II 

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. 

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: 

Sec. 1. Short title. 

TITLE I—ENSURING PERMANENCY FOR CERTIFIED COMMUNITY 

BEHAVIORAL HEALTH CLINICS IN THE MEDICAID PROGRAM 


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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. 

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

4 HEALTH CLINICS IN THE 

5 MEDICAID PROGRAM 

6 SEC. 101. ESTABLISHING CERTIFIED COMMUNITY BEHAV7 IORAL HEALTH CLINIC SERVICES AS A MED8 ICAID STATE PLAN OPTION. 

9 (a) IN GENERAL.—Section 1905 of the Social Secu10 rity Act (42 U.S.C. 1396d) is amended— 

11 (1) in subsection (a)— 

12 (A) in paragraph (30), by striking ‘‘; and’’ 

13 and inserting a semicolon; 

14 (B) by redesignating paragraph (31) as 

15 paragraph (32); and 

16 (C) by inserting after paragraph (30) the 

17 following new paragraph: 


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1 ‘‘(31) certified community behavioral health 

2 clinic services, as defined in subsection (jj); and’’; 

3 and 

4 (2) by adding at the end the following new sub5 section: 

6 ‘‘(jj) CERTIFIED COMMUNITY BEHAVIORAL HEALTH

7 CLINIC SERVICES.— 

8 ‘‘(1) IN GENERAL.—The term ‘certified commu9 nity behavioral health services’ means any of the fol10 lowing when furnished to an individual as a patient 

11 of a certified community behavioral health clinic (as 

12 defined in paragraph (2)), in a manner reflecting 

13 person-centered care and which, if not available di14 rectly through a certified community behavioral 

15 health clinic, may be provided or referred through 

16 formal relationships with other providers: 

17 ‘‘(A) Crisis mental health services, includ18 ing 24-hour mobile crisis teams, emergency cri19 sis intervention services, and crisis stabilization. 

20 ‘‘(B) Screening, assessment, and diagnosis, 

21 including risk assessment. 

22 ‘‘(C) Patient-centered treatment planning 

23 or similar processes, including risk assessment 

24 and crisis planning. 


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1 ‘‘(D) Outpatient mental health and sub2 stance use services. 

3 ‘‘(E) Outpatient clinic primary care screen4 ing and monitoring of key health indicators and 

5 health risk. 

6 ‘‘(F) Targeted case management. 

7 ‘‘(G) Psychiatric rehabilitation services. 

8 ‘‘(H) Peer support and counselor services 

9 and family supports. 

10 ‘‘(I) Intensive, community-based mental 

11 health care for members of the armed forces 

12 and veterans, particularly those members and 

13 veterans located in rural areas, provided the 

14 care is consistent with minimum clinical mental 

15 health guidelines promulgated by the Veterans 

16 Health Administration, including clinical guide17 lines contained in the Uniform Mental Health 

18 Services Handbook of such Administration. 

19 ‘‘(2) CERTIFIED COMMUNITY BEHAVIORAL

20 HEALTH CLINIC.—The term ‘certified community be21 havioral health clinic’ means an organization that— 

22 ‘‘(A) is engaged in furnishing to patients 

23 all of the services described in paragraph (1); 

24 ‘‘(B) is legally authorized to furnish such 

25 services under State law; 


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1 ‘‘(C) agrees, as a condition of the certifi2 cation described in subparagraph (D), to fur3 nish to the State or Secretary any data re4 quired as part of ongoing monitoring of the or5 ganization’s provision of services, including any 

6 such data as the State, by agreement with the 

7 Secretary, shall access via the system described 

8 in section 340J–4 of the Public Health Service 

9 Act; and 

10 ‘‘(D) has been certified by a State— 

11 ‘‘(i) as meeting the criteria established 

12 by the Secretary pursuant to subsection 

13 (a) of section 223 of the Protecting Access 

14 to Medicare Act and is carrying out a dem15 onstration program under this title under 

16 subsection (d) of such section; or 

17 ‘‘(ii) for purposes of services furnished 

18 on or after January 1, 2024, subject to 

19 paragraph (3), as meeting the criteria es20 tablished under section 340J–1(a) of the 

21 Public Health Service Act, and as being el22 igible to furnish medical assistance under 

23 the State plan under this title (or under a 

24 waiver of such plan) for certified commuVerDate Sep 11 2014 01:53 Oct 01, 2023 Jkt 039200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S2993.IS S2993

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1 nity behavioral health services described in 

2 paragraph (1). 

