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[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 2993 Introduced in Senate (IS)]

<DOC>

118th CONGRESS
  1st Session
                                S. 2993

 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 SENATE OF THE UNITED STATES

           September 28 (legislative day, September 22), 2023

  Ms. Stabenow (for herself and Mr. Cornyn) introduced the following 
  bill; which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 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.

    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 ``Ensuring 
Excellence in Mental Health Act''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.
TITLE I--ENSURING PERMANENCY FOR CERTIFIED COMMUNITY BEHAVIORAL HEALTH 
                    CLINICS IN THE MEDICAID PROGRAM

Sec. 101. Establishing Certified Community Behavioral Health Clinic 
                            Services as a Medicaid State Plan Option.
Sec. 102. 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.

TITLE I--ENSURING PERMANENCY FOR CERTIFIED COMMUNITY BEHAVIORAL HEALTH 
                    CLINICS IN THE MEDICAID PROGRAM

SEC. 101. ESTABLISHING CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC 
              SERVICES AS A MEDICAID STATE PLAN OPTION.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (30), by striking ``; and'' and 
                inserting a semicolon;
                    (B) by redesignating paragraph (31) as paragraph 
                (32); and
                    (C) by inserting after paragraph (30) the following 
                new paragraph:
            ``(31) certified community behavioral health clinic 
        services, as defined in subsection (jj); and''; and
            (2) by adding at the end the following new subsection:
    ``(jj) Certified Community Behavioral Health Clinic Services.--
            ``(1) In general.--The term `certified community behavioral 
        health services' means any of the following when furnished to 
        an individual as a patient of a certified community behavioral 
        health clinic (as defined in paragraph (2)), in a manner 
        reflecting person-centered care and which, if not available 
        directly through a certified community behavioral health 
        clinic, may be provided or referred through formal 
        relationships with other providers:
                    ``(A) Crisis mental health services, including 24-
                hour mobile crisis teams, emergency crisis intervention 
                services, and crisis stabilization.
                    ``(B) Screening, assessment, and diagnosis, 
                including risk assessment.
                    ``(C) Patient-centered treatment planning or 
                similar processes, including risk assessment and crisis 
                planning.
                    ``(D) Outpatient mental health and substance use 
                services.
                    ``(E) Outpatient clinic primary care screening and 
                monitoring of key health indicators and health risk.
                    ``(F) Targeted case management.
                    ``(G) Psychiatric rehabilitation services.
                    ``(H) Peer support and counselor services and 
                family supports.
                    ``(I) Intensive, community-based mental health care 
                for members of the armed forces and veterans, 
                particularly those members and veterans located in 
                rural areas, provided the care is consistent with 
                minimum clinical mental health guidelines promulgated 
                by the Veterans Health Administration, including 
                clinical guidelines contained in the Uniform Mental 
                Health Services Handbook of such Administration.
            ``(2) Certified community behavioral health clinic.--The 
        term `certified community behavioral health clinic' means an 
        organization that--
                    ``(A) is engaged in furnishing to patients all of 
                the services described in paragraph (1);
                    ``(B) is legally authorized to furnish such 
                services under State law;
                    ``(C) agrees, as a condition of the certification 
                described in subparagraph (D), to furnish to the State 
                or Secretary any data required as part of ongoing 
                monitoring of the organization's provision of services, 
                including any such data as the State, by agreement with 
                the Secretary, shall access via the system described in 
                section 340J-4 of the Public Health Service Act; and
                    ``(D) has been certified by a State--
                            ``(i) as meeting the criteria established 
                        by the Secretary pursuant to subsection (a) of 
                        section 223 of the Protecting Access to 
                        Medicare Act and is carrying out a 
                        demonstration program under this title under 
                        subsection (d) of such section; or
                            ``(ii) for purposes of services furnished 
                        on or after January 1, 2024, subject to 
                        paragraph (3), as meeting the criteria 
                        established under section 340J-1(a) of the 
                        Public Health Service Act, and as being 
                        eligible to furnish medical assistance under 
                        the State plan under this title (or under a 
                        waiver of such plan) for certified community 
                        behavioral health services described in 
                        paragraph (1).
            ``(3) Accreditation.--In the case of services furnished on 
        or after January 1, 2024, at State option, a State may 
        determine that an organization does not meet the criteria 
        established under section 340J-1(a) of the Public Health 
        Service Act unless the organization has an accreditation by an 
        accreditation body approved under section 340J-5 of the Public 
        Health Service Act. An election by a State under the preceding 
        sentence shall not relieve a State of the requirement to 
        certify an organization under paragraph (2)(D).''.
    (b) Conforming Amendments.--
            (1) Section 1902(nn)(3) of such Act (42 U.S.C. 
        1396a(nn)(3)), is amended by striking ``paragraph (31)'' and 
        inserting ``the last numbered paragraph''.
            (2) The fifth sentence of section 1905(a) of such Act (42 
        U.S.C. 1396d(a)) is amended by striking ``paragraph (30)'' and 
        inserting ``the last numbered paragraph''.
            (3) Effective July 1, 2025, section 1902(a)(84)(A) of such 
        Act (42 U.S.C. 1396a(a)(84)(A)), as amended by section 
        5122(a)(2) of division FF of Public Law 117-328, is amended by 
        striking ``paragraph (31)'' and inserting ``the last numbered 
        paragraph''.

