

7 a State elects to provide for payment for services de8 scribed in section 1905(a)(31) in accordance with 

9 the payment option under paragraph (1), the State 

10 plan shall provide for payment for such services in 

11 the first 2 years in which the clinic so qualifies in 

12 an amount (calculated on the basis of daily visits or 

13 unduplicated monthly visits, at the State’s election) 

14 that is equal to the rates established under this sub15 section for other such clinics located in the same or 

16 adjacent area with a similar case load, or in the ab17 sence of any such clinic, based on the average per18 unit rate for other certified community behavioral 

19 health clinics in the State; provided, however, that 

20 effective, at latest, as of the 3rd year in which the 

21 clinic furnishes such services, the State establishes a 

22 unique payment rate for the clinic based on the 

23 methodology described in paragraph (2), using al24 lowable costs from the clinic’s first 2 fiscal years of 

25 operation as the basis for establishing such rates; 


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1 and provided, additionally, that in any year following 

2 the establishment of an initial rate under this para3 graph, the State plan or waiver provides for the pay4 ment amount to be calculated in accordance with 

5 paragraph (2) or (3) (as applicable). 

6 ‘‘(5) ADMINISTRATION IN THE CASE OF MAN7 AGED CARE.— 

8 ‘‘(A) IN GENERAL.—In the case of services 

9 furnished by a certified community behavioral 

10 health clinic pursuant to a contract between the 

11 clinic and a managed care entity (as defined in 

12 section 1932(a)(1)(B)), the State plan or a 

13 waiver of such plan shall provide for 1 of the 

14 following: 

15 ‘‘(i) Payment to the clinic by the 

16 State of a supplemental payment equal to 

17 the amount (if any) by which the amount 

18 determined under paragraph (2), (3), or 

19 (4) (as applicable) exceeds the amount of 

20 payments under the contract, with such 

21 supplemental payment being made pursu22 ant to a payment schedule agreed to by the 

23 State and the certified community behav24 ioral health clinic, but in no case less fre25 quently than every 3 months. 


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1 ‘‘(ii) Delegation by the State to the 

2 managed care entity of the obligation to 

3 pay the clinic at least the rate determined 

4 under paragraph (2), (3), or (4) (as appli5 cable); provided, however, that the State 

6 shall use reconciliation and oversight proc7 esses to ensure that each clinic is paid at 

8 least the amounts required under such 

9 paragraphs. 

10 ‘‘(6) ALTERNATIVE PAYMENT METHODOLO11 GIES.—Notwithstanding any other provision of this 

12 subsection, the State plan or a waiver of such plan 

13 may provide for payment in any year to a certified 

14 community behavioral health clinic for services de15 scribed in paragraph (31) of section 1905(a) in an 

16 amount which is determined under an alternative 

17 payment methodology that— 

18 ‘‘(A) is agreed to by the State and the clin19 ic; and 

20 ‘‘(B) results in payment to the clinic of an 

21 amount which is not less than the amount oth22 erwise required to be paid to the clinic under 

23 this subsection.’’. 


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1 TITLE II—COVERAGE OF CER2 TIFIED COMMUNITY BEHAV3 IORAL HEALTH CLINIC SERV4 ICES UNDER THE MEDICARE 

5 PROGRAM 

6 SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAV7 IORAL HEALTH CLINIC SERVICES UNDER THE 

8 MEDICARE PROGRAM. 

9 (a) COVERAGE.—Section 1861(s)(2) of the Social Se10 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 

11 (1) in subparagraph (II), by striking ‘‘and’’ at 

12 the end; 

13 (2) in subparagraph (JJ), by inserting ‘‘and’’ 

14 at the end; and 

15 (3) by adding at the end the following new sub16 paragraph: 

17 ‘‘(KK) certified community behavioral health 

18 clinic services (as defined in subsection (aa)(8)) fur19 nished on or after January 1, 2024.’’. 

