I 

114TH CONGRESS 

1ST SESSION H. R. 2646 

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 HOUSE OF REPRESENTATIVES 

JUNE 4, 2015 

Mr. MURPHY of Pennsylvania (for himself, Ms. EDDIE BERNICE JOHNSON of 

Texas, Mr. BUCHANAN, Mr. DIAZ-BALART, Mr. BILIRAKIS, Mr. DOLD, 

Mr. GUINTA, Mrs. MIMI WALTERS of California, Mr. BRENDAN F. 

BOYLE of Pennsylvania, Mrs. ELLMERS of North Carolina, Mr. DENHAM, 

Mr. VARGAS, Mrs. MILLER of Michigan, Mr. HASTINGS, Mr. CALVERT, 

Mr. NUNES, Mr. HUNTER, Mr. BLUMENAUER, and Ms. SINEMA) introduced the following bill; which was referred to the Committee on Energy 

and Commerce, and in addition to the Committees on Ways and Means 

and Education and the Workforce, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 

A BILL 

To 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 ‘‘Helping Families in Mental Health Crisis Act of 2015’’. 


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

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Definitions. 

TITLE I—ASSISTANT SECRETARY FOR MENTAL HEALTH AND 

SUBSTANCE USE DISORDERS 

Sec. 101. Assistant Secretary for Mental Health and Substance Use Disorders. 

Sec. 102. Transfer of SAMHSA authorities. 

Sec. 103. Reports. 

Sec. 104. Advisory Council on Graduate Medical Education. 

TITLE II—GRANT REFORM AND RESTRUCTURING 

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. Workforce development. 

Sec. 208. Authorized grants and programs. 

TITLE III—INTERAGENCY SERIOUS MENTAL ILLNESS 

COORDINATING COMMITTEE 

Sec. 301. Interagency Serious Mental Illness Coordinating Committee. 

TITLE IV—HIPAA AND FERPA CAREGIVERS 

Sec. 401. Promoting appropriate treatment for mentally ill individuals by treating their caregivers as personal representatives for purposes of 

HIPAA privacy regulations. 

Sec. 402. Caregivers permitted access to certain education records under 

FERPA. 

Sec. 403. Confidentiality of records. 

TITLE V—MEDICARE AND MEDICAID REFORMS 

Sec. 501. Enhanced Medicaid coverage relating to certain mental health services. 

Sec. 502. Access to mental health prescription drugs under Medicare and Medicaid. 

Sec. 503. Elimination of 190-day lifetime limit on coverage of inpatient psychiatric hospital services under Medicare. 

Sec. 504. Modifications to Medicare discharge planning requirements. 

Sec. 505. Demonstration programs to improve community mental health services. 

TITLE VI—RESEARCH BY NATIONAL INSTITUTE OF MENTAL 

HEALTH 

Sec. 601. Increase in funding for certain research. 


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TITLE VII—BEHAVIORAL HEALTH INFORMATION TECHNOLOGY 

Sec. 701. Extension of health information technology assistance for behavioral 

and mental health and substance abuse. 

Sec. 702. Extension of eligibility for Medicare and Medicaid health information 

technology implementation assistance. 

TITLE VIII—SAMHSA REAUTHORIZATION AND REFORMS 

Subtitle A—Organization and General Authorities 

Sec. 801. In general. 

Sec. 802. Advisory councils. 

Sec. 803. Peer review. 

Subtitle B—Protection and Advocacy for Individuals With Mental Illness 

Sec. 811. Prohibition against lobbying by systems accepting Federal funds to 

protect and advocate the rights of individuals with mental illness. 

Sec. 812. Ensuring that caregivers of individuals with serious mental illness 

have access to the protected health information of such individuals. 

Sec. 813. Protection and advocacy activities to focus exclusively on safeguarding rights to be free from abuse and neglect. 

Sec. 814. Reporting. 

Sec. 815. Grievance procedure. 

Sec. 816. Evidence-based treatment for individuals with serious mental illness. 

TITLE IX—REPORTING 

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

1 SEC. 2. DEFINITIONS. 

2 In this Act: 

3 (1) Except as inconsistent with the provisions 

4 of this Act, the term ‘‘Assistant Secretary’’ means 

5 the Assistant Secretary for Mental Health and Sub6 stance Use Disorders. 

7 (2) The term ‘‘evidence-based’’ means the con8 scientious, systematic, explicit, and judicious ap9 praisal and use of external, current, reliable, and 

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1 sions about the effectiveness and efficacy of a pro2 gram, intervention, or treatment. 

3 TITLE I—ASSISTANT SECRETARY 

4 FOR MENTAL HEALTH AND 

5 SUBSTANCE USE DISORDERS 

6 SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH 

7 AND SUBSTANCE USE DISORDERS. 

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

9 of Health and Human Services an official to be known 

10 as the Assistant Secretary for Mental Health and Sub11 stance Use Disorders, who shall— 

12 (1) report directly to the Secretary; 

13 (2) be appointed by the Secretary of Health 

14 and Human Services, by and with the advice and 

15 consent of the Senate; and 

16 (3) be selected from among individuals who— 

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

18 or osteopathic medicine and clinical and re19 search experience in psychiatry; 

20 (ii) graduated from an Accreditation Coun21 cil for Graduate Medical Education-accredited 

22 psychiatric residency program; and 

23 (iii) have an understanding of biological, 

24 psychosocial, and pharmaceutical treatments of 

25 mental illness and substance use disorders; or 


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1 (B) have a doctoral degree in psychology 

2 with— 

3 (i) clinical and research experience re4 garding mental illness and substance use 

5 disorders; and 

6 (ii) an understanding of biological, 

7 psychosocial, and pharmaceutical treat8 ments of mental illness and substance use 

9 disorders. 

10 (b) DUTIES.—The Assistant Secretary shall— 

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

12 coordinate research, treatment, and services across 

13 departments, agencies, organizations, and individ14 uals with respect to the problems of individuals suf15 fering from substance use disorders or mental ill16 ness; 

17 (2) carry out any functions within the Depart18 ment of Health and Human Services— 

19 (A) to improve the treatment of, and re20 lated services to, individuals with respect to 

21 substance use disorders or mental illness; 

22 (B) to improve secondary prevention or 

23 tertiary prevention services for such individuals; 

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1 nesses and individuals with a substance use dis2 order; 

3 (D) to ensure that grant programs of the 

4 Department adhere to scientific standards with 

5 an emphasis on secondary prevention and ter6 tiary prevention for individuals with serious 

7 mental illness or substance use disorders; and 

8 (E) to develop and implement initiatives to 

9 encourage individuals to pursue careers (espe10 cially in underserved areas and populations) as 

11 psychiatrists, psychologists, psychiatric nurse 

12 practitioners, clinical social workers, and other 

13 licensed mental health professionals specializing 

14 in the diagnosis, evaluation, and treatment of 

15 individuals with severe mental illness, including 

16 individuals— 

17 (i) who are vulnerable to crises, psy18 chotic episodes, or suicidal rumination; 

19 (ii) whose deterioration can be rapid; 

20 or 

21 (iii) who require more frequent con22 tact or integration of a variety of services 

23 by the treating mental health professional; 

24 (3) carry out the administrative and financial 

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1 uation, knowledge dissemination, and public infor2 mation functions that are required for the implemen3 tation of mental health programs, including block 

4 grants, treatments, and data collection; 

5 (4) conduct and coordinate demonstration 

6 projects, evaluations, and service system assessments 

7 and other activities necessary to improve the avail8 ability and quality of treatment, prevention, and re9 lated services related to substance use disorders and 

10 mental illness; 

11 (5) within the Department of Health and 

12 Human Services, oversee and coordinate all pro13 grams and activities relating to— 

14 (A) the prevention of, or treatment or re15 habilitation for, mental health or substance use 

16 disorders; 

17 (B) parity in health insurance benefits and 

18 conditions relating to mental health and sub19 stance use disorder; or 

20 (C) the reduction of homelessness among 

21 individuals with mental illness; 

22 (6) across the Federal Government, in conjunc23 tion with the Interagency Serious Mental Illness Co24 ordinating Committee under section 501A— 


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1 (A) review all programs and activities re2 lating to the prevention of, or treatment or re3 habilitation for, mental illness or substance use 

4 disorders; 

5 (B) identify any such programs and activi6 ties that are duplicative; 

7 (C) identify any such programs and activi8 ties that are not evidence-based, effective, or ef9 ficient; and 

10 (D) formulate recommendations for ex11 panding, coordinating, eliminating, and improv12 ing programs and activities identified pursuant 

13 to subparagraph (B) or (C) and merging such 

14 programs and activities into other, successful 

15 programs and activities; 

16 (7) identify evidence-based best practices across 

17 the Federal Government for treatment and services 

18 for those with mental health and substance use dis19 orders by reviewing practices for efficiency, effective20 ness, quality, coordination, and cost effectiveness; 

21 (8) be the head of and supervise the National 

22 Mental Health Policy Laboratory; and 

23 (9) not later than one year after the date of en24 actment of the Helping Families in Mental Health 

25 Crisis Act of 2015, submit to the Congress a report 


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1 containing a nationwide strategy to increase the psy2 chiatric workforce and recruit medical professionals 

3 for the treatment of individuals with serious mental 

4 illness and substance use disorders. 

5 (c) NATIONWIDE STRATEGY.—The Assistant Sec6 retary shall ensure that the nationwide strategy in the re7 port under subsection (b)(9) is designed— 

8 (1) to encourage and incentivize students en9 rolled in an accredited medical or osteopathic med10 ical school to enter the specialty of psychiatry; 

11 (2) to promote greater research-oriented psy12 chiatrist residency training on evidence-based service 

13 delivery models for individuals with serious mental 

14 illness or substance use disorders; 

15 (3) to promote appropriate Federal administra16 tive and fiscal mechanisms that support— 

17 (A) evidence-based collaborative care mod18 els; and 

19 (B) the necessary psychiatric workforce ca20 pacity for these models, including psychiatrists 

21 (including child and adolescent psychiatrists), 

22 psychologists, psychiatric nurse practitioners, 

23 clinical social workers, and mental health, peer24 support specialists; 


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1 (4) to increase access to child and adolescent 

2 psychiatric services in order to promote early inter3 vention for prevention and mitigation of mental ill4 ness; and 

5 (5) to identify populations and locations that 

6 are the most underserved by mental health profes7 sionals and the most in need of psychiatrists (includ8 ing child and adolescent psychiatrists), psychologists, 

9 psychiatric nurse practitioners, clinical social work10 ers, and mental health, peer-support specialists. 

11 (d) PRIORITIZATION OF INTEGRATION OF SERVICES, 

12 EARLY DIAGNOSIS, INTERVENTION, AND WORKFORCE

13 DEVELOPMENT.—In carrying out the duties described in 

14 subsection (b), the Assistant Secretary shall prioritize— 

15 (1) the integration of mental health, substance 

16 use, and physical health services for the purpose of 

17 diagnosing, preventing, treating, or providing reha18 bilitation for mental illness or substance use dis19 orders, including any such services provided through 

20 the justice system (including departments of correc21 tion) or other entities other than the Department of 

22 Health and Human Services; 

23 (2) crisis intervention for, early diagnosis and 

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1 ment and rehabilitation for, serious mental illness or 

2 substance use disorders; and 

3 (3) workforce development for— 

4 (A) appropriate treatment of serious men5 tal illness or substance use disorders; and 

6 (B) research activities that advance sci7 entific and clinical understandings of these dis8 orders, including the development and imple9 mentation of a continuing nationwide strategy 

10 to increase the psychiatric workforce with psy11 chiatrists, child and adolescent psychiatrists, 

12 psychologists, psychiatric nurse practitioners, 

13 clinical social workers, and mental health peer 

14 support specialists. 

15 (e) REQUIREMENTS AND RESTRICTIONS ON AUTHOR16 ITY TO AWARD GRANTS.—In awarding any grant or fi17 nancial assistance, the Assistant Secretary, and any agen18 cy or official within the Office of the Assistant Secretary, 

19 shall comply with the following: 

20 (1) The grant or financial assistance shall be 

21 for activities consisting of, or based upon, applied 

22 scientific research. 

23 (2) Any program to be funded shall be dem24 onstrated— 


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1 (A) in the case of an ongoing program, to 

2 be effective; and 

3 (B) in the case of a new program, to have 

4 the prospect of being effective. 

5 (3) The programs and activities to be funded 

6 shall use evidence-based best practices or emerging 

7 evidence-based best practices that are translational 

8 and can be expanded or replicated to other States, 

9 local communities, agencies, or through the Medicaid 

10 program under title XIX of the Social Security Act. 

11 (4) An application for the grant or financial as12 sistance shall include, as applicable, a scientific jus13 tification based on previously demonstrated models, 

14 the number of individuals to be served, the popu15 lation to be targeted, what objective outcomes meas16 ures will be used, and details on how the program 

17 or activity to be funded can be replicated and by 

18 whom. 

19 (5) Applicants shall be evaluated and selected 

20 through a blind, peer-review process by expert men21 tal health care providers with professional experience 

22 in mental health research or treatment and where 

23 appropriate or necessary professional experience re24 lated to substance abuse and other areas of expertise 


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1 appropriate to the grant or other financial assist2 ance. 

3 (6) No member of a peer-review group con4 ducting a blind, peer-review process, as required by 

5 paragraph (5), may be related to anyone who may 

6 be applying for the type of award being reviewed, 

7 may be a current grant applicant, or may have a fi8 nancial or employment interested in selecting whom 

9 to receive the award. 

10 (7) Award recipients may be periodically re11 viewed and audited at the discretion of the Inspector 

12 General of the Department of Health and Human 

13 Services or the Comptroller General of the United 

14 States to ensure that— 

15 (A) the best scientific method for both 

16 services and data collection is being followed; 

17 and 

18 (B) Federal funds are being used as re19 quired by the conditions of the award and by 

20 applicable guidelines of the NMHPL. 

21 (8) Award recipients that fail an audit or fail 

22 to provide information pursuant to an audit shall 

23 have their awards terminated. 

24 (f) DEFINITIONS.—In this section: 


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1 (1) The term ‘‘secondary prevention’’ means 

2 prevention that is designed to prevent a disease or 

3 condition from occurring among individuals or a 

4 subpopulation determined to be at risk for the dis5 ease or condition. 

6 (2) The term ‘‘tertiary prevention’’ means pre7 vention that is designed to reduce or minimize the 

8 consequences of a disease or condition among indi9 viduals showing symptoms of the disease or condi10 tion. 

11 SEC. 102. TRANSFER OF SAMHSA AUTHORITIES. 

12 (a) IN GENERAL.—The Secretary of Health and 

13 Human Services shall delegate to the Assistant Secretary 

14 all duties and authorities that— 

15 (1) as of the day before the date of enactment 

16 of this Act, were vested in the Administrator of the 

17 Substance Abuse and Mental Health Services Ad18 ministration; and 

19 (2) are not terminated by this Act. 

20 (b) TRANSITION.—This section and the amendments 

21 made by this section apply beginning on the day that is 

22 6 months after the date of enactment of this Act. As of 

23 such day, the Secretary of Health and Human Services 

24 shall provide for the transfer of the personnel, assets, and 

25 obligations of the Substance Abuse and Mental Health 


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1 Services Administration to the Office of the Assistant Sec2 retary. 

3 (c) CONFORMING AMENDMENTS.—Title V of the 

4 Public Health Service Act (42 U.S.C. 290aa et seq.) is 

5 amended— 

6 (1) in the title heading, by striking ‘‘SUB7 STANCE ABUSE AND MENTAL HEALTH 

8 SERVICES ADMINISTRATION’’ and insert9 ing ‘‘MENTAL HEALTH AND SUBSTANCE 

10 USE DISORDERS’’; 

11 (2) by amending section 501(a) to read as fol12 lows: 

13 ‘‘(a) ASSISTANT SECRETARY.—The Assistant Sec14 retary for Mental Health and Substance Use Disorders 

15 shall have the duties and authorities vested in the Assist16 ant Secretary by this title in addition to the duties and 

17 authorities vested in the Assistant Secretary by section 

18 501 of the Helping Families in Mental Health Crisis Act 

19 of 2015 and other provisions of law.’’; 

20 (3) by amending section 501(c) to read as fol21 lows: 

22 ‘‘(c) DEPUTY ASSISTANT SECRETARY.—The Assist23 ant Secretary, with the approval of the Secretary, may ap24 point a Deputy Assistant Secretary and may employ and 

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1 cluding attorneys, as are necessary to administer the ac2 tivities to be carried out under this title.’’; 

3 (4) by striking subsection (o) (relating to au4 thorization of appropriations); 

5 (5) by striking ‘‘Administrator of the Substance 

6 Abuse and Mental Health Services Administration’’ 

7 each place it appears and inserting ‘‘Assistant Sec8 retary for Mental Health and Substance Use Dis9 orders’’; 

10 (6) by striking ‘‘Administrator’’ each place it 

11 appears and inserting ‘‘Assistant Secretary’’, except 

12 where the term ‘‘Administrator’’ appears within the 

13 term— 

14 (A) Associate Administrator; 

15 (B) Administrator of the Health Resources 

16 and Services Administration; 

17 (C) Administrator of the Centers for Medi18 care & Medicaid Services; or 

19 (D) Administrator of the Office of Juvenile 

20 Justice and Delinquency Prevention; 

21 (7) by striking ‘‘Substance Abuse and Mental 

22 Health Services Administration’’ each place it ap23 pears and inserting ‘‘Office of the Assistant Sec24 retary’’; 


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1 (8) in section 502, by striking ‘‘Administration 

2 or Center’’ each place it appears and inserting ‘‘Of3 fice or Center’’; 

4 (9) in section 502, by striking ‘‘Administra5 tion’s’’ and inserting ‘‘Office of the Assistant Sec6 retary’s’’; and 

7 (10) by striking the term ‘‘Administration’’ 

8 each place it appears and inserting ‘‘Office of the 

9 Assistant Secretary’’, except in the heading of sec10 tion 520G(b) and where the term ‘‘Administration’’ 

11 appears with the term— 

12 (A) Health Resources and Services Admin13 istration; or 

14 (B) National Highway Traffic Safety Ad15 ministration. 

16 (d) REFERENCES.—After executing subsection (a), 

17 subsection (b), and the amendments made by subsection 

18 (c)— 

19 (1) any reference in statute, regulation, or guid20 ance to the Administrator of the Substance Abuse 

21 and Mental Health Services Administration shall be 

22 construed to be a reference to the Assistant Sec23 retary for Mental Health and Substance Use Dis24 orders; and 


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1 (2) any reference in statute, regulation, or guid2 ance to the Substance Abuse and Mental Health 

3 Services Administration shall be construed to be a 

4 reference to the Office of the Assistant Secretary. 

5 SEC. 103. REPORTS. 

6 (a) REPORT ON INVESTIGATIONS REGARDING PAR7 ITY IN MENTAL HEALTH AND SUBSTANCE USE DIS8 ORDER BENEFITS.— 

9 (1) IN GENERAL.—Not later than 180 days 

10 after the enactment of this Act, and annually there11 after, the Administrator of the Centers for Medicare 

12 & Medicaid Services, in collaboration with the As13 sistant Secretary of Labor of the Employee Benefits 

14 Security Administration and the Secretary of the 

15 Treasury, and in consultation with the Assistant 

16 Secretary for Mental Health and Substance Use 

17 Disorders, shall submit to the Congress a report— 

18 (A) identifying Federal investigations con19 ducted or completed during the preceding 12- 

20 month period regarding compliance with parity 

21 in mental health and substance use disorder 

22 benefits, including benefits provided to persons 

23 with serious mental illness and substance use 

24 disorders, under the Paul Wellstone and Pete 

25 Domenici Mental Health Parity and Addiction 


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1 Equity Act of 2008 (subtitle B of title V of di2 vision C of Public Law 110–343); and 

3 (B) summarizing the results of such inves4 tigations. 