SEC. 102. ESTABLISHING A MEDICAID PROSPECTIVE PAYMENT SYSTEM FOR 
              CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS.

    Section 1902 of the Social Security Act (42 U.S.C. 1396a) is 
amended by adding at the end the following new subsection:
    ``(uu) Payment for Services Provided by Certified Community 
Behavioral Health Clinics.--
            ``(1) In general.--Beginning with fiscal year 2024, with 
        respect to services furnished on or after January 1, 2024, and 
        each succeeding fiscal year, a State may provide under the 
        State plan under this title (or under a waiver of such plan) 
        for payment for services described in section 1905(a)(31) 
        furnished by a certified community behavioral health clinic (in 
        this subsection referred to as a `clinic') in accordance with 
        the provisions of this subsection.
            ``(2) Payment for services in initial year and every third 
        year.--Subject to paragraphs (4), (5), and (6), for services 
        furnished by a clinic in the first fiscal year for which a 
        State elects to provide for payment for services described in 
        section 1905(a)(31) in accordance with the payment option under 
        paragraph (1), and every third fiscal year thereafter in which 
        the State makes such an election, the State shall provide for 
        payment for such services in an amount (calculated on the basis 
        of daily visits or unduplicated monthly visits, at the State's 
        election) that is equal to 100 percent of the average costs of 
        the clinic of furnishing any of the services described in 
        paragraph (31) of section 1905(a) during the 2 fiscal years 
        preceding the fiscal year involved which are reasonable and 
        related to the costs of furnishing such services; provided 
        that, in the absence of complete actual cost data representing 
        the provision of the full covered benefit in such preceding 
        fiscal years, certified community behavioral health clinics 
        may, at the State's discretion, use estimated or projected data 
        relating to specific services for which they lack cost 
        experience. The per-unit rate derived from such cost data shall 
        be adjusted to take into account any increase or decrease in 
        the scope of such services furnished by the clinic in the 
        fiscal year involved.
            ``(3) Payment for services in succeeding fiscal years.--
        Subject to paragraphs (4), (5), and (6), for services described 
        in section 1905(a)(31) furnished by a clinic for which a State 
        elects to provide for payment for such services in accordance 
        with the payment option under paragraph (1) and that are 
        furnished in a fiscal year that is not described in paragraph 
        (2), the State plan shall provide for payment for such services 
        in an amount (calculated on the basis of daily visits or 
        unduplicated monthly visits, at the State's election) that is 
        equal to the amount calculated under this subsection for such 
        services and clinic for the preceding year--
                    ``(A) increased by the percentage increase in the 
                inflationary factor described in section 
                1834(aa)(2)(C); and
                    ``(B) adjusted to take into account any increase or 
                decrease in the scope of such services furnished by the 
                clinic during the fiscal year involved.
            ``(4) Establishment of initial year payment for new 
        clinics.--In any case in which an entity first qualifies as a 
        certified community behavioral health clinic after the first 
        fiscal year in which a State elects to provide for payment for 