3 ‘‘(3) ACCREDITATION.—In the case of services 

4 furnished on or after January 1, 2024, at State op5 tion, a State may determine that an organization 

6 does not meet the criteria established under section 

7 340J–1(a) of the Public Health Service Act unless 

8 the organization has an accreditation by an accredi9 tation body approved under section 340J–5 of the 

10 Public Health Service Act. An election by a State 

11 under the preceding sentence shall not relieve a 

12 State of the requirement to certify an organization 

13 under paragraph (2)(D).’’. 

14 (b) CONFORMING AMENDMENTS.— 

15 (1) Section 1902(nn)(3) of such Act (42 U.S.C. 

16 1396a(nn)(3)), is amended by striking ‘‘paragraph 

17 (31)’’ and inserting ‘‘the last numbered paragraph’’. 

18 (2) The fifth sentence of section 1905(a) of 

19 such Act (42 U.S.C. 1396d(a)) is amended by strik20 ing ‘‘paragraph (30)’’ and inserting ‘‘the last num21 bered paragraph’’. 

22 (3) Effective July 1, 2025, section 

23 1902(a)(84)(A) of such Act (42 U.S.C. 

24 1396a(a)(84)(A)), as amended by section 5122(a)(2) 

25 of division FF of Public Law 117–328, is amended 


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1 by striking ‘‘paragraph (31)’’ and inserting ‘‘the last 

2 numbered paragraph’’. 

3 SEC. 102. ESTABLISHING A MEDICAID PROSPECTIVE PAY4 MENT SYSTEM FOR CERTIFIED COMMUNITY 

5 BEHAVIORAL HEALTH CLINICS. 

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

7 1396a) is amended by adding at the end the following new 

8 subsection: 

9 ‘‘(uu) PAYMENT FOR SERVICES PROVIDED BY CER10 TIFIED COMMUNITY BEHAVIORAL HEALTH CLINICS.— 

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

12 2024, with respect to services furnished on or after 

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

14 State may provide under the State plan under this 

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

16 for services described in section 1905(a)(31) fur17 nished by a certified community behavioral health 

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

19 accordance with the provisions of this subsection. 

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

21 AND EVERY THIRD YEAR.—Subject to paragraphs 

22 (4), (5), and (6), for services furnished by a clinic 

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

24 provide for payment for services described in section 

25 1905(a)(31) in accordance with the payment option 


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

2 thereafter in which the State makes such an elec3 tion, the State shall provide for payment for such 

4 services in an amount (calculated on the basis of 

5 daily visits or unduplicated monthly visits, at the 

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

7 average costs of the clinic of furnishing any of the 

8 services described in paragraph (31) of section 

9 1905(a) during the 2 fiscal years preceding the fis10 cal year involved which are reasonable and related to 

11 the costs of furnishing such services; provided that, 

12 in the absence of complete actual cost data rep13 resenting the provision of the full covered benefit in 

14 such preceding fiscal years, certified community be15 havioral health clinics may, at the State’s discretion, 

16 use estimated or projected data relating to specific 

17 services for which they lack cost experience. The 

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

19 adjusted to take into account any increase or de20 crease in the scope of such services furnished by the 

21 clinic in the fiscal year involved. 

22 ‘‘(3) PAYMENT FOR SERVICES IN SUCCEEDING

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

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

25 furnished by a clinic for which a State elects to proVerDate Sep 11 2014 01:53 Oct 01, 2023 Jkt 039200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S2993.IS S2993

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1 vide for payment for such services in accordance 

2 with the payment option under paragraph (1) and 

3 that are furnished in a fiscal year that is not de4 scribed in paragraph (2), the State plan shall pro5 vide for payment for such services in an amount 

6 (calculated on the basis of daily visits or 

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

8 that is equal to the amount calculated under this 

9 subsection for such services and clinic for the pre10 ceding year— 

11 ‘‘(A) increased by the percentage increase 

12 in the inflationary factor described in section 

13 1834(aa)(2)(C); and 

14 ‘‘(B) adjusted to take into account any in15 crease or decrease in the scope of such services 

16 furnished by the clinic during the fiscal year in17 volved. 