5 (2) CONTENTS.—Subject to paragraph (3), 

6 each report under paragraph (1) shall include the 

7 following information: 

8 (A) The number of investigations opened 

9 and closed during the covered reporting period. 

10 (B) The benefit classification or classifica11 tions examined by each investigation. 

12 (C) The subject matter or subject matters 

13 of each investigation, including quantitative and 

14 nonquantitative treatment limitations. 

15 (D) A summary of the basis of the final 

16 decision rendered for each investigation. 

17 (3) LIMITATION.—Individually identifiable in18 formation shall be excluded from reports under 

19 paragraph (1) consistent with Federal privacy pro20 tections. 

21 (b) REPORT ON BEST PRACTICES FOR PEER-SUP22 PORT SPECIALIST PROGRAMS, TRAINING, AND CERTIFI23 CATION.— 

24 (1) IN GENERAL.—Not later than 1 year after 

25 the date of enactment of this Act, and biannually 


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1 thereafter, the Assistant Secretary shall submit to 

2 the Congress and make publicly available a report on 

3 best practices and professional standards in States 

4 for— 

5 (A) establishing and operating health care 

6 programs using peer-support specialists; and 

7 (B) training and certifying peer-support 

8 specialists. 

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

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

11 means an individual who— 

12 (A) 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 li19 censed mental health or substance use treat20 ment professional; 

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

23 least the preceding 2 years; 

24 (C) does not provide direct medical serv25 ices; and 


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1 (D) does not perform services outside of 

2 his or her area of training, expertise, com3 petence, or 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) psychopharmacology; 

16 (ii) integrating physical medicine and 

17 mental health supportive services; 

18 (iii) ethics; 

19 (iv) scope of practice; 

20 (v) crisis intervention; 

21 (vi) identification and treatment of 

22 mental health disorders; 

23 (vii) State confidentiality laws; 


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1 (viii) Federal privacy protections, in2 cluding under the Health Insurance Port3 ability and Accountability Act of 1996; and 

4 (ix) other areas as determined by the 

5 Assistant Secretary. 

6 (E) Requirements to explain what, where, 

7 when, and how to accurately complete all re8 quired documentation activities. 

9 (F) Required or recommended skill sets, 

10 including— 

11 (i) identifying consumer risk indica12 tors, including individual stressors, trig13 gers, and indicators of escalating symp14 toms; 

15 (ii) explaining basic de-escalation 

16 techniques; 

17 (iii) explaining basic suicide preven18 tion concepts and techniques; 

19 (iv) identifying indicators that the 

20 consumer may be experiencing abuse or ne21 glect; 

22 (v) identifying and responding appro23 priately to personal stressors, triggers, and 

24 indicators; 


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1 (vi) identifying the consumer’s current 

2 stage of change or recovery; 

3 (vii) explaining the typical process 

4 that should be followed to access or partici5 pate in community mental health and re6 lated services; and 

7 (viii) identifying circumstances when 

8 it is appropriate to request assistance from 

9 other professionals to help meet the con10 sumer’s recovery goals. 

11 (G) Requirements for continuing education 

12 credits annually. 

13 (c) REPORT ON THE STATE OF THE STATES IN MEN14 TAL HEALTH AND SUBSTANCE USE TREATMENT.— 

15 (1) IN GENERAL.—Not later than 1 year after 

16 the date of enactment of this Act, and not less than 

17 every 2 years thereafter, the Assistant Secretary 

18 shall submit to the Congress and make available to 

19 the public a report on the state of the States in 

20 mental health and substance use treatment, includ21 ing the following: 

22 (A) A detailed report on how Federal men23 tal health and substance use treatment funds 

24 are used in each State including: 


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1 (i) The numbers of individuals with 

2 serious mental illness or substance use dis3 orders who are served with Federal funds. 

4 (ii) The types of programs made avail5 able to individuals with serious mental ill6 ness or substance use disorders. 

7 (B) A summary of best practice models in 

8 the States highlighting programs that are cost 

9 effective, provide evidence-based care, increase 

10 access to care, integrate physical, psychiatric, 

11 psychological, and behavioral medicine, and im12 prove outcomes for individuals with mental ill13 ness or substance use disorders. 

14 (C) A statistical report of outcome meas15 ures in each State, including— 

16 (i) rates of suicide, suicide attempts, 

17 substance abuse, overdose, overdose 

18 deaths, emergency psychiatric hospitaliza19 tions, and emergency room boarding; and 

20 (ii) for those with mental illness, ar21 rests, incarcerations, victimization, home22 lessness, joblessness, employment, and en23 rollment in educational or vocational pro24 grams. 


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1 (D) Outcome measures on State-assisted 

2 outpatient treatment programs, including— 

3 (i) rates of keeping treatment ap4 pointments and compliance with prescribed 

5 medications; 

6 (ii) participants’ perceived effective7 ness of the program; 

8 (iii) rates of the programs helping 

9 those with serious mental illness gain con10 trol over their lives; 

11 (iv) alcohol and drug abuse rates; 

12 (v) incarceration and arrest rates; 

13 (vi) violence against persons or prop14 erty; 

15 (vii) homelessness; and 

16 (viii) total treatment costs for compli17 ance with the program. 

18 (E) STATE AND COUNTIES WITH ASSISTED

19 OUTPATIENT TREATMENT PROGRAMS.—For 

20 States and counties with assisted outpatient 

21 treatment programs, the information reported 

22 under this subsection shall include a compari23 son of the outcomes of individuals with serious 

24 mental illness who participated in the programs 

25 versus the outcomes of individuals who did not 


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1 participate but were eligible to do so by nature 

2 of their history. 

3 (F) STATES AND COUNTIES WITHOUT AOT

4 PROGRAMS.—For States and counties without 

5 assisted outpatient treatment programs, the in6 formation reported under this subsection shall 

7 include data on individuals with mental illness 

8 who— 

9 (i) have a history of violence, incarcer10 ation, and arrests; 

11 (ii) have a history of emergency psy12 chiatric hospitalizations; 

13 (iii) are substantially unlikely to par14 ticipate in treatment on their own; 

15 (iv) may be unable for reasons other 

16 than indigence, to provide for any of their 

17 basic needs such as food, clothing, shelter, 

18 health or safety; 

19 (v) have a history of mental illness or 

20 condition that is likely to substantially de21 teriorate if the individual is not provided 

22 with timely treatment; and 

23 (vi) due to their mental illness, have a 

24 lack of capacity to fully understand or lack 

25 judgment, or diminished capacity to make 


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1 informed decisions, regarding their need 

2 for treatment, care, or supervision. 

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

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

5 admitting patients to an emergency department and 

6 holding them in the department until inpatient psy7 chiatric beds become available. 

8 (d) REPORTING COMPLIANCE STUDY.— 

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

10 Mental Health and Substance Use Disorders shall 

11 enter into an arrangement with the Institute of 

12 Medicine of the National Academies (or, if the Insti13 tute declines, another appropriate entity) under 

14 which, not later than 12 months after the date of 

15 enactment of this Act, the Institute will submit to 

16 the appropriate committees of Congress a report 

17 that evaluates the combined paperwork burden of— 

18 (A) community mental health centers 

19 meeting the criteria specified in section 1913(c) 

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

21 300x–2), including such centers meeting such 

22 criteria as in effect on the day before the date 

23 of enactment of this Act; and 

24 (B) federally qualified community mental 

25 health clinics certified pursuant to section 223 


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1 of the Protecting Access to Medicare Act of 

2 2014 (Public Law 113–93), as amended by sec3 tion 505. 

4 (2) SCOPE.—In preparing the report under sub5 section (a), the Institute of Medicine (or, if applica6 ble, other appropriate entity) shall examine licens7 ing, certification, service definitions, claims payment, 

8 billing codes, and financial auditing requirements 

9 used by the Office of Management and Budget, the 

10 Centers for Medicare & Medicaid Services, the 

11 Health Resources and Services Administration, the 

12 Substance Abuse and Mental Health Services Ad13 ministration, the Office of the Inspector General of 

14 the Department of Health and Human Services, 

15 State Medicaid agencies, State departments of 

16 health, State departments of education, and State 

17 and local juvenile justice and social service agencies 

18 to— 

19 (A) establish an estimate of the combined 

20 nationwide cost of complying with such require21 ments, in terms of both administrative funding 

22 and staff time; 

23 (B) establish an estimate of the per capita 

24 cost to each center or clinic described in sub25 paragraph (A) or (B) of paragraph (1) to comVerDate Sep 11 2014 07:09 Jun 05, 2015 Jkt 049200 PO 00000 Frm 00028 Fmt 6652 Sfmt 6201 E:\BILLS\H2646.IH H2646

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1 ply with such requirements, in terms of both 

2 administrative funding and staff time; and 

3 (C) make administrative and statutory rec4 ommendations to Congress (which recommenda5 tions may include a uniform methodology) to 

6 reduce the paperwork burden experienced by 

7 centers and clinics described in subparagraph 

8 (A) or (B) of paragraph (1). 

9 SEC. 104. ADVISORY COUNCIL ON GRADUATE MEDICAL 

10 EDUCATION. 

11 Section 762(b) of the Public Health Service Act (42 

12 U.S.C. 294o(b)) is amended— 

13 (1) by redesignating paragraphs (4) through 

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

15 (2) by inserting after paragraph (3) the fol16 lowing: 

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

18 and Substance Use Disorders;’’. 

19 TITLE II—GRANT REFORM AND 

20 RESTRUCTURING 

21 SEC. 201. NATIONAL MENTAL HEALTH POLICY LABORA22 TORY. 

23 (a) IN GENERAL.— 

24 (1) ESTABLISHMENT.—The Assistant Secretary 

25 for Mental Health and Substance Use Disorders 


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1 shall establish, within the Office of the Assistant 

2 Secretary, the National Mental Health Policy Lab3 oratory (in this section referred to as the 

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

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

6 shall— 

7 (A) identify, coordinate, and implement 

8 policy changes and other trends likely to have 

9 the most significant impact on mental health 

10 services and monitor their impact; 

11 (B) collect information from grantees 

12 under programs established or amended by this 

13 Act and under other mental health programs 

14 under the Public Health Service Act, including 

15 grantees that are States receiving funds under 

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

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

18 seq.); 

19 (C) evaluate and disseminate to such 

20 grantees evidence-based practices and services 

21 delivery models using the best available science 

22 shown to be cost-effective while enhancing the 

23 quality of care furnished to individuals; 


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1 (D) establish standards for the appoint2 ment of scientific peer-review panels to evaluate 

3 grant applications; and 

4 (E) establish standards for grant programs 

5 under subsection (b). 

6 (3) EVIDENCE-BASED PRACTICES AND SERVICE

7 DELIVERY MODELS.—In selecting evidence-based 

8 best practices and service delivery models for evalua9 tion and dissemination under paragraph (2)(C), the 

10 Director of the NMHPL— 

11 (A) shall give preference to models that 

12 improve— 

13 (i) the coordination between mental 

14 health and physical health providers; 

15 (ii) the coordination among such pro16 viders and the justice and corrections sys17 tem; and 

18 (iii) the cost effectiveness, quality, ef19 fectiveness, and efficiency of health care 

20 services furnished to individuals with seri21 ous mental illness, in mental health crisis, 

22 or at risk to themselves, their families, and 

23 the general public; and 

24 (B) may include clinical protocols and 

25 practices used in the Recovery After Initial 


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1 Schizophrenia Episode (RAISE) project and the 

2 North American Prodrome Longitudinal Study 

3 (NAPLS) of the National Institute of Mental 

4 Health. 

5 (4) DEADLINE FOR BEGINNING IMPLEMENTA6 TION.—The Director of the NMHPL shall begin im7 plementation of the duties described in this sub8 section not later than January 1, 2018. 

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

10 under this subsection, the Director of the NMHPL 

11 shall consult with— 

12 (A) representatives of the National Insti13 tute of Mental Health on organization, hiring 

14 decisions, and operations, initially and on an 

15 ongoing basis; 

16 (B) other appropriate Federal agencies; 

17 (C) clinical and analytical experts with ex18 pertise in medicine, psychiatric and clinical psy19 chological care, health care management, edu20 cation, corrections health care, and mental 

21 health court systems; and 

22 (D) other individuals and agencies as de23 termined appropriate by the Assistant Sec24 retary. 

25 (b) STANDARDS FOR GRANT PROGRAMS.— 


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1 (1) IN GENERAL.—The Director of the 

2 NMHPL shall set standards for grant programs ad3 ministered by the Assistant Secretary, and the As4 sistant Secretary shall comply with such standards, 

5 including standards for— 

6 (A) the extent to which the grantee must 

7 have the capacity to implement the award; 

8 (B) the extent to which the grant plan sub9 mitted by the grantee as part of its application 

10 must explain how the grantee will help to pro11 vide comprehensive community mental health or 

12 substance use services to adults with serious 

13 mental illness and children with serious emo14 tional disturbances; 

15 (C) the extent to which the grantee must 

16 identify priorities, as well as strategies and per17 formance indicators to address those priorities 

18 for the duration of the grant; 

19 (D) the extent to which the grantee must 

20 submit statements on the extent to which the 

21 grantee is meeting annual program priorities 

22 with quantifiable, objective, and scientific tar23 gets, measures, and outcomes; 

24 (E) the extent to which grantees are ex25 pected to collaborate with other child-serving 


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1 systems such as child welfare, education, juve2 nile justice, and primary care systems; 

3 (F) the extent to which the grantee must 

4 collect and report data; 

5 (G) the extent to which the grantee must 

6 use evidence-based practices and the extent to 

7 which those evidence-based practices must be 

8 used with respect to a population similar to the 

9 population for which the evidence-based prac10 tices were shown to be effective; and 

11 (H) the extent to which a grantee, when 

12 possible, must have a control group. 

13 (2) PUBLIC DISCLOSURE OF RESULTS.—The 

14 Director of the NMHPL— 

15 (A) shall make the standards under para16 graph (1), and the Director’s findings on com17 pliance by the Assistant Secretary and grantees 

18 with such standards, available to the public in 

19 a timely fashion; and 

20 (B) may establish requirements for States 

21 and other entities receiving funds through 

22 grants under programs established or amended 

23 by this Act and under other mental health pro24 grams under the Public Health Service Act, in25 cluding under a block grant under part B of 


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1 title XIX of the Public Health Service Act (42 

2 U.S.C. 300x et seq.), to collect information on 

3 evidence-based best practices and services deliv4 ery models selected under section 101(c)(2), as 

5 the Assistant Secretary determines necessary to 

6 monitor and evaluate such models. 

7 (c) STAFFING.— 

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

9 NMHPL, the Director of the NMHPL, in consulta10 tion with the Director of the National Institute of 

11 Mental Health, shall ensure the following: 

12 (A) At least 20 percent of the staff shall— 

13 (i) have a doctoral degree in medicine 

14 or osteopathic medicine and clinical and re15 search experience in psychiatry; 

16 (ii) have graduated from an Accredi17 tation Council for Graduate Medical Edu18 cation-accredited psychiatric residency pro19 gram; and 

20 (iii) have an understanding of biologi21 cal, psychosocial, and pharmaceutical 

22 treatments of mental illness and substance 

23 use disorders. 

24 (B) At least 20 percent of the staff shall 

25 have a doctoral degree in psychology with— 


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1 (i) clinical and research experience re2 garding mental illness and substance use 

3 disorders; and 

4 (ii) an understanding of biological, 

5 psychosocial, and pharmaceutical treat6 ments of mental illness and substance use 

7 disorders. 

8 (C) At least 20 percent of the staff shall 

9 be professionals or academics with clinical or 

10 research expertise in substance use disorders 

11 and treatment. 

12 (D) At least 20 percent of the staff shall 

13 be professionals or academics with expertise in 

14 research design and methodologies. 

15 (2) CONGRESSIONAL APPOINTMENTS.—At least 

16 20 percent, or two, whichever is greater, of the 

17 members of the staff of the NMHPL shall be ap18 pointed by Congress. 

19 (d) REPORT ON QUALITY OF CARE.—Not later than 

20 1 year after the date of enactment of this Act, and every 

21 2 years thereafter, the Director of the NMHPL shall sub22 mit to the Congress a report on the quality of care fur23 nished through grant programs administered by the As24 sistant Secretary under the respective services delivery 


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1 models, including measurement of patient-level outcomes 

2 and public health outcomes such as— 

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

4 substance abuse, overdose, overdose deaths, emer5 gency psychiatric hospitalizations, emergency room 

6 boarding, incarceration, crime, arrest, victimization, 

7 homelessness, and joblessness; 

8 (2) rates of employment and enrollment in edu9 cational and vocational programs; and 

10 (3) such other criteria as the Director may de11 termine. 

12 (e) DEFINITION.—In this section, the term ‘‘emer13 gency room boarding’’ means the practice of admitting pa14 tients to an emergency department and holding them in 

15 the department until inpatient psychiatric beds become 

16 available. 

17 SEC. 202. INNOVATION GRANTS. 

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

19 award grants to State and local governments, educational 

20 institutions, and nonprofit organizations for expanding a 

21 model that has been scientifically demonstrated to show 

22 promise, but would benefit from further applied research, 

23 for— 


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1 (1) enhancing the screening, diagnosis, and 

2 treatment of mental illness and serious mental ill3 ness; or 

4 (2) integrating or coordinating physical, mental 

5 health, and substance use services. 

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

7 for a period of not more than 2 years. 

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

9 for carrying out this section for a fiscal year— 

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

11 for use for primary prevention; and 

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

13 screening, diagnosis, treatment, or services, as de14 scribed in subsection (a), for individuals (or sub15 populations of individuals) who are below the age of 

16 18 when activities funded through the grant award 

17 are initiated. 

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

19 award under this section, an applicant shall agree to ad20 here to guidelines issued by the National Mental Health 

21 Policy Laboratory on research designs and data collection. 

22 (e) TERMINATION.—The Assistant Secretary may 

23 terminate any award under this section upon a determina24 tion that— 


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1 (1) the recipient is not providing information 

2 requested by the National Mental Health Policy 

3 Laboratory or the Assistant Secretary in connection 

4 with the award; or 

5 (2) there is a clear failure in the effectiveness 

6 of the recipient’s programs or activities funded 

7 through the award. 

8 (f) REPORTING.—As a condition on receipt of an 

9 award under this section, an applicant shall agree— 

10 (1) to report to the National Mental Health 

11 Policy Laboratory and the Assistant Secretary the 

12 results of programs and activities funded through 

13 the award; and 

14 (2) to include in such reporting any relevant 

15 data requested by the National Mental Health Policy 

16 Laboratory and the Assistant Secretary. 

17 (g) DEFINITION.—In this section, the term ‘‘primary 

18 prevention’’ means prevention that is designed to prevent 

19 a disease or condition from occurring among the general 

20 population without regard to identifying the presence of 

21 risk factors or symptoms in the population. 

22 (h) FUNDING.—Of the amounts made available to 

23 carry out sections 501, 509, 516, and 520A of the Public 

24 Health Service Act for a fiscal year, 5 percent of such 


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1 amounts are authorized to be used to carry out this sec2 tion. 

3 SEC. 203. DEMONSTRATION GRANTS. 

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

5 grants to States, counties, local governments, educational 

6 institutions, and private nonprofit organizations for the 

7 expansion, replication, or scaling of evidence-based pro8 grams across a wider area to enhance effective screening, 

9 early diagnosis, intervention, and treatment with respect 

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

11 (1) applied delivery of care, including training 

12 staff in effective evidence-based treatment; and 

13 (2) integrating models of care across specialties 

14 and jurisdictions. 

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

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

17 5 years. 