        services described in section 1905(a)(31) in accordance with 
        the payment option under paragraph (1), the State plan shall 
        provide for payment for such services in the first 2 years in 
        which the clinic so qualifies in an amount (calculated on the 
        basis of daily visits or unduplicated monthly visits, at the 
        State's election) that is equal to the rates established under 
        this subsection for other such clinics located in the same or 
        adjacent area with a similar case load, or in the absence of 
        any such clinic, based on the average per-unit rate for other 
        certified community behavioral health clinics in the State; 
        provided, however, that effective, at latest, as of the 3rd 
        year in which the clinic furnishes such services, the State 
        establishes a unique payment rate for the clinic based on the 
        methodology described in paragraph (2), using allowable costs 
        from the clinic's first 2 fiscal years of operation as the 
        basis for establishing such rates; and provided, additionally, 
        that in any year following the establishment of an initial rate 
        under this paragraph, the State plan or waiver provides for the 
        payment amount to be calculated in accordance with paragraph 
        (2) or (3) (as applicable).
            ``(5) Administration in the case of managed care.--
                    ``(A) In general.--In the case of services 
                furnished by a certified community behavioral health 
                clinic pursuant to a contract between the clinic and a 
                managed care entity (as defined in section 
                1932(a)(1)(B)), the State plan or a waiver of such plan 
                shall provide for 1 of the following:
                            ``(i) Payment to the clinic by the State of 
                        a supplemental payment equal to the amount (if 
                        any) by which the amount determined under 
                        paragraph (2), (3), or (4) (as applicable) 
                        exceeds the amount of payments under the 
                        contract, with such supplemental payment being 
                        made pursuant to a payment schedule agreed to 
                        by the State and the certified community 
                        behavioral health clinic, but in no case less 
                        frequently than every 3 months.
                            ``(ii) Delegation by the State to the 
                        managed care entity of the obligation to pay 
                        the clinic at least the rate determined under 
                        paragraph (2), (3), or (4) (as applicable); 
                        provided, however, that the State shall use 
                        reconciliation and oversight processes to 
                        ensure that each clinic is paid at least the 
                        amounts required under such paragraphs.
            ``(6) Alternative payment methodologies.--Notwithstanding 
        any other provision of this subsection, the State plan or a 
        waiver of such plan may provide for payment in any year to a 
        certified community behavioral health clinic for services 
        described in paragraph (31) of section 1905(a) in an amount 
        which is determined under an alternative payment methodology 
        that--
                    ``(A) is agreed to by the State and the clinic; and
                    ``(B) results in payment to the clinic of an amount 
                which is not less than the amount otherwise required to 
                be paid to the clinic under this subsection.''.

  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.

