II 

114TH CONGRESS 

1ST SESSION S. 1945 

To make available needed psychiatric, psychological, and supportive services 

for individuals with mental illness and families in mental health crisis, 

and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

AUGUST 5, 2015 

Mr. CASSIDY (for himself, Mr. MURPHY, and Ms. COLLINS) introduced the following bill; which was read twice and referred to the Committee on 

Health, Education, Labor, and Pensions 

A BILL 

To make available needed psychiatric, psychological, and supportive services for individuals with mental illness and 

families in mental health crisis, 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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Mental Health Reform Act of 2015’’. 

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

7 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 


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TITLE I—ASSISTANT SECRETARY FOR MENTAL HEALTH AND 

SUBSTANCE USE DISORDERS 

Sec. 101. Assistant Secretary for mental health and substance use disorders. 

Sec. 102. Reports. 

Sec. 103. Advisory Council on graduate medical education. 

TITLE II—GRANTS 

Sec. 201. National Mental Health Policy Laboratory. 

Sec. 202. Innovation grants. 

Sec. 203. Demonstration grants. 

Sec. 204. Early childhood intervention and treatment. 

Sec. 205. Extension of assisted outpatient treatment grant program for individuals with serious mental illness. 

Sec. 206. Block grants. 

Sec. 207. Telehealth child psychiatry access grants. 

Sec. 208. Liability protections for health care professional volunteers at community health centers and community mental health centers. 

Sec. 209. Minority fellowship program. 

Sec. 210. National health service corps. 

Sec. 211. Reauthorization of mental and behavioral health education training 

grant. 

Sec. 212. National suicide prevention lifeline program. 

TITLE III—INTEGRATION 

Sec. 301. Primary and behavioral health care integration grant programs. 

TITLE IV—INTERAGENCY SERIOUS MENTAL ILLNESS 

COORDINATING COMMITTEE 

Sec. 401. Interagency Serious Mental Illness Coordinating Committee. 

TITLE V—HIPAA CLARIFICATION 

Sec. 501. Findings. 

Sec. 502. Modifications to HIPAA. 

Sec. 503. Development and dissemination of model training programs. 

Sec. 504. Confidentiality of records. 

TITLE VI—MEDICARE AND MEDICAID REFORMS 

Sec. 601. Enhanced Medicaid coverage relating to certain mental health services. 

Sec. 602. Modifications to Medicare discharge planning requirements. 

TITLE VII—RESEARCH BY NATIONAL INSTITUTE OF MENTAL 

HEALTH 

Sec. 701. Increase in funding for certain research. 

TITLE VIII—SAMHSA REAUTHORIZATION AND REFORMS 

Subtitle A—Organization and General Authorities 

Sec. 801. Peer review. 

Sec. 802. Advisory councils. 

Sec. 803. Grants for jail diversion programs reauthorization. 


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Sec. 804. Projects for assistance in transition from homelessness. 

Sec. 805. Comprehensive community mental health services for children with 

serious emotional disturbances. 

Sec. 806. Reauthorization of priority mental health needs of regional and national significance. 

TITLE IX—MENTAL HEALTH PARITY 

Sec. 901. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. 

Sec. 902. Report on investigations regarding parity in mental health and substance use disorder benefits. 

Sec. 903. Strengthening parity in mental health and substance use disorder 

benefits. 

1 SEC. 2. DEFINITIONS. 

2 In this Act: 

3 (1) ASSISTANT SECRETARY.—Except as other4 wise specified, the term ‘‘Assistant Secretary’’ 

5 means the Assistant Secretary for Mental Health 

6 and Substance Use Disorders. 

7 (2) EVIDENCE-BASED.—The term ‘‘evidence8 based’’ means the conscientious, systematic, explicit, 

9 and judicious appraisal and use of external, current, 

10 reliable, and valid research findings as the basis for 

11 making decisions about the effectiveness and efficacy 

12 of a program, intervention, or treatment. 

13 TITLE I—ASSISTANT SECRETARY 

14 FOR MENTAL HEALTH AND 

15 SUBSTANCE USE DISORDERS 

16 SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH 

17 AND SUBSTANCE USE DISORDERS. 

18 (a) IN GENERAL.—There shall be in the Department 

19 of Health and Human Services an official to be known 


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1 as the Assistant Secretary for Mental Health and Sub2 stance Use Disorders, who shall— 

3 (1) report directly to the Secretary; 

4 (2) be appointed by the President, by and with 

5 the advice and consent of the Senate; and 

6 (3) be selected from among individuals who— 

7 (A)(i) have a doctoral degree in medicine 

8 or osteopathic medicine; 

9 (ii) have clinical, research, and policy expe10 rience in psychiatry; 

11 (iii) graduated from an Accreditation 

12 Council for Graduate Medical Education-ac13 credited psychiatric residency program; and 

14 (iv) have an understanding of biological, 

15 psychosocial, and pharmaceutical treatments of 

16 mental illness and substance use disorders; 

17 (B) have a doctoral degree in psychology 

18 and— 

19 (i) clinical, research, and policy expe20 rience regarding mental illness and sub21 stance use disorders; 

22 (ii) have completed an internship with 

23 an organization that is a member of the 

24 Association of Psychology Post-doctoral 


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1 and Internship Centers as part of doctoral 

2 degree completion; and 

3 (iii) an understanding of biological, 

4 psychosocial, and pharmaceutical treat5 ments of mental illness and substance use 

6 disorders; or 

7 (C) have a doctoral degree in social work 

8 and— 

9 (i) clinical, research, and policy expe10 rience regarding mental illness and sub11 stance use disorders; and 

12 (ii) an understanding of biological, 

13 psychosocial, and pharmaceutical treat14 ments of mental illness and substance use 

15 disorders. 

16 (b) SAMHSA ADMINISTRATOR.—Section 501(c)(1) 

17 of the Public Health Service Act (42 U.S.C. 290aa(c)(1)) 

18 is amended by striking ‘‘the President, by and with the 

19 advice and consent of the Senate’’ and inserting ‘‘, and 

20 serve under, the Assistant Secretary for Mental Health 

21 and Substance Use Disorders’’. 

22 (c) DUTIES.—The Assistant Secretary shall— 

23 (1) promote, evaluate, organize, integrate, and 

24 coordinate research, treatment, and services across 

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1 uals with respect to the problems of individuals suf2 fering from substance use disorders or mental ill3 ness; 

4 (2) carry out any functions within the Depart5 ment of Health and Human Services— 

6 (A) to improve services for individuals with 

7 substance use disorders or mental illness, in8 cluding services related to the prevention of, di9 agnosis of, intervention in, and treatment and 

10 rehabilitation of, substance use disorders or 

11 mental illness; 

12 (B) to ensure access to effective, evidence13 based diagnosis, prevention, intervention, treat14 ment and rehabilitation for individuals with 

15 mental illnesses and individuals with a sub16 stance use disorder; 

17 (C) to ensure that all grants with respect 

18 to serious mental illness or substance use dis19 orders, are consistent with the grant manage20 ment standards set forth by the Department, 

21 and that such grants are evidence-based, have 

22 scientific merit and avoid duplication; 

23 (D) to develop and implement initiatives to 

24 encourage individuals to pursue careers (espe25 cially in underserved areas and populations) as 


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1 psychiatrists, psychologists, psychiatric nurse 

2 practitioners, clinical social workers, and other 

3 licensed mental health professionals specializing 

4 in the diagnosis, evaluation, and treatment of 

5 individuals with severe mental illness; 

6 (E) to consult, coordinate with, facilitate 

7 joint efforts among, and support State, local, 

8 and tribal governments, nongovernmental enti9 ties, and individuals with a mental illness, par10 ticularly individuals with a serious mental ill11 ness and children and adolescents with a seri12 ous emotional disturbance, with respect to im13 proving community-based and other mental 

14 health services; 

15 (F) to disseminate evidenced-based and 

16 promising best practices developed by the Na17 tional Mental Health Policy Lab established 

18 under section 201 and other qualified research 

19 organizations that are culturally and linguis20 tically indicated treatment and prevention serv21 ices related to a mental illness, particularly in22 dividuals with a serious mental illness and chil23 dren and adolescents with a serious emotional 

24 disturbance; and 


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1 (G) to develop criteria for the application 

2 of best practices within the mental health and 

3 substance use disorder service delivery system; 

4 (3) within the Department of Health and 

5 Human Services, oversee and coordinate all pro6 grams and activities relating to— 

7 (A) diagnosis, prevention, intervention, 

8 treatment, rehabilitation with respect to mental 

9 health or substance use disorders; 

10 (B) parity in health insurance benefits and 

11 conditions relating to mental health and sub12 stance use disorders; or 

13 (C) the reduction of homelessness and in14 carceration among individuals with mental 

15 health and substance use disorders; 

16 (4) make recommendations to the Secretary of 

17 Health and Human Services regarding public par18 ticipation in decisions relating to mental health, in19 cluding serious mental illness, and serious emotional 

20 disturbances across the lifespan; 

21 (5) review and make recommendations with re22 spect to the Department of Health and Human 

23 Services budget to ensure the adequacy of such 

24 budget; 


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1 (6) across the Federal Government, in conjunc2 tion with the Interagency Serious Mental Illness Co3 ordinating Committee under section 501A of the 

4 Public Health Service Act (as added by section 

5 401)— 

6 (A) review all programs and activities re7 lating to the diagnosis or prevention of, or 

8 treatment or rehabilitation for, mental illness or 

9 substance use disorders; 

10 (B) identify any such programs and activi11 ties that are duplicative; 

12 (C) identify any such programs and activi13 ties that are not evidence-based, effective, or ef14 ficient; and 

15 (D) formulate recommendations for ex16 panding, coordinating, eliminating, and improv17 ing programs and activities identified pursuant 

18 to subparagraphs (B) and (C) and merging 

19 such programs and activities into other, suc20 cessful programs and activities; 

21 (7) identify evidence-based and promising best 

22 practices across the Federal Government for treat23 ment and services for individuals with mental health 

24 and substance use disorders by reviewing practices 


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1 for efficiency, effectiveness, quality, coordination, 

2 and cost effectiveness; and 

3 (8) not later than 18 months after the date of 

4 enactment of this Act and every 2 years thereafter, 

5 submit to Congress a report containing a nationwide 

6 strategy to recruit, train, and increase the mental 

7 health workforce for the treatment of individuals 

8 with mental illness, serious mental illness, substance 

9 use disorders, and co-occurring disorders. 

10 (d) NATIONWIDE STRATEGY.—The Assistant Sec11 retary shall ensure that the nationwide strategy in the re12 port under subsection (c)(8) is designed— 

13 (1) to encourage and incentivize students en14 rolled in an accredited medical or osteopathic school, 

15 or nursing, psychology, or social work graduate pro16 gram, to specialize in the mental health field; 

17 (2) to promote greater research-oriented psy18 chiatric, psychological, nursing, and social work 

19 training on evidence-based service delivery models 

20 for individuals with mental illness or substance use 

21 disorders, including models with family participation; 

22 (3) to promote appropriate Federal administra23 tive and fiscal mechanisms that support— 

24 (A) evidence-based collaborative care mod25 els; and 


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1 (B) the necessary mental health workforce 

2 capacity for the models under subparagraph 

3 (A), including psychiatrists, child and adoles4 cent psychiatrists, psychologists, psychiatric 

5 nurse practitioners, clinical social workers, and 

6 mental health, peer-support specialists; 

7 (4) to increase access to child and adolescent 

8 psychiatric services in order to promote early inter9 vention for prevention and mitigation of mental ill10 ness; 

11 (5) to identify populations and locations that 

12 are the most underserved by mental health profes13 sionals, including psychiatrists, child and adolescent 

14 psychiatrists, psychologists, psychiatric nurse practi15 tioners, clinical social workers, other licensed mental 

16 health professionals, and peer-support specialists; 

17 and 

18 (6) to identify means of alleviating the strain 

19 on the budgets of the criminal justice and correc20 tional systems and the capacity of such systems with 

21 respect to mental health and substance use dis22 orders. 

23 (e) PRIORITIZATION OF INTEGRATION OF SERVICES, 

24 EARLY DIAGNOSIS, INTERVENTION, AND WORKFORCE


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1 DEVELOPMENT.—In carrying out the duties described in 

2 subsection (c), the Assistant Secretary— 

3 (1) shall prioritize— 

4 (A) the integration of mental health, sub5 stance use, and physical health services for the 

6 purpose of diagnosing, preventing, treating, and 

7 providing rehabilitation for mental illness or 

8 substance use disorders, including any such 

9 services provided through the justice system 

10 (including departments of correction) or entities 

11 other than the Department of Health and 

12 Human Services; 

13 (B) the early diagnosis and intervention 

14 services for the prevention of, or crisis interven15 tion for, and treatment or rehabilitation for, se16 rious mental health disorders or substance use 

17 disorders, in selecting evidence-based practices 

18 and service delivery models for evaluation and 

19 dissemination under section 201(a)(2)(C); and 

20 (C) workforce development for— 

21 (i) appropriate treatment of serious 

22 mental illness or substance use disorders; 

23 (ii) research activities that advance 

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1 rious mental illness or substance use dis2 orders; and 

3 (iii) increasing the number of mental 

4 health professionals, including psychia5 trists, child and adolescent psychiatrists, 

6 psychologists, psychiatric nurse practi7 tioners, clinical social workers, and mental 

8 health peer support specialists; 

9 (2) shall give preference to models that improve 

10 the coordination, quality, and efficiency of health 

11 care services furnished to individuals with serious 

12 mental illness; and 

13 (3) may include clinical protocols and practices 

14 used in the Recovery After an Initial Schizophrenia 

15 Episode project of the National Institute of Mental 

16 Health or similar models, such as the Specialized 

17 Treatment Early in Psychosis program. 

18 SEC. 102. REPORTS. 

19 (a) REPORT ON BEST PRACTICES FOR PEER-SUP20 PORT SPECIALIST PROGRAMS, TRAINING, AND CERTIFI21 CATION.— 

22 (1) IN GENERAL.—Not later than 18 months 

23 after the date of enactment of this Act, and bian24 nually thereafter, the Assistant Secretary shall sub25 mit to Congress and make publicly available a report 


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1 on best practices and professional standards in 

2 States for— 

3 (A) establishing and operating health care 

4 programs using peer-support specialists; and 

5 (B) training and certifying peer-support 

6 specialists. 

7 (2) PEER-SUPPORT SPECIALIST DEFINED.—In 

8 this subsection, the term ‘‘peer-support specialist’’ 

9 means an individual who— 

10 (A) is credentialed by the State in which 

11 the individual practices; 

12 (B) uses his or her lived experience of re13 covery from mental illness or substance abuse, 

14 plus skills learned in formal training, to facili15 tate support groups, and to work on a one-on16 one basis, with individuals with a serious men17 tal illness or a substance use disorder, in con18 sultation with, and under the supervision of, a 

19 licensed mental health or substance use treat20 ment professional; 

21 (C) has been an active participant in men22 tal health or substance use treatment for at 

23 least the preceding year; 

24 (D) provides non-medical services; and 


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1 (E) performs services only within his or 

2 her area of training, expertise, competence, or 

3 scope of practice. 