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

19 for carrying out this section for a fiscal year— 

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

21 screening, diagnosis, intervention, and treatment, as 

22 described in subsection (a), for individuals (or sub23 populations of individuals) who are below the age of 

24 26 when activities funded through the grant award 

25 are initiated; 


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

2 program or project that is not evidence-based; 

3 (3) no amounts shall be made available for pri4 mary prevention; and 

5 (4) no amounts shall be made available solely 

6 for the purpose of expanding facilities or increasing 

7 staff at an existing program. 

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

9 award under this section, an applicant shall agree to ad10 here to guidelines issued by the National Mental Health 

11 Policy Laboratory on research designs and data collection. 

12 (e) TERMINATION.—The Assistant Secretary may 

13 terminate any award under this section upon a determina14 tion that— 

15 (1) the recipient is not providing information 

16 requested by the National Mental Health Policy 

17 Laboratory or the Assistant Secretary in connection 

18 with the award; or 

19 (2) there is a clear failure in the effectiveness 

20 of the recipient’s programs or activities funded 

21 through the award. 

22 (f) REPORTING.—As a condition on receipt of an 

23 award under this section, an applicant shall agree— 

24 (1) to report to the National Mental Health 

25 Policy Laboratory and the Assistant Secretary the 


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1 results of programs and activities funded through 

2 the award; and 

3 (2) to include in such reporting any relevant 

4 data requested by the National Mental Health Policy 

5 Laboratory and the Assistant Secretary. 

6 (g) FUNDING.—Of the amounts made available to 

7 carry out sections 501, 509, 516, and 520A of the Public 

8 Health Service Act for a fiscal year, 10 percent of such 

9 amounts are authorized to be used to carry out this sec10 tion. 

11 SEC. 204. EARLY CHILDHOOD INTERVENTION AND TREAT12 MENT. 

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

14 Health Policy Laboratory (in this section referred to as 

15 the ‘‘NMHPL’’) shall award— 

16 (1) grants to eligible entities to initiate and un17 dertake, for eligible children, early childhood inter18 vention and treatment programs, and specialized 

19 preschool and elementary school programs, with the 

20 goal of preventing chronic and serious mental illness; 

21 (2) grants to not more than 3 eligible entities 

22 for studying the longitudinal outcomes of programs 

23 funded under paragraph (1) on eligible children who 

24 were treated 5 or more years prior to the enactment 

25 of this Act; and 


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1 (3) ensure that programs and activities funded 

2 through grants under this subsection are based on 

3 a sound scientific model that shows evidence and 

4 promise and can be replicated in other settings. 

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

6 section: 

7 (1) ELIGIBLE ENTITY.—The term ‘‘eligible enti8 ty’’ means a nonprofit institution that— 

9 (A) is duly accredited by State mental 

10 health and education agencies, as applicable, for 

11 the treatment and education of children from 1 

12 to 10 years of age; and 

13 (B) provides services that include early 

14 childhood intervention and specialized preschool 

15 and elementary school programs focused on 

16 children whose primary need is a social or emo17 tional disability (in addition to any learning dis18 ability). 

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

20 child’’ means a child who is at least 0 years old and 

21 not more than 12 years old— 

22 (A) whose primary need is a social and 

23 emotional disability (in addition to any learning 

24 disability); 


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1 (B) who is at risk of developing serious 

2 mental illness and/or may show early signs of 

3 mental illness; and 

4 (C) who could benefit from early childhood 

5 intervention and specialized preschool or ele6 mentary school programs with the goal of pre7 venting or treating chronic and serious mental 

8 illness. 

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

10 under subsection (a) shall submit to the Secretary an ap11 plication at such time, in such manner, and containing 

12 such information as the Secretary may require. 

13 (d) USE OF FUNDS FOR EARLY CHILDHOOD INTER14 VENTION AND TREATMENT PROGRAMS.—An eligible enti15 ty shall use amounts awarded under a grant under sub16 section (a)(1) to carry out the following activities: 

17 (1) Deliver (or facilitate) for eligible children 

18 treatment and education, early childhood interven19 tion, and specialized preschool and elementary school 

20 programs, including the provision of medically based 

21 child care and early education services. 

22 (2) Treat and educate eligible children, includ23 ing startup, curricula development, operating and 

24 capital needs, staff and equipment, assessment and 

25 intervention services, administration and medication 


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1 requirements, enrollment costs, collaboration with 

2 primary care physicians and psychiatrists, other re3 lated services to meet emergency needs of children, 

4 and communication with families and medical pro5 fessionals concerning the children. 

6 (3) Develop and implement other strategies to 

7 address identified treatment and educational needs 

8 of eligible children that have reliable and valid eval9 uation modalities built into assess outcomes based 

10 on sound scientific metrics as determined by the 

11 NMHPL. 

12 (e) USE OF FUNDS FOR LONGITUDINAL STUDY.—In 

13 conducting a study on longitudinal outcomes through a 

14 grant under subsection (a)(2), an eligible entity shall in15 clude an analysis of— 

16 (1) the individuals treated and educated; 

17 (2) the success of such treatment and education 

18 in avoiding the onset of serious mental illness or the 

19 preparation of such children for the care and man20 agement of serious mental illness; 

21 (3) any evidence-based best practices generally 

22 applicable as a result of such treatment and edu23 cational techniques used with such children; and 

24 (4) the ability of programs to be replicated as 

25 a best practice model of intervention. 


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1 (f) REQUIREMENTS.—In carrying out this section, 

2 the Secretary shall ensure that each entity receiving a 

3 grant under subsection (a) maintains a written agreement 

4 with the Secretary, and provides regular written reports, 

5 as required by the Secretary, regarding the quality, effi6 ciency, and effectiveness of intervention and treatment for 

7 eligible children preventing or treating the development 

8 and onset of serious mental illness. 

9 (g) AMOUNT OF AWARDS.— 

10 (1) AMOUNTS FOR EARLY CHILDHOOD INTER11 VENTION AND TREATMENT PROGRAMS.—The 

12 amount of an award to an eligible entity under sub13 section (a)(1) shall be not more than $600,000 per 

14 fiscal year. 

15 (2) AMOUNTS FOR LONGITUDINAL STUDY.— 

16 The total amount of an award to an eligible entity 

17 under subsection (a)(2) (for one or more fiscal 

18 years) shall be not less than $1,000,000 and not 

19 greater than $2,000,000. 

20 (h) PROJECT TERMS.—The period of a grant— 

21 (1) for awards under subsection (a)(1), shall be 

22 not less than 3 fiscal years and not more than 10 

23 fiscal years; and 

24 (2) for awards under subsection (a)(2), shall be 

25 not more than 5 fiscal years. 


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1 (i) MATCHING FUNDS.—The Director of the 

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

3 eligible entity unless the eligible entity agrees, with respect 

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

5 out the activities described in subparagraph (D), to make 

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

7 toward such costs in an amount equal to not less than 

8 10 percent of Federal funds provided in the grant. 

9 (j) DEFINITIONS.—In this section: 

10 (1) The term ‘‘emergency room boarding’’ 

11 means the practice of admitting patients to an emer12 gency department and holding them in the depart13 ment until inpatient psychiatric beds become avail14 able. 

15 (2) The term ‘‘primary prevention’’ means pre16 vention that is designed to prevent a disease or con17 dition from occurring among the general population 

18 without regard to identifying the presence of risk 

19 factors or symptoms in the population. 

20 (k) FUNDING.—Of the amounts made available to 

21 carry out part E of title V of the Public Health Service 

22 Act (42 U.S.C. 290ff et seq.) for each of fiscal years 2016 

23 through 2021, not more than 5 percent of such amounts 

24 are authorized to be appropriated to carry out this section. 


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1 SEC. 205. EXTENSION OF ASSISTED OUTPATIENT TREAT2 MENT GRANT PROGRAM FOR INDIVIDUALS 

3 WITH SERIOUS MENTAL ILLNESS. 

4 Section 224 of the Protecting Access to Medicare Act 

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

6 (1) in subsection (e), by striking ‘‘and 2018’’ 

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

8 (2) in subsection (g)— 

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

10 and inserting ‘‘2020’’; 

11 (B) in paragraph (2)— 

12 (i) by striking ‘‘$15,000,000’’ and in13 serting ‘‘$20,000,000’’; and 

14 (ii) by striking ‘‘2018’’ and inserting 

15 ‘‘2020’’; and 

16 (C) by adding at the end the following: 

17 ‘‘(3) ALLOCATION.—Of the funds made avail18 able to carry out this section for a fiscal year, the 

19 Secretary shall allocate— 

20 ‘‘(A) 20 percent of such funds for existing 

21 assisted outpatient treatment programs; and 

22 ‘‘(B) 80 percent of such funds for new as23 sisted outpatient treatment programs.’’. 


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1 SEC. 206. BLOCK GRANTS. 

2 (a) BEST PRACTICES IN CLINICAL CARE MODELS.— 

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

4 300x–9) is amended by adding at the end the following: 

5 ‘‘(c) BEST PRACTICES IN CLINICAL CARE MOD6 ELS.—The Secretary, acting through the Director of the 

7 National Institute of Mental Health, shall obligate 5 per8 cent of the amounts appropriated for a fiscal year under 

9 subsection (a) for translating evidence-based (as defined 

10 in section 2 of the Helping Families in Mental Health Cri11 sis Act of 2015) interventions and best available science 

12 into systems of care, such as through models including— 

13 ‘‘(1) the Recovery After an Initial Schizo14 phrenia Episode research project of the National In15 stitute of Mental Health; and 

16 ‘‘(2) the North American Prodrome Longitu17 dinal Study.’’. 

18 (b) ADMINISTRATION OF BLOCK GRANTS BY ASSIST19 ANT SECRETARY.—Section 1911(a) of the Public Health 

20 Service Act (42 U.S.C. 300x) is amended by striking ‘‘act21 ing through the Director of the Center for Mental Health 

22 Services’’ and inserting ‘‘acting through the Assistant Sec23 retary for Mental Health and Substance Use Disorders’’. 

24 (c) ADDITIONAL PROGRAM REQUIREMENTS.— 


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

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

3 U.S.C. 300x–1(b)(1)) is amended— 

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

5 inserting: 

6 ‘‘(A) The plan provides’’; 

7 (B) in the subparagraph (A) inserted by 

8 paragraph (1), in the second sentence, by strik9 ing ‘‘health and mental health services’’ and in10 serting ‘‘integrated physical and mental health 

11 services’’; 

12 (C) in such subparagraph (A), by striking 

13 ‘‘The plan shall include’’ through the period at 

14 the end and inserting ‘‘The plan shall integrate 

15 and coordinate services to maximize the effi16 ciency, effectiveness, quality, coordination, and 

17 cost effectiveness of those services and pro18 grams to produce the best possible outcomes for 

19 those with serious mental illness.’’; and 

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

21 subparagraph: 

22 ‘‘(B) The plan shall include a separate de23 scription of case management services and pro24 vide for activities leading to reduction of rates 

25 of suicides, suicide attempts, substance abuse, 


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1 overdose deaths, emergency hospitalizations, in2 carceration, crimes, arrest, victimization, home3 lessness, joblessness, medication nonadherence, 

4 and education and vocational programs drop 

5 outs. The plan must also include a detailed list 

6 of services available for eligible patients (as de7 fined in subsection (d)(3)) in each county or 

8 county equivalent, including assisted outpatient 

9 treatment.’’. 

10 (2) DATA COLLECTION SYSTEM.—Subsection 

11 (b)(2) of section 1912 of the Public Health Service 

12 Act (42 U.S.C. 300x–1(b)(2)) is amended— 

13 (A) by striking ‘‘The plan contains an esti14 mate of’’ and inserting the following: ‘‘The plan 

15 contains— 

16 ‘‘(A) an estimate of’’; 

17 (B) in subparagraph (A), as inserted by 

18 paragraph (1), by inserting ‘‘, including reduc19 tions in homelessness, emergency hospitaliza20 tion, incarceration, and unemployment for eligi21 ble patients (as defined in subsection (d)(3)),’’ 

22 after ‘‘targets’’; 

23 (C) in such subparagraph, by striking the 

24 period at the end and inserting ‘‘; and’’; and 


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

2 subparagraph: 

3 ‘‘(B) an agreement by the State to report 

4 to the National Mental Health Policy Labora5 tory such data as may be required by the Sec6 retary concerning— 

7 ‘‘(i) comprehensive community mental 

8 health services in the State; and 

9 ‘‘(ii) public health outcomes for per10 sons with serious mental illness in the 

11 State, including rates of suicides, suicide 

12 attempts, substance abuse, overdose 

13 deaths, emergency hospitalizations, incar14 ceration, crimes, arrest, victimization, 

15 homelessness, joblessness, medication non16 adherence, and education and vocational 

17 programs drop outs.’’. 

18 (3) IMPLEMENTATION OF PLAN.—Subsection 

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

20 (42 U.S.C. 300x–1(d)) is amended— 

21 (A) in paragraph (1)— 

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

23 and inserting: 

24 ‘‘(A) Except as provided’’; and 


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1 (ii) by adding at the end the following 

2 new subparagraph: 

3 ‘‘(B) For eligible patients receiving treat4 ment through funds awarded under a grant 

5 under section 1911, a State shall include in the 

6 State plan for the first year beginning after the 

7 date of the enactment of this subparagraph and 

8 each subsequent year, a de-individualized re9 port, containing information that is open source 

10 and de-identified, on the services provided to 

11 those individuals, including— 

12 ‘‘(i) outcomes and the overall cost of 

13 such treatment provided; and 

14 ‘‘(ii) county or county equivalent level 

15 data on such patient population, including 

16 overall costs and raw number data on rates 

17 of involuntary inpatient and outpatient 

18 commitment orders, suicides, suicide at19 tempts, substance abuse, overdose deaths, 

20 emergency hospitalizations, incarceration, 

21 crimes, arrest, victimization, homelessness, 

22 joblessness, medication non-adherence, and 

23 education and vocational programs drop 

24 outs.’’; and 


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1 (B) by adding at the end the following new 

2 paragraph: 

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

4 ‘eligible patient’ means an adult mentally ill person 

5 who— 

6 ‘‘(A) may have a history of violence, incar7 ceration, or medically unnecessary hospitaliza8 tions; 

9 ‘‘(B) without supervision and treatment, 

10 may be a danger to self or others in the com11 munity; 

12 ‘‘(C) is substantially unlikely to voluntarily 

13 participate in treatment; 

14 ‘‘(D) may be unable, for reasons other 

15 than indigence, to provide for any of the basic 

16 needs of such person, such as food, clothing, 

17 shelter, health, or safety; 

18 ‘‘(E) with a history of mental illness or 

19 condition that is likely to substantially deterio20 rate if the person is not provided with timely 

21 treatment; 

22 ‘‘(F) due to mental illness, lacks capacity 

23 to fully understand or lacks judgment to make 

24 informed decisions regarding his or her need for 

25 treatment, care, or supervision; and 


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1 ‘‘(G) is likely to improve in mental health 

2 and reduce the symptoms of serious mental ill3 ness when in treatment.’’. 

4 (4) TREATMENT UNDER STATE LAW.— 

5 (A) IN GENERAL.—Section 1912 of the 

6 Public Health Service Act (42 U.S.C. 300x–1) 

7 is amended by adding at the end the following 

8 new subsections: 

9 ‘‘(e) ASSISTED OUTPATIENT TREATMENT UNDER

10 STATE LAW.— 

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

12 grant under section 1911 is that the State involved 

13 has in effect a law under which a State court may 

14 order a treatment plan for an eligible patient that— 

15 ‘‘(A) requires such patient to obtain out16 patient mental health treatment while the pa17 tient is living in a community; and 

18 ‘‘(B) is designed to improve access and ad19 herence by such patient to intensive behavioral 

20 health services in order to— 

21 ‘‘(i) avert relapse, repeated hos22 pitalizations, arrest, incarceration, suicide, 

23 property destruction, and violent behavior; 

24 and 


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1 ‘‘(ii) provide such patient with the op2 portunity to live in a less restrictive alter3 native to incarceration or involuntary hos4 pitalization. 

5 ‘‘(2) CERTIFICATION OF STATE COMPLIANCE.— 

6 A funding agreement described in paragraph (1) is 

7 effective only if the Assistant Secretary for Mental 

8 Health and Substance Use Disorders reviews the 

9 State law and certifies that it satisfies the criteria 

10 specified in such paragraph. 

11 ‘‘(f) TREATMENT STANDARD UNDER STATE LAW.— 

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

13 grant under section 1911 is that— 

14 ‘‘(A) the State involved has in effect a law 

15 under which, if a State court finds by clear and 

16 convincing evidence that an individual, as a re17 sult of mental illness, is a danger to self, is a 

18 danger to others, is persistently or acutely dis19 abled, or is gravely disabled and in need of 

20 treatment, and is either unwilling or unable to 

21 accept voluntary treatment, the court must 

22 order the individual to undergo inpatient or 

23 outpatient treatment; or 

24 ‘‘(B) the State involved has in effect a law 

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1 vidual with a mental illness to undergo inpa2 tient or outpatient treatment, the law was in ef3 fect on the date of enactment of the Helping 

4 Families in Mental Health Crisis Act of 2015, 

5 and the Secretary finds that the law requires a 

6 State court to order such treatment across all 

7 or a sufficient range of the type of cir8 cumstances described in subparagraph (A). 

9 ‘‘(2) DEFINITION.—For purposes of paragraph 

10 (1), the term ‘persistently or acutely disabled’ refers 

11 to a serious mental illness that meets all the fol12 lowing criteria: 

13 ‘‘(A) If not treated, the illness has a sub14 stantial probability of causing the individual to 

15 suffer or continue to suffer severe and abnor16 mal mental, emotional, or physical harm that 

17 significantly impairs judgment, reason, behav18 ior, or capacity to recognize reality. 

19 ‘‘(B) The illness substantially impairs the 

20 individual’s capacity to make an informed deci21 sion regarding treatment, and this impairment 

22 causes the individual to be incapable of under23 standing and expressing an understanding of 

24 the advantages and disadvantages of accepting 

25 treatment and understanding and expressing an 


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1 understanding of the alternatives to the par2 ticular treatment offered after the advantages, 

3 disadvantages, and alternatives are explained to 

4 that individual. 

5 ‘‘(C) The illness has a reasonable prospect 

6 of being treatable by outpatient, inpatient, or 

7 combined inpatient and outpatient treatment.’’. 

8 (B) FUNDING INCREASE.—Section 1918 of 

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

10 7) is amended— 

11 (i) in subsection (a)(1), by striking 

12 ‘‘subsection (b)’’ and inserting ‘‘sub13 sections (b) and (d)’’; and 

14 (ii) by adding at the end the following 

15 new subsection: 

16 ‘‘(d) INCREASE FOR CERTAIN STATES.—With respect 

17 to fiscal year 2016 and each subsequent fiscal year, in the 

18 case of a State that has in effect a law described in sub19 section (e)(1) or subparagraph (A) or (B) of subsection 

20 (f)(1), the amount of the allotment of a State under sec21 tion 1911 shall be for such fiscal year the amount that 

22 would otherwise be determined, without application of this 

23 subsection, for such State for such fiscal year, increased 

24 by 2 percent.’’. 