    (a) Coverage.--Section 1861(s)(2) of the Social Security Act (42 
U.S.C. 1395x(s)(2)) is amended--
            (1) in subparagraph (II), by striking ``and'' at the end;
            (2) in subparagraph (JJ), by inserting ``and'' at the end; 
        and
            (3) by adding at the end the following new subparagraph:
            ``(KK) certified community behavioral health clinic 
        services (as defined in subsection (aa)(8)) furnished on or 
        after January 1, 2024.''.
    (b) Definitions.--Section 1861(aa) of the Social Security Act (42 
U.S.C. 1395x) is amended--
            (1) in the heading, by striking ``and Federally Qualified 
        Health Center Services'' and inserting ``, Federally Qualified 
        Health Center Services, and Certified Community Behavioral 
        Health Clinic Services''; and
            (2) by adding at the end the following new paragraph:
    ``(8) The terms `certified community behavioral health clinic 
services' and `certified community behavioral health clinic' have the 
meaning given those terms in paragraphs (1) and (2), respectively, of 
section 1905(jj).''.
    (c) Payment.--
            (1) In general.--Section 1833(a)(1) of the Social Security 
        Act (42 U.S.C. 1395l(a)(1)) is amended--
                    (A) by striking ``and (HH)'' and inserting 
                ``(HH)''; and
                    (B) by inserting before the semicolon at the end 
                the following: ``, and (II) with respect to certified 
                community behavioral health clinic services for which 
                payment is made under section 1834(aa), the amounts 
                paid shall be equal to 80 percent of the lesser of the 
                actual charge or the amount determined under such 
                section''.
            (2) Development and implementation of prospective payment 
        system.--Section 1834 of the Social Security Act (42 U.S.C. 
        1395m) is amended by adding at the end the following new 
        subsection:
    ``(aa) Development and Implementation of Prospective Payment System 
for Certified Community Behavioral Health Clinics.--
            ``(1) Development.--The Secretary shall develop a 
        prospective payment system for payment to certified community 
        behavioral health clinics (as defined in section 1861(aa)(8)) 
        for the furnishing of certified community behavioral health 
        clinic services (as defined in such section) under this title. 
        Such system shall be established to take into account the type, 
        intensity, and duration of services furnished by certified 
        community behavioral health clinics. Such system may include 
        adjustments, including geographic adjustments, as determined 
        appropriate by the Secretary.
            ``(2) Implementation.--
                    ``(A) In general.--The Secretary shall provide, for 
                cost reporting periods beginning on or after January 1, 
                2024, for payments of prospective payment rates for 
                certified community behavioral health clinic services 
                furnished by certified community behavioral health 
                clinics under this title in accordance with the 
                prospective payment system developed by the Secretary 
                under paragraph (1).
                    ``(B) Initial payments.--The Secretary shall 
                implement such prospective payment system to reflect 
                the national average allowable service costs of such 
                clinics on the basis of the most current audited cost 