20 (b) DEFINITIONS.—Section 1861(aa) of the Social 

21 Security Act (42 U.S.C. 1395x) is amended— 

22 (1) in the heading, by striking ‘‘and Federally 

23 Qualified Health Center Services’’ and inserting ‘‘, 

24 Federally Qualified Health Center Services, and CerVerDate Sep 11 2014 04:00 Jul 10, 2024 Jkt 049200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H8543.IH H8543

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1 tified Community Behavioral Health Clinic Serv2 ices’’; and 

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

4 paragraph: 

5 ‘‘(8) The terms ‘certified community behavioral 

6 health clinic services’ and ‘certified community behavioral 

7 health clinic’ have the meaning given those terms in para8 graphs (1) and (2), respectively, of section 1905(jj).’’. 

9 (c) PAYMENT.— 

10 (1) IN GENERAL.—Section 1833(a)(1) of the 

11 Social Security Act (42 U.S.C. 1395l(a)(1)) is 

12 amended— 

13 (A) by striking ‘‘and (HH)’’ and inserting 

14 ‘‘(HH)’’; and 

15 (B) by inserting before the semicolon at 

16 the end the following: ‘‘, and (II) with respect 

17 to certified community behavioral health clinic 

18 services for which payment is made under sec19 tion 1834(aa), the amounts paid shall be equal 

20 to 80 percent of the lesser of the actual charge 

21 or the amount determined under such section’’. 

22 (2) DEVELOPMENT AND IMPLEMENTATION OF

23 PROSPECTIVE PAYMENT SYSTEM.—Section 1834 of 

24 the Social Security Act (42 U.S.C. 1395m) is 


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1 amended by adding at the end the following new 

2 subsection: 

3 ‘‘(aa) DEVELOPMENT AND IMPLEMENTATION OF

4 PROSPECTIVE PAYMENT SYSTEM FOR CERTIFIED COM5 MUNITY BEHAVIORAL HEALTH CLINICS.— 

6 ‘‘(1) DEVELOPMENT.—The Secretary shall de7 velop a prospective payment system for payment to 

8 certified community behavioral health clinics (as de9 fined in section 1861(aa)(8)) for the furnishing of 

10 certified community behavioral health clinic services 

11 (as defined in such section) under this title. Such 

12 system shall be established to take into account the 

13 type, intensity, and duration of services furnished by 

14 certified community behavioral health clinics. Such 

15 system may include adjustments, including geo16 graphic adjustments, as determined appropriate by 

17 the Secretary. 

18 ‘‘(2) IMPLEMENTATION.— 

19 ‘‘(A) IN GENERAL.—The Secretary shall 

20 provide, for cost reporting periods beginning on 

21 or after January 1, 2024, for payments of pro22 spective payment rates for certified community 

23 behavioral health clinic services furnished by 

24 certified community behavioral health clinics 

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1 tive payment system developed by the Secretary 

2 under paragraph (1). 

3 ‘‘(B) INITIAL PAYMENTS.—The Secretary 

4 shall implement such prospective payment sys5 tem to reflect the national average allowable 

6 service costs of such clinics on the basis of the 

7 most current audited cost report data for two 

8 fiscal years available to the Secretary; provided 

9 that, in the absence of complete actual cost 

10 data representing the provision of the full cov11 ered benefit during the relevant fiscal years, 

12 certified community behavioral health clinics 

13 may, at the Secretary’s discretion, use esti14 mated or projected data relating to specific 

15 services. Initial payments shall be established 

16 without the application of a per visit limit or 

17 productivity screen and shall be based on na18 tional average costs per unit of service, updated 

19 as appropriate by the inflationary adjustment 

20 described in subparagraph (C). 