18 ‘‘(4) ESTABLISHMENT OF INITIAL YEAR PAY19 MENT FOR NEW CLINICS.—In any case in which an 

20 entity first qualifies as a certified community behav21 ioral health clinic after the first fiscal year in which 

22 a State elects to provide for payment for services de23 scribed in section 1905(a)(31) in accordance with 

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

25 plan shall provide for payment for such services in 


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

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

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

4 that is equal to the rates established under this sub5 section for other such clinics located in the same or 

6 adjacent area with a similar case load, or in the ab7 sence of any such clinic, based on the average per8 unit rate for other certified community behavioral 

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

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

11 clinic furnishes such services, the State establishes a 

12 unique payment rate for the clinic based on the 

13 methodology described in paragraph (2), using al14 lowable costs from the clinic’s first 2 fiscal years of 

15 operation as the basis for establishing such rates; 

16 and provided, additionally, that in any year following 

17 the establishment of an initial rate under this para18 graph, the State plan or waiver provides for the pay19 ment amount to be calculated in accordance with 

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

21 ‘‘(5) ADMINISTRATION IN THE CASE OF MAN22 AGED CARE.— 

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

24 furnished by a certified community behavioral 

25 health clinic pursuant to a contract between the 


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1 clinic and a managed care entity (as defined in 

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

3 waiver of such plan shall provide for 1 of the 

4 following: 

5 ‘‘(i) Payment to the clinic by the 

6 State of a supplemental payment equal to 

7 the amount (if any) by which the amount 

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

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

10 payments under the contract, with such 

11 supplemental payment being made pursu12 ant to a payment schedule agreed to by the 

13 State and the certified community behav14 ioral health clinic, but in no case less fre15 quently than every 3 months. 

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

17 managed care entity of the obligation to 

18 pay the clinic at least the rate determined 

19 under paragraph (2), (3), or (4) (as appli20 cable); provided, however, that the State 

21 shall use reconciliation and oversight proc22 esses to ensure that each clinic is paid at 

23 least the amounts required under such 

24 paragraphs. 


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1 ‘‘(6) ALTERNATIVE PAYMENT METHODOLO2 GIES.—Notwithstanding any other provision of this 

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

4 may provide for payment in any year to a certified 

5 community behavioral health clinic for services de6 scribed in paragraph (31) of section 1905(a) in an 

7 amount which is determined under an alternative 

8 payment methodology that— 

9 ‘‘(A) is agreed to by the State and the clin10 ic; and 

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

12 amount which is not less than the amount oth13 erwise required to be paid to the clinic under 

14 this subsection.’’. 

15 TITLE II—COVERAGE OF CER16 TIFIED COMMUNITY BEHAV17 IORAL HEALTH CLINIC SERV18 ICES UNDER THE MEDICARE 

19 PROGRAM 

20 SEC. 201. COVERAGE OF CERTIFIED COMMUNITY BEHAV21 IORAL HEALTH CLINIC SERVICES UNDER THE 

22 MEDICARE PROGRAM. 

23 (a) COVERAGE.—Section 1861(s)(2) of the Social Se24 curity Act (42 U.S.C. 1395x(s)(2)) is amended— 


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

2 the end; 

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

4 at the end; and 

5 (3) by adding at the end the following new sub6 paragraph: 

7 ‘‘(KK) certified community behavioral health 

8 clinic services (as defined in subsection (aa)(8)) fur9 nished on or after January 1, 2024.’’. 

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

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

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

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

14 Federally Qualified Health Center Services, and Cer15 tified Community Behavioral Health Clinic Serv16 ices’’; and 

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

18 paragraph: 

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

20 health clinic services’ and ‘certified community behavioral 

21 health clinic’ have the meaning given those terms in para22 graphs (1) and (2), respectively, of section 1905(jj).’’. 

23 (c) PAYMENT.— 


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

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

3 amended— 

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

5 ‘‘(HH)’’; and 

6 (B) by inserting before the semicolon at 

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

8 to certified community behavioral health clinic 

9 services for which payment is made under sec10 tion 1834(aa), the amounts paid shall be equal 

11 to 80 percent of the lesser of the actual charge 

12 or the amount determined under such section’’. 