4 (3) CONTENTS.—Each report under this sub5 section shall include information on best practices 

6 and standards with regard to the following: 

7 (A) Hours of formal work or volunteer ex8 perience related to mental health and substance 

9 use issues. 

10 (B) Types of peer specialist exams re11 quired. 

12 (C) Code of ethics. 

13 (D) Additional training required prior to 

14 certification, including in areas such as— 

15 (i) ethics; 

16 (ii) scope of practice; 

17 (iii) crisis intervention; 

18 (iv) State confidentiality laws; 

19 (v) Federal privacy protections, in20 cluding under the Health Insurance Port21 ability and Accountability Act of 1996 

22 (Public Law 104–191); and 

23 (vi) other areas, as determined by the 

24 Assistant Secretary. 


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1 (E) Requirements to explain what, where, 

2 when, and how to accurately complete all re3 quired documentation activities. 

4 (F) Required or recommended skill sets, 

5 including knowledge of— 

6 (i) risk indicators and responding ap7 propriately to individual stressors, triggers, 

8 and indicators of pre-crisis symptoms; 

9 (ii) basic crisis avoidance techniques; 

10 (iii) basic suicide prevention concepts 

11 and techniques; 

12 (iv) indicators that an individual may 

13 be experiencing abuse or neglect; 

14 (v) stages of change or recovery; 

15 (vi) the typical process that should be 

16 followed to access or participate in commu17 nity mental health and related services; 

18 and 

19 (vii) circumstances when it is appro20 priate to request assistance from other 

21 professionals to help meet the individual’s 

22 recovery goals. 

23 (G) Annual requirements for continuing 

24 education credits. 


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1 (b) REPORT ON MENTAL HEALTH AND SUBSTANCE

2 USE TREATMENT IN THE STATES.— 

3 (1) IN GENERAL.—Not later than 18 months 

4 after the date of enactment of this Act, and not less 

5 than every 18 months thereafter, the Assistant Sec6 retary for Mental Health and Substance Use Dis7 orders, in collaboration with the Director of the 

8 Agency for Healthcare Research and Quality and 

9 Director of the National Institutes of Health, shall 

10 submit to Congress and make available to the public 

11 a report on mental health and substance use treat12 ment in the States, including the following: 

13 (A) A detailed report on how Federal men14 tal health and substance use treatment funds 

15 are used in each State, including: 

16 (i) The numbers of individuals with 

17 mental illness, serious mental illness, sub18 stance use disorders, or co-occurring dis19 orders who are served with Federal funds. 

20 (ii) The types of programs made avail21 able to individuals with mental illness, seri22 ous mental illness, substance use disorders, 

23 or co-occurring disorders. 

24 (B) A summary of best practice models in 

25 the States highlighting programs that are cost 


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1 effective, provide evidence-based care, increase 

2 access to care, integrate physical, psychiatric, 

3 psychological, and behavioral medicine, and im4 prove outcomes for individuals with serious 

5 mental illness or substance use disorders. 

6 (C) A statistical report of outcome meas7 ures in each State for individuals with mental 

8 illness, serious mental illness, substance use dis9 orders, or co-occurring disorders, including 

10 rates of suicide, suicide attempts, substance 

11 abuse, overdose, overdose deaths, health out12 comes, emergency psychiatric hospitalizations 

13 and emergency room boarding, arrests, incar14 cerations, homelessness, joblessness, employ15 ment, and enrollment in educational or voca16 tional programs. 

17 (D) A comparative effectiveness research 

18 study analyzing outcomes for different models 

19 of outpatient treatment programs for the seri20 ously mentally ill that include outpatient mental 

21 health services that are court ordered or vol22 untary, including— 

23 (i) rates of keeping treatment ap24 pointments and compliance with prescribed 

25 medications; 


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1 (ii) participants’ perceived effective2 ness of the program; 

3 (iii) rates of the programs helping in4 dividuals with serious mental illness gain 

5 control over their lives; 

6 (iv) alcohol and drug abuse rates; 

7 (v) incarceration and arrest rates; 

8 (vi) violence against persons or prop9 erty; 

10 (vii) homelessness; 

11 (viii) total treatment costs for compli12 ance with program; and 

13 (ix) health outcomes. 

14 (2) DEFINITION.—In this subsection, the term 

15 ‘‘emergency room boarding’’ means the practice of 

16 admitting patients to an emergency department and 

17 holding such patients in the department until inpa18 tient psychiatric beds become available. 

19 (c) REPORTING COMPLIANCE STUDY.— 

20 (1) IN GENERAL.—The Assistant Secretary for 

21 Mental Health and Substance Use Disorders shall 

22 enter into an arrangement with the National Acad23 emy of Medicine (or, if the National Academy of 

24 Medicine declines, another appropriate entity) under 

25 which, not later than 18 months after the date of 


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1 enactment of this Act, the National Academy of 

2 Medicine will submit to the appropriate committees 

3 of Congress a report that evaluates the combined pa4 perwork burden of— 

5 (A) community mental health centers 

6 meeting the criteria specified in section 1913(c) 

7 of the Public Health Service Act (42 U.S.C. 

8 300x–2(c)), including such centers meeting 

9 such criteria as in effect on the day before the 

10 date of enactment of this Act; and 

11 (B) community mental health centers, as 

12 defined in section 1861(ff)(3)(B) of the Social 

13 Security Act. 

14 (2) SCOPE.—In preparing the report under sub15 section (a), the National Academy of Medicine (or, 

16 if applicable, other appropriate entity) shall examine 

17 licensing, certification, service definitions, claims 

18 payment, billing codes, and financial auditing re19 quirements used by the Office of Management and 

20 Budget, the Centers for Medicare & Medicaid Serv21 ices, the Health Resources and Services Administra22 tion, the Substance Abuse and Mental Health Serv23 ices Administration, the Office of the Inspector Gen24 eral of the Department of Health and Human Serv25 ices, State Medicaid agencies, State departments of 


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1 health, State departments of education, and State 

2 and local juvenile justice and social service agencies 

3 to make administrative and statutory recommenda4 tions to Congress (which recommendations may in5 clude a uniform methodology) to reduce the paper6 work burden experienced by centers and clinics de7 scribed in paragraph (1). 

8 SEC. 103. ADVISORY COUNCIL ON GRADUATE MEDICAL 

9 EDUCATION. 

10 (a) IN GENERAL.—Section 762(b) of the Public 

11 Health Service Act (42 U.S.C. 294o(b)) is amended— 

12 (1) by redesignating paragraphs (4) through 

13 (6) as paragraphs (5) through (7), respectively; and 

14 (2) by inserting after paragraph (3) the fol15 lowing: 

16 ‘‘(4) the Assistant Secretary for Mental Health 

17 and Substance Use Disorders;’’. 

18 (b) CONFORMING AMENDMENT.—Section 762(c) of 

19 the Public Health Service Act (42 U.S.C. 294o(c)) is 

20 amended by striking ‘‘paragraphs (4), (5), and (6)’’ each 

21 place it appears and inserting ‘‘paragraphs (5), (6), and 

22 (7)’’. 


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1 TITLE II—GRANTS 

2 SEC. 201. NATIONAL MENTAL HEALTH POLICY LABORA3 TORY. 

4 (a) IN GENERAL.— 

5 (1) ESTABLISHMENT.—The Assistant Secretary 

6 for Mental Health and Substance Use Disorders 

7 shall establish, within the Office of the Assistant 

8 Secretary, the National Mental Health Policy Lab9 oratory (in this section referred to as the 

10 ‘‘NMHPL’’), to be headed by a Director. 

11 (2) DUTIES.—The Director of the NMHPL 

12 shall— 

13 (A) identify, coordinate, and implement 

14 policy changes and other trends likely to have 

15 the most significant impact on mental health 

16 services and monitor their impact; 

17 (B) collect information from grantees 

18 under programs established or amended by this 

19 Act and under other mental health programs 

20 under the Public Health Service Act, including 

21 grantees that are States receiving funds under 

22 a block grant under part B of title XIX of the 

23 Public Health Service Act (42 U.S.C. 300x et 

24 seq.); 


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1 (C) evaluate and disseminate to such 

2 grantees evidence-based practices and service 

3 delivery models using the best available science 

4 shown to be cost-effective while enhancing the 

5 quality of care furnished to individuals; and 

6 (D) establish standards for the appoint7 ment of scientific peer-review panels to evaluate 

8 grant applications. 

9 (3) EVIDENCE-BASED PRACTICES AND SERVICE

10 DELIVERY MODELS.—In selecting evidence-based 

11 best practices and service delivery models for evalua12 tion and dissemination under paragraph (2)(C), the 

13 Director of the NMHPL— 

14 (A) shall give preference to models that— 

15 (i) improve the coordination between 

16 mental health and physical health pro17 viders; 

18 (ii) improve the coordination among 

19 such providers and the justice and correc20 tions system; 

21 (iii) improve the cost effectiveness, 

22 quality, effectiveness, and efficiency of 

23 health care services furnished to individ24 uals with serious mental illness, in mental 


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1 health crisis, or at risk to themselves, their 

2 families, and the general public; and 

3 (iv) recognize the importance of fam4 ily participation in recovery; and 

5 (B) may include clinical protocols and 

6 practices used in the Recovery After Initial 

7 Schizophrenia Episode project of the National 

8 Institute of Mental Health and the Specialized 

9 Treatment Early in Psychosis program. 

10 (4) DEADLINE FOR BEGINNING IMPLEMENTA11 TION.—The Director of the NMHPL shall begin im12 plementation of the duties described in this sub13 section not later than January 1, 2018. 

14 (5) CONSULTATION.—In carrying out the duties 

15 under this subsection, the Director of the NMHPL 

16 may consult with— 

17 (A) representatives of the National Insti18 tute of Mental Health on organizational and 

19 operational issues; 

20 (B) other appropriate Federal agencies; 

21 (C) clinical and analytical experts with ex22 pertise in medicine, psychiatric and clinical psy23 chological care, health care management, edu24 cation, corrections health care, social services, 

25 and mental health court systems; and 


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1 (D) other individuals and agencies as the 

2 Assistant Secretary determines appropriate. 

3 (b) STAFFING.— 

4 (1) COMPOSITION.—In selecting the staff of the 

5 NMHPL, the Director of the NMHPL, in consulta6 tion with the Director of the National Institute of 

7 Mental Health, shall include individuals with ad8 vanced degrees and clinical and research experience, 

9 and who have an understanding of biological, psy10 chosocial, and pharmaceutical treatments of mental 

11 illness and substance use disorders, including— 

12 (A) individuals with a medical degree or 

13 doctoral degree from an accredited program 

14 in— 

15 (i) allopathic or osteopathic medicine, 

16 and who have specialized training in psy17 chiatry; 

18 (ii) psychology; or 

19 (iii) social work; 

20 (B) professionals or academics with clinical 

21 or research expertise in substance use disorders 

22 and treatment; and 

23 (C) professionals or academics with exper24 tise in research design and methodologies. 


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1 (c) REPORT ON QUALITY OF CARE.—Not later than 

2 2 years after the date of enactment of this Act, and every 

3 2 years thereafter, the Director of the NMHPL shall sub4 mit to Congress a report on the quality of care furnished 

5 through grant programs administered by the Assistant 

6 Secretary under the respective services delivery models, in7 cluding measurement of patient-level outcomes and public 

8 health outcomes, such as— 

9 (1) reduced rates of suicide, suicide attempts, 

10 substance abuse, overdose, overdose deaths, emer11 gency psychiatric hospitalizations, emergency room 

12 boarding, incarceration, crime, arrest, homelessness, 

13 and joblessness; 

14 (2) rates of employment and enrollment in edu15 cational and vocational programs; and 

16 (3) such other criteria as the Director may de17 termine. 

18 (d) DEFINITION.—In this section, the term ‘‘emer19 gency room boarding’’ means the practice of admitting pa20 tients to an emergency department and holding such pa21 tients in the department until inpatient psychiatric beds 

22 become available. 

23 SEC. 202. INNOVATION GRANTS. 

24 (a) IN GENERAL.—The Assistant Secretary shall 

25 award grants to State and local governments, educational 


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1 institutions, and nonprofit organizations for expanding a 

2 model that has been scientifically demonstrated to show 

3 promise, but would benefit from further applied research, 

4 for— 

5 (1) enhancing the prevention, diagnosis, inter6 vention, treatment, and rehabilitation of mental ill7 ness, serious emotional disorder, substance use dis8 order, and co-occurring disorders; or 

9 (2) integrating or coordinating physical health, 

10 mental health, and substance use services. 

11 (b) DURATION.—A grant under this section shall be 

12 for a period of not more than 3 years. 

13 (c) LIMITATIONS.—Of the amounts made available 

14 for carrying out this section for a fiscal year— 

15 (1) not more than one-third shall be awarded 

16 for use for prevention; and 

17 (2) not less than one-third shall be awarded for 

18 screening, diagnosis, treatment, or services, as de19 scribed in subsection (a), for individuals (or sub20 populations of individuals) who are below the age of 

21 18 when activities funded through the grant award 

22 are initiated. 

23 (d) GUIDELINES.—As a condition on receipt of an 

24 award under this section, an applicant shall agree to adVerDate Sep 11 2014 23:24 Aug 11, 2015 Jkt 049200 PO 00000 Frm 00027 Fmt 6652 Sfmt 6201 E:\BILLS\S1945.IS S1945

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1 here to guidelines issued by the National Mental Health 

2 Policy Laboratory on research designs and data collection. 

3 (e) AUTHORIZATION OF APPROPRIATIONS.—To carry 

4 out this section, there are authorized to be appropriated 

5 $10,000,000 for each of fiscal years 2017 through 2021. 

6 SEC. 203. DEMONSTRATION GRANTS. 

7 (a) GRANTS.—The Assistant Secretary shall award 

8 grants to States, counties, local governments, educational 

9 institutions, and private nonprofit organizations for the 

10 expansion, replication, or scaling of evidence-based pro11 grams across a wider area to enhance effective screening, 

12 early diagnosis, intervention, and treatment with respect 

13 to mental illness and serious mental illness, primarily by— 

14 (1) applied delivery of care, including training 

15 staff in effective evidence-based treatment; and 

16 (2) integrating models of care across specialties 

17 and jurisdictions. 

18 (b) DURATION.—A grant under this section shall be 

19 for a period of not less than 2 years and not more than 

20 5 years. 

21 (c) LIMITATIONS.—Of the amounts made available 

22 for carrying out this section for a fiscal year— 

23 (1) not less than half shall be awarded for 

24 screening, diagnosis, intervention, and treatment, as 

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1 populations of individuals) who are below the age of 

2 26 when activities funded through the grant award 

3 are initiated; 

4 (2) no amounts shall be made available for any 

5 program or project that is not evidence-based; 

6 (3) no amounts shall be made available for pri7 mary prevention; and 

8 (4) no amounts shall be made available solely 

9 for the purpose of expanding facilities or increasing 

10 staff at an existing program. 