21 ‘‘(C) PAYMENTS IN SUBSEQUENT YEARS.— 

22 Payment rates in years after the year of imple23 mentation of such system shall be the payment 

24 rates in the previous year increased— 


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1 ‘‘(i) in the first year after implemen2 tation of such system, by the percentage 

3 increase in the MEI (as defined in section 

4 1842(i)(3)) for the year involved; and 

5 ‘‘(ii) in subsequent years, by the per6 centage increase in a market basket of cer7 tified community behavioral health clinic 

8 services, designed by the Secretary, or if 

9 such an index is not available, by the per10 centage increase in the MEI (as defined in 

11 section 1842(i)(3)) for the year involved. 

12 ‘‘(3) UNIT OF PAYMENT.—In establishing a 

13 prospective payment amount under the system under 

14 this subsection, the Secretary shall consider an ap15 propriate unit of service and a general system design 

16 that provides for continued access to quality serv17 ices. 

18 ‘‘(4) PERIODIC REEVALUATION OF RATES.—At 

19 the Secretary’s discretion, the Secretary shall, from 

20 time to time, adjust the amounts that would other21 wise be applicable under subparagraph (2) by a per22 centage determined appropriate by the Secretary to 

23 reflect such factors as changes in the intensity of 

24 services furnished within a unit of service, the aver25 age cost of providing care per unit of service, and 


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1 other factors that the Secretary considers to be rel2 evant. Such adjustment shall be made before the up3 date under clause (i) or (ii) of paragraph (2)(C)(i) 

4 has been applied for the year.’’. 

5 (d) WAIVER OF APPLICATION OF DEDUCTIBLE.— 

6 Section 1833(b)(4) of the Social Security Act (42 U.S.C. 

7 1395l(b)(4)) is amended by inserting ‘‘or certified commu8 nity behavioral health clinic services’’ before the comma 

9 at the end. 

10 (e) PRRB REVIEW OF COST REPORTS.—Section 

11 1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) 

12 is amended by striking ‘‘and a Federally qualified health 

13 center’’ and inserting ‘‘, a Federally qualified health cen14 ter, and a certified community behavioral health clinic’’. 

15 (f) SAFE HARBOR FOR WAIVER OF COINSURANCE.— 

16 Section 1128B(b)(3)(D) of the Social Security Act (42 

17 U.S.C. 1320a–7b(b)(3)(D)) is amended by inserting ‘‘or 

18 a certified community behavioral health clinic’’ after 

19 ‘‘Federally qualified health care center’’. 

20 (g) EFFECTIVE DATE.—The amendments made by 

21 this section shall apply with respect to services furnished 

22 on or after January 1, 2024. 


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1 TITLE III—COMMUNITY BEHAV2 IORAL HEALTH CLINIC 

3 GRANTS 

4 SEC. 301. OPERATING GRANTS FOR COMMUNITY BEHAV5 IORAL HEALTH CLINICS. 

6 Part D of title III of the Public Health Service Act 

7 (42 U.S.C. 254b et seq.) is amended by adding at the end 

8 the following: 

9 ‘‘Subpart XIII—Community Behavioral Health 

10 Clinics 

11 ‘‘SEC. 340J. DEFINITIONS. 

12 ‘‘In this subpart: 

13 ‘‘(1) CERTIFIED COMMUNITY BEHAVIORAL

14 HEALTH CLINIC.—The term ‘certified community be15 havioral health clinic’ has the meaning given the 

16 term in section 1905(jj)(2)) of the Social Security 

17 Act. 

18 ‘‘(2) CERTIFIED COMMUNITY BEHAVIORAL

19 HEALTH SERVICES.—The term ‘certified community 

20 behavioral health services’ has the meaning given the 

21 term in section 1905(jj)(1) of the Social Security 

22 Act. 


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1 ‘‘SEC. 340J–1. COMMUNITY BEHAVIORAL HEALTH CLINIC 

2 CERTIFICATION. 

3 ‘‘(a) IN GENERAL.—Not later than 180 days after 

4 the date of enactment of the Ensuring Excellence in Men5 tal Health Act, the Secretary, after public notice and op6 portunity for comment, shall publish in the Federal Reg7 ister criteria for a clinic to be certified as a community 

8 behavioral health clinic for purposes of section 

9 1905(jj)(2)(D)(ii) of the Social Security Act. 