                report data for two fiscal years available to the 
                Secretary; provided that, in the absence of complete 
                actual cost data representing the provision of the full 
                covered benefit during the relevant fiscal years, 
                certified community behavioral health clinics may, at 
                the Secretary's discretion, use estimated or projected 
                data relating to specific services. Initial payments 
                shall be established without the application of a per 
                visit limit or productivity screen and shall be based 
                on national average costs per unit of service, updated 
                as appropriate by the inflationary adjustment described 
                in subparagraph (C).
                    ``(C) Payments in subsequent years.--Payment rates 
                in years after the year of implementation of such 
                system shall be the payment rates in the previous year 
                increased--
                            ``(i) in the first year after 
                        implementation of such system, by the 
                        percentage increase in the MEI (as defined in 
                        section 1842(i)(3)) for the year involved; and
                            ``(ii) in subsequent years, by the 
                        percentage increase in a market basket of 
                        certified community behavioral health clinic 
                        services, designed by the Secretary, or if such 
                        an index is not available, by the percentage 
                        increase in the MEI (as defined in section 
                        1842(i)(3)) for the year involved.
            ``(3) Unit of payment.--In establishing a prospective 
        payment amount under the system under this subsection, the 
        Secretary shall consider an appropriate unit of service and a 
        general system design that provides for continued access to 
        quality services.
            ``(4) Periodic reevaluation of rates.--At the Secretary's 
        discretion, the Secretary shall, from time to time, adjust the 
        amounts that would otherwise be applicable under subparagraph 
        (2) by a percentage determined appropriate by the Secretary to 
        reflect such factors as changes in the intensity of services 
        furnished within a unit of service, the average cost of 
        providing care per unit of service, and other factors that the 
        Secretary considers to be relevant. Such adjustment shall be 
        made before the update under clause (i) or (ii) of paragraph 
        (2)(C)(i) has been applied for the year.''.
    (d) Waiver of Application of Deductible.--Section 1833(b)(4) of the 
Social Security Act (42 U.S.C. 1395l(b)(4)) is amended by inserting 
``or certified community behavioral health clinic services'' before the 
comma at the end.
    (e) PRRB Review of Cost Reports.--Section 1878(j) of the Social 
Security Act (42 U.S.C. 1395oo(j)) is amended by striking ``and a 
Federally qualified health center'' and inserting ``, a Federally 
qualified health center, and a certified community behavioral health 
clinic''.
    (f) Safe Harbor for Waiver of Coinsurance.--Section 1128B(b)(3)(D) 
of the Social Security Act (42 U.S.C. 1320a-7b(b)(3)(D)) is amended by 
inserting ``or a certified community behavioral health clinic'' after 
``Federally qualified health care center''.
    (g) Effective Date.--The amendments made by this section shall 
apply with respect to services furnished on or after January 1, 2024.