11 (d) GUIDELINES.—As a condition on receipt of an 

12 award under this section, an applicant shall agree to ad13 here to guidelines issued by the National Mental Health 

14 Policy Laboratory (established under section 201) on re15 search designs and data collection. 

16 (e) REPORTING.—As a condition on receipt of an 

17 award under this section, an applicant shall agree— 

18 (1) to report to the National Mental Health 

19 Policy Laboratory and the Assistant Secretary the 

20 results of programs and activities funded through 

21 the award; and 

22 (2) to include in such reporting any relevant 

23 data requested by the National Mental Health Policy 

24 Laboratory and the Assistant Secretary. 


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1 (f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there are authorized to be appropriated 

3 $10,000,000 for each of fiscal years 2017 through 2021. 

4 SEC. 204. EARLY CHILDHOOD INTERVENTION AND TREAT5 MENT. 

6 (a) GRANTS.—The Director of the National Mental 

7 Health Policy Laboratory (in this section referred to as 

8 the ‘‘NMHPL’’) shall— 

9 (1) award grants to eligible entities to initiate 

10 and undertake early childhood intervention and 

11 treatment programs, and specialized programs for 

12 preschool- and elementary school-aged children at 

13 significant risk or who show early signs of social or 

14 emotional disability (in addition to any learning dis15 ability); and 

16 (2) ensure that programs funded through 

17 grants under this section are based on promising or 

18 evidence-based models and methods that are cul19 turally and linguistically relevant and can be rep20 licated in other settings. 

21 (b) ELIGIBLE ENTITIES AND CHILDREN.—In this 

22 section: 

23 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti24 ty’’ means a nonprofit institution that— 


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1 (A) is accredited by a State mental health 

2 or education agency, as applicable, for the 

3 intervention, treatment, or education of children 

4 from 3 to 12 years of age; and 

5 (B) provides services that include early 

6 intervention and treatment or specialized pro7 grams for preschool- and elementary school8 aged children whose primary need is a social or 

9 emotional disability (in addition to any learning 

10 disability). 

11 (2) ELIGIBLE CHILD.—The term ‘‘eligible 

12 child’’ means a child who is at least 3 years old and 

13 not more than 12 years old— 

14 (A) whose primary need is a social or emo15 tional disability (in addition to any learning dis16 ability); and 

17 (B) who could benefit from early childhood 

18 intervention and specialized preschool or ele19 mentary school programs with the goal of inter20 vening or treating social or emotional disabil21 ities. 

22 (c) APPLICATION.—An eligible entity seeking a grant 

23 under subsection (a) shall submit to the Secretary an ap24 plication at such time, in such manner, and containing 

25 such information as the Secretary may require. 


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1 (d) USE OF FUNDS FOR EARLY INTERVENTION AND

2 TREATMENT PROGRAMS.—An eligible entity shall use 

3 amounts awarded under a grant under subsection (a)(1) 

4 to carry out the following activities: 

5 (1) Deliver for eligible children mental health 

6 education and treatment, early childhood education 

7 and intervention, and specialized programs for 

8 preschool- and elementary school-aged children at 

9 significant risk or who show early signs of social or 

10 emotional disability (in addition to any learning dis11 ability), including the provision of day treatment and 

12 social-emotional and behavioral services. 

13 (2) Treat and educate eligible children, includ14 ing by providing funding for— 

15 (A) program and curricula development; 

16 (B) staff; 

17 (C) assessment, intervention, and treat18 ment services; 

19 (D) administrative costs, including oper20 ating costs, capital needs, and equipment; 

21 (E) enrollment costs; 

22 (F) collaboration with primary care physi23 cians, psychiatrists, and clinical services of psy24 chologists of other related mental health spe25 cialists; 


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1 (G) services to meet emergency needs of 

2 children; and 

3 (H) communication with families and phys4 ical and mental health professionals concerning 

5 the children. 

6 (3) Develop and implement other strategies to 

7 address identified intervention, treatment, and edu8 cational needs of eligible children that incorporate 

9 reliable and valid evaluation modalities into the pro10 gram to ensure outcomes based on sound scientific 

11 metrics as determined by the NMHPL. 

12 (e) AMOUNT OF AWARDS.—The amount of an award 

13 to an eligible entity under subsection (a)(1) shall be not 

14 more than $600,000 per fiscal year. 

15 (f) PROJECT TERMS.—The period of a grant for 

16 awards under subsection (a)(1), shall be not less than 3 

17 fiscal years and not more than 10 fiscal years. 

18 (g) MATCHING FUNDS.—The Director of the 

19 NMHPL may not award a grant under this section to an 

20 eligible entity unless the eligible entity agrees, with respect 

21 to the costs to be incurred by the eligible entity in carrying 

22 out the activities described in subsection (d), to make 

23 available non-Federal contributions (in cash or in kind) 

24 toward such costs in an amount that is not less than 10 

25 percent of Federal funds provided in the grant. 


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1 (h) AUTHORIZATION OF APPROPRIATIONS.—To carry 

2 out this section, there are authorized to be appropriated 

3 $10,000,000 for each of fiscal years 2017 through 2021. 

4 SEC. 205. EXTENSION OF ASSISTED OUTPATIENT TREAT5 MENT GRANT PROGRAM FOR INDIVIDUALS 

6 WITH SERIOUS MENTAL ILLNESS. 

7 Section 224 of the Protecting Access to Medicare Act 

8 of 2014 (42 U.S.C. 290aa note) is amended— 

9 (1) in subsection (a), by striking ‘‘4-year’’ and 

10 inserting ‘‘6-year’’; 

11 (2) in subsection (e), by striking ‘‘and 2018’’ 

12 and inserting ‘‘2018, 2019, and 2020’’; and 

13 (3) in subsection (g)— 

14 (A) in paragraph (1), by striking ‘‘2018’’ 

15 and inserting ‘‘2020’’; 

16 (B) in paragraph (2) by striking ‘‘2018’’ 

17 and inserting ‘‘2020’’; and 

18 (C) by striking ‘‘$15,000,000’’ and insert19 ing ‘‘$20,000,000’’. 

20 SEC. 206. BLOCK GRANTS. 

21 (a) REAUTHORIZATION OF BLOCK GRANT.—Section 

22 1920(a) of the Public Health Service Act (42 U.S.C. 

23 300x–9(a)) is amended by striking ‘‘$450,000,000 for fis24 cal year 2001, and such sums as may be necessary for 

25 each of the fiscal years 2002 and 2003’’ and inserting 


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1 ‘‘$483,000,000 for fiscal year 2017 and such sums as may 

2 be necessary for each of fiscal years 2018 through 2019’’. 

3 (b) BEST PRACTICES IN CLINICAL CARE MODELS.— 

4 Section 1920 of the Public Health Service Act (42 U.S.C. 

5 300x–9) is amended by adding at the end the following: 

6 ‘‘(c) BEST PRACTICES IN CLINICAL CARE MOD7 ELS.—The Assistant Secretary, acting through the Ad8 ministrator of the Substance Abuse and Mental Health 

9 Services and in collaboration with the Director of the Na10 tional Institute of Mental Health, shall obligate 5 percent 

11 of the amounts appropriated for a fiscal year under sub12 section (a) for translating evidence-based (as defined in 

13 section 2 of the Mental Health Reform Act of 2015) inter14 ventions and best available science into systems of care, 

15 such as through models including the Recovery After an 

16 Initial Schizophrenia Episode research project of the Na17 tional Institute of Mental Health.’’. 

18 (c) ADDITIONAL PROGRAM REQUIREMENTS.— 

19 (1) INTEGRATED SERVICES.—Subsection (b)(1) 

20 of section 1912 of the Public Health Service Act (42 

21 U.S.C. 300x–1(b)(1)) is amended— 

22 (A) by striking ‘‘The plan provides’’ and 

23 inserting the following: 

24 ‘‘(A) IN GENERAL.—The plan provides’’; 


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1 (B) in the second sentence, by striking 

2 ‘‘health and mental health services’’ and insert3 ing ‘‘integrated physical and mental health 

4 services’’; 

5 (C) by striking ‘‘The plan shall include’’ 

6 and all that follows through the period at the 

7 end and inserting ‘‘The plan shall integrate and 

8 coordinate services to maximize the efficiency, 

9 effectiveness, quality, coordination, and cost ef10 fectiveness of those services and programs to 

11 produce the best possible outcomes for individ12 uals with serious mental illness.’’; and 

13 (D) by adding at the end the following new 

14 subparagraph: 

15 ‘‘(B) ADDITIONAL REQUIREMENTS.—The 

16 plan shall include a separate description of case 

17 management services and provide for activities 

18 leading to reduction of rates of suicides, suicide 

19 attempts, substance abuse, overdose deaths, 

20 emergency hospitalizations, incarceration, 

21 crimes, arrest, homelessness, joblessness, medi22 cation nonadherence, and education and voca23 tional programs drop outs. The plan shall in24 clude a detailed list of services available for eliVerDate Sep 11 2014 23:24 Aug 11, 2015 Jkt 049200 PO 00000 Frm 00036 Fmt 6652 Sfmt 6201 E:\BILLS\S1945.IS S1945

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1 gible patients in each county or county equiva2 lent.’’. 

3 (2) DATA COLLECTION SYSTEM.— 

4 (A) Subsection (b)(1)(A) (as so designated 

5 by paragraph (1)) of section 1912 of the Public 

6 Health Service Act (42 U.S.C. 300x– 

7 1(b)(1)(A)) is amended by inserting ‘‘legal serv8 ices, and’’ before ‘‘other support services’’. 

9 (B) Subsection (b)(2) of section 1912 of 

10 the Public Health Service Act (42 U.S.C. 300x– 

11 1(b)(2)) is amended by inserting ‘‘and outcome 

12 measures for services and resources’’ before the 

13 period. 

14 (3) IMPLEMENTATION OF PLAN.—Subsection 

15 (d) of section 1912 of the Public Health Service Act 

16 (42 U.S.C. 300x–1(d)) is amended— 

17 (A) in paragraph (1)— 

18 (i) by striking ‘‘Except as provided’’ 

19 and inserting the following: 

20 ‘‘(A) IN GENERAL.—Except as provided’’; 

21 and 

22 (ii) by adding at the end the following 

23 new subparagraph: 

24 ‘‘(B) DE-IDENTIFIED REPORTS.—For eligi25 ble patients receiving treatment through funds 


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1 awarded under a grant under section 1911, a 

2 State shall include in the State plan for the 

3 first year beginning after the date of the enact4 ment of the Mental Health Reform Act of 2015 

5 and each subsequent year, a de-identified re6 port, containing information that is open source 

7 and de-identified, on the outcomes measures 

8 collected in subsection (b)(2) of section 1912 of 

9 the Public Health Service Act and the overall 

10 cost of such treatment provided.’’. 

11 (4) INCENTIVES FOR STATE-BASED OUTCOME

12 MEASURES.—Section 1920 of the Public Health 

13 Service Act (42 U.S.C. 300x–9) is amended by add14 ing at the end the following: 

15 ‘‘(c) INCENTIVES FOR STATE-BASED OUTCOME

16 MEASURES.— 

17 ‘‘(1) IN GENERAL.—In addition to the amounts 

18 made available under subsection (a) for fiscal year 

19 2019, the Secretary shall provide to each State that 

20 meets the conditions under paragraph (2) for fiscal 

21 year 2019, an amount equal to 2 percent of the for22 mula grant amount described in section 1911 and 

23 section 1921. 

24 ‘‘(2) CONDITIONS.—The Secretary shall define 

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1 ceive the additional amount under paragraph (1), 

2 based on the report on mental health and substance 

3 use treatment in the States under section 102(b) of 

4 the Mental Health Reform Act of 2015. 

5 ‘‘(3) CLARIFICATION.—Any amounts made 

6 available under paragraph (1) shall be in addition to 

7 the State’s block grant allocation and shall be made 

8 to a State for a fiscal year, as a single payment, not 

9 later than the last day of the first calendar quarter 

10 of fiscal year 2020.’’. 

11 (5) EVIDENCE-BASED SERVICES DELIVERY

12 MODELS.—Section 1912 of the Public Health Serv13 ice Act (42 U.S.C. 300x–1) is amended by adding at 

14 the end the following new subsection: 

15 ‘‘(e) EXPANSION OF MODELS.— 

16 ‘‘(1) IN GENERAL.—Taking into account the re17 sults of evaluations under section 201(a)(2)(C) of 

18 the Mental Health Reform Act of 2015, the Assist19 ant Secretary may, by rule, as part of the program 

20 of block grants under this subpart, provide for ex21 panded use across the Nation of evidence-based serv22 ice delivery models by providers funded under such 

23 block grants, so long as— 

24 ‘‘(A) the Assistant Secretary for Mental 

25 Health and Substance Use Disorders (in this 


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1 subsection referred to as the ‘Assistant Sec2 retary’) determines that such expansion will— 

3 ‘‘(i) result in more effective use of 

4 funds under such block grants without re5 ducing the quality of care; or 

6 ‘‘(ii) improve the quality of patient 

7 care without significantly increasing spend8 ing; 

9 ‘‘(B) the Director of the National Institute 

10 of Mental Health determines that such expan11 sion would improve the quality of patient care; 

12 and 

13 ‘‘(C) the Assistant Secretary determines 

14 that the change will— 

15 ‘‘(i) significantly reduce severity and 

16 duration of symptoms of mental illness; 

17 ‘‘(ii) reduce rates of suicide, suicide 

18 attempts, substance abuse, overdose, emer19 gency hospitalizations, emergency room 

20 boarding, incarceration, crime, arrest, 

21 homelessness, or joblessness; or 

22 ‘‘(iii) significantly improve the quality 

23 of patient care and mental health crisis 

24 outcomes without significantly increasing 

25 spending. 


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1 ‘‘(2) DEFINITION.—In this subsection, the term 

2 ‘emergency room boarding’ means the practice of ad3 mitting patients to an emergency department and 

4 holding such patients in the department until inpa5 tient psychiatric beds become available.’’. 

6 (d) PERIOD FOR EXPENDITURE OF GRANT FUNDS.— 

7 Section 1913 of the Public Health Service Act (42 U.S.C. 

8 300x–2) is amended by adding at the end the following: 

9 ‘‘(d) PERIOD FOR EXPENDITURE OF GRANT

10 FUNDS.—In implementing a plan submitted under section 

11 1912(a), a State receiving a grant under section 1911 may 

12 make such funds available to providers of services de13 scribed in subsection (b) for the provision of services with14 out fiscal year limitation.’’. 