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1 (5) EVIDENCE-BASED SERVICES DELIVERY

2 MODELS.—Section 1912 of the Public Health Serv3 ice Act (42 U.S.C. 300x–1), as amended by para4 graph (4), is further amended by adding at the end 

5 the following new subsection: 

6 ‘‘(g) EXPANSION OF MODELS.— 

7 ‘‘(1) IN GENERAL.—Taking into account the re8 sults of evaluations under section 201(a)(2)(C) of 

9 the Helping Families in Mental Health Crisis Act of 

10 2015, the Assistant Secretary may, by rule, as part 

11 of the program of block grants under this subpart, 

12 provide for expanded use across the Nation of evi13 dence-based service delivery models by providers 

14 funded under such block grants, so long as— 

15 ‘‘(A) the Assistant Secretary for Mental 

16 Health and Substance Use Disorders (in this 

17 subsection referred to as the ‘Assistant Sec18 retary’) determines that such expansion will— 

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

20 funds under such block grants without re21 ducing the quality of care; or 

22 ‘‘(ii) improve the quality of patient 

23 care without significantly increasing spend24 ing; 


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

2 of Mental Health determines that such expan3 sion would improve the quality of patient care; 

4 and 

5 ‘‘(C) the Assistant Secretary determines 

6 that the change will— 

7 ‘‘(i) significantly reduce severity and 

8 duration of symptoms of mental illness; 

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

10 attempts, substance abuse, overdose, emer11 gency hospitalizations, emergency room 

12 boarding, incarceration, crime, arrest, vic13 timization, homelessness, or joblessness; or 

14 ‘‘(iii) significantly improve the quality 

15 of patient care and mental health crisis 

16 outcomes without significantly increasing 

17 spending. 

18 ‘‘(2) CONGRESSIONAL REVIEW.—Any rule pro19 mulgated pursuant to paragraph (1) is deemed to be 

20 a major rule subject to congressional review and dis21 approval under chapter 8 of title 5, United States 

22 Code. 

23 ‘‘(3) DEFINITION.—In this subsection, the term 

24 ‘emergency room boarding’ means the practice of ad25 mitting patients to an emergency department and 


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1 holding them in the department until inpatient psy2 chiatric beds become available.’’. 

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

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

5 300x–2), as amended, is further amended by adding at 

6 the end the following: 

7 ‘‘(d) PERIOD FOR EXPENDITURE OF GRANT

8 FUNDS.—In implementing a plan submitted under section 

9 1912(a), a State receiving grant funds under section 1911 

10 may make such funds available to providers of services de11 scribed in subsection (b) for the provision of services with12 out fiscal year limitation.’’. 

13 (e) ACTIVE OUTREACH AND ENGAGEMENT.—Section 

14 1915 of the Public Health Service Act (42 U.S.C. 300x– 

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

16 ‘‘(c) ACTIVE OUTREACH AND ENGAGEMENT TO PER17 SONS WITH SERIOUS MENTAL ILLNESS.—A funding 

18 agreement for a grant under section 1911 is that the State 

19 involved has in effect active programs, including assisted 

20 outpatient treatment, to engage persons with serious men21 tal illness who are substantially unlikely to voluntarily 

22 seek treatment, in comprehensive services in order to avert 

23 relapse, repeated hospitalizations, arrest, incarceration, 

24 and suicide to provide the patient with the opportunity 

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1 fined in section 2 of the Helping Families in Mental 

2 Health Crisis Act of 2015) assertive outreach and engage3 ment services targeting individuals that are homeless, have 

4 co-occurring disorders, or have a history of treatment fail5 ure. The Assistant Secretary for Mental Health and Sub6 stance Use Disorders shall work with the Director of the 

7 National Institute of Mental Health to develop a list of 

8 such evidence-based (as defined in section 2 of the Helping 

9 Families in Mental Health Crisis Act of 2015) assertive 

10 outreach and engagement services, as well as criteria to 

11 be used to assess the scope and effectiveness of such ap12 proaches. These programs may include assistant out13 patient treatment programs under State law where State 

14 courts may order a treatment plan for an eligible patient 

15 that requires— 

16 ‘‘(1) such patient to obtain outpatient mental 

17 health treatment while the patient is living in the 

18 community; and 

19 ‘‘(2) a design to improve access and adherence 

20 by such patient to intensive mental health services.’’. 

21 SEC. 207. WORKFORCE DEVELOPMENT. 

22 (a) TELEPSYCHIATRY AND PRIMARY CARE PHYSI23 CIAN TRAINING GRANT PROGRAM.— 

24 (1) IN GENERAL.—The Assistant Secretary of 

25 Mental Health and Substance Use Disorders (in this 


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1 subsection referred to as the ‘‘Assistant Secretary’’) 

2 shall establish a grant program (in this subsection 

3 referred to as the ‘‘grant program’’) under which the 

4 Assistant Secretary shall award to 10 eligible States 

5 (as described in paragraph (5)) grants for carrying 

6 out all of the purposes described in paragraphs (2), 

7 (3), and (4). 

8 (2) TRAINING PROGRAM FOR CERTAIN PRIMARY

9 CARE PHYSICIANS.—For purposes of paragraph (1), 

10 the purpose described in this paragraph, with re11 spect to a grant awarded to a State under the grant 

12 program, is for the State to establish a training pro13 gram to train primary care physicians in— 

14 (A) valid and reliable behavioral-health 

15 screening tools for violence and suicide risk, 

16 early signs of serious mental illness, and un17 treated substance abuse, including any stand18 ardized behavioral-health screening tools that 

19 are determined appropriate by the Assistant 

20 Secretary; 

21 (B) implementing the use of behavioral22 health screening tools in their practices; 

23 (C) establishment of recommended inter24 vention and treatment protocols for individuals 

25 in mental health crisis, especially for individuals 


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1 whose illness makes them less receptive to men2 tal health services; and 

3 (D) implementing the evidence-based col4 laborative care model of integrated medical-be5 havioral health care in their practices. 

6 (3) PAYMENTS FOR MENTAL HEALTH SERVICES

7 PROVIDED BY CERTAIN PRIMARY CARE PHYSI8 CIANS.— 

9 (A) IN GENERAL.—For purposes of para10 graph (1), the purpose described in this para11 graph, with respect to a grant awarded to a 

12 State under the grant program, is for the State 

13 to provide, in accordance with this paragraph, 

14 in the case of a primary care physician who 

15 participates in the training program of the 

16 State establish pursuant to paragraph (2), pay17 ments to the primary care physician for services 

18 furnished by the primary care physician. 

19 (B) CONSIDERATIONS.—The Assistant 

20 Secretary, in determining the structure, quality, 

21 and form of payment under subparagraph (A) 

22 shall seek to find innovative payment systems 

23 which may take into account— 

24 (i) the nature and quality of services 

25 rendered; 


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1 (ii) the patients’ health outcome; 

2 (iii) the geographical location where 

3 services were provided; 

4 (iv) the acuteness of the patient’s 

5 medical condition; 

6 (v) the duration of services provided; 

7 (vi) the feasibility of replicating the 

8 payment model in other locations nation9 wide; and 

10 (vii) proper triage and enduring link11 age to appropriate treatment provider for 

12 subspecialty care in child or forensic 

13 issues; family crisis intervention; drug or 

14 alcohol rehabilitation; management of sui15 cidal or violent behavior risk, and treat16 ment for serious mental illness. 

17 (4) TELEHEALTH SERVICES FOR MENTAL

18 HEALTH DISORDERS.— 

19 (A) IN GENERAL.—For purposes of para20 graph (1), the purpose described in this para21 graph, with respect to a grant awarded to a 

22 State under the grant program, is for the State 

23 to provide, in the case of an individual fur24 nished items and services by a primary care 

25 physician during an office visit, for payment for 


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1 a consultation provided by a psychiatrist or psy2 chologist to such physician with respect to such 

3 individual through the use of qualified tele4 health technology for the identification, diag5 nosis, mitigation, or treatment of a mental 

6 health disorder if such consultation occurs not 

7 later than the first business day that follows 

8 such visit. 

9 (B) QUALIFIED TELEHEALTH TECH10 NOLOGY.—For purposes of subparagraph (A), 

11 the term ‘‘qualified telehealth technology’’, with 

12 respect to the provision of items and services to 

13 a patient by a health care provider, includes the 

14 use of interactive audio, audio-only telephone 

15 conversation, video, or other telecommuni16 cations technology by a health care provider to 

17 deliver health care services within the scope of 

18 the provider’s practice at a site other than the 

19 site where the patient is located, including the 

20 use of electronic media for consultation relating 

21 to the health care diagnosis or treatment of the 

22 patient. 

23 (5) ELIGIBLE STATE.— 

24 (A) IN GENERAL.—For purposes of this 

25 subsection, an eligible State is a State that has 


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1 submitted to the Assistant Secretary an appli2 cation under subparagraph (B) and has been 

3 selected under subparagraph (D). 

4 (B) APPLICATION.—A State seeking to 

5 participate in the grant program under this 

6 subsection shall submit to the Assistant Sec7 retary, at such time and in such format as the 

8 Assistant Secretary requires, an application 

9 that includes such information, provisions, and 

10 assurances as the Assistant Secretary may re11 quire. 

12 (C) MATCHING REQUIREMENT.—The As13 sistant Secretary may not make a grant under 

14 the grant program unless the State involved 

15 agrees, with respect to the costs to be incurred 

16 by the State in carrying out the purposes de17 scribed in this subsection, to make available 

18 non-Federal contributions (in cash or in kind) 

19 toward such costs in an amount equal to not 

20 less than 20 percent of Federal funds provided 

21 in the grant. 

22 (D) SELECTION.—A State shall be deter23 mined eligible for the grant program by the As24 sistant Secretary on a competitive basis among 

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1 ments of subparagraphs (B) and (C). In select2 ing State applications for the grant program, 

3 the Secretary shall seek to achieve an appro4 priate national balance in the geographic dis5 tribution of grants awarded under the grant 

6 program. 

7 (6) TARGET POPULATION.—In seeking a grant 

8 under this subsection, a State shall demonstrate how 

9 the grant will improve care for individuals with co10 occurring behavioral health and physical health con11 ditions, vulnerable populations, socially isolated pop12 ulations, rural populations, and other populations 

13 who have limited access to qualified mental health 

14 providers. 

15 (7) LENGTH OF GRANT PROGRAM.—The grant 

16 program under this subsection shall be conducted for 

17 a period of 3 consecutive years. 

18 (8) PUBLIC AVAILABILITY OF FINDINGS AND

19 CONCLUSIONS.—Subject to Federal privacy protec20 tions with respect to individually identifiable infor21 mation, the Assistant Secretary shall make the find22 ings and conclusions resulting from the grant pro23 gram under this subsection available to the public. 

24 (9) AUTHORIZATION OF APPROPRIATIONS.—Out 

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1 priated, there is authorized to be appropriated to 

2 carry out this subsection, $3,000,000 for each of the 

3 fiscal years 2016 through 2020. 

4 (10) REPORTS.— 

5 (A) REPORTS.—For each fiscal year that 

6 grants are awarded under this subsection, the 

7 Assistant Secretary and the National Mental 

8 Health Policy Laboratory shall conduct a study 

9 on the results of the grants and submit to the 

10 Congress a report on such results that includes 

11 the following: 

12 (i) An evaluation of the grant pro13 gram outcomes, including a summary of 

14 activities carried out with the grant and 

15 the results achieved through those activi16 ties. 

17 (ii) Recommendations on how to im18 prove access to mental health services at 

19 grantee locations. 

20 (iii) An assessment of access to men21 tal health services under the program. 

22 (iv) An assessment of the impact of 

23 the demonstration project on the costs of 

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1 cluding inpatient, emergency and ambula2 tory care). 

3 (v) Recommendations on congres4 sional action to improve the grant. 

5 (vi) Recommendations to improve 

6 training of primary care physicians. 

7 (B) REPORT.—Not later than December 

8 31, 2018, the Assistant Secretary and the Na9 tional Mental Health Policy Laboratory shall 

10 submit to Congress and make available to the 

11 public a report on the findings of the evaluation 

12 under subparagraph (A) and also a policy out13 line on how Congress can expand the grant pro14 gram to the national level. 

15 (b) LIABILITY PROTECTIONS FOR HEALTH CARE

16 PROFESSIONAL VOLUNTEERS AT COMMUNITY HEALTH

17 CENTERS AND FEDERALLY QUALIFIED COMMUNITY BE18 HAVIORAL HEALTH CLINICS.—Section 224 of the Public 

19 Health Service Act (42 U.S.C. 233) is amended by adding 

20 at the end the following: 

21 ‘‘(q)(1) In this subsection, the term ‘federally quali22 fied community behavioral health clinic’ means— 

23 ‘‘(A) a federally qualified community behavioral 

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1 tion 223 of the Protecting Access to Medicare Act 

2 of 2014; or 

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

4 the criteria specified in section 1913(c) of this Act. 

5 ‘‘(2) For purposes of this section, a health care pro6 fessional volunteer at an entity described in subsection 

7 (g)(4) or a federally qualified community behavioral health 

8 clinic shall, in providing health care services eligible for 

9 funding under section 330 or subpart I of part B of title 

10 XIX to an individual, be deemed to be an employee of the 

11 Public Health Service for a calendar year that begins dur12 ing a fiscal year for which a transfer was made under 

13 paragraph (5)(C). The preceding sentence is subject to the 

14 provisions of this subsection. 

15 ‘‘(3) In providing a health care service to an indi16 vidual, a health care professional shall for purposes of this 

17 subsection be considered to be a health professional volun18 teer at an entity described in subsection (g)(4) or at a 

19 federally qualified community behavioral health clinic if 

20 the following conditions are met: 

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

22 the facilities of an entity described in subsection 

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

24 health clinic, or through offsite programs or events 

25 carried out by the center. 


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

2 health care professional volunteer pursuant to para3 graph (4)(B). 

4 ‘‘(C) The health care professional does not re5 ceive any compensation for the service from the indi6 vidual or from any third-party payer (including re7 imbursement under any insurance policy or health 

8 plan, or under any Federal or State health benefits 

9 program), except that the health care professional 

10 may receive repayment from the entity described in 

11 subsection (g)(4) or the center for reasonable ex12 penses incurred by the health care professional in 

13 the provision of the service to the individual. 

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

15 care professional or the center or entity described in 

16 subsection (g)(4) posts a clear and conspicuous no17 tice at the site where the service is provided of the 

18 extent to which the legal liability of the health care 

19 professional is limited pursuant to this subsection. 

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

21 health care professional is licensed or certified in ac22 cordance with applicable law regarding the provision 

23 of the service. 

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

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


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1 professional for purposes of this subsection to the same 

2 extent and in the same manner as such subsections apply 

3 to an officer, governing board member, employee, or con4 tractor of an entity described in subsection (g)(4), subject 

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

6 ‘‘(A) The first sentence of paragraph (2) ap7 plies in lieu of the first sentence of subsection 

8 (g)(1)(A). 

9 ‘‘(B) With respect to an entity described in sub10 section (g)(4) or a federally qualified community be11 havioral health clinic, a health care professional is 

12 not a health professional volunteer at such center 

13 unless the center sponsors the health care profes14 sional. For purposes of this subsection, the center 

15 shall be considered to be sponsoring the health care 

16 professional if— 

17 ‘‘(i) with respect to the health care profes18 sional, the center submits to the Secretary an 

19 application meeting the requirements of sub20 section (g)(1)(D); and 

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

22 (g)(1)(E), determines that the health care pro23 fessional is deemed to be an employee of the 

24 Public Health Service. 


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

2 who is determined by the Secretary pursuant to sub3 section (g)(1)(E) to be a health professional volun4 teer at such center, this subsection applies to the 

5 health care professional (with respect to services de6 scribed in paragraph (2)) for any cause of action 

7 arising from an act or omission of the health care 

8 professional occurring on or after the date on which 

9 the Secretary makes such determination. 

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

11 professional volunteer for purposes of this subsection 

12 only to the extent that, in providing health services 

13 to an individual, each of the conditions specified in 

14 paragraph (3) is met. 

15 ‘‘(5)(A) Amounts in the fund established under sub16 section (k)(2) shall be available for transfer under sub17 paragraph (C) for purposes of carrying out this subsection 

18 for health professional volunteers at entities described in 

19 subsection (g)(4). 

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

21 Attorney General, in consultation with the Secretary, shall 

22 submit to the Congress a report providing an estimate of 

23 the amount of claims (together with related fees and ex24 penses of witnesses) that, by reason of the acts or omis25 sions of health care professional volunteers, will be paid 


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1 pursuant to this subsection during the calendar year that 

2 begins in the following fiscal year. Subsection (k)(1)(B) 

3 applies to the estimate under the preceding sentence re4 garding health care professional volunteers to the same 

5 extent and in the same manner as such subsection applies 

6 to the estimate under such subsection regarding officers, 

7 governing board members, employees, and contractors of 

8 entities described in subsection (g)(4). 

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

10 the Secretary shall transfer from the fund under sub11 section (k)(2) to the appropriate accounts in the Treasury 

12 an amount equal to the estimate made under subpara13 graph (B) for the calendar year beginning in such fiscal 

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

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

16 2017, except as provided in subparagraph (B). 

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

18 subsection— 

19 ‘‘(i) the Secretary may issue regulations for car20 rying out this subsection, and the Secretary may ac21 cept and consider applications submitted pursuant to 

22 paragraph (4)(B); and 

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

24 submitted to the Congress.’’. 


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1 (c) MINORITY FELLOWSHIP PROGRAM.—Title V of 

2 the Public Health Service Act (42 U.S.C. 290aa et seq.), 

3 as amended, is further amended by adding at the end the 

4 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 $6,000,000 for each of fiscal years 2016 through 

8 2020.’’. 

9 (d) NATIONAL HEALTH SERVICE CORPS.— 

10 (1) DEFINITIONS.— 

11 (A) PRIMARY HEALTH SERVICES.—Section 

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

13 (42 U.S.C. 254d(a)(3)) is amended by inserting 

14 ‘‘(including pediatric mental health subspecialty 

15 services)’’ after ‘‘pediatrics’’. 

16 (B) BEHAVIORAL AND MENTAL HEALTH

17 PROFESSIONALS.—Clause (i) of section 

18 331(a)(3)(E)(i) of the Public Health Service 

19 Act (42 U.S.C. 254d(a)(3)(E)(i)) is amended 

20 by inserting ‘‘(and pediatric subspecialists 

21 thereof)’’ before the period at the end. 

22 (C) HEALTH PROFESSIONAL SHORTAGE

23 AREA.—Section 332(a)(1) of the Public Health 

24 Service Act is amended by inserting ‘‘(including 


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1 children and adolescents)’’ after ‘‘population 

2 group’’. 

3 (D) MEDICAL FACILITY.—Section 

4 332(a)(2)(A) of the Public Health Service Act 

5 is amended by inserting ‘‘medical residency or 

6 fellowship training site for training in child and 

7 adolescent psychiatry,’’ before ‘‘facility operated 

8 by a city or county health department,’’. 

9 (2) ELIGIBILITY TO PARTICIPATE IN LOAN RE10 PAYMENT PROGRAM.—Section 338A(b)(1)(B) of the 

11 Public Health Service Act (42 U.S.C. 254l– 

12 1(b)(1)(B)) is amended by inserting ‘‘, including any 

13 physician child and adolescent psychiatry residency 

14 or fellowship training program’’ after ‘‘be enrolled in 

15 an approved graduate training program in medicine, 

16 osteopathic medicine, dentistry, behavioral and men17 tal health, or other health profession’’. 

18 (e) CRISIS INTERVENTION GRANTS FOR POLICE OF19 FICERS AND FIRST RESPONDERS.— 

20 (1) GRANTS.—The Assistant Secretary may 

21 award grants to provide specialized training to law 

22 enforcement officers, corrections officers, para23 medics, emergency medical services workers, and 

24 other first responders (including village public safety 

25 officers (as defined in section 247 of the Indian Arts 


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1 and Crafts Amendments Act of 2010 (42 U.S.C. 

2 3796dd note)))— 

3 (A) to recognize individuals who have men4 tal illness and how to properly intervene with 

5 individuals with mental illness; and 

6 (B) to establish programs that enhance the 

7 ability of law enforcement agencies to address 

8 the mental health, behavioral, and substance 

9 use problems of individuals encountered in the 

10 line of duty. 