13 (2) DEVELOPMENT AND IMPLEMENTATION OF

14 PROSPECTIVE PAYMENT SYSTEM.—Section 1834 of 

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

16 amended by adding at the end the following new 

17 subsection: 

18 ‘‘(aa) DEVELOPMENT AND IMPLEMENTATION OF

19 PROSPECTIVE PAYMENT SYSTEM FOR CERTIFIED COM20 MUNITY BEHAVIORAL HEALTH CLINICS.— 

21 ‘‘(1) DEVELOPMENT.—The Secretary shall de22 velop a prospective payment system for payment to 

23 certified community behavioral health clinics (as de24 fined in section 1861(aa)(8)) for the furnishing of 

25 certified community behavioral health clinic services 


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

2 system shall be established to take into account the 

3 type, intensity, and duration of services furnished by 

4 certified community behavioral health clinics. Such 

5 system may include adjustments, including geo6 graphic adjustments, as determined appropriate by 

7 the Secretary. 

8 ‘‘(2) IMPLEMENTATION.— 

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

10 provide, for cost reporting periods beginning on 

11 or after January 1, 2024, for payments of pro12 spective payment rates for certified community 

13 behavioral health clinic services furnished by 

14 certified community behavioral health clinics 

15 under this title in accordance with the prospec16 tive payment system developed by the Secretary 

17 under paragraph (1). 

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

19 shall implement such prospective payment sys20 tem to reflect the national average allowable 

21 service costs of such clinics on the basis of the 

22 most current audited cost report data for two 

23 fiscal years available to the Secretary; provided 

24 that, in the absence of complete actual cost 

25 data representing the provision of the full covVerDate Sep 11 2014 01:53 Oct 01, 2023 Jkt 039200 PO 00000 Frm 00015 Fmt 6652 Sfmt 6201 E:\BILLS\S2993.IS S2993

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1 ered benefit during the relevant fiscal years, 

2 certified community behavioral health clinics 

3 may, at the Secretary’s discretion, use esti4 mated or projected data relating to specific 

5 services. Initial payments shall be established 

6 without the application of a per visit limit or 

7 productivity screen and shall be based on na8 tional average costs per unit of service, updated 

9 as appropriate by the inflationary adjustment 

10 described in subparagraph (C). 

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

12 Payment rates in years after the year of imple13 mentation of such system shall be the payment 

14 rates in the previous year increased— 

15 ‘‘(i) in the first year after implemen16 tation of such system, by the percentage 

17 increase in the MEI (as defined in section 

18 1842(i)(3)) for the year involved; and 

19 ‘‘(ii) in subsequent years, by the per20 centage increase in a market basket of cer21 tified community behavioral health clinic 

22 services, designed by the Secretary, or if 

23 such an index is not available, by the per24 centage increase in the MEI (as defined in 

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


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

2 prospective payment amount under the system under 

3 this subsection, the Secretary shall consider an ap4 propriate unit of service and a general system design 

5 that provides for continued access to quality serv6 ices. 

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

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

9 time to time, adjust the amounts that would other10 wise be applicable under subparagraph (2) by a per11 centage determined appropriate by the Secretary to 

12 reflect such factors as changes in the intensity of 

13 services furnished within a unit of service, the aver14 age cost of providing care per unit of service, and 

15 other factors that the Secretary considers to be rel16 evant. Such adjustment shall be made before the up17 date under clause (i) or (ii) of paragraph (2)(C)(i) 

18 has been applied for the year.’’. 

19 (d) WAIVER OF APPLICATION OF DEDUCTIBLE.— 

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

21 1395l(b)(4)) is amended by inserting ‘‘or certified commu22 nity behavioral health clinic services’’ before the comma 

23 at the end. 

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

25 1878(j) of the Social Security Act (42 U.S.C. 1395oo(j)) 


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

2 center’’ and inserting ‘‘, a Federally qualified health cen3 ter, and a certified community behavioral health clinic’’. 

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

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

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

7 a certified community behavioral health clinic’’ after 

8 ‘‘Federally qualified health care center’’. 

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

10 this section shall apply with respect to services furnished 

11 on or after January 1, 2024. 

12 TITLE III—COMMUNITY BEHAV13 IORAL HEALTH CLINIC 

14 GRANTS 

15 SEC. 301. OPERATING GRANTS FOR COMMUNITY BEHAV16 IORAL HEALTH CLINICS. 

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

18 (42 U.S.C. 254b et seq.) is amended by adding at the end 

19 the following: 

20 ‘‘Subpart XIII—Community Behavioral Health 

21 Clinics 

22 ‘‘SEC. 340J. DEFINITIONS. 