15 (e) ACTIVE OUTREACH AND ENGAGEMENT.—Section 

16 1915 of the Public Health Service Act (42 U.S.C. 300x– 

17 4) is amended by adding at the end of the following: 

18 ‘‘(c) ACTIVE OUTREACH AND ENGAGEMENT TO PER19 SONS WITH SERIOUS MENTAL ILLNESS.— 

20 ‘‘(1) IN GENERAL.—A funding agreement for a 

21 grant under section 1911 is that the State involved 

22 has in effect active programs that seek to engage in23 dividuals with serious mental illness in comprehen24 sive services in order to avert relapse, repeated hos25 pitalizations, arrest, incarceration, suicide, and to 


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1 provide the patient with the opportunity to live in 

2 the least restrictive setting, through a comprehensive 

3 program of evidence-based and culturally relevant 

4 assertive outreach and engagement services focusing 

5 on individuals who are homeless, have co-occurring 

6 disorders, are at risk for incarceration or re-incar7 ceration, or have a history of treatment failure, in8 cluding repeated hospitalizations or emergency room 

9 usage. 

10 ‘‘(2) EVIDENCE-BASED ASSERTIVE OUTREACH

11 AND ENGAGEMENT SERVICES.— 

12 ‘‘(A) SAMHSA.—The Administrator of 

13 the Substance Abuse and Mental Health Serv14 ices Administration, in cooperation with the Di15 rector of the National Institute of Mental 

16 Health, shall develop— 

17 ‘‘(i) a list of evidence-based culturally 

18 and linguistically relevant assertive out19 reach and engagement services; and 

20 ‘‘(ii) criteria to be used to assess the 

21 scope and effectiveness of the approaches 

22 taken by such services, such as the ability 

23 to provide same-day appointments for 

24 emergent situations. 


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1 ‘‘(B) TYPES OF ASSERTIVE OUTREACH

2 AND ENGAGEMENT SERVICES.—For purposes of 

3 paragraph (1), appropriate programs of evi4 dence-based assertive outreach and engagement 

5 services may include peer support programs; 

6 the Wellness Recovery Action Plan, Assertive 

7 Community Treatment, and Forensic Assertive 

8 Community Treatment of the Substance Abuse 

9 and Mental Health Services Administration; as10 sisted outpatient treatment, appropriate sup11 portive housing programs incorporating a Hous12 ing First model; and intensive, evidence-based 

13 approaches to early intervention in psychosis, 

14 such as the Recovery After an Initial Schizo15 phrenia Episode model of the National Institute 

16 of Mental Health and the Specialized Treat17 ment Early in Psychosis program. 

18 ‘‘(d) PSYCHIATRIC ADVANCED DIRECTIVES.—A 

19 funding agreement for a grant under section 1911 is that 

20 the State involved has in effect active programs that seek 

21 to engage individuals with serious mental illness in 

22 proactively making their own health care decisions and en23 hancing communication between themselves, their fami24 lies, and their treatment providers by allowing for early 

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1 voluntary treatment by developing psychiatric advanced 

2 directives through a comprehensive program— 

3 ‘‘(1) of assertive outreach and engagement serv4 ices focusing on individuals diagnosed with serious 

5 mental illness or self-identifying as in recovery from 

6 serious mental illness to obtain a psychiatric ad7 vanced directive; or 

8 ‘‘(2) to support States in providing accessible 

9 legal counsel to individuals diagnosed with serious 

10 mental illness.’’. 

11 SEC. 207. TELEHEALTH CHILD PSYCHIATRY ACCESS 

12 GRANTS. 

13 (a) IN GENERAL.—The Secretary, acting through the 

14 Administrator of the Health Resources and Services Ad15 ministration, shall award grants to States and Indian 

16 tribes or tribal organizations (as defined in section 4 of 

17 the Indian Self-Determination and Education Assistance 

18 Act) to promote behavioral health integration in pediatric 

19 primary care by— 

20 (1) supporting the creation of statewide child 

21 psychiatry access programs; and 

22 (2) supporting the expansion of existing state23 wide or regional child psychiatry access programs. 

24 (b) PROGRAM REQUIREMENTS.— 


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1 (1) IN GENERAL.—To be eligible for funding 

2 under subsection (a), a child psychiatry access pro3 gram shall— 

4 (A) be a statewide network of pediatric 

5 mental health teams that provide support to pe6 diatric primary care sites as an integrated 

7 team; 

8 (B) support and further develop organized 

9 State networks of child and adolescent psychia10 trists to provide consultative support to pedi11 atric primary care sites; 

12 (C) conduct an assessment of critical be13 havioral consultation needs among pediatric 

14 providers and such providers’ preferred mecha15 nisms for receiving consultation and training 

16 and technical assistance; 

17 (D) develop an online database and com18 munication mechanisms, including telehealth, to 

19 facilitate consultation support to pediatric prac20 tices; 

21 (E) provide rapid (within 30 minutes) 

22 statewide clinical telephone consultations when 

23 requested between the pediatric mental health 

24 teams and pediatric primary care providers; 


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1 (F) conduct training and provide technical 

2 assistance to pediatric primary care providers to 

3 support the early identification, diagnosis, 

4 treatment, and referral of children with behav5 ioral health conditions; 

6 (G) inform and assist pediatric providers 

7 in accessing child psychiatry consultations and 

8 in scheduling and conducting technical assist9 ance; 

10 (H) assist with referrals to specialty care 

11 and community and behavioral health resources; 

12 and 

13 (I) establish mechanisms for measuring 

14 and monitoring increased access to child and 

15 adolescent psychiatric services by pediatric pri16 mary care providers and expanded capacity of 

17 pediatric primary care providers to identify, 

18 treat, and refer children with mental health 

19 problems. 

20 (2) PEDIATRIC MENTAL HEALTH TEAMS.—For 

21 purposes of this subsection, the term ‘‘pediatric 

22 mental health team’’ means a team of case coordina23 tors, child and adolescent psychiatrists, and a li24 censed clinical mental health professional, such as a 

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1 selor. Such a team may be regionally based, provided 

2 there is access to a pediatric mental health team 

3 across the State. 

4 (c) APPLICATION.—A State, political subdivision of 

5 a State, Indian tribe, or tribal organization that desires 

6 a grant under this section shall submit an application to 

7 the Secretary at such time, in such manner, and con8 taining such information as the Secretary may require, in9 cluding a plan for the rigorous evaluation of activities that 

10 are carried out with funds received under such grant. 

11 (d) EVALUATION.—A State, political subdivision of a 

12 State, Indian tribe, or tribal organization that receives a 

13 grant under this section shall prepare and submit an eval14 uation to the Secretary at such time, in such manner, and 

15 containing such information as the Secretary may reason16 ably require, including an evaluation of activities carried 

17 out with funds received under such grant and a process 

18 and outcome evaluation. 

19 (e) MATCHING REQUIREMENT.—The Secretary may 

20 not award a grant under the grant program unless the 

21 State involved agrees, with respect to the costs to be in22 curred by the State in carrying out the purpose described 

23 in this section, to make available non-Federal contribu24 tions (in cash or in kind) toward such costs in an amount 


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1 that is not less than 20 percent of Federal funds provided 

2 in the grant. 

3 (f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

4 out this section, there are authorized to be appropriated 

5 $25,000,000 for fiscal year 2017 and such sums as may 

6 be necessary for each of fiscal years 2018 through 2021. 

7 SEC. 208. LIABILITY PROTECTIONS FOR HEALTH CARE 

8 PROFESSIONAL VOLUNTEERS AT COMMU9 NITY HEALTH CENTERS AND COMMUNITY 

10 MENTAL HEALTH CENTERS. 

11 Section 224 of the Public Health Service Act (42 

12 U.S.C. 233) is amended by adding at the end the fol13 lowing: 

14 ‘‘(q)(1) In this subsection, the term ‘community men15 tal health center’ means— 

16 ‘‘(A) a community mental health center, as de17 fined in section 1861(ff) of the Social Security Act; 

18 or 

19 ‘‘(B) a community mental health center meeting 

20 the criteria specified in section 1913(c). 

21 ‘‘(2) For purposes of this section, a health care pro22 fessional volunteer at an entity described in subsection 

23 (g)(4) or a community mental health center shall, in pro24 viding health care services eligible for funding under sec25 tion 330 or subpart I of part B of title XIX to an indiVerDate Sep 11 2014 23:24 Aug 11, 2015 Jkt 049200 PO 00000 Frm 00048 Fmt 6652 Sfmt 6201 E:\BILLS\S1945.IS S1945

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1 vidual, be deemed to be an employee of the Public Health 

2 Service for a calendar year that begins during a fiscal year 

3 for which a transfer was made under paragraph (5)(C). 

4 The preceding sentence is subject to the provisions of this 

5 subsection. 

6 ‘‘(3) In providing a health care service to an indi7 vidual, a health care professional shall, for purposes of this 

8 subsection be considered to be a health professional volun9 teer at an entity described in subsection (g)(4) or at a 

10 community mental health center if the following conditions 

11 are met: 

12 ‘‘(A) The service is provided to the individual at 

13 the facilities of an entity described in subsection 

14 (g)(4), at a federally qualified community behavioral 

15 health clinic, or through offsite programs or events 

16 carried out by the center. 

17 ‘‘(B) The center or entity is sponsoring the 

18 health care professional volunteer pursuant to para19 graph (4)(B). 

20 ‘‘(C) The health care professional does not re21 ceive any compensation for the service from the indi22 vidual or from any third-party payer (including re23 imbursement under any insurance policy or health 

24 plan, or under any Federal or State health benefits 

25 program), except that the health care professional 


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1 may receive repayment from the entity described in 

2 subsection (g)(4) or the center for reasonable ex3 penses incurred by the health care professional in 

4 the provision of the service to the individual. 

5 ‘‘(D) Before the service is provided, the health 

6 care professional or the center or entity described in 

7 subsection (g)(4) posts a clear and conspicuous no8 tice at the site where the service is provided of the 

9 extent to which the legal liability of the health care 

10 professional is limited pursuant to this subsection. 

11 ‘‘(E) At the time the service is provided, the 

12 health care professional is licensed or certified in ac13 cordance with applicable law regarding the provision 

14 of the service. 

15 ‘‘(4) Subsection (g) (other than paragraphs (3) and 

16 (5)) and subsections (h), (i), and (l) apply to a health care 

17 professional for purposes of this subsection to the same 

18 extent and in the same manner as such subsections apply 

19 to an officer, governing board member, employee, or con20 tractor of an entity described in subsection (g)(4), subject 

21 to paragraph (5) and subject to the following: 

22 ‘‘(A) The first sentence of paragraph (2) ap23 plies in lieu of the first sentence of subsection 

24 (g)(1)(A). 


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1 ‘‘(B) With respect to an entity described in sub2 section (g)(4) or a federally qualified community be3 havioral health clinic, a health care professional is 

4 not a health professional volunteer at such center 

5 unless the center sponsors the health care profes6 sional. For purposes of this subsection, the center 

7 shall be considered to be sponsoring the health care 

8 professional if— 

9 ‘‘(i) with respect to the health care profes10 sional, the center submits to the Secretary an 

11 application meeting the requirements of sub12 section (g)(1)(D); and 

13 ‘‘(ii) the Secretary, pursuant to subsection 

14 (g)(1)(E), determines that the health care pro15 fessional is deemed to be an employee of the 

16 Public Health Service. 

17 ‘‘(C) In the case of a health care professional 

18 who is determined by the Secretary pursuant to sub19 section (g)(1)(E) to be a health professional volun20 teer at such center, this subsection applies to the 

21 health care professional (with respect to services de22 scribed in paragraph (2)) for any cause of action 

23 arising from an act or omission of the health care 

24 professional occurring on or after the date on which 

25 the Secretary makes such determination. 


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1 ‘‘(D) Subsection (g)(1)(F) applies to a health 

2 professional volunteer for purposes of this subsection 

3 only to the extent that, in providing health services 

4 to an individual, each of the conditions specified in 

5 paragraph (3) is met. 

6 ‘‘(5)(A) Amounts in the fund established under sub7 section (k)(2) shall be available for transfer under sub8 paragraph (C) for purposes of carrying out this subsection 

9 for health professional volunteers at entities described in 

10 subsection (g)(4). 

11 ‘‘(B) Not later than May 1 of each fiscal year, the 

12 Attorney General, in consultation with the Secretary, shall 

13 submit to Congress a report providing an estimate of the 

14 amount of claims (together with related fees and expenses 

15 of witnesses) that, by reason of the acts or omissions of 

16 health care professional volunteers, will be paid pursuant 

17 to this subsection during the calendar year that begins in 

18 the following fiscal year. Subsection (k)(1)(B) applies to 

19 the estimate under the preceding sentence regarding 

20 health care professional volunteers to the same extent and 

21 in the same manner as such subsection applies to the esti22 mate under such subsection regarding officers, governing 

23 board members, employees, and contractors of entities de24 scribed in subsection (g)(4). 


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1 ‘‘(C) Not later than December 31 of each fiscal year, 

2 the Secretary shall transfer from the fund under sub3 section (k)(2) to the appropriate accounts in the Treasury 

4 an amount equal to the estimate made under subpara5 graph (B) for the calendar year beginning in such fiscal 

6 year, subject to the extent of amounts in the fund. 

7 ‘‘(6)(A) This subsection takes effect on October 1, 

8 2017, except as provided in subparagraph (B). 

9 ‘‘(B) Effective on the date of the enactment of this 

10 subsection— 

11 ‘‘(i) the Secretary may issue regulations for car12 rying out this subsection, and the Secretary may ac13 cept and consider applications submitted pursuant to 

14 paragraph (4)(B); and 

15 ‘‘(ii) reports under paragraph (5)(B) may be 

16 submitted to Congress.’’. 

17 SEC. 209. MINORITY FELLOWSHIP PROGRAM. 

18 Title V of the Public Health Service Act (42 U.S.C. 

19 290aa et seq.) is amended— 

20 (1) by redesignating part G (42 U.S.C. 290kk 

21 et seq.), relating to services provided through reli22 gious organizations and added by section 144 of the 

23 Community Renewal Tax Relief Act of 2000, as en24 acted into law by section 1(a)(7) of Public Law 106– 

25 554, as part J; 


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1 (2) by redesignating sections 581 through 584 

2 of part J, as so redesignated, as sections 596 

3 through 596C, respectively; and 

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

5 ‘‘PART K—MINORITY FELLOWSHIP PROGRAM 

6 ‘‘SEC. 597. FELLOWSHIPS. 

7 ‘‘(a) IN GENERAL.—The Secretary shall maintain a 

8 program, to be known as the Minority Fellowship Pro9 gram, under which the Secretary awards fellowships, 

10 which may include stipends, for the purposes of— 

11 ‘‘(1) increasing behavioral health practitioners’ 

12 knowledge of issues related to prevention, treatment, 

13 and recovery support for mental and substance use 

14 disorders among racial and ethnic minority popu15 lations; 

16 ‘‘(2) improving the quality of mental and sub17 stance use disorder prevention and treatment deliv18 ered to ethnic minorities; and 

19 ‘‘(3) increasing the number of culturally com20 petent behavioral health professionals who teach, ad21 minister, conduct services research, and provide di22 rect mental health or substance use services to un23 derserved minority populations. 