11 (2) FUNDING.—Of the amounts made available 

12 to carry out sections 501, 509, 516, and 520A of the 

13 Public Health Service Act for a fiscal year, 5 per14 cent of such amounts are authorized to be used to 

15 carry out this subsection. 

16 SEC. 208. AUTHORIZED GRANTS AND PROGRAMS. 

17 (a) CHILDREN’S RECOVERY FROM TRAUMA.—Sec18 tion 582 of the Public Health Service Act (42 U.S.C. 

19 290hh–1) is amended— 

20 (1) in subsection (a), by striking ‘‘developing 

21 programs’’ and all that follows and inserting the fol22 lowing: ‘‘developing and maintaining programs that 

23 provide for— 

24 ‘‘(1) the continued operation of the National 

25 Child Traumatic Stress Initiative (referred to in this 


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1 section as the ‘NCTSI’), which includes a coordi2 nating center, that focuses on the mental, behav3 ioral, and biological aspects of psychological trauma 

4 response; and 

5 ‘‘(2) the development of knowledge with regard 

6 to evidence-based (as defined in section 2 of the 

7 Helping Families in Mental Health Crisis Act of 

8 2015) practices for identifying and treating mental, 

9 behavioral, and biological disorders of children and 

10 youth resulting from witnessing or experiencing a 

11 traumatic event.’’; 

12 (2) in subsection (b)— 

13 (A) by striking ‘‘subsection (a) related’’ 

14 and inserting ‘‘subsection (a)(2) (related’’; 

15 (B) by striking ‘‘treating disorders associ16 ated with psychological trauma’’ and inserting 

17 ‘‘treating mental, behavioral, and biological dis18 orders associated with psychological trauma)’’; 

19 and 

20 (C) by striking ‘‘mental health agencies 

21 and programs that have established clinical and 

22 basic research’’ and inserting ‘‘universities, hos23 pitals, mental health agencies, and other pro24 grams that have established clinical expertise 

25 and research’’; 


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1 (3) by redesignating subsections (c) through (g) 

2 as subsections (g) through (k), respectively; 

3 (4) by inserting after subsection (b), the fol4 lowing: 

5 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi6 nating center shall collect, analyze, and report NCTSI7 wide child treatment process and outcome data regarding 

8 the early identification and delivery of evidence-based (as 

9 defined in section 2 of the Helping Families in Mental 

10 Health Crisis Act of 2015) treatment and services for chil11 dren and families served by the NCTSI grantees. 

12 ‘‘(d) TRAINING.—The NCTSI coordinating center 

13 shall facilitate the coordination of training initiatives in 

14 evidence-based (as defined in section 2 of the Helping 

15 Families in Mental Health Crisis Act of 2015) and trau16 ma-informed treatments, interventions, and practices of17 fered to NCTSI grantees, providers, and partners. 

18 ‘‘(e) DISSEMINATION.—The NCTSI coordinating 

19 center shall, as appropriate, collaborate with the Secretary 

20 in the dissemination of evidence-based and trauma-in21 formed interventions, treatments, products, and other re22 sources to appropriate stakeholders. 

23 ‘‘(f) REVIEW.—The Secretary shall, consistent with 

24 the peer-review process, ensure that NCTSI applications 

25 are reviewed by appropriate experts in the field as part 


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1 of a consensus review process. The Secretary shall include 

2 review criteria related to expertise and experience in child 

3 trauma and evidence-based (as defined in section 2 of the 

4 Helping Families in Mental Health Crisis Act of 2015) 

5 practices.’’; 

6 (5) in subsection (g) (as so redesignated), by 

7 striking ‘‘with respect to centers of excellence are 

8 distributed equitably among the regions of the coun9 try’’ and inserting ‘‘are distributed equitably among 

10 the regions of the United States’’; 

11 (6) in subsection (i) (as so redesignated), by 

12 striking ‘‘recipient may not exceed 5 years’’ and in13 serting ‘‘recipient shall not be less than 4 years, but 

14 shall not exceed 5 years’’; and 

15 (7) in subsection (j) (as so redesignated), by 

16 striking ‘‘$50,000,000’’ and all that follows through 

17 ‘‘2006’’ and inserting ‘‘$45,713,000 for each of fis18 cal years 2014 through 2018’’. 

19 (b) REDUCING THE STIGMA OF SERIOUS MENTAL

20 ILLNESS.— 

21 (1) IN GENERAL.—The Secretary of Education, 

22 along with the Assistant Secretary for Mental 

23 Health and Substance Use Disorders, shall organize 

24 a national awareness campaign involving public 

25 health organizations, advocacy groups for persons 


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1 with serious mental illness, and social media compa2 nies to assist secondary school students and postsec3 ondary students in— 

4 (A) reducing the stigma associated with se5 rious mental illness; 

6 (B) understanding how to assist an indi7 vidual who is demonstrating signs of a serious 

8 mental illness; and 

9 (C) understanding the importance of seek10 ing treatment from a physician, clinical psychol11 ogist, or licensed mental health professional 

12 when a student believes the student may be suf13 fering from a serious mental illness or behav14 ioral health disorder. 

15 (2) DATA COLLECTION.—The Secretary of Edu16 cation shall— 

17 (A) evaluate the program under subsection 

18 (a) on public health to determine whether the 

19 program has made an impact on public health, 

20 including mortality rates of persons with seri21 ous mental illness, prevalence of serious mental 

22 illness, physician and clinical psychological vis23 its, emergency room visits; and 


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1 (B) submit a report on the evaluation to 

2 the National Mental Health Policy Laboratory 

3 created by title I of this Act. 

4 (3) SECONDARY SCHOOL DEFINED.—For pur5 poses of this section, the term ‘‘secondary school’’ 

6 has the meaning given the term in section 9101 of 

7 the Elementary and Secondary Education Act of 

8 1965 (20 U.S.C. 7801). 

9 (c) GARRETT LEE SMITH REAUTHORIZATION.— 

10 (1) SUICIDE PREVENTION TECHNICAL ASSIST11 ANCE CENTER.—Section 520C of the Public Health 

12 Service Act (42 U.S.C. 290bb–34) is amended to 

13 read as follows: 

14 ‘‘SEC. 520C. SUICIDE PREVENTION TECHNICAL ASSISTANCE 

15 CENTER. 

16 ‘‘(a) PROGRAM AUTHORIZED.—The Assistant Sec17 retary for Mental Health and Substance Use Disorders 

18 shall award a grant for the operation and maintenance 

19 of a research, training, and technical assistance resource 

20 center to provide appropriate information, training, and 

21 technical assistance to States, political subdivisions of 

22 States, federally recognized Indian tribes, tribal organiza23 tions, institutions of higher education, public organiza24 tions, or private nonprofit organizations concerning the 


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1 prevention of suicide among all ages, particularly among 

2 groups that are at high risk for suicide. 

3 ‘‘(b) RESPONSIBILITIES OF THE CENTER.—The cen4 ter operated and maintained under subsection (a) shall— 

5 ‘‘(1) assist in the development or continuation 

6 of statewide and tribal suicide early intervention and 

7 prevention strategies for all ages, particularly among 

8 groups that are at high risk for suicide; 

9 ‘‘(2) ensure the surveillance of suicide early 

10 intervention and prevention strategies for all ages, 

11 particularly among groups that are at high risk for 

12 suicide; 

13 ‘‘(3) study the costs and effectiveness of state14 wide and tribal suicide early intervention and pre15 vention strategies in order to provide information 

16 concerning relevant issues of importance to State, 

17 tribal, and national policymakers; 

18 ‘‘(4) further identify and understand causes 

19 and associated risk factors for suicide for all ages, 

20 particularly among groups that are at high risk for 

21 suicide; 

22 ‘‘(5) analyze the efficacy of new and existing 

23 suicide early intervention and prevention techniques 

24 and technology for all ages, particularly among 

25 groups that are at high risk for suicide; 


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1 ‘‘(6) ensure the surveillance of suicidal behav2 iors and nonfatal suicidal attempts; 

3 ‘‘(7) study the effectiveness of State-sponsored 

4 statewide and tribal suicide early intervention and 

5 prevention strategies for all ages particularly among 

6 groups that are at high risk for suicide on the over7 all wellness and health promotion strategies related 

8 to suicide attempts; 

9 ‘‘(8) promote the sharing of data regarding sui10 cide with Federal agencies involved with suicide 

11 early intervention and prevention, and State-spon12 sored statewide and tribal suicide early intervention 

13 and prevention strategies for the purpose of identi14 fying previously unknown mental health causes and 

15 associated risk factors for suicide among all ages 

16 particularly among groups that are at high risk for 

17 suicide; 

18 ‘‘(9) evaluate and disseminate outcomes and 

19 best practices of mental health and substance use 

20 disorder services at institutions of higher education; 

21 and 

22 ‘‘(10) conduct other activities determined ap23 propriate by the Secretary. 

24 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 

25 purpose of carrying out this section, there are authorized 


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1 to be appropriated $4,957,000 for each of the fiscal years 

2 2016 through 2020.’’. 

3 (2) YOUTH SUICIDE INTERVENTION AND PRE4 VENTION STRATEGIES.—Section 520E of the Public 

5 Health Service Act (42 U.S.C. 290bb–36) is amend6 ed to read as follows: 

7 ‘‘SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND 

8 PREVENTION STRATEGIES. 

9 ‘‘(a) IN GENERAL.—The Secretary, acting through 

10 the Assistant Secretary, shall award grants or cooperative 

11 agreements to eligible entities to— 

12 ‘‘(1) develop and implement State-sponsored 

13 statewide or tribal youth suicide early intervention 

14 and prevention strategies in schools, educational in15 stitutions, juvenile justice systems, substance use 

16 disorder programs, mental health programs, foster 

17 care systems, and other child and youth support or18 ganizations; 

19 ‘‘(2) support public organizations and private 

20 nonprofit organizations actively involved in State21 sponsored statewide or tribal youth suicide early 

22 intervention and prevention strategies and in the de23 velopment and continuation of State-sponsored 

24 statewide youth suicide early intervention and pre25 vention strategies; 


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1 ‘‘(3) provide grants to institutions of higher 

2 education to coordinate the implementation of State3 sponsored or tribal youth suicide early intervention 

4 and prevention strategies; 

5 ‘‘(4) collect and analyze data on State-spon6 sored statewide or tribal youth suicide early inter7 vention and prevention services that can be used to 

8 monitor the effectiveness of such services and for re9 search, technical assistance, and policy development; 

10 and 

11 ‘‘(5) assist eligible entities, through State-spon12 sored statewide or tribal youth suicide early inter13 vention and prevention strategies, in achieving tar14 gets for youth suicide reductions under title V of the 

15 Social Security Act. 

16 ‘‘(b) ELIGIBLE ENTITY.— 

17 ‘‘(1) DEFINITION.—In this section, the term 

18 ‘eligible entity’ means— 

19 ‘‘(A) a State; 

20 ‘‘(B) a public organization or private non21 profit organization designated by a State to de22 velop or direct the State-sponsored statewide 

23 youth suicide early intervention and prevention 

24 strategy; or 


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1 ‘‘(C) a federally recognized Indian tribe or 

2 tribal organization (as defined in the Indian 

3 Self-Determination and Education Assistance 

4 Act) or an urban Indian organization (as de5 fined in the Indian Health Care Improvement 

6 Act) that is actively involved in the development 

7 and continuation of a tribal youth suicide early 

8 intervention and prevention strategy. 

9 ‘‘(2) LIMITATION.—In carrying out this section, 

10 the Secretary shall ensure that a State does not re11 ceive more than one grant or cooperative agreement 

12 under this section at any one time. For purposes of 

13 the preceding sentence, a State shall be considered 

14 to have received a grant or cooperative agreement if 

15 the eligible entity involved is the State or an entity 

16 designated by the State under paragraph (1)(B). 

17 Nothing in this paragraph shall be construed to 

18 apply to entities described in paragraph (1)(C). 

19 ‘‘(c) PREFERENCE.—In providing assistance under a 

20 grant or cooperative agreement under this section, an eli21 gible entity shall give preference to public organizations, 

22 private nonprofit organizations, political subdivisions, in23 stitutions of higher education, and tribal organizations ac24 tively involved with the State-sponsored statewide or tribal 


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1 youth suicide early intervention and prevention strategy 

2 that— 

3 ‘‘(1) provide early intervention and assessment 

4 services, including screening programs, to youth who 

5 are at risk for mental or emotional disorders that 

6 may lead to a suicide attempt, and that are inte7 grated with school systems, educational institutions, 

8 juvenile justice systems, substance use disorder pro9 grams, mental health programs, foster care systems, 

10 and other child and youth support organizations; 

11 ‘‘(2) demonstrate collaboration among early 

12 intervention and prevention services or certify that 

13 entities will engage in future collaboration; 

14 ‘‘(3) employ or include in their applications a 

15 commitment to evaluate youth suicide early interven16 tion and prevention practices and strategies adapted 

17 to the local community; 

18 ‘‘(4) provide timely referrals for appropriate 

19 community-based mental health care and treatment 

20 of youth who are at risk for suicide in child-serving 

21 settings and agencies; 

22 ‘‘(5) provide immediate support and informa23 tion resources to families of youth who are at risk 

24 for suicide; 


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1 ‘‘(6) offer access to services and care to youth 

2 with diverse linguistic and cultural backgrounds; 

3 ‘‘(7) offer appropriate postsuicide intervention 

4 services, care, and information to families, friends, 

5 schools, educational institutions, juvenile justice sys6 tems, substance use disorder programs, mental 

7 health programs, foster care systems, and other 

8 child and youth support organizations of youth who 

9 recently completed suicide; 

10 ‘‘(8) offer continuous and up-to-date informa11 tion and awareness campaigns that target parents, 

12 family members, child care professionals, community 

13 care providers, and the general public and highlight 

14 the risk factors associated with youth suicide and 

15 the life-saving help and care available from early 

16 intervention and prevention services; 

17 ‘‘(9) ensure that information and awareness 

18 campaigns on youth suicide risk factors, and early 

19 intervention and prevention services, use effective 

20 communication mechanisms that are targeted to and 

21 reach youth, families, schools, educational institu22 tions, and youth organizations; 

23 ‘‘(10) provide a timely response system to en24 sure that child-serving professionals and providers 

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1 tion and prevention strategies and that child-serving 

2 professionals and providers involved in early inter3 vention and prevention services are properly trained 

4 in effectively identifying youth who are at risk for 

5 suicide; 

6 ‘‘(11) provide continuous training activities for 

7 child care professionals and community care pro8 viders on the latest youth suicide early intervention 

9 and prevention services practices and strategies; 

10 ‘‘(12) conduct annual self-evaluations of out11 comes and activities, including consulting with inter12 ested families and advocacy organizations; 

13 ‘‘(13) provide services in areas or regions with 

14 rates of youth suicide that exceed the national aver15 age as determined by the Centers for Disease Con16 trol and Prevention; and 

17 ‘‘(14) obtain informed written consent from a 

18 parent or legal guardian of an at-risk child before 

19 involving the child in a youth suicide early interven20 tion and prevention program. 

21 ‘‘(d) REQUIREMENT FOR DIRECT SERVICES.—Not 

22 less than 85 percent of grant funds received under this 

23 section shall be used to provide direct services, of which 

24 not less than 5 percent shall be used for activities author25 ized under subsection (a)(3). 


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1 ‘‘(e) CONSULTATION AND POLICY DEVELOPMENT.— 

2 ‘‘(1) IN GENERAL.—In carrying out this sec3 tion, the Secretary shall collaborate with the Sec4 retary of Education and relevant Federal agencies 

5 and suicide working groups responsible for early 

6 intervention and prevention services relating to 

7 youth suicide. 

8 ‘‘(2) CONSULTATION.—In carrying out this sec9 tion, the Secretary shall consult with— 

10 ‘‘(A) State and local agencies, including 

11 agencies responsible for early intervention and 

12 prevention services under title XIX of the So13 cial Security Act, the State Children’s Health 

14 Insurance Program under title XXI of the So15 cial Security Act, and programs funded by 

16 grants under title V of the Social Security Act; 

17 ‘‘(B) local and national organizations that 

18 serve youth at risk for suicide and their fami19 lies; 

20 ‘‘(C) relevant national medical and other 

21 health and education specialty organizations; 

22 ‘‘(D) youth who are at risk for suicide, 

23 who have survived suicide attempts, or who are 

24 currently receiving care from early intervention 

25 services; 


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1 ‘‘(E) families and friends of youth who are 

2 at risk for suicide, who have survived suicide at3 tempts, who are currently receiving care from 

4 early intervention and prevention services, or 

5 who have completed suicide; 

6 ‘‘(F) qualified professionals who possess 

7 the specialized knowledge, skills, experience, 

8 and relevant attributes needed to serve youth at 

9 risk for suicide and their families; and 

10 ‘‘(G) third-party payers, managed care or11 ganizations, and related commercial industries. 

12 ‘‘(3) POLICY DEVELOPMENT.—In carrying out 

13 this section, the Secretary shall— 

14 ‘‘(A) coordinate and collaborate on policy 

15 development at the Federal level with the rel16 evant Department of Health and Human Serv17 ices agencies and suicide working groups; and 

18 ‘‘(B) consult on policy development at the 

19 Federal level with the private sector, including 

20 consumer, medical, suicide prevention advocacy 

21 groups, and other health and education profes22 sional-based organizations, with respect to 

23 State-sponsored statewide or tribal youth sui24 cide early intervention and prevention strate25 gies. 


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1 ‘‘(f) RULE OF CONSTRUCTION; RELIGIOUS AND

2 MORAL ACCOMMODATION.—Nothing in this section shall 

3 be construed to require suicide assessment, early interven4 tion, or treatment services for youth whose parents or 

5 legal guardians object based on the parents’ or legal 

6 guardians’ religious beliefs or moral objections. 

7 ‘‘(g) EVALUATIONS AND REPORT.— 

8 ‘‘(1) EVALUATIONS BY ELIGIBLE ENTITIES.— 

9 Not later than 18 months after receiving a grant or 

10 cooperative agreement under this section, an eligible 

11 entity shall submit to the Secretary the results of an 

12 evaluation to be conducted by the entity concerning 

13 the effectiveness of the activities carried out under 

14 the grant or agreement. 

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

16 date of enactment of this section, the Secretary shall 

17 submit to the appropriate committees of Congress a 

18 report concerning the results of— 

19 ‘‘(A) the evaluations conducted under 

20 paragraph (1); and 

21 ‘‘(B) an evaluation conducted by the Sec22 retary to analyze the effectiveness and efficacy 

23 of the activities conducted with grants, collabo24 rations, and consultations under this section. 


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1 ‘‘(h) RULE OF CONSTRUCTION; STUDENT MEDICA2 TION.—Nothing in this section shall be construed to allow 

3 school personnel to require that a student obtain any 

4 medication as a condition of attending school or receiving 

5 services. 

6 ‘‘(i) PROHIBITION.—Funds appropriated to carry out 

7 this section, section 527, or section 529 shall not be used 

8 to pay for or refer for abortion. 

9 ‘‘(j) PARENTAL CONSENT.—States and entities re10 ceiving funding under this section shall obtain prior writ11 ten, informed consent from the child’s parent or legal 

12 guardian for assessment services, school-sponsored pro13 grams, and treatment involving medication related to 

14 youth suicide conducted in elementary and secondary 

15 schools. The requirement of the preceding sentence does 

16 not apply in the following cases: 

17 ‘‘(1) In an emergency, where it is necessary to 

18 protect the immediate health and safety of the stu19 dent or other students. 

20 ‘‘(2) Other instances, as defined by the State, 

21 where parental consent cannot reasonably be ob22 tained. 