          TITLE III--COMMUNITY BEHAVIORAL HEALTH CLINIC GRANTS

SEC. 301. OPERATING GRANTS FOR COMMUNITY BEHAVIORAL HEALTH CLINICS.

    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:

          ``Subpart XIII--Community Behavioral Health Clinics

``SEC. 340J. DEFINITIONS.

    ``In this subpart:
            ``(1) Certified community behavioral health clinic.--The 
        term `certified community behavioral health clinic' has the 
        meaning given the term in section 1905(jj)(2)) of the Social 
        Security Act.
            ``(2) Certified community behavioral health services.--The 
        term `certified community behavioral health services' has the 
        meaning given the term in section 1905(jj)(1) of the Social 
        Security Act.

``SEC. 340J-1. COMMUNITY BEHAVIORAL HEALTH CLINIC CERTIFICATION.

    ``(a) In General.--Not later than 180 days after the date of 
enactment of the Ensuring Excellence in Mental Health Act, the 
Secretary, after public notice and opportunity for comment, shall 
publish in the Federal Register criteria for a clinic to be certified 
as a community behavioral health clinic for purposes of section 
1905(jj)(2)(D)(ii) of the Social Security Act.
    ``(b) Requirements.--The criteria published under subsection (a) 
shall include criteria with respect to the following:
            ``(1) Staffing.--Staffing requirements, including criteria 
        that staff have diverse disciplinary backgrounds, have 
        necessary State-required license and accreditation, and are 
        culturally and linguistically trained to serve the needs of the 
        patient populations of the community behavioral health clinic.
            ``(2) Availability and accessibility of services.--
        Availability and accessibility of services, including crisis 
        management services that are available and accessible 24 hours 
        a day, the use of a sliding scale for payment, and no rejection 
        for services or limiting of services on the basis of a 
        patient's ability to pay or a place of residence.
            ``(3) Care coordination.--Care coordination, including 
        requirements to coordinate care across settings and providers 
        to ensure seamless transitions for patients across the full 
        spectrum of health services including acute, chronic, and 
        behavioral health needs. Care coordination requirements shall 
        include partnerships or formal contracts with the following:
                    ``(A) Federally-qualified health centers (as 
                defined in section 1905(l) of the Social Security Act) 
                and, as applicable, rural health clinics (as so 
                defined), to provide Federally-qualified health center 
                services (as so defined) and, as applicable, rural 
                health clinic services (as so defined), to the extent 
                such services are not provided directly through the 
                community behavioral health clinic.
                    ``(B) Inpatient psychiatric facilities and 
                substance use detoxification, post-detoxification step-
                down services, and residential programs.
                    ``(C) Other community or regional services, 
                supports, and providers, including schools, child 
                welfare agencies, juvenile and criminal justice 
                agencies and facilities, Indian Health Service youth 
                regional treatment centers, State-licensed and 
                nationally accredited child placing agencies for 
                therapeutic foster care service, and other social and 
                human services.
                    ``(D) Medical centers, outpatient clinics, and 
                drop-in centers of the Department of Veterans Affairs 
                and other facilities of the Department (as defined in 
                section 1701 of title 38, United States Code).
                    ``(E) Inpatient acute care hospitals and hospital 
                outpatient clinics.
            ``(4) Scope of services.--Provision (in a manner reflecting 
        person-centered care) of the full array of certified community 
        behavioral health services which, if not available directly 
        through the community behavioral health clinic, are provided or 
        referred through formal relationships with other providers.
            ``(5) Quality and other reporting.--Requirements relating 
        to development by the community behavioral health clinic of an 
        effective procedure for compiling and reporting to the 
        Secretary such statistics and other information as the 
        Secretary may require relating to--
                    ``(A) the costs of its operations;
                    ``(B) the patterns of use of its services, 
                including the reporting of encounter data, clinical 
                outcomes data, quality data, and such other data as the 
                Secretary may require;
                    ``(C) the availability, accessibility, and 
                acceptability of its services; and
                    ``(D) such other matters relating to operations of 
                the applicant as the Secretary may require.
            ``(6) Organizational authority.--Requirements that a 
        community behavioral health clinic be--
                    ``(A) a nonprofit entity;
                    ``(B) part of a local government behavioral health 
                authority;
                    ``(C) operated under the authority of the Indian 
                Health Service;
                    ``(D) operated by an Indian Tribe or Tribal 
                organization pursuant to a contract, grant, cooperative 
                agreement, or compact with the Indian Health Service 
                pursuant to the Indian Self-Determination and Education 
                Assistance Act; or
                    ``(E) operated by an urban Indian organization 
                pursuant to a grant or contract with the Indian Health 
                Service under title V of the Indian Health Care 
                Improvement Act.

``SEC. 340J-2. OPERATING GRANTS FOR COMMUNITY BEHAVIORAL HEALTH 
              CLINICS.