24 ‘‘(b) TRAINING COVERED.—The fellowships under 

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1 cluding for master’s and doctoral degrees) for mental 

2 health professionals, including in the fields of psychiatry, 

3 nursing, social work, psychology, marriage and family 

4 therapy, and substance use and addiction counseling. 

5 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 

6 carry out this section, there are authorized to be appro7 priated $10,000,000 for each of fiscal years 2017 through 

8 2021.’’. 

9 SEC. 210. NATIONAL HEALTH SERVICE CORPS. 

10 (a) DEFINITIONS.— 

11 (1) PRIMARY HEALTH SERVICES.—Section 

12 331(a)(3)(D) of the Public Health Service Act (42 

13 U.S.C. 254d(a)(3)(D)) is amended by inserting ‘‘(in14 cluding pediatric mental health subspecialty serv15 ices)’’ after ‘‘pediatrics’’. 

16 (2) BEHAVIORAL AND MENTAL HEALTH PRO17 FESSIONALS.—Clause (i) of section 331(a)(3)(E)(i) 

18 of the Public Health Service Act (42 U.S.C. 

19 254d(a)(3)(E)(i)) is amended by inserting ‘‘, includ20 ing such professionals who are pediatric subspecial21 ists’’ before the period at the end. 

22 (3) HEALTH PROFESSIONAL SHORTAGE

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1 ing ‘‘(which may be a group comprised of children 

2 and adolescents)’’ after ‘‘population group’’. 

3 (4) MEDICAL FACILITY.—Section 332(a)(2)(A) 

4 of the Public Health Service Act (42 U.S.C. 

5 254e(a)(2)(A)) is amended by inserting ‘‘medical 

6 residency or fellowship training site for training in 

7 child and adolescent psychiatry,’’ before ‘‘facility op8 erated by a city or county health department,’’. 

9 (b) ELIGIBILITY TO PARTICIPATE IN LOAN REPAY10 MENT PROGRAM.—Section 338B(b)(1)(B) of the Public 

11 Health Service Act (42 U.S.C. 254l–1(b)(1)(B)) is amend12 ed by inserting ‘‘, including any child and adolescent psy13 chiatry medical residency or fellowship training program’’ 

14 before the semicolon. 

15 SEC. 211. REAUTHORIZATION OF MENTAL AND BEHAV16 IORAL HEALTH EDUCATION TRAINING 

17 GRANT. 

18 Section 756 of the Public Health Service Act (42 

19 U.S.C. 294e–1) is amended to read as follows: 

20 ‘‘SEC. 756. MENTAL AND BEHAVIORAL HEALTH EDUCATION 

21 AND TRAINING GRANTS. 

22 ‘‘(a) GRANTS AUTHORIZED.—The Secretary, acting 

23 through the Administrators of the Substance Abuse and 

24 Mental Health Administration and the Health Resources 

25 and Services Administration, may award grants to eligible 


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1 institutions to support the recruitment of students for, 

2 and education and clinical experience of the students in— 

3 ‘‘(1) accredited institutions of higher education 

4 or accredited professional training programs that are 

5 establishing or expanding internships or other field 

6 placement programs in mental health in psychiatry, 

7 psychology, school psychology, behavioral pediatrics, 

8 psychiatric nursing, social work, school social work, 

9 substance abuse prevention and treatment, marriage 

10 and family therapy, school counseling, or profes11 sional counseling, with a preference for programs 

12 addressing child and adolescent mental health, in 

13 particular transitional age youth between 16 to 25 

14 years old; 

15 ‘‘(2) accredited doctoral, internship, and post16 doctoral residency programs of health service psy17 chology (which includes clinical psychology, coun18 seling, and school psychology) for the development 

19 and implementation of interdisciplinary training of 

20 psychology graduate students for providing behav21 ioral and mental health services, including substance 

22 abuse prevention and treatment services, as well as 

23 the development of faculty in health service psy24 chology; 


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1 ‘‘(3) accredited master’s and doctoral degree 

2 programs of social work for the development and im3 plementation of interdisciplinary training of social 

4 work graduate students for providing behavioral and 

5 mental health services, including substance abuse 

6 prevention and treatment services, and the develop7 ment of faculty in social work; or 

8 ‘‘(4) paraprofessional certificate training pro9 grams offered by accredited community and tech10 nical colleges granting State licensure or certifi11 cation in a behavioral health-related paraprofessional 

12 field, such as community health worker, outreach 

13 worker, social services aide, mental health worker, 

14 substance abuse or addictions worker, youth worker, 

15 promotora, or peer paraprofessional, with preference 

16 for pre-service or in-service training of paraprofes17 sional child and adolescent mental health workers. 

18 ‘‘(b) ELIGIBILITY REQUIREMENTS.—To be eligible to 

19 receive a grant under this section, an institution shall 

20 demonstrate— 

21 ‘‘(1) an ability to recruit and place psychia22 trists, psychologists, social workers, or paraprofes23 sionals in areas with a high need and high demand 

24 population; 


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1 ‘‘(2) participation of individuals and groups 

2 from different racial, ethnic, cultural, geographic, re3 ligious, linguistic, and class backgrounds, and dif4 ferent genders and orientations in the institution’s 

5 programs; 

6 ‘‘(3) knowledge and understanding of the con7 cerns of the individuals and groups described in 

8 paragraph (2), especially individuals with mental 

9 health symptoms or diagnoses, particularly children 

10 and adolescents, with a special emphasis on transi11 tional-aged persons 16 to 25 years old; 

12 ‘‘(4) prioritization of cultural and linguistic 

13 competency in training professionals and paraprofes14 sionals in any academic program, field placement, 

15 internship, or post-doctoral position; and 

16 ‘‘(5) the willingness to provide to the Secretary 

17 such data, assurances, and information as the Sec18 retary may require. 

19 ‘‘(c) PRIORITY.—In selecting grant recipients the 

20 Secretary shall give priority to— 

21 ‘‘(1) programs that have demonstrated the abil22 ity to train psychology and social work professionals 

23 to work in integrated care settings; and 

24 ‘‘(2) programs for paraprofessionals that offer 

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1 ily and the lived experience of the consumer and 

2 family-paraprofessional partnerships. 

3 ‘‘(d) INSTITUTIONAL REQUIREMENT.—Of the grants 

4 awarded under paragraphs (2) and (3) of subsection (a), 

5 at least 4 of the grant recipients shall be historically black 

6 colleges or other minority serving institutions. 

7 ‘‘(e) REPORT TO CONGRESS.—Not later than 2 years 

8 after the date of enactment of the Mental Health Reform 

9 Act of 2015, and annually thereafter, the Secretary, acting 

10 through the Administrators of the Substance Abuse and 

11 Mental Health Services Administration and the Health 

12 Resources Services Administration, shall submit to Con13 gress a report on the effectiveness of— 

14 ‘‘(1) providing graduate students support for 

15 experiential training (internship or field placement); 

16 ‘‘(2) recruitment of students interested in be17 havioral health practice; 

18 ‘‘(3) development and implementation of inter19 professional training and integration within primary 

20 care; 

21 ‘‘(4) development and implementation of ac22 credited field placements and internships; and 

23 ‘‘(5) data collected on the number of students 

24 trained in mental health and the number of available 

25 accredited internships and field placements. 


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1 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For 

2 each of fiscal years 2017 through 2021, there are author3 ized to be appropriated to carry out this section 

4 $44,000,000, to be allocated as follows: 

5 ‘‘(1) $15,000,000 shall be allocated to institu6 tions to expand mental health internships or other 

7 field placement programs under subsection (a)(1). 

8 ‘‘(2) $14,000,000 shall be allocated to training 

9 in graduate psychology under subsection (a)(2). 

10 ‘‘(3) $10,000,000 shall be allocated to training 

11 in graduate social work under subsection (a)(3). 

12 ‘‘(4) $5,000,000 shall be allocated to training 

13 paraprofessionals under subsection (a)(4).’’. 

14 SEC. 212. NATIONAL SUICIDE PREVENTION LIFELINE PRO15 GRAM. 

16 Subpart 3 of part B of title V of the Public Health 

17 Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 

18 inserting after section 520E–2 the following: 

19 ‘‘SEC. 520E–3. NATIONAL SUICIDE PREVENTION LIFELINE 

20 PROGRAM. 

21 ‘‘(a) IN GENERAL.—The Secretary shall maintain the 

22 National Suicide Prevention Lifeline program. The activi23 ties of the Secretary under such program shall include— 

24 ‘‘(1) coordinating a network of crisis centers 

25 across the Nation for providing suicide prevention 


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1 and crisis intervention services to individuals seeking 

2 help at any time, day or night; 

3 ‘‘(2) maintaining a suicide prevention hotline to 

4 link callers to local emergency, mental health, and 

5 social services resources; and 

6 ‘‘(3) consulting with the Secretary of Veterans 

7 Affairs to ensure that veterans calling the suicide 

8 prevention hotline have access to a specialized vet9 erans’ suicide prevention hotline. 

10 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—To 

11 carry out this section, there are authorized to be appro12 priated $5,000,000 for each of fiscal years 2016 through 

13 2020.’’. 

14 TITLE III—INTEGRATION 

15 SEC. 301. PRIMARY AND BEHAVIORAL HEALTH CARE INTE16 GRATION GRANT PROGRAMS. 

17 Section 520K of the Public Health Service Act (42 

18 U.S.C. 290bb–42) is amended to read as follows: 

19 ‘‘SEC. 520K. INTEGRATION INCENTIVE GRANTS. 

20 ‘‘(a) IN GENERAL.—There is established within the 

21 Substance Abuse and Mental Health Services Administra22 tion a primary and behavioral health care integration 

23 grant program. The Assistant Secretary for Mental 

24 Health and Substance Use Disorders may award grants 

25 and cooperative agreements to eligible entities to expend 


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1 funds for improvements in integrated settings with inte2 grated practices. 

3 ‘‘(b) DEFINITIONS.—In this section: 

4 ‘‘(1) INTEGRATED CARE.—The term ‘integrated 

5 care’ means full collaboration in merged or trans6 formed practices offering mental and physical health 

7 services within the same shared practice space in the 

8 same facility, where the entity— 

9 ‘‘(A) provides services in a shared space 

10 that ensures services will be available and ac11 cessible promptly and in a manner which pre12 serves human dignity and assures continuity of 

13 care; 

14 ‘‘(B) ensures communication among the in15 tegrated care team that is consistent and team16 based; 

17 ‘‘(C) ensures shared decisionmaking be18 tween mental health and primary care pro19 viders; 

20 ‘‘(D) provides evidence-based services in a 

21 mode of service delivery appropriate for the tar22 get population; 

23 ‘‘(E) employs staff who are multidisci24 plinary and culturally and linguistically com25 petent; 


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1 ‘‘(F) provides integrated services related to 

2 screening, diagnosis, and treatment of mental 

3 illness and co-occurring primary care conditions 

4 and chronic diseases; and 

5 ‘‘(G) provides targeted case management, 

6 including services to assist individuals gaining 

7 access to needed medical, social, educational, 

8 and other services and applying for income se9 curity, housing, employment, and other benefits 

10 to which they may be entitled. 

11 ‘‘(2) INTEGRATED CARE TEAM.—The term ‘in12 tegrated care team’ means a team that includes— 

13 ‘‘(A) allopathic or osteopathic medical doc14 tors, including a primary care physician and a 

15 board certified psychiatrist; 

16 ‘‘(B) licensed clinical mental health profes17 sionals, such as psychologists or social workers; 

18 ‘‘(C) a case manager; and 

19 ‘‘(D) other members, which may include 

20 psychiatric advanced practice nurses and other 

21 allied health professionals, such as mental 

22 health counselors, or others as appropriate. 

23 ‘‘(3) SPECIAL POPULATION.—The term ‘special 

24 population’ means— 


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1 ‘‘(A) adults with mental illnesses who have 

2 co-occurring primary care conditions with 

3 chronic diseases; 

4 ‘‘(B) adults with serious mental illnesses 

5 who have co-occurring primary care conditions 

6 with chronic diseases; 

7 ‘‘(C) children and adolescents with serious 

8 emotional disorders with co-occurring primary 

9 care conditions and chronic diseases; or 

10 ‘‘(D) individuals with substance use dis11 order. 

12 ‘‘(c) PURPOSE.—The grant program under this sec13 tion shall be designed to lead to full collaboration between 

14 primary and behavioral health in an integrated practice 

15 model at a statewide level, to ensure that— 

16 ‘‘(1) the overall wellness and physical health 

17 status of individuals with serious mental illness and 

18 co-occurring substance use disorders is supported 

19 through integration of primary care into community 

20 mental health centers meeting the criteria specified 

21 in section 1913(c) of the Social Security Act or cer22 tified community behavioral health clinics described 

23 in section 223 of the Protecting Access to Medicare 

24 Act of 2014; and 


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1 ‘‘(2) the mental health status of individuals 

2 with significant co-occurring psychiatric and physical 

3 conditions will be supported through integration of 

4 behavioral health into primary care settings. 

5 ‘‘(d) ELIGIBLE ENTITIES.—To be eligible to receive 

6 a grant or cooperative agreement under this section, an 

7 entity shall be a State department of health, State mental 

8 health or addiction agency, or State Medicaid agency. The 

9 Administrator shall give preference to States that have ex10 isting integrated care models, such as those authorized by 

11 section 1945 of the Social Security Act. 

12 ‘‘(e) APPLICATION.—An eligible entity desiring a 

13 grant or cooperative agreement under this section shall 

14 submit an application to the Administrator at such time, 

15 in such manner, and accompanied by such information as 

16 the Administrator may require, including a description of 

17 a plan to achieve fully collaborative agreements to provide 

18 services to special populations and— 

19 ‘‘(1) a document that summarizes the State20 specific policies that inhibit the provision of inte21 grated care, and the specific steps that will be taken 

22 to address such barriers, such as through licensing 

23 and billing procedures; and 

24 ‘‘(2) a plan to develop and share a de-identified 

25 patient registry to track treatment implementation 


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1 and clinical outcomes to inform clinical interven2 tions, patient education, and engagement with 

3 merged or transformed integrated practices in com4 pliance with applicable national and State health in5 formation privacy laws. 

6 ‘‘(f) GRANT AMOUNTS.—The maximum annual grant 

7 amount under this section shall be $2,000,000, of which 

8 not more than 10 percent may be allocated to State ad9 ministrative functions, and the remaining amounts shall 

10 be allocated to health facilities that provide integrated 

11 care. 

12 ‘‘(g) DURATION.—A grant under this section shall be 

13 for a period of 5 years. 