23 ‘‘(k) RELATION TO EDUCATION PROVISIONS.—Noth24 ing in this section shall be construed to supersede section 

25 444 of the General Education Provisions Act, including 


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1 the requirement of prior parental consent for the disclo2 sure of any education records. Nothing in this section shall 

3 be construed to modify or affect parental notification re4 quirements for programs authorized under the Elementary 

5 and Secondary Education Act of 1965 (as amended by the 

6 No Child Left Behind Act of 2001; Public Law 107–110). 

7 ‘‘(l) DEFINITIONS.—In this section: 

8 ‘‘(1) EARLY INTERVENTION.—The term ‘early 

9 intervention’ means a strategy or approach that is 

10 intended to prevent an outcome or to alter the 

11 course of an existing condition. 

12 ‘‘(2) EDUCATIONAL INSTITUTION; INSTITUTION

13 OF HIGHER EDUCATION; SCHOOL.—The term— 

14 ‘‘(A) ‘educational institution’ means a 

15 school or institution of higher education; 

16 ‘‘(B) ‘institution of higher education’ has 

17 the meaning given such term in section 101 of 

18 the Higher Education Act of 1965; and 

19 ‘‘(C) ‘school’ means an elementary or sec20 ondary school (as such terms are defined in sec21 tion 9101 of the Elementary and Secondary 

22 Education Act of 1965). 

23 ‘‘(3) PREVENTION.—The term ‘prevention’ 

24 means a strategy or approach that reduces the likeli25 hood or risk of onset, or delays the onset, of adverse 


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1 health problems that have been known to lead to sui2 cide. 

3 ‘‘(4) YOUTH.—The term ‘youth’ means individ4 uals who are between 10 and 26 years of age. 

5 ‘‘(m) AUTHORIZATION OF APPROPRIATIONS.—For 

6 the purpose of carrying out this section, there are author7 ized to be appropriated $29,738,000 for each of the fiscal 

8 years 2016 through 2020.’’. 

9 (3) SUICIDE PREVENTION FOR YOUTH.—Sec10 tion 520E–1 of the Public Health Service Act (42 

11 U.S.C. 290bb–36a) is amended— 

12 (A) by amending the section heading to 

13 read as follows: ‘‘SUICIDE PREVENTION FOR

14 YOUTH’’; and 

15 (B) by striking subsection (n) and insert16 ing the following: 

17 ‘‘(n) AUTHORIZATION OF APPROPRIATIONS.—For the 

18 purpose of carrying out this section, there is authorized 

19 to be appropriated such sums as may be necessary for 

20 each of fiscal years 2016 through 2020.’’. 

21 (4) MENTAL HEALTH AND SUBSTANCE USE

22 DISORDERS SERVICES AND OUTREACH ON CAM23 PUS.—Section 520E–2 of the Public Health Service 

24 Act (42 U.S.C. 290bb–36b) is amended to read as 

25 follows: 


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1 ‘‘SEC. 520E–2. MENTAL HEALTH AND SUBSTANCE USE DIS2 ORDERS SERVICES ON CAMPUS. 

3 ‘‘(a) IN GENERAL.—The Secretary, acting through 

4 the Director of the Center for Mental Health Services and 

5 in consultation with the Secretary of Education, shall 

6 award grants on a competitive basis to institutions of 

7 higher education to enhance services for students with 

8 mental health or substance use disorders and to develop 

9 best practices for the delivery of such services. 

10 ‘‘(b) USES OF FUNDS.—Amounts received under a 

11 grant under this section shall be used for 1 or more of 

12 the following activities: 

13 ‘‘(1) The provision of mental health and sub14 stance use disorder services to students, including 

15 prevention, promotion of mental health, voluntary 

16 screening, early intervention, voluntary assessment, 

17 treatment, and management of mental health and 

18 substance use disorder issues. 

19 ‘‘(2) The provision of outreach services to notify 

20 students about the existence of mental health and 

21 substance use disorder services. 

22 ‘‘(3) Educating students, families, faculty, staff, 

23 and communities to increase awareness of mental 

24 health and substance use disorders. 

25 ‘‘(4) The employment of appropriately trained 

26 staff, including administrative staff. 


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1 ‘‘(5) The provision of training to students, fac2 ulty, and staff to respond effectively to students with 

3 mental health and substance use disorders. 

4 ‘‘(6) The creation of a networking infrastruc5 ture to link colleges and universities with providers 

6 who can treat mental health and substance use dis7 orders. 

8 ‘‘(7) Developing, supporting, evaluating, and 

9 disseminating evidence-based and emerging best 

10 practices. 

11 ‘‘(c) IMPLEMENTATION OF ACTIVITIES USING GRANT

12 FUNDS.—An institution of higher education that receives 

13 a grant under this section may carry out activities under 

14 the grant through— 

15 ‘‘(1) college counseling centers; 

16 ‘‘(2) college and university psychological service 

17 centers; 

18 ‘‘(3) mental health centers; 

19 ‘‘(4) psychology training clinics; 

20 ‘‘(5) institution of higher education supported, 

21 evidence-based, mental health and substance use dis22 order programs; or 

23 ‘‘(6) any other entity that provides mental 

24 health and substance use disorder services at an in25 stitution of higher education. 


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1 ‘‘(d) APPLICATION.—To be eligible to receive a grant 

2 under this section, an institution of higher education shall 

3 prepare and submit to the Secretary an application at 

4 such time and in such manner as the Secretary may re5 quire. At a minimum, such application shall include the 

6 following: 

7 ‘‘(1) A description of identified mental health 

8 and substance use disorder needs of students at the 

9 institution of higher education. 

10 ‘‘(2) A description of Federal, State, local, pri11 vate, and institutional resources currently available 

12 to address the needs described in paragraph (1) at 

13 the institution of higher education. 

14 ‘‘(3) A description of the outreach strategies of 

15 the institution of higher education for promoting ac16 cess to services, including a proposed plan for reach17 ing those students most in need of mental health 

18 services. 

19 ‘‘(4) A plan, when applicable, to meet the spe20 cific mental health and substance use disorder needs 

21 of veterans attending institutions of higher edu22 cation. 

23 ‘‘(5) A plan to seek input from community 

24 mental health providers, when available, community 


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1 groups and other public and private entities in car2 rying out the program under the grant. 

3 ‘‘(6) A plan to evaluate program outcomes, in4 cluding a description of the proposed use of funds, 

5 the program objectives, and how the objectives will 

6 be met. 

7 ‘‘(7) An assurance that the institution will sub8 mit a report to the Secretary each fiscal year con9 cerning the activities carried out with the grant and 

10 the results achieved through those activities. 

11 ‘‘(e) SPECIAL CONSIDERATIONS.—In awarding 

12 grants under this section, the Secretary shall give special 

13 consideration to applications that describe programs to be 

14 carried out under the grant that— 

15 ‘‘(1) demonstrate the greatest need for new or 

16 additional mental and substance use disorder serv17 ices, in part by providing information on current ra18 tios of students to mental health and substance use 

19 disorder health professionals; and 

20 ‘‘(2) demonstrate the greatest potential for rep21 lication. 

22 ‘‘(f) REQUIREMENT OF MATCHING FUNDS.— 

23 ‘‘(1) IN GENERAL.—The Secretary may make a 

24 grant under this section to an institution of higher 

25 education only if the institution agrees to make 


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1 available (directly or through donations from public 

2 or private entities) non-Federal contributions in an 

3 amount that is not less than $1 for each $1 of Fed4 eral funds provided under the grant, toward the 

5 costs of activities carried out with the grant (as de6 scribed in subsection (b)) and other activities by the 

7 institution to reduce student mental health and sub8 stance use disorders. 

9 ‘‘(2) DETERMINATION OF AMOUNT CONTRIB10 UTED.—Non-Federal contributions required under 

11 paragraph (1) may be in cash or in kind. Amounts 

12 provided by the Federal Government, or services as13 sisted or subsidized to any significant extent by the 

14 Federal Government, may not be included in deter15 mining the amount of such non-Federal contribu16 tions. 

17 ‘‘(3) WAIVER.—The Secretary may waive the 

18 application of paragraph (1) with respect to an insti19 tution of higher education if the Secretary deter20 mines that extraordinary need at the institution jus21 tifies the waiver. 

22 ‘‘(g) REPORTS.—For each fiscal year that grants are 

23 awarded under this section, the Secretary shall conduct 

24 a study on the results of the grants and submit to the 


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1 Congress a report on such results that includes the fol2 lowing: 

3 ‘‘(1) An evaluation of the grant program out4 comes, including a summary of activities carried out 

5 with the grant and the results achieved through 

6 those activities. 

7 ‘‘(2) Recommendations on how to improve ac8 cess to mental health and substance use disorder 

9 services at institutions of higher education, including 

10 efforts to reduce the incidence of suicide and sub11 stance use disorders. 

12 ‘‘(h) DEFINITIONS.—In this section: 

13 ‘‘(1) The term ‘evidence-based’ has the meaning 

14 given to such term in section 2 of the Helping Fami15 lies in Mental Health Crisis Act of 2015. 

16 ‘‘(2) The term ‘institution of higher education’ 

17 has the meaning given such term in section 101 of 

18 the Higher Education Act of 1965. 

19 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For the 

20 purpose of carrying out this section, there are authorized 

21 to be appropriated $4,975,000 for each of fiscal years 

22 2016 through 2020.’’. 

23 (5) SUICIDE LIFELINE.—Subpart 3 of part B 

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1 ed by inserting after section 520E–2 of such Act (42 

2 U.S.C. 290bb–36b), as amended, the following: 

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

4 PROGRAM. 

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

6 National Suicide Prevention Lifeline program, including 

7 by— 

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

9 across the United States for providing suicide pre10 vention and crisis intervention services to individuals 

11 seeking help at any time, day or night; 

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

13 link callers to local emergency, mental health, and 

14 social services resources; and 

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

16 Affairs to ensure that veterans calling the suicide 

17 prevention hotline have access to a specialized vet18 erans’ suicide prevention hotline. 

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

20 carry out this section, there are authorized to be appro21 priated $8,000,000 for each of fiscal years 2016 through 

22 2020.’’. 


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1 TITLE III—INTERAGENCY SERI2 OUS MENTAL ILLNESS CO3 ORDINATING COMMITTEE 

4 SEC. 301. INTERAGENCY SERIOUS MENTAL ILLNESS CO5 ORDINATING COMMITTEE. 

6 Title V of the Public Health Service Act, as amended 

7 by section 101, is further amended by inserting after sec8 tion 501 of such Act the following: 

9 ‘‘SEC. 501A. INTERAGENCY SERIOUS MENTAL ILLNESS CO10 ORDINATING COMMITTEE. 

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

12 Mental Health and Substance Use Disorders (in this sec13 tion referred to as the ‘Assistant Secretary’) shall estab14 lish a committee, to be known as the Interagency Serious 

15 Mental Illness Coordinating Committee (in this section re16 ferred to as the ‘Committee’), to assist the Assistant Sec17 retary in carrying out the Assistant Secretary’s duties. 

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

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

20 advances in serious mental illness research related to 

21 causes, prevention, treatment, early screening, diag22 nosis or rule out, intervention, and access to services 

23 and supports for individuals with serious mental ill24 ness; 


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1 ‘‘(2) monitor Federal activities with respect to 

2 serious mental illness; 

3 ‘‘(3) make recommendations to the Assistant 

4 Secretary regarding any appropriate changes to such 

5 activities, including recommendations to the Director 

6 of NIH with respect to the strategic plan developed 

7 under paragraph (5); 

8 ‘‘(4) make recommendations to the Assistant 

9 Secretary regarding public participation in decisions 

10 relating to serious mental illness; 

11 ‘‘(5) develop and annually update a strategic 

12 plan for advancing— 

13 ‘‘(A) public utilization of effective mental 

14 health services; and 

15 ‘‘(B) compliance with treatment; 

16 ‘‘(6) develop and annually update a strategic 

17 plan for the conduct of, and support for, serious 

18 mental illness research, including proposed budg19 etary requirements; and 

20 ‘‘(7) submit to the Congress such strategic plan 

21 and any updates to such plan. 

22 ‘‘(c) MEMBERSHIP.— 

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

24 composed of— 


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1 ‘‘(A) the Assistant Secretary for Mental 

2 Health and Substance Use Disorders (or the 

3 Assistant Secretary’s designee), who shall serve 

4 as the Chair of the Committee; 

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

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

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

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

9 ‘‘(D) the Director of the Centers for Dis10 ease Control and Prevention (or the Director’s 

11 designee); 

12 ‘‘(E) the Director of the National Insti13 tutes of Health (or the Director’s designee); 

14 ‘‘(F) the directors of such national re15 search institutes of the National Institutes of 

16 Health as the Assistant Secretary for Mental 

17 Health and Substance Use Disorders deter18 mines appropriate (or their designees); 

19 ‘‘(G) a member of the United States Inter20 agency Council on Homelessness; 

21 ‘‘(H) representatives, appointed by the As22 sistant Secretary, of Federal agencies that are 

23 outside of the Department of Health and 

24 Human Services and serve individuals with seri25 ous mental illness, including representatives of 


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1 the Bureau of Indian Affairs, the Department 

2 of Defense, the Department of Education, the 

3 Department of Housing and Urban Develop4 ment, the Department of Labor, the Depart5 ment of Veterans Affairs, and the Social Secu6 rity Administration; 

7 ‘‘(I) 4 members, of which— 

8 ‘‘(i) 1 shall be appointed by the 

9 Speaker of the House of Representatives; 

10 ‘‘(ii) 1 shall be appointed by the mi11 nority leader of the House of Representa12 tives; 

13 ‘‘(iii) 1 shall be appointed by the ma14 jority leader of the Senate; and 

15 ‘‘(iv) 1 shall be appointed by the mi16 nority leader of the Senate; and 

17 ‘‘(J) the additional members appointed 

18 under paragraph (2). 

19 ‘‘(2) ADDITIONAL MEMBERS.—Not fewer than 

14 members of the Committee, or 1 20 ⁄3 of the total 

21 membership of the Committee, whichever is greater, 

22 shall be composed of non-Federal public members to 

23 be appointed by the Assistant Secretary, of which— 

24 ‘‘(A) at least one such member shall be an 

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1 ous mental illness who has benefitted from and 

2 is receiving medical treatment under the care of 

3 a licensed mental health professional; 

4 ‘‘(B) at least one such member shall be a 

5 parent or legal guardian of an individual with 

6 a history of serious mental illness who has ei7 ther attempted suicide or is incarcerated for vi8 olence committed while experiencing a serious 

9 mental illness; 

10 ‘‘(C) at least one such member shall be a 

11 representative of a leading research, advocacy, 

12 and service organization for individuals with se13 rious mental illness; 

14 ‘‘(D) at least one such member shall be— 

15 ‘‘(i) a licensed psychiatrist with expe16 rience treating serious mental illness; or 

17 ‘‘(ii) a licensed clinical psychologist 

18 with experience treating serious mental ill19 ness; 

20 ‘‘(E) at least one member shall be a li21 censed mental health counselor or 

22 psychotherapist; 

23 ‘‘(F) at least one member shall be a li24 censed clinical social worker; 


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1 ‘‘(G) at least one member shall be a li2 censed psychiatric nurse or nurse practitioner; 

3 ‘‘(H) at least one member shall be a men4 tal health professional with a significant focus 

5 in his or her practice working with children and 

6 adolescents; 

7 ‘‘(I) at least one member shall be a mental 

8 health professional who spends a significant 

9 concentration of his or her professional time or 

10 leadership practicing community mental health; 

11 ‘‘(J) at least one member shall be a mental 

12 health professional with substantial experience 

13 working with mentally ill individuals who have 

14 a history of violence or suicide; 

15 ‘‘(K) at least one such member shall be a 

16 State certified mental health peer specialist; 

17 ‘‘(L) at least one member shall be a judge 

18 with experiences applying assisted outpatient 

19 treatment; 

20 ‘‘(M) at least one member shall be a law 

21 enforcement officer with extensive experience in 

22 interfacing with psychiatric and psychological 

23 disorders or individuals in mental health crisis; 

24 and 


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1 ‘‘(N) at least one member shall be a cor2 rections officer. 

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

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

5 thereafter, the Committee shall submit a report to the 

6 Congress— 

7 ‘‘(1) analyzing the efficiency, effectiveness, 

8 quality, coordination, and cost effectiveness of Fed9 eral programs and activities relating to the preven10 tion of, or treatment or rehabilitation for, mental 

11 health or substance use disorders, including an ac12 counting of the costs of such programs and activi13 ties, with administrative costs disaggregated from 

14 the costs of services and care provided; 

15 ‘‘(2) 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, incarceration, crime, arrest, vic24 timization, homelessness, and 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 ‘‘(3) formulating recommendations for the co7 ordination and improvement of Federal programs 

8 and activities described in paragraph (2); 

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

11 ‘‘(5) summarizing all recommendations made, 

12 activities carried out, and results achieved pursuant 

13 to the workforce development strategy under section 

14 501(b)(9) of the Public Health Service Act, as 

15 amended by section 101. 

16 ‘‘(e) ADMINISTRATIVE SUPPORT; TERMS OF SERV17 ICE; OTHER PROVISIONS.—The following provisions shall 

18 apply with respect to the Committee: 

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

20 administrative support to the Committee as may be 

21 necessary for the Committee to carry out its respon22 sibilities. 

23 ‘‘(2) Members of the Committee appointed 

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

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1 tional 4-year terms. Any member appointed to fill a 

2 vacancy for an unexpired term shall be appointed for 

3 the remainder of such term. A member may serve 

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

5 successor has taken office. 

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

7 the chair or upon the request of the Assistant Sec8 retary. The Committee shall meet not fewer than 2 

9 times each year. 

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

11 public and shall include appropriate time periods for 

12 questions and presentations by the public. 

13 ‘‘(f) SUBCOMMITTEES; ESTABLISHMENT AND MEM14 BERSHIP.—In carrying out its functions, the Committee 

15 may establish subcommittees and convene workshops and 

16 conferences. Such subcommittees shall be composed of 

17 Committee members and may hold such meetings as are 

18 necessary to enable the subcommittees to carry out their 

19 duties.’’. 


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1 TITLE IV—HIPAA AND FERPA 

2 CAREGIVERS 

3 SEC. 401. PROMOTING APPROPRIATE TREATMENT FOR 

4 MENTALLY ILL INDIVIDUALS BY TREATING 

5 THEIR CAREGIVERS AS PERSONAL REP6 RESENTATIVES FOR PURPOSES OF HIPAA 

7 PRIVACY REGULATIONS. 

8 (a) CAREGIVER ACCESS TO INFORMATION.—In ap9 plying section 164.502(g) of title 45, Code of Federal Reg10 ulations, to an individual with serious mental illness an 

11 exception for disclosure of specific limited protected health 

12 information shall be provided if all of the following criteria 

13 are met for the disclosure by a physician (as defined in 

14 paragraphs (1) and (2) of section 1861(r) of the Social 

15 Security Act (42 U.S.C. 1395x(r))) or other licensed men16 tal health or health care professional to an identified re17 sponsible caregiver: 

18 (1) Such disclosure is for information limited to 

19 the diagnoses, treatment plans, appointment sched20 uling, medications, and medication-related instruc21 tions, but not including any personal psychotherapy 

22 notes. 

23 (2) Such disclosure is necessary to protect the 

24 health, safety, or welfare of the individual or general 

25 public. 


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1 (3) The information to be disclosed will be ben2 eficial to the treatment of the individual if that indi3 vidual has a co-occurring acute or chronic medical 

4 illness. 

5 (4) The information to be disclosed is necessary 

6 for the continuity of treatment of the medical condi7 tion or mental illness of the individual. 

8 (5) The absence of such information or treat9 ment will contribute to a worsening prognosis or an 

10 acute medical condition. 

11 (6) The individual by nature of the severe men12 tal illness has or has had a diminished capacity to 

13 fully understand or follow a treatment plan for their 

14 medical condition or may become gravely disabled in 

15 absence of treatment. 