10 ‘‘(b) REQUIREMENTS.—The criteria published under 

11 subsection (a) shall include criteria with respect to the fol12 lowing: 

13 ‘‘(1) STAFFING.—Staffing requirements, includ14 ing criteria that staff have diverse disciplinary back15 grounds, have necessary State-required license and 

16 accreditation, and are culturally and linguistically 

17 trained to serve the needs of the patient populations 

18 of the community behavioral health clinic. 

19 ‘‘(2) AVAILABILITY AND ACCESSIBILITY OF

20 SERVICES.—Availability and accessibility of services, 

21 including crisis management services that are avail22 able and accessible 24 hours a day, the use of a slid23 ing scale for payment, and no rejection for services 

24 or limiting of services on the basis of a patient’s 

25 ability to pay or a place of residence. 


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1 ‘‘(3) CARE COORDINATION.—Care coordination, 

2 including requirements to coordinate care across set3 tings and providers to ensure seamless transitions 

4 for patients across the full spectrum of health serv5 ices including acute, chronic, and behavioral health 

6 needs. Care coordination requirements shall include 

7 partnerships or formal contracts with the following: 

8 ‘‘(A) Federally-qualified health centers (as 

9 defined in section 1905(l) of the Social Security 

10 Act) and, as applicable, rural health clinics (as 

11 so defined), to provide Federally-qualified 

12 health center services (as so defined) and, as 

13 applicable, rural health clinic services (as so de14 fined), to the extent such services are not pro15 vided directly through the community behav16 ioral health clinic. 

17 ‘‘(B) Inpatient psychiatric facilities and 

18 substance use detoxification, post-detoxification 

19 step-down services, and residential programs. 

20 ‘‘(C) Other community or regional services, 

21 supports, and providers, including schools, child 

22 welfare agencies, juvenile and criminal justice 

23 agencies and facilities, Indian Health Service 

24 youth regional treatment centers, State-licensed 

25 and nationally accredited child placing agencies 


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1 for therapeutic foster care service, and other so2 cial and human services. 

3 ‘‘(D) Medical centers, outpatient clinics, 

4 and drop-in centers of the Department of Vet5 erans Affairs and other facilities of the Depart6 ment (as defined in section 1701 of title 38, 

7 United States Code). 

8 ‘‘(E) Inpatient acute care hospitals and 

9 hospital outpatient clinics. 

10 ‘‘(4) SCOPE OF SERVICES.—Provision (in a 

11 manner reflecting person-centered care) of the full 

12 array of certified community behavioral health serv13 ices which, if not available directly through the com14 munity behavioral health clinic, are provided or re15 ferred through formal relationships with other pro16 viders. 

17 ‘‘(5) QUALITY AND OTHER REPORTING.—Re18 quirements relating to development by the commu19 nity behavioral health clinic of an effective procedure 

20 for compiling and reporting to the Secretary such 

21 statistics and other information as the Secretary 

22 may require relating to— 

23 ‘‘(A) the costs of its operations; 

24 ‘‘(B) the patterns of use of its services, in25 cluding the reporting of encounter data, clinical 


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1 outcomes data, quality data, and such other 

2 data as the Secretary may require; 

3 ‘‘(C) the availability, accessibility, and ac4 ceptability of its services; and 

5 ‘‘(D) such other matters relating to oper6 ations of the applicant as the Secretary may re7 quire. 