    ``(a) In General.--The Secretary shall establish a grant program 
under which the Secretary shall award grants to eligible community 
behavioral health clinics to provide (in a manner reflecting person-
centered care) the full array of certified community behavioral health 
services.
    ``(b) Eligibility.--To be eligible to receive a grant under 
subsection (a), a community behavioral health clinic shall be--
            ``(1) a certified community behavioral health clinic; or
            ``(2) a community behavioral health clinic that indicates 
        in the grant application that the clinic will use the grant 
        funds to meet the criteria described in section 340J-1(a).
    ``(c) Use of Funds.--A community behavioral health clinic that 
receives a grant under subsection (a)--
            ``(1) shall use the grant funds--
                    ``(A) to provide the services described in 
                subsection (a); and
                    ``(B) in the case of a community behavioral health 
                clinic described in subsection (b)(2), to meet the 
                criteria described in section 340J-1(a); and
            ``(2) may use the grant funds--
                    ``(A) to carry out other activities that--
                            ``(i) reduce costs associated with the 
                        provision of certified community behavioral 
                        health services;
                            ``(ii) improve access to, and availability 
                        of, certified community behavioral health 
                        services provided to individuals served by the 
                        community behavioral health clinic;
                            ``(iii) enhance the quality and 
                        coordination of certified community behavioral 
                        health services; or
                            ``(iv) improve the health status of 
                        communities; and
                    ``(B) to pay for--
                            ``(i) the costs of acquiring and leasing 
                        buildings and equipment (including the costs of 
                        amortizing the principal of, and paying 
                        interest on, loans);
                            ``(ii) costs relating to the purchase or 
                        lease of equipment, including data and 
                        information systems and behavioral health 
                        information technology to facilitate data 
                        reporting and other purposes;
                            ``(iii) the costs of in-service staff 
                        training and other operational or 
                        infrastructure costs identified by the 
                        Secretary; and
                            ``(iv) costs associated with expanding and 
                        modernizing existing buildings or constructing 
                        new buildings (including the costs of 
                        amortizing the principal of, and paying the 
                        interest on, loans), if such costs are 
                        specifically allowed for in the grant 
                        opportunity published by the Secretary.
    ``(d) Term.--Grants awarded under subsection (a) shall be for a 
period of not more than 5 years.
    ``(e) Condition on Receipt of Funds.--The Secretary shall not make 
a grant to an applicant under subsection (a) unless the applicant 
provides assurances to the Secretary that within 120 days of receiving 
grant funding for the operation of the clinic, the applicant will 
submit for approval by the Secretary an implementation plan that 
describes how the applicant will--
            ``(1) provide the services described in subsection (a); and
            ``(2) in the case of a community behavioral health clinic 
        described in subsection (b)(2), meet the criteria described in 
        section 340J-1(a).
    ``(f) Amount of Grant.--
            ``(1) In general.--Subject to paragraph (2), the amount of 
        a grant made in any fiscal year to a community behavioral 
        health clinic under subsection (a) shall be determined by the 
        Secretary based on information provided by the community 
        behavioral health clinic, but may not exceed an amount equal to 
        the difference obtained by subtracting--
                    ``(A) the sum obtained by adding--
                            ``(i) the total State, local, and other 
                        operational funding provided to the clinic for 
                        such fiscal year; and
                            ``(ii) the fees, premiums, and third-party 
                        reimbursements that the clinic reasonably 
                        expects to receive for its operations in such 
                        fiscal year; from
                    ``(B) the costs of operating the clinic to meet the 
                purposes and requirements of the grant program under 
                this section during such fiscal year.
            ``(2) Requirement.--
                    ``(A) In general.--In determining the costs 
                described in paragraph (1)(B), the Secretary may 
                estimate the anticipated costs of the grant recipient 
                in--
                            ``(i) providing the services described in 
                        subsection (a), including the anticipated costs 
                        of providing any individual certified community 
                        behavioral health service that the applicant 
                        entity does not have cost experience providing 
                        at the time of submitting an application for 
                        such grant; and
                            ``(ii) if applicable, meeting the criteria 
                        described in section 340J-1(a).
                    ``(B) Anticipated costs.--The Secretary shall base 
                the estimate of anticipated costs under subparagraph 
                (A) on an estimate of anticipated costs provided by the 
                applicable community behavioral health clinic.
            ``(3) Payments.--The Secretary may--
                    ``(A) award grants under subsection (a)--
                            ``(i) in advance or through reimbursement; 
                        and
                            ``(ii) in installments;
                    ``(B) make adjustments to account for overpayments 
                or underpayments.
    ``(g) Use of Accreditation.--
            ``(1) In general.--In selecting grant recipients under this 
        section, the Secretary may take into account whether an 
        applicant community behavioral health clinic is accredited 
        under section 340J-5(a).
            ``(2) Compliance.--In determining whether a community 
        behavioral health clinic receiving a grant under this section 
        is providing the services described in subsection (a) and, if 
        applicable, meeting the criteria described in section 340J-
        1(a), the Secretary may take into account whether the community 
        behavioral health clinic is accredited under section 340J-5(a).
    ``(h) Authorization of Appropriations.--
            ``(1) In general.--There is authorized to be appropriated 
        to carry out this section, $552,500,000 for each of fiscal 
        years 2024 through 2028.
            ``(2) Maintenance of funding.--The amount made available 
        under paragraph (1) shall supplement (and not supplant) any 
        other Federal funding made available for community behavioral 
        health clinics.

``SEC. 340J-3. TECHNICAL ASSISTANCE.