23 ‘‘In this subpart: 

24 ‘‘(1) CERTIFIED COMMUNITY BEHAVIORAL

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1 havioral health clinic’ has the meaning given the 

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

3 Act. 

4 ‘‘(2) CERTIFIED COMMUNITY BEHAVIORAL

5 HEALTH SERVICES.—The term ‘certified community 

6 behavioral health services’ has the meaning given the 

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

8 Act. 

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

10 CERTIFICATION. 

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, after public notice and op14 portunity for comment, shall publish in the Federal Reg15 ister criteria for a clinic to be certified as a community 

16 behavioral health clinic for purposes of section 

17 1905(jj)(2)(D)(ii) of the Social Security Act. 

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

19 subsection (a) shall include criteria with respect to the fol20 lowing: 

21 ‘‘(1) STAFFING.—Staffing requirements, includ22 ing criteria that staff have diverse disciplinary back23 grounds, have necessary State-required license and 

24 accreditation, and are culturally and linguistically 


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1 trained to serve the needs of the patient populations 

2 of the community behavioral health clinic. 

3 ‘‘(2) AVAILABILITY AND ACCESSIBILITY OF

4 SERVICES.—Availability and accessibility of services, 

5 including crisis management services that are avail6 able and accessible 24 hours a day, the use of a slid7 ing scale for payment, and no rejection for services 

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

9 ability to pay or a place of residence. 

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

11 including requirements to coordinate care across set12 tings and providers to ensure seamless transitions 

13 for patients across the full spectrum of health serv14 ices including acute, chronic, and behavioral health 

15 needs. Care coordination requirements shall include 

16 partnerships or formal contracts with the following: 

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

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

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

20 so defined), to provide Federally-qualified 

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

22 applicable, rural health clinic services (as so de23 fined), to the extent such services are not pro24 vided directly through the community behav25 ioral health clinic. 


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1 ‘‘(B) Inpatient psychiatric facilities and 

2 substance use detoxification, post-detoxification 

3 step-down services, and residential programs. 

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

5 supports, and providers, including schools, child 

6 welfare agencies, juvenile and criminal justice 

7 agencies and facilities, Indian Health Service 

8 youth regional treatment centers, State-licensed 

9 and nationally accredited child placing agencies 

10 for therapeutic foster care service, and other so11 cial and human services. 

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

13 and drop-in centers of the Department of Vet14 erans Affairs and other facilities of the Depart15 ment (as defined in section 1701 of title 38, 

16 United States Code). 

17 ‘‘(E) Inpatient acute care hospitals and 

18 hospital outpatient clinics. 

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

20 manner reflecting person-centered care) of the full 

21 array of certified community behavioral health serv22 ices which, if not available directly through the com23 munity behavioral health clinic, are provided or re24 ferred through formal relationships with other pro25 viders. 


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1 ‘‘(5) QUALITY AND OTHER REPORTING.—Re2 quirements relating to development by the commu3 nity behavioral health clinic of an effective procedure 

4 for compiling and reporting to the Secretary such 

5 statistics and other information as the Secretary 

6 may require relating to— 

7 ‘‘(A) the costs of its operations; 

8 ‘‘(B) the patterns of use of its services, in9 cluding the reporting of encounter data, clinical 

10 outcomes data, quality data, and such other 

11 data as the Secretary may require; 

12 ‘‘(C) the availability, accessibility, and ac13 ceptability of its services; and 

14 ‘‘(D) such other matters relating to oper15 ations of the applicant as the Secretary may re16 quire. 

17 ‘‘(6) ORGANIZATIONAL AUTHORITY.—Require18 ments that a community behavioral health clinic 

19 be— 

20 ‘‘(A) a nonprofit entity; 

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

22 health authority; 

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

24 Indian Health Service; 


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1 ‘‘(D) operated by an Indian Tribe or Trib2 al organization pursuant to a contract, grant, 

3 cooperative agreement, or compact with the In4 dian Health Service pursuant to the Indian 

5 Self-Determination and Education Assistance 

6 Act; or 

7 ‘‘(E) operated by an urban Indian organi8 zation pursuant to a grant or contract with the 

9 Indian Health Service under title V of the In10 dian Health Care Improvement Act. 

11 ‘‘SEC. 340J–2. OPERATING GRANTS FOR COMMUNITY BE12 HAVIORAL HEALTH CLINICS. 