8 ‘‘(6) ORGANIZATIONAL AUTHORITY.—Require9 ments that a community behavioral health clinic 

10 be— 

11 ‘‘(A) a nonprofit entity; 

12 ‘‘(B) part of a local government behavioral 

13 health authority; 

14 ‘‘(C) operated under the authority of the 

15 Indian Health Service; 

16 ‘‘(D) operated by an Indian Tribe or Trib17 al organization pursuant to a contract, grant, 

18 cooperative agreement, or compact with the In19 dian Health Service pursuant to the Indian 

20 Self-Determination and Education Assistance 

21 Act; or 

22 ‘‘(E) operated by an urban Indian organi23 zation pursuant to a grant or contract with the 

24 Indian Health Service under title V of the In25 dian Health Care Improvement Act. 


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1 ‘‘SEC. 340J–2. OPERATING GRANTS FOR COMMUNITY BE2 HAVIORAL HEALTH CLINICS. 

3 ‘‘(a) IN GENERAL.—The Secretary shall establish a 

4 grant program under which the Secretary shall award 

5 grants to eligible community behavioral health clinics to 

6 provide (in a manner reflecting person-centered care) the 

7 full array of certified community behavioral health serv8 ices. 

9 ‘‘(b) ELIGIBILITY.—To be eligible to receive a grant 

10 under subsection (a), a community behavioral health clinic 

11 shall be— 

12 ‘‘(1) a certified community behavioral health 

13 clinic; or 

14 ‘‘(2) a community behavioral health clinic that 

15 indicates in the grant application that the clinic will 

16 use the grant funds to meet the criteria described in 

17 section 340J–1(a). 

18 ‘‘(c) USE OF FUNDS.—A community behavioral 

19 health clinic that receives a grant under subsection (a)— 

20 ‘‘(1) shall use the grant funds— 

21 ‘‘(A) to provide the services described in 

22 subsection (a); and 

23 ‘‘(B) in the case of a community behavioral 

24 health clinic described in subsection (b)(2), to 

25 meet the criteria described in section 340J– 

26 1(a); and 


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1 ‘‘(2) may use the grant funds— 

2 ‘‘(A) to carry out other activities that— 

3 ‘‘(i) reduce costs associated with the 

4 provision of certified community behavioral 

5 health services; 

6 ‘‘(ii) improve access to, and avail7 ability of, certified community behavioral 

8 health services provided to individuals 

9 served by the community behavioral health 

10 clinic; 

11 ‘‘(iii) enhance the quality and coordi12 nation of certified community behavioral 

13 health services; or 

14 ‘‘(iv) improve the health status of 

15 communities; and 

16 ‘‘(B) to pay for— 

17 ‘‘(i) the costs of acquiring and leasing 

18 buildings and equipment (including the 

19 costs of amortizing the principal of, and 

20 paying interest on, loans); 

21 ‘‘(ii) costs relating to the purchase or 

22 lease of equipment, including data and in23 formation systems and behavioral health 

24 information technology to facilitate data 

25 reporting and other purposes; 


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1 ‘‘(iii) the costs of in-service staff 

2 training and other operational or infra3 structure costs identified by the Secretary; 

4 and 

5 ‘‘(iv) costs associated with expanding 

6 and modernizing existing buildings or con7 structing new buildings (including the 

8 costs of amortizing the principal of, and 

9 paying the interest on, loans), if such costs 

10 are specifically allowed for in the grant op11 portunity published by the Secretary. 

12 ‘‘(d) TERM.—Grants awarded under subsection (a) 

13 shall be for a period of not more than 5 years. 

14 ‘‘(e) CONDITION ON RECEIPT OF FUNDS.—The Sec15 retary shall not make a grant to an applicant under sub16 section (a) unless the applicant provides assurances to the 

17 Secretary that within 120 days of receiving grant funding 

18 for the operation of the clinic, the applicant will submit 

19 for approval by the Secretary an implementation plan that 

20 describes how the applicant will— 

21 ‘‘(1) provide the services described in subsection 

22 (a); and 

23 ‘‘(2) in the case of a community behavioral 

24 health clinic described in subsection (b)(2), meet the 

25 criteria described in section 340J–1(a). 