14 ‘‘(h) REPORT ON PROGRAM OUTCOMES.—An entity 

15 receiving a grant or cooperative agreement under this sec16 tion shall submit an annual report to the Administrator 

17 that includes— 

18 ‘‘(1) the progress to reduce barriers to inte19 grated care, including regulatory and billing bar20 riers, as described in the entity’s application under 

21 subsection (d); and 

22 ‘‘(2) a description of functional outcomes of 

23 special populations, including— 

24 ‘‘(A) with respect to individuals with seri25 ous mental illness, participation in supportive 


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1 housing or independent living programs, attend2 ance in social and rehabilitative programs, par3 ticipation in job training opportunities, satisfac4 tory performance in work settings, attendance 

5 at scheduled medical and mental health ap6 pointments, and compliance with prescribed 

7 medication regimes; 

8 ‘‘(B) with respect to individuals with co-oc9 curring mental illness and primary care condi10 tions and chronic diseases, attendance at sched11 uled medical and mental health appointments, 

12 compliance with prescribed medication regimes, 

13 and participation in learning opportunities re14 lated to improved health and lifestyle practice; 

15 and 

16 ‘‘(C) with respect to children and adoles17 cents with serious emotional disorders who have 

18 co-occurring primary care conditions and chron19 ic diseases, attendance at scheduled medical 

20 and mental health appointments, compliance 

21 with prescribed medication regimes, and partici22 pation in learning opportunities at school and 

23 extracurricular activities. 

24 ‘‘(i) TECHNICAL ASSISTANCE CENTER FOR PRIMARY25 BEHAVIORAL HEALTH CARE INTEGRATION.— 


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1 ‘‘(1) IN GENERAL.—The Assistant Secretary for 

2 Mental Health and Substance Use Disorders shall 

3 establish a program through which such Assistant 

4 Secretary shall provide appropriate information, 

5 training, and technical assistance to eligible entities 

6 that receive a grant or cooperative agreement under 

7 this section, in order to help such entities to meet 

8 the requirements of this section, including assistance 

9 with— 

10 ‘‘(A) development and selection of inte11 grated care models; 

12 ‘‘(B) dissemination of evidence-based inter13 ventions in integrated care; 

14 ‘‘(C) establishment of organizational prac15 tices to support operational and administrative 

16 success; and 

17 ‘‘(D) other activities, as the Assistant Sec18 retary for Mental Health and Substance Use 

19 Disorders determines appropriate. 

20 ‘‘(2) ADDITIONAL DISSEMINATION OF TECH21 NICAL INFORMATION.—The information and re22 sources provided by the technical assistance program 

23 established under paragraph (1) shall be made avail24 able to States, political subdivisions of a State, In25 dian tribes or tribal organizations (as defined in secVerDate Sep 11 2014 23:24 Aug 11, 2015 Jkt 049200 PO 00000 Frm 00069 Fmt 6652 Sfmt 6201 E:\BILLS\S1945.IS S1945

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1 tion 4 of the Indian Self-Determination and Edu2 cation Assistance Act), outpatient mental health and 

3 addiction treatment centers, community mental 

4 health centers that meet the criteria under section 

5 1913(c), certified community behavioral health clin6 ics described in section 223 of the Protecting Access 

7 to Medicare Act of 2014, primary care organizations 

8 such as Federally qualified health centers or rural 

9 health centers, other community-based organiza10 tions, or other entities engaging in integrated care 

11 activities, as the Assistant Secretary for Mental 

12 Health and Substance Use Disorders determines ap13 propriate. 

14 ‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—To 

15 carry out this section, there are authorized to be appro16 priated $50,000,000 for each of fiscal years 2017 through 

17 2021, of which $2,000,000 shall be available to the tech18 nical assistance program under subsection (i).’’. 

19 TITLE IV—INTERAGENCY SERI20 OUS MENTAL ILLNESS CO21 ORDINATING COMMITTEE 

22 SEC. 401. INTERAGENCY SERIOUS MENTAL ILLNESS CO23 ORDINATING COMMITTEE. 

24 Title V of the Public Health Service Act is amended 

25 by inserting after section 501 the following: 


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1 ‘‘SEC. 501A. INTERAGENCY SERIOUS MENTAL ILLNESS CO2 ORDINATING COMMITTEE. 

3 ‘‘(a) ESTABLISHMENT.—The Assistant Secretary for 

4 Mental Health and Substance Use Disorders (in this sec5 tion referred to as the ‘Assistant Secretary’) shall estab6 lish a committee, to be known as the Interagency Serious 

7 Mental Illness Coordinating Committee (in this section re8 ferred to as the ‘Committee’), to assist the Assistant Sec9 retary in carrying out the Assistant Secretary’s duties. 

10 ‘‘(b) RESPONSIBILITIES.—The Committee shall— 

11 ‘‘(1) develop and annually update a summary of 

12 advances in serious mental illness research related to 

13 prevention of, diagnosis of, intervention in, and 

14 treatment and rehabilitation of, serious mental ill15 ness, and access to services and supports for individ16 uals with serious mental illness; 

17 ‘‘(2) monitor Federal programs and activities 

18 with respect to serious mental illness; 

19 ‘‘(3) make recommendations to the Assistant 

20 Secretary regarding any appropriate changes to such 

21 activities, including recommendations to the Director 

22 of NIH with respect to the strategic plan developed 

23 under paragraph (5); 

24 ‘‘(4) make recommendations to the Assistant 

25 Secretary regarding public participation in decisions 

26 relating to serious mental illness; 


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1 ‘‘(5) develop and update every 3 years a stra2 tegic plan for the conduct and support of programs 

3 and services to assist individuals with serious mental 

4 illness, including— 

5 ‘‘(A) a summary of the advances in serious 

6 mental illness research developed in under para7 graph (1); 

8 ‘‘(B) a list of the Federal programs and 

9 activities identified in paragraph (2); 

10 ‘‘(C) an analysis of the efficiency, effective11 ness, quality, coordination, and cost-effective12 ness of Federal programs and activities relating 

13 to the prevention, diagnosis, treatment, or reha14 bilitation of serious mental illness, including an 

15 accounting of the costs of such programs and 

16 activities with administrative costs 

17 disaggregated from the costs of services and 

18 care; and 

19 ‘‘(D) a plan with recommendations— 

20 ‘‘(i) for the coordination and improve21 ment of Federal programs and activities 

22 related to serious mental illness, including 

23 budgetary requirements; 

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1 cluding appropriate benchmarks to meas2 ure progress on achieving improvements; 

3 ‘‘(iii) for the mental health workforce; 

4 ‘‘(iv) to disseminate relevant informa5 tion developed by the coordinating com6 mittee to the public, health care providers, 

7 social service providers, public health offi8 cials, courts, law enforcement, and other 

9 relevant groups; 

10 ‘‘(v) to identify research needs, includ11 ing longitudinal studies of pediatric popu12 lations; and 

13 ‘‘(vi) for vulnerable and underserved 

14 populations, including pediatric and geri15 atric populations; and 

16 ‘‘(6) submit to Congress such strategic plan 

17 and any updates to such plan. 

18 ‘‘(c) MEMBERSHIP.— 

19 ‘‘(1) IN GENERAL.—The Committee shall be 

20 composed of not more than 9 Federal representa21 tives including— 

22 ‘‘(A) the Assistant Secretary for Mental 

23 Health and Substance Use Disorders (or the 

24 Assistant Secretary’s designee), who shall serve 

25 as the Chair of the Committee; 


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1 ‘‘(B) the Director of the National Institute 

2 of Mental Health (or the Director’s designee); 

3 ‘‘(C) the Attorney General of the United 

4 States (or the Attorney General’s designee); 

5 ‘‘(D) the Director of the Centers for Dis6 ease Control and Prevention (or the Director’s 

7 designee); 

8 ‘‘(E) the Director of the National Insti9 tutes of Health (or the Director’s designee); 

10 ‘‘(F) a member of the United States Inter11 agency Council on Homelessness; 

12 ‘‘(G) representatives, appointed by the As13 sistant Secretary, of Federal agencies that serve 

14 individuals with serious mental illness, including 

15 representatives of the Centers for Medicare & 

16 Medicaid Services, the Administration on Com17 munity Living, the Agency for Healthcare Re18 search and Quality, the Bureau of Indian Af19 fairs, the Department of Defense, the Depart20 ment of Education, the Department of Housing 

21 and Urban Development, the Department of 

22 Labor, the Department of Veterans Affairs, and 

23 the Social Security Administration; and 

24 ‘‘(H) the additional members appointed 

25 under paragraph (2). 


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1 ‘‘(2) ADDITIONAL MEMBERS.—At least 14 

2 members of the Committee shall be non-Federal 

3 public members appointed by the Assistant Sec4 retary, of which— 

5 ‘‘(A) at least 1 member shall be an indi6 vidual in recovery from a diagnosis of serious 

7 mental illness who has benefitted from and is 

8 receiving medical treatment under the care of a 

9 licensed mental health professional; 

10 ‘‘(B) at least 1 member shall be a parent 

11 or legal guardian of an individual with a history 

12 of serious mental illness who has either at13 tempted suicide or is incarcerated for violence 

14 committed while experiencing a serious mental 

15 illness; 

16 ‘‘(C) at least 1 member shall be a rep17 resentative of a leading research, advocacy, and 

18 service organization for individuals with serious 

19 mental illness; 

20 ‘‘(D) at least 2 members shall be— 

21 ‘‘(i) a licensed psychiatrist with expe22 rience treating serious mental illness; 

23 ‘‘(ii) a licensed psychologist with expe24 rience treating serious mental illness; 


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1 ‘‘(iii) a licensed clinical social worker; 

2 or 

3 ‘‘(iv) a licensed psychiatric nurse or 

4 nurse practitioner; 

5 ‘‘(E) at least 1 member shall be a mental 

6 health professional with a significant focus in 

7 his or her practice on working with children 

8 and adolescents; 

9 ‘‘(F) at least 1 member shall be a mental 

10 health professional who has demonstrated cul11 tural competencies and has research or clinical 

12 mental health experience working with minori13 ties; 

14 ‘‘(G) at least 1 member shall be a State 

15 certified mental health peer specialist; 

16 ‘‘(H) at least 1 member shall be a judge 

17 with experience adjudicating cases related to 

18 criminal justice and serious mental illness; 

19 ‘‘(I) at least 1 member shall be a law en20 forcement officer or corrections officer with ex21 tensive experience in interfacing with psy22 chiatric and psychological disorders or individ23 uals in mental health crisis; and 

24 ‘‘(J) 4 members, of which— 


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1 ‘‘(i) 1 shall be appointed by the ma2 jority leader of the Senate; 

3 ‘‘(ii) 1 shall be appointed by the mi4 nority leader of the Senate; 

5 ‘‘(iii) 1 shall be appointed by the 

6 Speaker of the House of Representatives; 

7 and 

8 ‘‘(iv) 1 shall be appointed by the mi9 nority leader of the House of Representa10 tives. 

11 ‘‘(d) REPORTS TO CONGRESS.—Not later than 1 year 

12 after the date of release of the first strategic plan under 

13 subsection (b)(5) and annually thereafter, the Committee 

14 shall submit a report to Congress— 

15 ‘‘(1) evaluating the impact on public health of 

16 projects addressing priority mental health needs of 

17 regional and national significance under sections 

18 501, 509, 516, and 520A, including measurement of 

19 public health outcomes such as— 

20 ‘‘(A) reduced rates of suicide, suicide at21 tempts, substance abuse, overdose, overdose 

22 deaths, emergency hospitalizations, emergency 

23 room boarding (as defined in section 1912(e)), 

24 incarceration, crime, arrest, homelessness, and 

25 joblessness; 


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1 ‘‘(B) increased rates of employment and 

2 enrollment in educational and vocational pro3 grams; and 

4 ‘‘(C) such other criteria as may be deter5 mined by the Assistant Secretary; 

6 ‘‘(2) formulating recommendations for the co7 ordination and improvement of Federal programs 

8 and activities described in paragraph (2); 

9 ‘‘(3) identifying any such programs and activi10 ties that are duplicative; and 

11 ‘‘(4) summarizing all recommendations made, 

12 activities carried out, and results achieved pursuant 

13 to the workforce development strategy under section 

14 101(c)(8) of the Mental Health Reform Act of 2015. 

15 ‘‘(e) ADMINISTRATIVE SUPPORT; TERMS OF SERV16 ICE; OTHER PROVISIONS.—The following provisions shall 

17 apply with respect to the Committee: 

18 ‘‘(1) The Assistant Secretary shall provide such 

19 administrative support to the Committee as may be 

20 necessary for the Committee to carry out its respon21 sibilities. 

22 ‘‘(2) Members of the Committee appointed 

23 under subsection (c)(2) shall serve for a term of 4 

24 years, and may be reappointed for one or more addi25 tional 4-year terms. Any member appointed to fill a 


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1 vacancy for an unexpired term shall be appointed for 

2 the remainder of such term. A member may serve 

3 after the expiration of the member’s term until a 

4 successor has taken office. 

5 ‘‘(3) The Committee shall meet at the call of 

6 the chair or upon the request of the Assistant Sec7 retary. The Committee shall meet not fewer than 2 

8 times each year. 

9 ‘‘(4) All meetings of the Committee shall be 

10 public and shall include appropriate time periods for 

11 questions and presentations by the public. 

12 ‘‘(f) SUBCOMMITTEES; ESTABLISHMENT AND MEM13 BERSHIP.—In carrying out its functions, the Committee 

14 may establish subcommittees and convene workshops and 

15 conferences. Such subcommittees shall be composed of 

16 Committee members and may hold such meetings as are 

17 necessary to enable the subcommittees to carry out their 

18 duties.’’. 

19 TITLE V—HIPAA CLARIFICATION 

20 SEC. 501. FINDINGS. 

21 The Senate makes the following findings: 

22 (1) The privacy regulations promulgated under 

23 section 264(c) of the Health Insurance Portability 

24 and Accountability Act (42 U.S.C. 1320d–2 note) 

25 recognize the value of family members in the health 


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1 and well-being of individuals experiencing temporary 

2 psychosis. However, a lack of understanding by 

3 health professionals has been a barrier to many fam4 ily members assisting in the treatment of an indi5 vidual with serious mental illness. 

6 (2) The privacy rule under section 

7 164.510(b)(2) of title 45, Code of Federal Regula8 tions allows for the disclosure of protected health in9 formation in the event that a covered entity receives 

10 the individual’s agreement provides an opportunity 

11 for an individual to object, and the individual does 

12 not express an objection or the covered entity rea13 sonably infers that the individual does not object. 

14 (3) The privacy rule under section 

15 164.510(b)(3) of title 45, Code of Federal Regula16 tions allows for the disclosure of protected health in17 formation if an individual is not present or is other18 wise incapacitated if the medical provider determines 

19 that the disclosure is in the best interests of the in20 dividual. 

21 (4) Engagement by family members has been 

22 shown to help individuals with serious mental illness 

23 adhere to a treatment plan and improved outcomes. 

24 (5) Whenever possible, an individual who is the 

25 subject of protected health information shall be 


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1 given advanced notice of the desire to share informa2 tion with family members or other caregivers. This 

3 notice should include an explanation of what infor4 mation is to be shared and why it is clinically desir5 able to share such information. 

6 (6) The use of psychiatric advance directives 

7 should be encouraged for individuals with serious 

8 mental illness. 