    ``(a) In General.--Not later than 180 days after the date of 
enactment of the Ensuring Excellence in Mental Health Act, the 
Secretary shall establish programs through which the Secretary shall 
provide (either through the Department of Health and Human Services or 
by grant or contract) technical assistance and other assistance to any 
of the following:
            ``(1) Entities that receive a grant under section 340J-2.
            ``(2) Entities participating in a Medicaid demonstration 
        program under section 223(d) of the Protecting Access to 
        Medicare Act.
            ``(3) Certified community behavioral health clinics (as 
        defined in sections 1861(aa)(8) and 1905(jj)(2) of the Social 
        Security Act), furnishing services under title XVIII or title 
        XIX of such Act.
            ``(4) Health or social service provider organizations 
        pursuing or considering certified community behavioral health 
        clinic status or partnering with certified community behavioral 
        health clinics.
            ``(5) Other stakeholders, for the purpose of facilitating 
        successful implementation of the certified community behavioral 
        health clinic model.
    ``(b) Inclusions.--Assistance provided by the Secretary under 
subsection (a) may include technical and nonfinancial assistance, 
including--
            ``(1) fiscal and program management assistance;
            ``(2) operational and administrative support; and
            ``(3) the provision of information to the entities about 
        the variety of resources available under this part and how 
        those resources can be best used to meet the health and 
        behavioral health needs of the communities served by the 
        entities.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $6,000,000 for each of fiscal 
years 2024 through 2028.

``SEC. 340J-4. DATA INFRASTRUCTURE FOR COMMUNITY BEHAVIORAL HEALTH 
              CLINIC REPORTING.

    ``(a) In General.--Not later than 180 days after the date of 
enactment of the Ensuring Excellence in Mental Health Act, the 
Secretary shall establish a system under which the Secretary shall 
collect and analyze data on community behavioral health clinics.
    ``(b) Scope of Data Collection.--The system established under 
subsection (a) shall be used by the Secretary to collect and analyze 
data from--
            ``(1) entities that receive a grant under section 340J-2; 
        and
            ``(2) organizations that provide services, or have applied 
        to provide services, under title XVIII of the Social Security 
        Act, as described in section 1861(aa)(8) of such Act, or under 
        a State Medicaid program in accordance with section 1905(jj) of 
        such Act.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $51,000,000 for each of fiscal 
years 2024 through 2028.

``SEC. 340J-5. COMMUNITY BEHAVIORAL HEALTH CLINIC ACCREDITATION.

    ``(a) Accreditation Standards.--A community behavioral health 
clinic may be accredited if the entity--
            ``(1) meets the standards of an approved accreditation 
        body; and
            ``(2) authorizes the accreditation body to submit to the 
        Secretary (or such agency as the Secretary may designate) such 
        records or other information as the Secretary may require.
    ``(b) Approval of Accreditation Bodies.--
            ``(1) In general.--The Secretary may approve a private 
        nonprofit organization to be an accreditation body for the 
        accreditation of community behavioral health clinics under 
        subsection (a) if--
                    ``(A) using inspectors qualified to evaluate 
                quality of care in a behavioral health service setting, 
                the accreditation body agrees to inspect the clinic 
                with such frequency as is determined by the Secretary;
                    ``(B) the standards applied by the body in 
                determining whether or not to accredit a clinic 
                correspond to the criteria described in section 340J-
                1(a), and are not less restrictive than such criteria;
                    ``(C) there is adequate provision for assuring that 
                the standards of the accreditation body continue to be 
                met by the clinic;
                    ``(D) in the case of any clinic previously 
                accredited by the body which has had its accreditation 
                denied, suspended, withdrawn, or revoked or which has 
                had any other action taken against it by the 
                accrediting body, the accrediting body agrees to submit 
                to the Secretary the name of such clinic within 30 days 
                of the action taken; and
                    ``(E) if the accreditation body has its approval 
                withdrawn by the Secretary, the body agrees to notify 
                each clinic accredited by the body of the withdrawal 
                within 10 days of the withdrawal.''.
                                 <all>
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