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1 ‘‘(f) AMOUNT OF GRANT.— 

2 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

3 the amount of a grant made in any fiscal year to a 

4 community behavioral health clinic under subsection 

5 (a) shall be determined by the Secretary based on 

6 information provided by the community behavioral 

7 health clinic, but may not exceed an amount equal 

8 to the difference obtained by subtracting— 

9 ‘‘(A) the sum obtained by adding— 

10 ‘‘(i) the total State, local, and other 

11 operational funding provided to the clinic 

12 for such fiscal year; and 

13 ‘‘(ii) the fees, premiums, and third14 party reimbursements that the clinic rea15 sonably expects to receive for its operations 

16 in such fiscal year; from 

17 ‘‘(B) the costs of operating the clinic to 

18 meet the purposes and requirements of the 

19 grant program under this section during such 

20 fiscal year. 

21 ‘‘(2) REQUIREMENT.— 

22 ‘‘(A) IN GENERAL.—In determining the 

23 costs described in paragraph (1)(B), the Sec24 retary may estimate the anticipated costs of the 

25 grant recipient in— 


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1 ‘‘(i) providing the services described in 

2 subsection (a), including the anticipated 

3 costs of providing any individual certified 

4 community behavioral health service that 

5 the applicant entity does not have cost ex6 perience providing at the time of submit7 ting an application for such grant; and 

8 ‘‘(ii) if applicable, meeting the criteria 

9 described in section 340J–1(a). 

10 ‘‘(B) ANTICIPATED COSTS.—The Secretary 

11 shall base the estimate of anticipated costs 

12 under subparagraph (A) on an estimate of an13 ticipated costs provided by the applicable com14 munity behavioral health clinic. 

15 ‘‘(3) PAYMENTS.—The Secretary may— 

16 ‘‘(A) award grants under subsection (a)— 

17 ‘‘(i) in advance or through reimburse18 ment; and 

19 ‘‘(ii) in installments; 

20 ‘‘(B) make adjustments to account for 

21 overpayments or underpayments. 

22 ‘‘(g) USE OF ACCREDITATION.— 

23 ‘‘(1) IN GENERAL.—In selecting grant recipi24 ents under this section, the Secretary may take into 


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1 account whether an applicant community behavioral 

2 health clinic is accredited under section 340J–5(a). 

3 ‘‘(2) COMPLIANCE.—In determining whether a 

4 community behavioral health clinic receiving a grant 

5 under this section is providing the services described 

6 in subsection (a) and, if applicable, meeting the cri7 teria described in section 340J–1(a), the Secretary 

8 may take into account whether the community be9 havioral health clinic is accredited under section 

10 340J–5(a). 

11 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 

12 ‘‘(1) IN GENERAL.—There is authorized to be 

13 appropriated to carry out this section, $552,500,000 

14 for each of fiscal years 2024 through 2028. 

15 ‘‘(2) MAINTENANCE OF FUNDING.—The 

16 amount made available under paragraph (1) shall 

17 supplement (and not supplant) any other Federal 

18 funding made available for community behavioral 

19 health clinics. 

20 ‘‘SEC. 340J–3. TECHNICAL ASSISTANCE. 

21 ‘‘(a) IN GENERAL.—Not later than 180 days after 

22 the date of enactment of the Ensuring Excellence in Men23 tal Health Act, the Secretary shall establish programs 

24 through which the Secretary shall provide (either through 

25 the Department of Health and Human Services or by 


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1 grant or contract) technical assistance and other assist2 ance to any of the following: 

3 ‘‘(1) Entities that receive a grant under section 

4 340J–2. 

5 ‘‘(2) Entities participating in a Medicaid dem6 onstration program under section 223(d) of the Pro7 tecting Access to Medicare Act. 

8 ‘‘(3) Certified community behavioral health clin9 ics (as defined in sections 1861(aa)(8) and 

10 1905(jj)(2) of the Social Security Act), furnishing 

11 services under title XVIII or title XIX of such Act. 

12 ‘‘(4) Health or social service provider organiza13 tions pursuing or considering certified community 

14 behavioral health clinic status or partnering with 

15 certified community behavioral health clinics. 