9 SEC. 502. MODIFICATIONS TO HIPAA. 

10 In applying section 164.510(b)(3) of title 45, Code 

11 of Federal Regulations, for the purposes of assisting 

12 health professionals to determine the best interests of the 

13 individual, the Secretary of Health and Human Services 

14 shall consider the following factors: 

15 (1) Timely intervention for treatment of a seri16 ous mental or general medical illness. 

17 (2) Safe and stable housing for the individual. 

18 (3) Increased daily living skills that are likely to 

19 allow the individual to live within the community. 

20 (4) An increased capacity of caregivers to sup21 port the patient to live within the community. 

22 SEC. 503. DEVELOPMENT AND DISSEMINATION OF MODEL 

23 TRAINING PROGRAMS. 

24 (a) INITIAL PROGRAMS AND MATERIALS.—Not later 

25 than 1 year after the date of enactment of this Act, the 


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1 Secretary of Health and Human Services (in this section 

2 referred to as the ‘‘Secretary’’), in consultation with ap3 propriate experts, shall develop and disseminate— 

4 (1) a model program and materials for training 

5 health care providers (including physicians, emer6 gency medical personnel, psychiatrists, psychologists, 

7 counselors, therapists, behavioral health facilities 

8 and clinics, care managers, and hospitals) regarding 

9 the circumstances under which, consistent with the 

10 standards governing the privacy and security of indi11 vidually identifiable health information promulgated 

12 by the Secretary under section 264 of the Health In13 surance Portability and Accountability Act of 1996 

14 (42 U.S.C. 1320d–2 note) and part C of title XI of 

15 the Social Security Act (42 U.S.C. 1320d et seq.), 

16 the protected health information of patients with a 

17 mental illness may be disclosed with and without pa18 tient consent; 

19 (2) a model program and materials for training 

20 lawyers and others in the legal profession on such 

21 circumstances; and 

22 (3) a model program and materials for training 

23 patients and their families regarding their rights to 

24 protect and obtain information under the standards 

25 specified in paragraph (1). 


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1 (b) PERIODIC UPDATES.—The Secretary shall— 

2 (1) periodically review, evaluate, and update the 

3 model programs and materials developed under sub4 section (a); and 

5 (2) disseminate the updated model programs 

6 and materials. 

7 (c) CONTENTS.—The programs and materials devel8 oped under subsection (a) shall address the guidance enti9 tled ‘‘HIPAA Privacy Rule and Sharing Information Re10 lated to Mental Health’’, issued by the Department of 

11 Health and Human Services on February 20, 2014. 

12 (d) COORDINATION.—The Secretary shall carry out 

13 this section in coordination with the Director of the Office 

14 for Civil Rights within the Department of Health and 

15 Human Services, the Administrator of the Substance 

16 Abuse and Mental Health Services Administration, the 

17 Administrator of the Health Resources and Services Ad18 ministration, and the heads of other relevant agencies 

19 within the Department of Health and Human Services. 

20 (e) INPUT OF CERTAIN ENTITIES.—In developing the 

21 model programs and materials required under subsections 

22 (a) and (b), the Secretary shall solicit the input of relevant 

23 national, State, and local associations, medical societies, 

24 and licensing boards. 


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1 (f) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section 

3 $5,000,000 for each of fiscal years 2017 through 2022. 

4 SEC. 504. CONFIDENTIALITY OF RECORDS. 

5 Section 543 of the Public Health Service Act (42 

6 U.S.C. 290dd–2) is amended by inserting after subsection 

7 (h) the following: 

8 ‘‘(i) STREAMLINED CONSENT IN INTEGRATED CARE

9 SETTINGS.— 

10 ‘‘(1) IN GENERAL.—For the sharing of records 

11 described in subsection (a) involving the interchange 

12 of electronic health records (as defined in section 

13 13400 of division A of Public Law 111–5) solely for 

14 the purposes of improving the provision of health 

15 care and health care coordination solely within ac16 countable care organizations described in section 

17 1899 of the Social Security Act, health information 

18 exchanges (as defined for purposes of section 3013), 

19 health homes (as defined in section 1945(h)(3) of 

20 the Social Security Act), or other integrated care ar21 rangements (in existence before, on, or after the 

22 date of the enactment of the Mental Health Reform 

23 Act of 2015), a patient’s prior written or electronic 

24 consent for disclosure and re-disclosure of records 

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1 ocable format to and for all of the health care pro2 viders in the accountable care organization, health 

3 information exchange, health home, or other inte4 grated care arrangement, who are involved in the 

5 patient’s care. 

6 ‘‘(2) DISCLOSURE REQUIRED.—For all other 

7 disclosures or re-disclosures of the records described 

8 in subsection (a), except those expressly proscribed 

9 in paragraph 1, patient consent is required to be ob10 tained in accordance with the procedures described 

11 in part 2 of title 42, Code of Federal Regulations. 

12 ‘‘(3) PROHIBITIONS.—It shall be unlawful for 

13 any health plan or health insurance program to use 

14 the records described in subsection (a) or this sub15 section to deny or condition the issuance of a plan, 

16 policy, or coverage on the basis of the contents of 

17 such records, or for a health care provider to use the 

18 records described in subsection (a) and this section 

19 to discriminate in the provision of medically nec20 essary health care services to an individual who is 

21 the subject of such records.’’. 


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1 TITLE VI—MEDICARE AND 

2 MEDICAID REFORMS 

3 SEC. 601. ENHANCED MEDICAID COVERAGE RELATING TO 

4 CERTAIN MENTAL HEALTH SERVICES. 

5 (a) MEDICAID COVERAGE OF MENTAL HEALTH

6 SERVICES AND PRIMARY CARE SERVICES FURNISHED ON

7 THE SAME DAY.— 

8 (1) IN GENERAL.—Section 1902(a) of the So9 cial Security Act (42 U.S.C. 1396a(a)) is amended 

10 by inserting after paragraph (77) the following new 

11 paragraph: 

12 ‘‘(78) not prohibit payment under the plan for 

13 a mental health service or primary care service fur14 nished to an individual at a community mental 

15 health center meeting the criteria specified in section 

16 1913(c) of the Public Health Service Act or a Fed17 erally qualified health center (as defined in section 

18 1861(aa)(4)) for which payment would otherwise be 

19 payable under the plan, with respect to such indi20 vidual, if such service were not a same-day quali21 fying service (as defined in subsection (ll)).’’. 

22 (2) SAME-DAY QUALIFYING SERVICES DE23 FINED.—Section 1902 of the Social Security Act (42 

24 U.S.C. 1396a) is amended by adding at the end the 

25 following new subsection: 


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1 ‘‘(ll) SAME-DAY QUALIFYING SERVICES DEFINED.— 

2 For purposes of subsection (a)(78), the term ‘same-day 

3 qualifying service’ means— 

4 ‘‘(1) a primary care service furnished to an in5 dividual by a provider at a facility on the same day 

6 a mental health service is furnished to such indi7 vidual by such provider (or another provider) at the 

8 facility; and 

9 ‘‘(2) a mental health service furnished to an in10 dividual by a provider at a facility on the same day 

11 a primary care service is furnished to such individual 

12 by such provider (or another provider) at the facil13 ity.’’. 

14 (b) STATE OPTION TO PROVIDE MEDICAL ASSIST15 ANCE FOR CERTAIN INPATIENT PSYCHIATRIC SERVICES

16 TO NONELDERLY ADULTS.—Section 1905 of the Social 

17 Security Act (42 U.S.C. 1396d) is amended— 

18 (1) in subsection (a)— 

19 (A) in paragraph (16)— 

20 (i) by striking ‘‘effective’’ and insert21 ing ‘‘(A) effective’’; and 

22 (ii) by inserting before the semicolon 

23 at the end the following: ‘‘, and (B) quali24 fied inpatient psychiatric hospital services 

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1 viduals over 21 years of age and under 65 

2 years of age’’; and 

3 (B) in the subdivision (B) that follows 

4 paragraph (29), by inserting ‘‘(other than serv5 ices described in subparagraph (B) of para6 graph (16) for individuals described in such 

7 subparagraph)’’ after ‘‘patient in an institution 

8 for mental diseases’’; and 

9 (2) in subsection (h), by adding at the end the 

10 following new paragraph: 

11 ‘‘(3) For purposes of subsection (a)(16)(B), the 

12 term ‘qualified inpatient psychiatric hospital serv13 ices’’ means, with respect to individuals described in 

14 such subsection, services described in subparagraphs 

15 (A) and (B) of paragraph (1) that are furnished in 

16 an acute care psychiatric unit in a State-operated 

17 psychiatric hospital or a psychiatric hospital (as de18 fined section 1861(f)) if such unit or hospital, as ap19 plicable, has a facility-wide average (determined on 

20 an annual basis) length of stay of less than 20 

21 days.’’. 

22 (c) STUDY AND REPORT.— 

23 (1) STUDY.—The Secretary shall conduct a 

24 study to determine the impact of the amendments 

25 made by this section on the Medicaid IMD exclusion. 


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1 (2) REPORT.—Not later than 2 years after the 

2 date of enactment of this Act, the Secretary shall 

3 submit to Congress a report containing the results 

4 of the study conducted under paragraph (1). The re5 port shall include the following information: 

6 (A) An assessment of the level of State ex7 penditures on short-term acute inpatient psy8 chiatric hospital care for which no Federal fi9 nancial participation is provided for the most 

10 recent State fiscal year ending prior to the ef11 fective date of the amendments made by this 

12 section and an analysis of the impact of the 

13 changes to the Medicaid IMD exclusion made 

14 by such amendments on State expenditures for 

15 such care. 

16 (B) An assessment of the extent to which 

17 States used disproportionate share hospital pay18 ment adjustments described in section 1923 of 

19 the Social Security Act (42 U.S.C. 1396r–4) to 

20 fund short-term acute inpatient psychiatric hos21 pital care prior to the effective date of the 

22 amendments made by this section and an anal23 ysis of the impact of the changes to the Med24 icaid IMD exclusion made by such amendments 


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1 on the use of such payment adjustments to 

2 fund such care. 

3 (C) The total amount by which State ex4 penditures and the extent to which States use 

5 disproportionate share hospital payment adjust6 ments for short-term acute inpatient psychiatric 

7 hospital care have been reduced due to the 

8 changes to the Medicaid IMD exclusion made 

9 by the amendments made by this section. 

10 (D) Recommendations for strategies to en11 courage States to reinvest savings in State ex12 penditures and disproportionate share hospital 

13 payment adjustments that result from the 

14 changes to the Medicaid IMD exclusion made 

15 by the amendments made by this section in 

16 community-based mental health services. 

17 (3) DEFINITIONS.—For purposes of this sub18 section: 

19 (A) MEDICAID IMD EXCLUSION.—The term 

20 ‘‘Medicaid IMD exclusion’’ means the prohibi21 tion on Federal matching payments under Med22 icaid for care or services provided to patients 

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1 lowing paragraph (29) of section 1905(a) of the 

2 Social Security Act (42 U.S.C. 1396d(a)). 

3 (B) SECRETARY.—The term ‘‘Secretary’’ 

4 means the Secretary of Health and Human 

5 Services. 

6 (C) SHORT-TERM ACUTE INPATIENT PSY7 CHIATRIC HOSPITAL CARE.—The term ‘‘short8 term acute inpatient psychiatric hospital care’’ 

9 means care provided in either— 

10 (i) an acute-care psychiatric unit with 

11 an average annual length of stay of fewer 

12 than 20 days that is operated within a 

13 State-operated psychiatric hospital; or 

14 (ii) a psychiatric hospital with an av15 erage length of stay of fewer than 20 days 

16 on an annual basis. 

17 (d) EFFECTIVE DATE.— 

18 (1) IN GENERAL.—Subject to paragraphs (2) 

19 and (3), the amendments made by this section shall 

20 apply to items and services furnished after the first 

21 day of the first calendar year that begins after the 

22 date of the enactment of this section. 

23 (2) CERTIFICATION OF NO INCREASED SPEND24 ING.—The amendments made by this section shall 

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1 ters for Medicare & Medicaid Services certifies that 

2 the inclusion of qualified inpatient psychiatric hos3 pital services (as defined by paragraph (3) of section 

4 1905(h) of the Social Security Act (42 U.S.C. 

5 1396d(h)), as added by subsection (b)) furnished to 

6 nonelderly adults as medical assistance under section 

7 1905(a) of the Social Security Act (42 U.S.C. 

8 1396d(a)), as amended by subsection (b), would not 

9 result in any increase in net program spending 

10 under title XIX of such Act. 

11 (3) EXCEPTION FOR STATE LEGISLATION.—In 

12 the case of a State plan under title XIX of the So13 cial Security Act, which the Secretary of Health and 

14 Human Services determines requires State legisla15 tion in order for the respective plan to meet any re16 quirement imposed by amendments made by this 

17 section, the respective plan shall not be regarded as 

18 failing to comply with the requirements of such title 

19 solely on the basis of its failure to meet such an ad20 ditional requirement before the first day of the first 

21 calendar quarter beginning after the close of the 

22 first regular session of the State legislature that be23 gins after the date of enactment of this section. For 

24 purposes of the previous sentence, in the case of a 

25 State that has a 2-year legislative session, each year 


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1 of the session shall be considered to be a separate 

2 regular session of the State legislature. 

3 SEC. 602. MODIFICATIONS TO MEDICARE DISCHARGE PLAN4 NING REQUIREMENTS. 

5 Section 1861(ee) of the Social Security Act (42 

6 U.S.C. 1395x(ee)) is amended— 

7 (1) in paragraph (1), by inserting ‘‘and, in the 

8 case of a psychiatric hospital or a psychiatric unit 

9 (as described in the matter following clause (v) of 

10 section 1886(d)(1)(B)), if it also meets the guide11 lines and standards established by the Secretary 

12 under paragraph (4)’’ before the period at the end; 

13 and 

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

15 paragraph: 

16 ‘‘(4) The Secretary shall develop guidelines and 

17 standards, in addition to those developed under 

18 paragraph (2), for the discharge planning process of 

19 a psychiatric hospital or a psychiatric unit (as de20 scribed in the matter following clause (v) of section 

21 1886(d)(1)(B)) in order to ensure a timely and 

22 smooth transition to the most appropriate type of, 

23 and setting for, posthospital or rehabilitative care. 

24 The Secretary shall issue final regulations imple25 menting such guidelines and standards not later 


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1 than 24 months after the date of the enactment of 

2 this paragraph. The guidelines and standards shall 

3 include the following: 

4 ‘‘(A) The hospital or unit must identify the 

5 types of services needed upon discharge by a 

6 patient being treated by the hospital or unit. 

7 ‘‘(B) The hospital or unit must— 

8 ‘‘(i) identify organizations that offer 

9 community services to the community that 

10 is served by the hospital or unit and the 

11 types of services provided by the organiza12 tions; and 

13 ‘‘(ii) make demonstrated efforts to es14 tablish connections, relationships, and 

15 partnerships with such organizations. 