16 (b) TRAINING.—In applying section 164.530 of title 

17 45, Code of Federal Regulations, the training described 

18 in paragraph (b)(1) of such section shall include training 

19 with respect to the disclosure of information to a caregiver 

20 of an individual pursuant to subsection (a). 

21 (c) AGE OF MAJORITY.—In applying section 

22 164.502(g) of title 45, Code of Federal Regulations, not23 withstanding any other provision of law, an 

24 unemancipated minor shall be an individual under the age 

25 of 18 years. 


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1 (d) PROVIDER ACCESS TO INFORMATION.—Health 

2 care providers may listen to information or review medical 

3 history provided by family members or other caregivers 

4 who may have concerns about the health and well-being 

5 of the patient, so the health care provider can factor that 

6 information into the patient’s care. 

7 (e) DEFINITIONS.—For purposes of this section: 

8 (1) COVERED ENTITY.—The term ‘‘covered en9 tity’’ has the meaning given such term in section 

10 106.103 of title 45, Code of Federal Regulations. 

11 (2) PROTECTED HEALTH INFORMATION.—The 

12 term ‘‘protected health information’’ has the mean13 ing given such term in section 106.103 of title 45, 

14 Code of Federal Regulations. 

15 (3) CAREGIVER.—The term ‘‘caregiver’’ means, 

16 with respect to an individual with a serious mental 

17 illness— 

18 (A) an immediate family member of such 

19 individual; 

20 (B) an individual who assumes primary re21 sponsibility for providing a basic need of such 

22 individual; 

23 (C) a personal representative of the indi24 vidual as determined by the law of the State in 

25 which such individual resides; 


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1 (D) can establish a longstanding involve2 ment and is responsible with the individual with 

3 a serious mental illness and the health care of 

4 the individual; and 

5 (E) excludes an individual with a docu6 mented history of abuse. 

7 (4) INDIVIDUAL WITH A SERIOUS MENTAL ILL8 NESS.—The term ‘‘individual with a serious mental 

9 illness’’ means, with respect to the disclosure to a 

10 caregiver of protected health information of an indi11 vidual, an individual who— 

12 (A) is 18 years of age or older; and 

13 (B) has, within one year before the date of 

14 the disclosure, been evaluated, diagnosed, or 

15 treated for a mental, behavioral, or emotional 

16 disorder that— 

17 (i) is determined by a physician to be 

18 of sufficient duration to meet diagnostic 

19 criteria specified within the Diagnostic and 

20 Statistical Manual of Mental Disorders; 

21 and 

22 (ii) results in functional impairment 

23 of the individual that substantially inter24 feres with or limits one or more major life 

25 activities of the individual. 


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1 Such term includes an individual with autism 

2 spectrum disorder or other developmental dis3 ability if such individual has a co-occurring 

4 mental illness. 

5 SEC. 402. CAREGIVERS PERMITTED ACCESS TO CERTAIN 

6 EDUCATION RECORDS UNDER FERPA. 

7 Section 444 of the General Education Provisions Act 

8 (20 U.S.C. 1232g) is amended by adding at the end the 

9 following new subsection: 

10 ‘‘(k) DISCLOSURES TO CAREGIVERS.— 

11 ‘‘(1) IN GENERAL.—With respect to a student 

12 who is 18 years of age or older, an educational agen13 cy or institution may disclose to the caregiver of the 

14 student, without regard to whether the student has 

15 explicitly provided consent to the agency or institu16 tion for the disclosure of the student’s education 

17 record, the education record of such student if a 

18 physician (as defined in paragraphs (1) and (2) of 

19 section 1861(r) of the Social Security Act), psycholo20 gist, or other recognized mental health professional 

21 or paraprofessional acting in his or her professional 

22 or paraprofessional capacity, or assisting in that ca23 pacity reasonably believes such disclosure to the 

24 caregiver is necessary to protect the health, safety, 


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1 or welfare of such student or the safety of one or 

2 more other individuals. 

3 ‘‘(2) DEFINITIONS.—In this subsection: 

4 ‘‘(A) CAREGIVER.—The term ‘caregiver’ 

5 means, with respect to a student, a family 

6 member or immediate past legal guardian who 

7 assumes a primary responsibility for providing 

8 a basic need of such student (such as a family 

9 member or past legal guardian of the student 

10 who has assumed the responsibility of co-sign11 ing a loan with the student). 

12 ‘‘(B) EDUCATION RECORD.—Notwith13 standing subsection (a)(4)(B), the term ‘edu14 cation record’ shall include a record described 

15 in clause (iv) of such subsection.’’. 

16 SEC. 403. CONFIDENTIALITY OF RECORDS. 

17 Section 543(e) of the Public Health Service Act (42 

18 U.S.C. 290dd–2(e)) is amended— 

19 (1) in paragraph (1), by striking ‘‘; or’’ and in20 serting a semicolon; 

21 (2) in paragraph (2), by striking the period and 

22 inserting ‘‘; or’’; and 

23 (3) after paragraph (2), by inserting the fol24 lowing: 


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1 ‘‘(3) within accountable care organizations de2 scribed in section 1899 of the Social Security Act 

3 (42 U.S.C. 1395jjj), health information exchanges 

4 (as defined for purposes of section 3013), health 

5 homes (as defined in section 1945(h)(3) of such Act 

6 42 U.S.C. 1396w–4(h)(3)), or other integrated care 

7 arrangements (in existence before, on, or after the 

8 date of the enactment of this paragraph) involving 

9 the interchange of electronic health records (as de10 fined in section 13400 of division A of Public Law 

11 111–5) (42 U.S.C. 17921(5)) containing information 

12 described in subsection (a) for purposes of attaining 

13 interoperability, improving care coordination, reduc14 ing health care costs, and securing or providing pa15 tient safety.’’. 

16 TITLE V—MEDICARE AND 

17 MEDICAID REFORMS 

18 SEC. 501. ENHANCED MEDICAID COVERAGE RELATING TO 

19 CERTAIN MENTAL HEALTH SERVICES. 

20 (a) MEDICAID COVERAGE OF MENTAL HEALTH

21 SERVICES AND PRIMARY CARE SERVICES FURNISHED ON

22 THE SAME DAY.— 

23 (1) IN GENERAL.—Section 1902(a) of the So24 cial Security Act (42 U.S.C. 1396a(a)) is amended 


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1 by inserting after paragraph (77) the following new 

2 paragraph: 

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

4 a mental health service or primary care service fur5 nished to an individual at a community mental 

6 health center meeting the criteria specified in section 

7 1913(c) of the Public Health Service Act or a feder8 ally qualified health center (as defined in section 

9 1861(aa)(3)) for which payment would otherwise be 

10 payable under the plan, with respect to such indi11 vidual, if such service were not a same-day quali12 fying service (as defined in subsection (ll));’’. 

13 (2) SAME-DAY QUALIFYING SERVICES DE14 FINED.—Section 1902 of the Social Security Act (42 

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

16 following new subsection: 

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

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

19 qualifying service’ means— 

20 ‘‘(1) a primary care service furnished to an in21 dividual by a provider at a facility on the same day 

22 a mental health service is furnished to such indi23 vidual by such provider (or another provider) at the 

24 facility; and 


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1 ‘‘(2) a mental health service furnished to an in2 dividual by a provider at a facility on the same day 

3 a primary care service is furnished to such individual 

4 by such provider (or another provider) at the facil5 ity.’’. 

6 (b) STATE OPTION TO PROVIDE MEDICAL ASSIST7 ANCE FOR CERTAIN INPATIENT PSYCHIATRIC SERVICES

8 TO NONELDERLY ADULTS.—Section 1905 of the Social 

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

10 (1) in subsection (a)— 

11 (A) in paragraph (16)— 

12 (i) by striking ‘‘effective’’ and insert13 ing ‘‘(A) effective’’; and 

14 (ii) by inserting before the semicolon 

15 at the end the following: ‘‘, (B) qualified 

16 inpatient psychiatric hospital services (as 

17 defined in subsection (h)(3)) for individ18 uals over 21 years of age and under 65 

19 years of age, and (C) psychiatric residen20 tial treatment facility services (as defined 

21 in subsection (h)(4)) for individuals over 

22 21 years of age and under 65 years of 

23 age’’; and 

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

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1 ices described in subparagraphs (B) and (C) of 

2 paragraph (16) for individuals described in such 

3 subparagraphs)’’ after ‘‘patient in an institution 

4 for mental diseases’’; and 

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

6 following new paragraphs: 

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

8 ‘qualified inpatient psychiatric hospital services’ means, 

9 with respect to individuals described in such subsection, 

10 services described in subparagraphs (A) and (B) of para11 graph (1) that are furnished in an acute care psychiatric 

12 unit in a State-operated psychiatric hospital or a psy13 chiatric hospital (as defined section 1861(f)) if such unit 

14 or hospital, as applicable, has a facilitywide average (de15 termined on an annual basis) length of stay of less than 

16 30 days. 

17 ‘‘(4) For purposes of subsection (a)(16)(C), the term 

18 ‘psychiatric residential treatment facility services’ means, 

19 with respect to individuals described in such subsection, 

20 services described in subparagraphs (A) and (B) of para21 graph (1) that are furnished in a psychiatric residential 

22 treatment facility (as defined in section 484.353 of title 

23 42, Code of Federal Regulations, as in effect on December 

24 9, 2013).’’. 

25 (c) REPORT.— 


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

2 Mental Health and Substance Use Disorders shall 

3 report on the impact of the amendments made by 

4 subsection (b) on the funds made available by States 

5 for inpatient psychiatric hospital care and for com6 munity-based mental health services. Such study 

7 shall include an assessment of each of the following: 

8 (A) The amount of funds expended annu9 ally by States on short-term, acute inpatient 

10 psychiatric hospital care. 

11 (B) The amount of funds expended annu12 ally on short-term, acute inpatient psychiatric 

13 hospital care through disproportionate share 

14 hospital payments under section 1923 of the 

15 Social Security Act (42 U.S.C. 1396r–4). 

16 (C) The reduction in the amount of funds 

17 described in subparagraph (A) that is attrib18 utable to the amendments made by subsection 

19 (b). 

20 (D) The reduction in the amount of funds 

21 described in subparagraph (B) that is attrib22 utable to the amendment made by such sub23 section. 

24 (E) The total amount of the reductions de25 scribed in subparagraphs (C) and (D). 


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1 (2) DEFINITION OF SHORT-TERM, ACUTE INPA2 TIENT PSYCHIATRIC HOSPITAL CARE.—For purposes 

3 of paragraph (1), the term ‘‘short-term, acute inpa4 tient psychiatric hospital care’’ means care that is 

5 provided in either— 

6 (A) an acute-care psychiatric unit with an 

7 average annual length of stay of fewer than 30 

8 days that is operated within a psychiatric hos9 pital operated by a State; or 

10 (B) a psychiatric hospital with an average 

11 annual length of stay of fewer than 30 days. 

12 (3) REPORT.—Not later than two years after 

13 the date of the enactment of this Act, such Assistant 

14 Secretary shall submit a report to Congress on the 

15 results of the study described in paragraph (1), in16 cluding recommendations with respect to strategies 

17 that can be used to reinvest in community-based 

18 mental health services funds equal to the total 

19 amount of the reductions described in paragraph 

20 (1)(E). 

21 (d) EFFECTIVE DATE.— 

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

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

24 apply to items and services furnished after the first 


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1 day of the first calendar year that begins after the 

2 date of the enactment of this section. 

3 (2) CERTIFICATION OF NO INCREASED SPEND4 ING.—The amendments made by this section shall 

5 not be effective unless the Chief Actuary of the Cen6 ters for Medicare & Medicaid Services certifies that 

7 the inclusion of qualified inpatient psychiatric hos8 pital services and psychiatric residential treatment 

9 facility services (as those terms are defined in sec10 tion 1905(h) of the Social Security Act (42 U.S.C. 

11 1396d(h))) furnished to nonelderly adults as medical 

12 assistance under section 1905(a) of the Social Secu13 rity Act (42 U.S.C. 1396d(a)), as amended by sub14 section (a), would not result in any increase in net 

15 program spending under title XIX of such Act. 

16 (3) EXCEPTION FOR STATE LEGISLATION.—In 

17 the case of a State plan under title XIX of the So18 cial Security Act, which the Secretary of Health and 

19 Human Services determines requires State legisla20 tion in order for the respective plan to meet any re21 quirement imposed by amendments made by this 

22 section, the respective plan shall not be regarded as 

23 failing to comply with the requirements of such title 

24 solely on the basis of its failure to meet such an ad25 ditional requirement before the first day of the first 


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1 calendar quarter beginning after the close of the 

2 first regular session of the State legislature that be3 gins after the date of enactment of this section. For 

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

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

6 of the session shall be considered to be a separate 

7 regular session of the State legislature. 

8 SEC. 502. ACCESS TO MENTAL HEALTH PRESCRIPTION 

9 DRUGS UNDER MEDICARE AND MEDICAID. 

10 (a) COVERAGE OF PRESCRIPTION DRUGS USED TO

11 TREAT MENTAL HEALTH DISORDERS UNDER MEDI12 CARE.—Section 1860D–4(b)(3)(G) of the Social Security 

13 Act (42 U.S.C. 1395w–104(b)(3)(G)) is amended— 

14 (1) in clause (i)(I), by striking ‘‘in the cat15 egories’’ and inserting ‘‘in the categories and classes 

16 of drugs specified in subclauses (II) and (IV) of 

17 clause (iv) and in other categories’’; 

18 (2) in clause (i)(II), by inserting ‘‘, for cat19 egories and classes of drugs other than the cat20 egories and classes of drugs specified in subclauses 

21 (II) and (IV) of clause (iv),’’ before ‘‘exceptions’’; 

22 (3) in clause (ii)(I), by inserting at the end the 

23 following new sentence: ‘‘For purposes of the pre24 vious sentence, the categories and classes of drugs 


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1 specified in subclauses (II) and (IV) of clause (iv) 

2 shall be deemed to be of clinical concern.’’; and 

3 (4) in clause (iv), in the matter preceding sub4 clause (I), by inserting ‘‘(and in the case of cat5 egories and classes of drugs specified in subclauses 

6 (II) and (IV), before, on, and after the Secretary es7 tablishes such criteria)’’ after ‘‘clause (ii)(II)’’. 

8 (b) COVERAGE OF PRESCRIPTION DRUGS USED TO

9 TREAT MENTAL HEALTH DISORDERS UNDER MED10 ICAID.— 

11 (1) IN GENERAL.—Section 1927(d) of the So12 cial Security Act (42 U.S.C. 1396r–8(d)) is amend13 ed by adding at the end the following new para14 graph: 

15 ‘‘(8) ACCESS TO MENTAL HEALTH DRUGS.— 

16 With respect to covered outpatient drugs used for 

17 the treatment of a mental health disorder, including 

18 major depression, bipolar (manic-depressive) dis19 order, panic disorder, obsessive-compulsive disorder, 

20 schizophrenia, and schizoaffective disorder, a State 

21 shall not exclude from coverage or otherwise restrict 

22 access to such drugs other than pursuant to a prior 

23 authorization program that is consistent with para24 graph (5).’’. 


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1 (2) MEDICAID MANAGED CARE ORGANIZA2 TIONS.—Section 1932(b) of the Social Security Act 

3 (42 U.S.C. 1396u–2(b)) is amended by adding at 

4 the end the following new paragraph: 

5 ‘‘(9) COVERAGE OF PRESCRIPTION DRUGS USED

6 TO TREAT MENTAL HEALTH DISORDERS.—Each con7 tract with a managed care entity under section 

8 1903(m) or under section 1905(t)(3) shall require 

9 coverage of all covered outpatient drugs used for the 

10 treatment of a mental health disorder, in accordance 

11 with section 1927(d)(8).’’. 

12 SEC. 503. ELIMINATION OF 190-DAY LIFETIME LIMIT ON 

13 COVERAGE OF INPATIENT PSYCHIATRIC HOS14 PITAL SERVICES UNDER MEDICARE. 

15 (a) IN GENERAL.—Section 1812 of the Social Secu16 rity Act (42 U.S.C. 1395d) is amended— 

17 (1) in subsection (b)— 

18 (A) in paragraph (1), by adding ‘‘or’’ at 

19 the end; 

20 (B) in paragraph (2), by striking ‘‘; or’’ at 

21 the end and inserting a period; and 

22 (C) by striking paragraph (3); and 

23 (2) in subsection (c), by striking ‘‘or in deter24 mining the 190-day limit under subsection (b)(3)’’. 


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1 (b) EFFECTIVE DATE; CERTIFICATION OF NO IN2 CREASED SPENDING.— 

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

4 the amendments made by subsection (a) shall apply 

5 to items and services furnished on or after January 

6 1, 2016. 

7 (2) CERTIFICATION OF NO INCREASED SPEND8 ING.—The amendments made by subsection (a) shall 

9 not be effective unless the Chief Actuary of the Cen10 ters for Medicare & Medicaid Services certifies that 

11 such amendments will not result in any increase in 

12 net Federal expenditures under title XVIII of the 

13 Social Security Act. 

14 SEC. 504. MODIFICATIONS TO MEDICARE DISCHARGE PLAN15 NING REQUIREMENTS. 

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

17 U.S.C. 1395x(ee)) is amended— 

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

19 case of a psychiatric hospital or a psychiatric unit 

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

21 section 1886(d)(1)(B)), if it also meets the guide22 lines and standards established by the Secretary 

23 under paragraph (3)’’ before the period at the end; 

24 and 


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

2 paragraph: 

3 ‘‘(3) The Secretary shall develop guidelines and 

4 standards, in addition to those developed under paragraph 

5 (2), for the discharge planning process of a psychiatric 

6 hospital or a psychiatric unit (as described in the matter 

7 following clause (v) of section 1886(d)(1)(B)) in order to 

8 ensure a timely and smooth transition to the most appro9 priate type of and setting for posthospital or rehabilitative 

10 care. The Secretary shall issue final regulations imple11 menting such guidelines and standards not later than 24 

12 months after the date of the enactment of this paragraph. 

13 The guidelines and standards shall include the following: 

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

15 types of services needed upon discharge for the pa16 tients being treated by the hospital or unit. 

17 ‘‘(B) The hospital or unit must— 

18 ‘‘(i) identify organizations that offer com19 munity services to the community that is served 

20 by the hospital or unit and the types of services 

21 provided by the organizations; and 

22 ‘‘(ii) must make demonstrated efforts to 

23 establish connections, relationships, and part24 nerships with such organizations. 


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1 ‘‘(C) The hospital or unit must arrange (with 

2 the participation of the patient and of any other in3 dividuals selected by the patient for such purpose) 

4 for the development and implementation of a dis5 charge plan for the patient as part of the patient’s 

6 overall treatment plan from admission to discharge. 

7 Such discharge plan shall meet the requirements de8 scribed in subparagraphs (G) and (H) of paragraph 

9 (2). 

10 ‘‘(D) The hospital or unit shall coordinate with 

11 the patient (or assist the patient with) the referral 

12 for posthospital or rehabilitative care and as part of 

13 that referral the hospital or unit shall include trans14 mitting to the receiving organization, in a timely 

15 manner, appropriate information about the care fur16 nished to the patient by the hospital or unit and rec17 ommendations for posthospital or rehabilitative care 

18 to be furnished to the patient by the organization.’’. 

19 SEC. 505. DEMONSTRATION PROGRAMS TO IMPROVE COM20 MUNITY MENTAL HEALTH SERVICES. 

21 Section 223 of the Protecting Access to Medicare Act 

22 of 2014 (Public Law 113–93; 128 Stat. 1077) is amended 

23 to read as follows: 


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1 ‘‘SEC. 223. DEMONSTRATION PROGRAMS TO IMPROVE COM2 MUNITY MENTAL HEALTH SERVICES. 