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

14 grant program under which the Secretary shall award 

15 grants to eligible community behavioral health clinics to 

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

17 full array of certified community behavioral health serv18 ices. 

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

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

21 shall be— 

22 ‘‘(1) a certified community behavioral health 

23 clinic; or 

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

25 indicates in the grant application that the clinic will 


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1 use the grant funds to meet the criteria described in 

2 section 340J–1(a). 

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

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

5 ‘‘(1) shall use the grant funds— 

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

7 subsection (a); and 

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

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

10 meet the criteria described in section 340J– 

11 1(a); and 

12 ‘‘(2) may use the grant funds— 

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

14 ‘‘(i) reduce costs associated with the 

15 provision of certified community behavioral 

16 health services; 

17 ‘‘(ii) improve access to, and avail18 ability of, certified community behavioral 

19 health services provided to individuals 

20 served by the community behavioral health 

21 clinic; 

22 ‘‘(iii) enhance the quality and coordi23 nation of certified community behavioral 

24 health services; or 


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•S 2993 IS

1 ‘‘(iv) improve the health status of 

2 communities; and 

3 ‘‘(B) to pay for— 

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

5 buildings and equipment (including the 

6 costs of amortizing the principal of, and 

7 paying interest on, loans); 

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

9 lease of equipment, including data and in10 formation systems and behavioral health 

11 information technology to facilitate data 

12 reporting and other purposes; 

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

14 training and other operational or infra15 structure costs identified by the Secretary; 

16 and 

17 ‘‘(iv) costs associated with expanding 

18 and modernizing existing buildings or con19 structing new buildings (including the 

20 costs of amortizing the principal of, and 

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

22 are specifically allowed for in the grant op23 portunity published by the Secretary. 

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

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


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1 ‘‘(e) CONDITION ON RECEIPT OF FUNDS.—The Sec2 retary shall not make a grant to an applicant under sub3 section (a) unless the applicant provides assurances to the 

4 Secretary that within 120 days of receiving grant funding 

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

6 for approval by the Secretary an implementation plan that 

7 describes how the applicant will— 

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

9 (a); and 

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

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

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

13 ‘‘(f) AMOUNT OF GRANT.— 

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

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

16 community behavioral health clinic under subsection 

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

18 information provided by the community behavioral 

19 health clinic, but may not exceed an amount equal 

20 to the difference obtained by subtracting— 

21 ‘‘(A) the sum obtained by adding— 

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

23 operational funding provided to the clinic 

24 for such fiscal year; and 


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1 ‘‘(ii) the fees, premiums, and third2 party reimbursements that the clinic rea3 sonably expects to receive for its operations 

4 in such fiscal year; from 

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

6 meet the purposes and requirements of the 

7 grant program under this section during such 

8 fiscal year. 

9 ‘‘(2) REQUIREMENT.— 

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

11 costs described in paragraph (1)(B), the Sec12 retary may estimate the anticipated costs of the 

13 grant recipient in— 

14 ‘‘(i) providing the services described in 

15 subsection (a), including the anticipated 

16 costs of providing any individual certified 

17 community behavioral health service that 

18 the applicant entity does not have cost ex19 perience providing at the time of submit20 ting an application for such grant; and 

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

22 described in section 340J–1(a). 

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

24 shall base the estimate of anticipated costs 

25 under subparagraph (A) on an estimate of anVerDate Sep 11 2014 01:53 Oct 01, 2023 Jkt 039200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S2993.IS S2993

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1 ticipated costs provided by the applicable com2 munity behavioral health clinic. 

3 ‘‘(3) PAYMENTS.—The Secretary may— 

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

5 ‘‘(i) in advance or through reimburse6 ment; and 

7 ‘‘(ii) in installments; 

8 ‘‘(B) make adjustments to account for 

9 overpayments or underpayments. 

10 ‘‘(g) USE OF ACCREDITATION.— 

11 ‘‘(1) IN GENERAL.—In selecting grant recipi12 ents under this section, the Secretary may take into 

13 account whether an applicant community behavioral 

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

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

16 community behavioral health clinic receiving a grant 

17 under this section is providing the services described 

18 in subsection (a) and, if applicable, meeting the cri19 teria described in section 340J–1(a), the Secretary 

20 may take into account whether the community be21 havioral health clinic is accredited under section 

22 340J–5(a). 