16 ‘‘(5) Other stakeholders, for the purpose of fa17 cilitating successful implementation of the certified 

18 community behavioral health clinic model. 

19 ‘‘(b) INCLUSIONS.—Assistance provided by the Sec20 retary under subsection (a) may include technical and 

21 nonfinancial assistance, including— 

22 ‘‘(1) fiscal and program management assist23 ance; 

24 ‘‘(2) operational and administrative support; 

25 and 


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1 ‘‘(3) the provision of information to the entities 

2 about the variety of resources available under this 

3 part and how those resources can be best used to 

4 meet the health and behavioral health needs of the 

5 communities served by the entities. 

6 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

7 is authorized to be appropriated to carry out this section 

8 $6,000,000 for each of fiscal years 2024 through 2028. 

9 ‘‘SEC. 340J–4. DATA INFRASTRUCTURE FOR COMMUNITY 

10 BEHAVIORAL HEALTH CLINIC REPORTING. 

11 ‘‘(a) IN GENERAL.—Not later than 180 days after 

12 the date of enactment of the Ensuring Excellence in Men13 tal Health Act, the Secretary shall establish a system 

14 under which the Secretary shall collect and analyze data 

15 on community behavioral health clinics. 

16 ‘‘(b) SCOPE OF DATA COLLECTION.—The system es17 tablished under subsection (a) shall be used by the Sec18 retary to collect and analyze data from— 

19 ‘‘(1) entities that receive a grant under section 

20 340J–2; and 

21 ‘‘(2) organizations that provide services, or have 

22 applied to provide services, under title XVIII of the 

23 Social Security Act, as described in section 

24 1861(aa)(8) of such Act, or under a State Medicaid 


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1 program in accordance with section 1905(jj) of such 

2 Act. 

3 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

4 is authorized to be appropriated to carry out this section 

5 $51,000,000 for each of fiscal years 2024 through 2028. 

6 ‘‘SEC. 340J–5. COMMUNITY BEHAVIORAL HEALTH CLINIC 

7 ACCREDITATION. 

8 ‘‘(a) ACCREDITATION STANDARDS.—A community 

9 behavioral health clinic may be accredited if the entity— 

10 ‘‘(1) meets the standards of an approved ac11 creditation body; and 

12 ‘‘(2) authorizes the accreditation body to sub13 mit to the Secretary (or such agency as the Sec14 retary may designate) such records or other infor15 mation as the Secretary may require. 

16 ‘‘(b) APPROVAL OF ACCREDITATION BODIES.— 

17 ‘‘(1) IN GENERAL.—The Secretary may approve 

18 a private nonprofit organization to be an accredita19 tion body for the accreditation of community behav20 ioral health clinics under subsection (a) if— 

21 ‘‘(A) using inspectors qualified to evaluate 

22 quality of care in a behavioral health service 

23 setting, the accreditation body agrees to inspect 

24 the clinic with such frequency as is determined 

25 by the Secretary; 


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1 ‘‘(B) the standards applied by the body in 

2 determining whether or not to accredit a clinic 

3 correspond to the criteria described in section 

4 340J–1(a), and are not less restrictive than 

5 such criteria; 

6 ‘‘(C) there is adequate provision for assur7 ing that the standards of the accreditation body 

8 continue to be met by the clinic; 

9 ‘‘(D) in the case of any clinic previously 

10 accredited by the body which has had its ac11 creditation denied, suspended, withdrawn, or re12 voked or which has had any other action taken 

13 against it by the accrediting body, the accred14 iting body agrees to submit to the Secretary the 

15 name of such clinic within 30 days of the action 

16 taken; and 

17 ‘‘(E) if the accreditation body has its ap18 proval withdrawn by the Secretary, the body 

19 agrees to notify each clinic accredited by the 

20 body of the withdrawal within 10 days of the 

21 withdrawal.’’. 

Æ 


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