I 

114TH CONGRESS 

2D SESSION H. R. 5462 

To amend title XIX of the Social Security Act to provide for a State Medicaid 

option to enhance administrative matching funds to support statewide 

behavioral health access program activities for children under 21 years 

of age, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 13, 2016 

Mr. LOEBSACK (for himself, Mr. TONKO, Mrs. DINGELL, Mr. KENNEDY, Mr. 

HASTINGS, Ms. CLARKE of New York, and Mr. ENGEL) introduced the 

following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend title XIX of the Social Security Act to provide 

for a State Medicaid option to enhance administrative 

matching funds to support statewide behavioral health 

access program activities for children under 21 years 

of age, 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, 


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1 SECTION 1. COVERAGE OF STATEWIDE BEHAVIORAL 

2 HEALTH ACCESS PROGRAM ACTIVITIES FOR 

3 CHILDREN UNDER AGE 21. 

4 (a) CHILD BEHAVIORAL HEALTH ACCESS PROGRAM

5 ACTIVITIES FOR CHILDREN UNDER AGE 21.—Title XIX 

6 of the Social Security Act is amended by adding at the 

7 end the following new section: 

8 ‘‘SEC. 1947. COVERAGE OF STATEWIDE BEHAVIORAL 

9 HEALTH ACCESS PROGRAM ACTIVITIES FOR 

10 CHILDREN UNDER AGE 21. 

11 ‘‘(a) IN GENERAL.—Notwithstanding section 

12 1902(a)(10)(B) (relating to comparability) and any other 

13 provision of this title for which the Secretary determines 

14 it is necessary to waive in order to implement this section, 

15 beginning January 1, 2017, a State, at its option as a 

16 State plan amendment, may provide for medical assistance 

17 under this title for child behavioral health access program 

18 activities. 

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

20 ‘‘(1) CHILD BEHAVIORAL HEALTH ACCESS AD21 MINISTRATIVE PROGRAM ACTIVITIES.—The term 

22 ‘child behavioral health access administrative pro23 gram activities’ means administrative activities that 

24 are carried out with respect to a child behavioral 

25 health access administrative program. 


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1 ‘‘(2) CHILD BEHAVIORAL HEALTH ACCESS AD2 MINISTRATIVE PROGRAM.—The term ‘child behav3 ioral health access administrative program’ means a 

4 program that, with respect to behavioral health serv5 ices furnished to individuals under 21 years of age— 

6 ‘‘(A) designs, develops, and implements an 

7 organized statewide or regional network of men8 tal health professionals that may include child 

9 and adolescent psychiatrists, psychologists, so10 cial workers, psychiatric nurses, nurse practi11 tioners, and substance abuse counselors to ex12 pand the capacity of pediatric primary care pro13 viders to deliver family-centered behavioral 

14 health care; 

15 ‘‘(B) conducts an assessment of critical 

16 child behavioral health consultation needs 

17 among pediatric primary care providers and 

18 their preferred mechanisms for receiving con19 sultation and training and technical assistance; 

20 ‘‘(C) develops an online database and com21 munication mechanisms, including telehealth, to 

22 facilitate consultation support to pediatric pri23 mary care providers, to track referrals for be24 havioral evaluation made by such providers, and 

25 to facilitate follow-up visits to such providers; 


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1 ‘‘(D) conducts training and provides tech2 nical assistance to pediatric primary care pro3 viders to support the prevention, early identi4 fication, diagnosis, treatment, and referral of 

5 children with mental or behavioral health condi6 tions; 

7 ‘‘(E) informs and assists pediatric pro8 viders in accessing child and adolescent psychi9 atry or behavioral health consultations, referral 

10 for behavioral evaluation and treatment, and in 

11 scheduling and conducting training and tech12 nical assistance; 

13 ‘‘(F) informs children eligible to receive 

14 medical assistance under this title and their 

15 families about the availability of the assistance 

16 available through the program; 

17 ‘‘(G) establishes mechanisms for meas18 uring and monitoring increased access to child 

19 and adolescent behavioral health activities by 

20 pediatric primary care providers and expanded 

21 capacity of pediatric primary care providers to 

22 identify, treat, and refer children with mental 

23 or behavioral health problems; and 


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1 ‘‘(H) establishes mechanisms for coordina2 tion with other State mental or behavioral 

3 health resources for children and adolescents. 

4 ‘‘(3) PEDIATRIC PRIMARY CARE PROVIDER.— 

5 The term ‘pediatric primary care provider’ includes 

6 a provider who is a general practitioner, family med7 icine physician, internal medicine physician, or pedi8 atrician.’’. 

9 (b) ENHANCED FMAP.—Section 1903(a) of the So10 cial Security Act (42 U.S.C. 1396b(a)) is amended— 

11 (1) by redesignating paragraph (7) as para12 graph (8); and 

13 (2) by inserting after paragraph (6) the fol14 lowing new paragraph: 

15 ‘‘(7) for each calendar quarter during— 

16 ‘‘(A) 2016, an amount equal to 100 per17 cent, 

18 ‘‘(B) 2017, an amount equal to 90 percent, 

19 ‘‘(C) 2018, an amount equal to 80 percent, 

20 ‘‘(D) 2019, an amount equal to 70 per21 cent, and 

22 ‘‘(E) 2020 and each year thereafter, an 

23 amount equal to 60 percent, 

24 of so much of the sums expended by the State plan 

25 as are attributable to providing child behavioral 


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1 health access administrative program activities (as 

2 defined in section 1947); plus’’. 

3 (c) EFFECTIVE DATE.—The amendments made in 

4 this section shall apply to items and services furnished on 

5 or after the date that is 90 days after the date of the 

6 enactment of this Act. 

Æ 


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