23 ‘‘(h) AUTHORIZATION OF APPROPRIATIONS.— 


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

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

3 for each of fiscal years 2024 through 2028. 

4 ‘‘(2) MAINTENANCE OF FUNDING.—The 

5 amount made available under paragraph (1) shall 

6 supplement (and not supplant) any other Federal 

7 funding made available for community behavioral 

8 health clinics. 

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

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

11 the date of enactment of the Ensuring Excellence in Men12 tal Health Act, the Secretary shall establish programs 

13 through which the Secretary shall provide (either through 

14 the Department of Health and Human Services or by 

15 grant or contract) technical assistance and other assist16 ance to any of the following: 

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

18 340J–2. 

19 ‘‘(2) Entities participating in a Medicaid dem20 onstration program under section 223(d) of the Pro21 tecting Access to Medicare Act. 

22 ‘‘(3) Certified community behavioral health clin23 ics (as defined in sections 1861(aa)(8) and 

24 1905(jj)(2) of the Social Security Act), furnishing 

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


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1 ‘‘(4) Health or social service provider organiza2 tions pursuing or considering certified community 

3 behavioral health clinic status or partnering with 

4 certified community behavioral health clinics. 

5 ‘‘(5) Other stakeholders, for the purpose of fa6 cilitating successful implementation of the certified 

7 community behavioral health clinic model. 

8 ‘‘(b) INCLUSIONS.—Assistance provided by the Sec9 retary under subsection (a) may include technical and 

10 nonfinancial assistance, including— 

11 ‘‘(1) fiscal and program management assist12 ance; 

13 ‘‘(2) operational and administrative support; 

14 and 

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

16 about the variety of resources available under this 

17 part and how those resources can be best used to 

18 meet the health and behavioral health needs of the 

19 communities served by the entities. 

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

21 is authorized to be appropriated to carry out this section 

22 $6,000,000 for each of fiscal years 2024 through 2028. 


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

2 BEHAVIORAL HEALTH CLINIC REPORTING. 

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 shall establish a system 

6 under which the Secretary shall collect and analyze data 

7 on community behavioral health clinics. 

8 ‘‘(b) SCOPE OF DATA COLLECTION.—The system es9 tablished under subsection (a) shall be used by the Sec10 retary to collect and analyze data from— 

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

12 340J–2; and 

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

14 applied to provide services, under title XVIII of the 

15 Social Security Act, as described in section 

16 1861(aa)(8) of such Act, or under a State Medicaid 

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

18 Act. 

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

20 is authorized to be appropriated to carry out this section 

21 $51,000,000 for each of fiscal years 2024 through 2028. 

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

23 ACCREDITATION. 

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

25 behavioral health clinic may be accredited if the entity— 


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1 ‘‘(1) meets the standards of an approved ac2 creditation body; and 

3 ‘‘(2) authorizes the accreditation body to sub4 mit to the Secretary (or such agency as the Sec5 retary may designate) such records or other infor6 mation as the Secretary may require. 

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

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

9 a private nonprofit organization to be an accredita10 tion body for the accreditation of community behav11 ioral health clinics under subsection (a) if— 

12 ‘‘(A) using inspectors qualified to evaluate 

13 quality of care in a behavioral health service 

14 setting, the accreditation body agrees to inspect 

15 the clinic with such frequency as is determined 

16 by the Secretary; 

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

18 determining whether or not to accredit a clinic 

19 correspond to the criteria described in section 

20 340J–1(a), and are not less restrictive than 

21 such criteria; 

22 ‘‘(C) there is adequate provision for assur23 ing that the standards of the accreditation body 

24 continue to be met by the clinic; 


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

2 accredited by the body which has had its ac3 creditation denied, suspended, withdrawn, or re4 voked or which has had any other action taken 

5 against it by the accrediting body, the accred6 iting body agrees to submit to the Secretary the 

7 name of such clinic within 30 days of the action 

8 taken; and 

9 ‘‘(E) if the accreditation body has its ap10 proval withdrawn by the Secretary, the body 

11 agrees to notify each clinic accredited by the 

12 body of the withdrawal within 10 days of the 

13 withdrawal.’’. 

Æ 


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