16 ‘‘(C) The hospital or unit must arrange 

17 (with the participation of the patient and of any 

18 other individuals selected by the patient for 

19 such purpose) for the development and imple20 mentation of a discharge plan for the patient as 

21 part of the patient’s overall treatment plan 

22 from admission to discharge. Such discharge 

23 plan shall meet the requirements described in 

24 subparagraphs (G) and (H) of paragraph (2). 


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1 ‘‘(D) The hospital or unit shall coordinate 

2 with the patient (or assist the patient with) the 

3 referral for posthospital or rehabilitative care 

4 and as part of that referral the hospital or unit 

5 shall include transmitting to the receiving orga6 nization, in a timely manner, appropriate infor7 mation about the care furnished to the patient 

8 by the hospital or unit and recommendations 

9 for posthospital or rehabilitative care to be fur10 nished to the patient by the organization.’’. 

11 TITLE VII—RESEARCH BY NA12 TIONAL INSTITUTE OF MEN13 TAL HEALTH 

14 SEC. 701. INCREASE IN FUNDING FOR CERTAIN RESEARCH. 

15 Section 402A(a) of the Public Health Service Act (42 

16 U.S.C. 282a(a)) is amended by adding at the end the fol17 lowing: 

18 ‘‘(3) FUNDING FOR THE BRAIN INITIATIVE AT

19 THE NATIONAL INSTITUTE OF MENTAL HEALTH.— 

20 ‘‘(A) FUNDING.—In addition to amounts 

21 made available pursuant to paragraphs (1) and 

22 (2), there are authorized to be appropriated to 

23 the National Institute of Mental Health for the 

24 purposes described in subparagraph (B) 


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1 $40,000,000 for each of fiscal years 2017 

2 through 2021. 

3 ‘‘(B) PURPOSES.—Amounts appropriated 

4 pursuant to subparagraph (A) shall be used ex5 clusively for the purpose of conducting or sup6 porting— 

7 ‘‘(i) research on the determinants of 

8 self- and other directed-violence in mental 

9 illness, including studies directed at reduc10 ing the risk of self harm, suicide, and 

11 interpersonal violence; or 

12 ‘‘(ii) brain research through the Brain 

13 Research through Advancing Innovative 

14 Neurotechnologies Initiative.’’. 

15 TITLE VIII—SAMHSA REAUTHOR16 IZATION AND REFORMS 

17 Subtitle A—Organization and 

18 General Authorities 

19 SEC. 801. PEER REVIEW. 

20 (a) Section 501(h) of the Public Health Service Act 

21 (42 U.S.C. 290aa(h)) is amended by inserting at the end 

22 the following: ‘‘In the case of any such peer-review group 

23 that is reviewing a proposal or grant related to mental 

24 illness, no fewer than half of the members of the group 

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1 chology, or advanced degree in nursing or social work from 

2 an accredited graduate school, and shall specialize in the 

3 mental health field.’’. 

4 (b) Section 504 of the Public Health Service Act (42 

5 U.S.C. 290aa–3) is amended by adding at the end of sub6 section (b) the following: ‘‘At least half of the members 

7 of any peer-review group established under subsection (a) 

8 shall have a medical degree, a doctoral degree in psy9 chology, or advanced degree in nursing or social work from 

10 an accredited graduate school, and shall specialize in the 

11 mental health field.’’. 

12 SEC. 802. ADVISORY COUNCILS. 

13 Paragraph (3) of section 502(b) of the Public Health 

14 Service Act (42 U.S.C. 290aa–1(b)) is amended by adding 

15 at the end the following: 

16 ‘‘(C) Not fewer than half of the members 

17 of the group shall have a medical degree, a doc18 toral degree in psychology, or advanced degree 

19 in nursing or social work from an accredited 

20 graduate school and shall specialize in the men21 tal health field. 

22 ‘‘(D) Each advisory committee shall in23 clude at least one member of the National Insti24 tute of Mental Health and 1 member from any 


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1 Federal agency that has a program serving a 

2 similar population.’’. 

3 SEC. 803. GRANTS FOR JAIL DIVERSION PROGRAMS REAU4 THORIZATION. 

5 Section 520G(i) of the Public Health Service Act (42 

6 U.S.C. 290bb–38(i)) is amended by striking ‘‘$10,000,000 

7 for fiscal year 2001, and such sums as may be necessary 

8 for fiscal years 2002 through 2003’’ and inserting 

9 ‘‘$5,000,000 for each of fiscal years 2017 through 2021’’. 

10 SEC. 804. PROJECTS FOR ASSISTANCE IN TRANSITION 

11 FROM HOMELESSNESS. 

12 Section 535(a) of the Public Health Service Act (42 

13 U.S.C. 290cc–35(a)) is amended by striking ‘‘$75,000,000 

14 for each of the fiscal years 2001 through 2003’’ and in15 serting ‘‘$65,000,000 for each of fiscal years 2017 

16 through 2021’’. 

17 SEC. 805. COMPREHENSIVE COMMUNITY MENTAL HEALTH 

18 SERVICES FOR CHILDREN WITH SERIOUS 

19 EMOTIONAL DISTURBANCES. 

20 Section 565 of the Public Health Service Act (42 

21 U.S.C. 290ff–4) is amended— 

22 (1) in subsection (b)(1), by striking ‘‘receiving 

23 a grant under section 561(a)’’ and inserting ‘‘(irre24 spective of whether the public entity is in receipt of 

25 a grant under section 561(a))’’; 


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1 (2) in subsection (b)(1)(B), by striking ‘‘pursu2 ant to section 562’’ and inserting ‘‘described in sec3 tion 562’’; and 

4 (3) in subsection (f)(1), by striking 

5 ‘‘$100,000,000 for fiscal year 2001, and such sums 

6 as may be necessary for each of the fiscal years 

7 2002 and 2003’’ and inserting ‘‘$117,000,000 for 

8 each of fiscal years 2017 through 2021’’. 

9 SEC. 806. REAUTHORIZATION OF PRIORITY MENTAL 

10 HEALTH NEEDS OF REGIONAL AND NA11 TIONAL SIGNIFICANCE. 

12 Section 520A(f)(1) of the Public Health Service Act 

13 (42 U.S.C. 290bb–32(f)(1)) is amended by striking 

14 ‘‘$300,000,000 for fiscal year 2001, and such sums as 

15 may be necessary for each of the fiscal years 2002 and 

16 2003’’ and inserting ‘‘$370,000,000 for each of fiscal 

17 years 2017 through 2021’’. 

18 TITLE IX—MENTAL HEALTH 

19 PARITY 

20 SEC. 901. GAO STUDY ON PREVENTING DISCRIMINATORY 

21 COVERAGE LIMITATIONS FOR INDIVIDUALS 

22 WITH SERIOUS MENTAL ILLNESS AND SUB23 STANCE USE DISORDERS. 

24 Not later than 1 year after the date of enactment 

25 of this Act, the Comptroller General of the United States, 


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1 in consultation with the Assistant Secretary for Mental 

2 Health and Substance Use Disorders, the Secretary of 

3 Health and Human Services, the Secretary of Labor, and 

4 the Secretary of the Treasury, shall submit to Congress 

5 a report detailing the extent to which covered group health 

6 plans (or health insurance coverage offered in connection 

7 with such plans), including Medicaid managed care plans 

8 under section 1903 of the Social Security Act (42 U.S.C. 

9 1396b), comply with the Paul Wellstone and Pete Domen10 ici Mental Health Parity and Addiction Equity Act of 

11 2008 (subtitle B of title V of division C of Public Law 

12 110–343) (in this section referred to as the ‘‘law’’), includ13 ing— 

14 (1) how nonquantitative treatment limitations, 

15 including medical necessity criteria, of covered group 

16 health plans comply with the law; 

17 (2) how the responsible Federal departments 

18 and agencies ensure that plans comply with the law; 

19 and 

20 (3) how proper enforcement, education, and co21 ordination activities within responsible Federal de22 partments and agencies can be used to ensure full 

23 compliance with the law, including educational ac24 tivities directed to State insurance commissioners. 


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1 SEC. 902. REPORT ON INVESTIGATIONS REGARDING PAR2 ITY IN MENTAL HEALTH AND SUBSTANCE 

3 USE DISORDER BENEFITS. 

4 (a) IN GENERAL.—Not later than 1 year after the 

5 date of enactment of this Act, and annually thereafter, 

6 the Administrator of the Centers for Medicare & Medicaid 

7 Services, in collaboration with the Assistant Secretary of 

8 Labor of the Employee Benefits Security Administration 

9 and the Secretary of the Treasury, and in consultation 

10 with the Assistant Secretary for Mental Health and Sub11 stance Use Disorders, shall submit to Congress a report— 

12 (1) identifying Federal investigations conducted 

13 or completed during the preceding 12-month period 

14 regarding compliance with parity in mental health 

15 and substance use disorder benefits, including bene16 fits provided to persons with serious mental illness 

17 and substance use disorders, under the Paul 

18 Wellstone and Pete Domenici Mental Health Parity 

19 and Addiction Equity Act of 2008 (subtitle B of title 

20 V of division C of Public Law 110–343); and 

21 (2) summarizing the results of such investiga22 tions. 

23 (b) CONTENTS.—Subject to subsection (c), each re24 port under subsection (a) shall include the following infor25 mation: 


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1 (1) The number of investigations opened and 

2 closed during the covered reporting period. 

3 (2) The benefit classification or classifications 

4 examined by each investigation. 

5 (3) The subject matter or subject matters of 

6 each investigation, including quantitative and non7 quantitative treatment limitations. 

8 (4) A summary of the basis of the final decision 

9 rendered for each investigation. 

10 (c) LIMITATION.—Individually identifiable informa11 tion shall be excluded from reports under subsection (a) 

12 consistent with Federal privacy protections. 

13 SEC. 903. STRENGTHENING PARITY IN MENTAL HEALTH 

14 AND SUBSTANCE USE DISORDER BENEFITS. 

15 Section 2726(a) of the Public Health Service Act (42 

16 U.S.C. 300gg–26(a)) is amended by adding at the end the 

17 following new paragraph: 

18 ‘‘(6) DISCLOSURE AND ENFORCEMENT RE19 QUIREMENTS.— 

20 ‘‘(A) DISCLOSURE REQUIREMENTS.— 

21 ‘‘(i) REGULATIONS.—Not later than 

22 March 1, 2016, the Secretary, in coopera23 tion with the Secretary of Labor and the 

24 Secretary of the Treasury shall issue addi25 tional regulations or sub-regulatory guidVerDate Sep 11 2014 23:24 Aug 11, 2015 Jkt 049200 PO 00000 Frm 00102 Fmt 6652 Sfmt 6201 E:\BILLS\S1945.IS S1945

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1 ance for carrying out this section, includ2 ing an explanation of documents that are 

3 required to be disclosed, and analyses that 

4 are required to be conducted, including 

5 how non-quantitative treatment limitations 

6 are applied to mental health or substance 

7 use disorder benefits and medical or sur8 gical benefits covered under the plan, by a 

9 group health plan (or health insurance 

10 issuer) offering health insurance coverage 

11 in the group or individual market in order 

12 for such plan or issuer to demonstrate 

13 compliance with the provisions of this sec14 tion. The disclosure requirements shall in15 clude a report detailing the specific anal16 yses performed to develop a compliance re17 view of the requirements of the Paul 

18 Wellstone and Pete Domenici Mental 

19 Health Parity and Addiction Equity Act of 

20 2008, including the amendments made by 

21 such Act. With respect to non-quantitative 

22 treatment limitations, this report shall— 

23 ‘‘(I) identify the specific factors 

24 used by the plan in performing its 


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1 non-quantitative treatment limitations 

2 analysis; 

3 ‘‘(II) identify and define the spe4 cific evidentiary standards relied on to 

5 evaluate the factors; 

6 ‘‘(III) describe how the evi7 dentiary standards were applied to 

8 each service category; 

9 ‘‘(IV) disclose the results of the 

10 analyses of the specific evidentiary 

11 standards in each service category; 

12 and 

13 ‘‘(V) disclose the plan’s specific 

14 findings in each service category and 

15 the conclusions reached with respect 

16 to compliance with comparability and 

17 stringency of application tests under 

18 the non-quantitative treatment limita19 tions rule. 

20 ‘‘(ii) GUIDANCE.—The Secretary, in 

21 cooperation with the Secretary of Labor 

22 and the Secretary of the Treasury shall 

23 issue guidance to group health plans and 

24 health insurance issuers offering health in25 surance coverage in the group or individual 


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1 markets on how to satisfy the requirements 

2 of this section with respect to making in3 formation, including certificate of coverage 

4 documents and instruments under which 

5 the plan is administered and operated that 

6 specify, include, or refer to procedures, for7 mulas, and methodologies applied to deter8 mine a participant or beneficiary’s benefit 

9 under the plan, regardless of whether such 

10 information is contained in a document 

11 designated as the ‘plan document’ available 

12 to current and potential participants and 

13 beneficiaries. This guidance shall include 

14 plan disclosure of how the plan has met 

15 the 2-part test under the non-quantitative 

16 treatment limitations rule of comparability 

17 and stringency in application. 

18 ‘‘(B) ENFORCEMENT.— 

19 ‘‘(i) PROCESS FOR COMPLAINTS.—The 

20 Secretary, in cooperation with the Sec21 retary of Labor and the Secretary of the 

22 Treasury, as appropriate, shall, with re23 spect to group health plans and health in24 surance issuers offering health insurance 

25 coverage in the group or individual market, 


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1 issue guidance to clarify the process and 

2 timeline for current and potential partici3 pants and beneficiaries and their author4 ized representatives and providers with re5 spect to such plans and coverage to file 

6 formal complaints of such plans or issuers 

7 being in violation of this section, including 

8 guidance on the relevant individual State, 

9 regional, and national offices with which 

10 such claims should be filed by plan type. 

11 ‘‘(ii) AUTHORITY FOR PUBLIC EN12 FORCEMENT.—The Secretary shall make 

13 available to the public de-identified infor14 mation on audits and investigations of 

15 group health plans and health insurance 

16 issuers conducted under this section. 

17 ‘‘(iii) AUDITS.— 

18 ‘‘(I) RANDOMIZED AUDITS.—The 

19 Secretary is authorized to conduct 

20 randomized audits of group health 

21 plans and health insurance issuers of22 fering health insurance coverage in 

23 the group or individual market to de24 termine compliance with this section. 

25 Such audits shall be conducted on no 


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1 fewer than 12 plans and issuers per 

2 plan year. The information shall be 

3 made plainly available on the public 

4 Internet websites of the Department 

5 of Health and Human Services and 

6 the Department of Labor. 

7 ‘‘(II) ADDITIONAL AUDITS.—In 

8 the case of a group health plan or 

9 health insurance issuer offering health 

10 insurance coverage in the group or in11 dividual market with respect to which 

12 at least 5 substantiated claims of the 

13 same type of non-compliance with this 

14 section have been filed during a plan 

15 year, the Secretary shall audit plan 

16 documents to determine compliance 

17 with this section. Information detail18 ing the results of the audit shall be 

19 made available on the public Internet 

20 website of the Department of Health 

21 and Human Services.’’. 

Æ 


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