3 ‘‘(a) CRITERIA FOR CERTIFIED COMMUNITY BEHAV4 IORAL HEALTH CLINICS TO PARTICIPATE IN DEM5 ONSTRATION PROGRAMS.— 

6 ‘‘(1) PUBLICATION.—Not later than September 

7 1, 2015, the Secretary shall publish criteria for a 

8 clinic to be certified by a State as a certified com9 munity behavioral health clinic for purposes of par10 ticipating in a demonstration program conducted 

11 under subsection (d). 

12 ‘‘(2) REQUIREMENTS.—The criteria published 

13 under this subsection shall include criteria with re14 spect to the following: 

15 ‘‘(A) STAFFING.—Staffing requirements, 

16 including criteria that staff have diverse dis17 ciplinary backgrounds, have necessary State-re18 quired license and accreditation, and are cul19 turally and linguistically trained to serve the 

20 needs of the clinic’s patient population. 

21 ‘‘(B) AVAILABILITY AND ACCESSIBILITY OF

22 SERVICES.—Availability and accessibility of 

23 services, including crisis management services 

24 that are available and accessible 24 hours a 

25 day, the use of a sliding scale for payment, and 

26 no rejection for services or limiting of services 


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1 on the basis of a patient’s ability to pay or a 

2 place of residence. 

3 ‘‘(C) CARE COORDINATION.—Care coordi4 nation, including requirements to coordinate 

5 care across settings and providers to ensure 

6 seamless transitions for patients across the full 

7 spectrum of health services including acute, 

8 chronic, and behavioral health needs. Care co9 ordination requirements shall include partner10 ships or formal contracts with the following: 

11 ‘‘(i) Federally-qualified health centers 

12 (and as applicable, rural health clinics) to 

13 provide Federally-qualified health center 

14 services (and as applicable, rural health 

15 clinic services) to the extent such services 

16 are not provided directly through the cer17 tified community behavioral health clinic. 

18 ‘‘(ii) Inpatient psychiatric facilities 

19 and substance use detoxification, post-de20 toxification step-down services, and resi21 dential programs. 

22 ‘‘(iii) Other community or regional 

23 services, supports, and providers, including 

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1 dian Health Service youth regional treat2 ment centers, State-licensed and nationally 

3 accredited child placing agencies for thera4 peutic foster care service, and other social 

5 and human services. 

6 ‘‘(iv) Department of Veterans Affairs 

7 medical centers, independent outpatient 

8 clinics, drop-in centers, and other facilities 

9 of the Department as defined in section 

10 1801 of title 38, United States Code. 

11 ‘‘(v) Inpatient acute care hospitals 

12 and hospital outpatient clinics. 

13 ‘‘(D) SCOPE OF SERVICES.—Provision (in 

14 a manner reflecting person-centered care) of the 

15 following services which, if not available directly 

16 through the certified community behavioral 

17 health clinic, are provided or referred through 

18 formal relationships with other providers: 

19 ‘‘(i) Crisis mental health services, in20 cluding 24-hour mobile crisis teams, emer21 gency crisis intervention services, and cri22 sis stabilization. 

23 ‘‘(ii) Screening, assessment, and diag24 nosis, including risk assessment. 


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1 ‘‘(iii) Patient-centered treatment plan2 ning or similar processes, including risk as3 sessment and crisis planning. 

4 ‘‘(iv) Outpatient mental health and 

5 substance use services. 

6 ‘‘(v) Outpatient clinic primary care 

7 screening and monitoring of key health in8 dicators and health risk. 

9 ‘‘(vi) Targeted case management. 

10 ‘‘(vii) Psychiatric rehabilitation serv11 ices. 

12 ‘‘(viii) Peer support and counselor 

13 services and family supports. 

14 ‘‘(ix) Intensive, community-based 

15 mental health care for members of the 

16 Armed Forces and veterans, particularly 

17 those members and veterans located in 

18 rural areas, provided the care is consistent 

19 with minimum clinical mental health guide20 lines promulgated by the Veterans Health 

21 Administration including clinical guidelines 

22 contained in the Uniform Mental Health 

23 Services Handbook of such Administration. 

24 ‘‘(E) QUALITY AND OTHER REPORTING.— 

25 Reporting of encounter data, clinical outcomes 


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1 data, quality data, and such other data as the 

2 Secretary requires. 

3 ‘‘(F) ORGANIZATIONAL AUTHORITY.—Cri4 teria that a clinic be a non-profit or part of a 

5 local government behavioral health authority or 

6 operated under the authority of the Indian 

7 Health Service, an Indian tribe or tribal organi8 zation pursuant to a contract, grant, coopera9 tive agreement, or compact with the Indian 

10 Health Service pursuant to the Indian Self-De11 termination Act (25 U.S.C. 450 et seq.), or an 

12 urban Indian organization pursuant to a grant 

13 or contract with the Indian Health Service 

14 under title V of the Indian Health Care Im15 provement Act (25 U.S.C. 1601 et seq.). 

16 ‘‘(b) GUIDANCE ON DEVELOPMENT OF PROSPECTIVE

17 PAYMENT SYSTEM FOR TESTING UNDER DEMONSTRA18 TION PROGRAMS.— 

19 ‘‘(1) IN GENERAL.—Not later than September 

20 1, 2015, the Secretary, through the Administrator of 

21 the Centers for Medicare & Medicaid Services, shall 

22 issue guidance for the establishment of a prospective 

23 payment system that shall only apply to medical as24 sistance for mental health services furnished by a 

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1 pating in a demonstration program under subsection 

2 (d). 

3 ‘‘(2) REQUIREMENTS.—The guidance issued by 

4 the Secretary under paragraph (1) shall provide 

5 that— 

6 ‘‘(A) no payment shall be made for inpa7 tient care, residential treatment, room and 

8 board expenses, or any other nonambulatory 

9 services, as determined by the Secretary; and 

10 ‘‘(B) no payment shall be made to satellite 

11 facilities of certified community behavioral 

12 health clinics if such facilities are established 

13 after the date of enactment of this Act. 

14 ‘‘(c) PLANNING GRANTS.— 

15 ‘‘(1) IN GENERAL.—Not later than January 1, 

16 2016, the Secretary shall award planning grants to 

17 States for the purpose of developing proposals to 

18 participate in time-limited demonstration programs 

19 described in subsection (d). 

20 ‘‘(2) USE OF FUNDS.—A State awarded a plan21 ning grant under this subsection shall— 

22 ‘‘(A) solicit input with respect to the devel23 opment of such a demonstration program from 

24 patients, providers, and other stakeholders; 


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1 ‘‘(B) certify clinics as certified community 

2 behavioral health clinics for purposes of partici3 pating in a demonstration program conducted 

4 under subsection (d); and 

5 ‘‘(C) establish a prospective payment sys6 tem for mental health services furnished by a 

7 certified community behavioral health clinic 

8 participating in a demonstration program under 

9 subsection (d) in accordance with the guidance 

10 issued under subsection (b). 

11 ‘‘(d) DEMONSTRATION PROGRAMS.— 

12 ‘‘(1) IN GENERAL.—Not later than September 

13 1, 2017, the Secretary shall select States to partici14 pate in demonstration programs that are developed 

15 through planning grants awarded under subsection 

16 (c), meet the requirements of this subsection, and 

17 represent a diverse selection of geographic areas, in18 cluding rural and underserved areas. 

19 ‘‘(2) APPLICATION REQUIREMENTS.— 

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

21 solicit applications to participate in demonstra22 tion programs under this subsection solely from 

23 States awarded planning grants under sub24 section (c). 


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1 ‘‘(B) REQUIRED INFORMATION.—An appli2 cation for a demonstration program under this 

3 subsection shall include the following: 

4 ‘‘(i) The target Medicaid population 

5 to be served under the demonstration pro6 gram. 

7 ‘‘(ii) A list of participating certified 

8 community behavioral health clinics. 

9 ‘‘(iii) Verification that the State has 

10 certified a participating clinic as a certified 

11 community behavioral health clinic in ac12 cordance with the requirements of sub13 section (b). 

14 ‘‘(iv) A description of the scope of the 

15 mental health services available under the 

16 State Medicaid program that will be paid 

17 for under the prospective payment system 

18 tested in the demonstration program. 

19 ‘‘(v) Verification that the State has 

20 agreed to pay for such services at the rate 

21 established under the prospective payment 

22 system. 

23 ‘‘(vi) Such other information as the 

24 Secretary may require relating to the dem25 onstration program including with respect 


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1 to determining the soundness of the pro2 posed prospective payment system. 

3 ‘‘(3) NUMBER AND LENGTH OF DEMONSTRA4 TION PROGRAMS.—Not more than 10 States shall be 

5 selected for 4-year demonstration programs under 

6 this subsection. 

7 ‘‘(4) REQUIREMENTS FOR SELECTING DEM8 ONSTRATION PROGRAMS.— 

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

10 give preference to selecting demonstration pro11 grams where participating certified community 

12 behavioral health clinics— 

13 ‘‘(i) provide the most complete scope 

14 of services described in subsection 

15 (a)(2)(D) to individuals eligible for medical 

16 assistance under the State Medicaid pro17 gram; 

18 ‘‘(ii) will improve availability of, ac19 cess to, and participation in, services de20 scribed in subsection (a)(2)(D) to individ21 uals eligible for medical assistance under 

22 the State Medicaid program; 

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1 patient mental health treatment in the 

2 State; or 

3 ‘‘(iv) demonstrate the potential to ex4 pand available mental health services in a 

5 demonstration area and increase the qual6 ity of such services without increasing net 

7 Federal spending. 

8 ‘‘(5) PAYMENT FOR MEDICAL ASSISTANCE FOR

9 MENTAL HEALTH SERVICES PROVIDED BY CER10 TIFIED COMMUNITY BEHAVIORAL HEALTH CLIN11 ICS.— 

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

13 pay a State participating in a demonstration 

14 program under this subsection the Federal 

15 matching percentage specified in subparagraph 

16 (B) for amounts expended by the State to pro17 vide medical assistance for mental health serv18 ices described in the demonstration program ap19 plication in accordance with paragraph 

20 (2)(B)(iv) that are provided by certified com21 munity behavioral health clinics to individuals 

22 who are enrolled in the State Medicaid pro23 gram. Payments to States made under this 

24 paragraph shall be considered to have been 

25 under, and are subject to the requirements of, 


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1 section 1903 of the Social Security Act (42 

2 U.S.C. 1396b). 

3 ‘‘(B) FEDERAL MATCHING PERCENTAGE.— 

4 The Federal matching percentage specified in 

5 this subparagraph is with respect to medical as6 sistance described in subparagraph (A) that is 

7 furnished— 

8 ‘‘(i) to a newly eligible individual de9 scribed in paragraph (2) of section 1905(y) 

10 of the Social Security Act (42 U.S.C. 

11 1396d(y)), the matching rate applicable 

12 under paragraph (1) of that section; and 

13 ‘‘(ii) to an individual who is not a 

14 newly eligible individual (as so described) 

15 but who is eligible for medical assistance 

16 under the State Medicaid program, the en17 hanced FMAP applicable to the State. 

18 ‘‘(C) LIMITATIONS.— 

19 ‘‘(i) IN GENERAL.—Payments shall be 

20 made under this paragraph to a State only 

21 for mental health services— 

22 ‘‘(I) that are described in the 

23 demonstration program application in 

24 accordance with paragraph (2)(B)(iv); 


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1 ‘‘(II) for which payment is avail2 able under the State Medicaid pro3 gram; and 

4 ‘‘(III) that are provided to an in5 dividual who is eligible for medical as6 sistance under the State Medicaid 

7 program. 

8 ‘‘(ii) PROHIBITED PAYMENTS.—No 

9 payment shall be made under this para10 graph— 

11 ‘‘(I) for inpatient care, residen12 tial treatment, room and board ex13 penses, or any other nonambulatory 

14 services, as determined by the Sec15 retary; or 

16 ‘‘(II) with respect to payments 

17 made to satellite facilities of certified 

18 community behavioral health clinics if 

19 such facilities are established after the 

20 date of enactment of this Act. 

21 ‘‘(6) WAIVER OF STATEWIDENESS REQUIRE22 MENT.—The Secretary shall waive section 

23 1902(a)(1) of the Social Security Act (42 U.S.C. 

24 1396a(a)(1)) (relating to statewideness) as may be 


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1 necessary to conduct demonstration programs in ac2 cordance with the requirements of this subsection. 

3 ‘‘(7) ANNUAL REPORTS.— 

4 ‘‘(A) IN GENERAL.—Not later than 1 year 

5 after the date on which the first State is se6 lected for a demonstration program under this 

7 subsection, and annually thereafter, the Sec8 retary shall submit to Congress an annual re9 port on the use of funds provided under all 

10 demonstration programs conducted under this 

11 subsection. Each such report shall include— 

12 ‘‘(i) an assessment of access to com13 munity-based mental health services under 

14 the Medicaid program in the area or areas 

15 of a State targeted by a demonstration 

16 program compared to other areas of the 

17 State; 

18 ‘‘(ii) an assessment of the quality and 

19 scope of services provided by certified com20 munity behavioral health clinics compared 

21 to community-based mental health services 

22 provided in States not participating in a 

23 demonstration program under this sub24 section and in areas of a demonstration 


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1 State that are not participating in the 

2 demonstration program; and 

3 ‘‘(iii) an assessment of the impact of 

4 the demonstration programs on the Fed5 eral and State costs of a full range of men6 tal health services (including inpatient, 

7 emergency and ambulatory services). 

8 ‘‘(B) RECOMMENDATIONS.—Not later than 

9 December 31, 2021, the Secretary shall submit 

10 to Congress recommendations concerning 

11 whether the demonstration programs under this 

12 section should be continued, expanded, modi13 fied, or terminated. 

14 ‘‘(e) DEFINITIONS.—In this section: 

15 ‘‘(1) FEDERALLY-QUALIFIED HEALTH CENTER

16 SERVICES; FEDERALLY-QUALIFIED HEALTH CENTER; 

17 RURAL HEALTH CLINIC SERVICES; RURAL HEALTH

18 CLINIC.—The terms ‘Federally-qualified health cen19 ter services’, ‘Federally-qualified health center’, 

20 ‘rural health clinic services’, and ‘rural health clinic’ 

21 have the meanings given those terms in section 

22 1905(l) of the Social Security Act (42 U.S.C. 

23 1396d(l)). 

24 ‘‘(2) ENHANCED FMAP.—The term ‘enhanced 

25 FMAP’ has the meaning given that term in section 


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1 2105(b) of the Social Security Act (42 U.S.C. 

2 1397dd(b)) but without regard to the second and 

3 third sentences of that section. 

4 ‘‘(3) SECRETARY.—The term ‘Secretary’ means 

5 the Secretary of Health and Human Services. 

6 ‘‘(4) STATE.—The term ‘State’ has the mean7 ing given such term for purposes of title XIX of the 

8 Social Security Act (42 U.S.C. 1396 et seq.). 

9 ‘‘(f) FUNDING.— 

10 ‘‘(1) IN GENERAL.—Out of any funds in the 

11 Treasury not otherwise appropriated, there is appro12 priated to the Secretary— 

13 ‘‘(A) for purposes of carrying out sub14 sections (a), (b), and (d)(7), $2,000,000 for fis15 cal year 2014; and 

16 ‘‘(B) for purposes of awarding planning 

17 grants under subsection (c), $25,000,000 for 

18 fiscal year 2016. 

19 ‘‘(2) AVAILABILITY.—Funds appropriated 

20 under paragraph (1) shall remain available until ex21 pended.’’. 


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1 TITLE VI—RESEARCH BY NA2 TIONAL INSTITUTE OF MEN3 TAL HEALTH 

4 SEC. 601. INCREASE IN FUNDING FOR CERTAIN RESEARCH. 

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

6 U.S.C. 282a(a)) is amended by adding at the end the fol7 lowing: 

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

9 THE NATIONAL INSTITUTE OF MENTAL HEALTH.— 

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

11 made available pursuant to paragraphs (1) and 

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

13 the National Institute of Mental Health for the 

14 purpose described in subparagraph (B)(ii) 

15 $40,000,000 for each of fiscal years 2016 

16 through 2020. 

17 ‘‘(B) PURPOSES.—Amounts appropriated 

18 pursuant to subparagraph (A) shall be used ex19 clusively for the purpose of conducting or sup20 porting— 

21 ‘‘(i) research on the determinants of 

22 self- and other directed-violence in mental 

23 illness, including studies directed at reduc24 ing the risk of self harm, suicide, and 

25 interpersonal violence; or 


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1 ‘‘(ii) brain research through the Brain 

2 Research through Advancing Innovative 

3 Neurotechnologies Initiative.’’. 

4 TITLE VII—BEHAVIORAL 

5 HEALTH INFORMATION TECH6 NOLOGY 

7 SEC. 701. EXTENSION OF HEALTH INFORMATION TECH8 NOLOGY ASSISTANCE FOR BEHAVIORAL AND 

9 MENTAL HEALTH AND SUBSTANCE ABUSE. 

10 Section 3000(3) of the Public Health Service Act (42 

11 U.S.C. 300jj(3)) is amended by inserting before ‘‘and any 

12 other category’’ the following: ‘‘behavioral and mental 

13 health professionals (as defined in section 

14 331(a)(3)(E)(i)), a substance abuse professional, a psy15 chiatric hospital (as defined in section 1861(f) of the So16 cial Security Act), a community mental health center 

17 meeting the criteria specified in section 1913(c), a residen18 tial or outpatient mental health or substance use treat19 ment facility,’’. 

20 SEC. 702. EXTENSION OF ELIGIBILITY FOR MEDICARE AND 

21 MEDICAID HEALTH INFORMATION TECH22 NOLOGY IMPLEMENTATION ASSISTANCE. 

23 (a) PAYMENT INCENTIVES FOR ELIGIBLE PROFES24 SIONALS UNDER MEDICARE.—Section 1848 of the Social 

25 Security Act (42 U.S.C. 1395w–4) is amended— 


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1 (1) in subsection (a)(7)— 

2 (A) in subparagraph (E), by adding at the 

3 end the following new clause: 

4 ‘‘(iv) ADDITIONAL ELIGIBLE PROFES5 SIONAL.—The term ‘additional eligible pro6 fessional’ means a clinical psychologist pro7 viding qualified psychologist services (as 

8 defined in section 1861(ii)).’’; and 

9 (B) by adding at the end the following new 

10 subparagraph: 

11 ‘‘(F) APPLICATION TO ADDITIONAL ELIGI12 BLE PROFESSIONALS.—The Secretary shall 

13 apply the provisions of this paragraph with re14 spect to an additional eligible professional in 

15 the same manner as such provisions apply to an 

16 eligible professional, except in applying sub17 paragraph (A)— 

18 ‘‘(i) in clause (i), the reference to 

19 2015 shall be deemed a reference to 2020; 

20 ‘‘(ii) in clause (ii), the references to 

21 2015, 2016, and 2017 shall be deemed ref22 erences to 2020, 2021, and 2022, respec23 tively; and 


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1 ‘‘(iii) in clause (iii), the reference to 

2 2018 shall be deemed a reference to 

3 2023.’’; and 

4 (2) in subsection (o)— 

5 (A) in paragraph (5), by adding at the end 

6 the following new subparagraph: 

7 ‘‘(D) ADDITIONAL ELIGIBLE PROFES8 SIONAL.—The term ‘additional eligible profes9 sional’ means a clinical psychologist providing 

10 qualified psychologist services (as defined in 

11 section 1861(ii)).’’; and 

12 (B) by adding at the end the following new 

13 paragraph: 

14 ‘‘(6) APPLICATION TO ADDITIONAL ELIGIBLE

15 PROFESSIONALS.—The Secretary shall apply the 

16 provisions of this subsection with respect to an addi17 tional eligible professional in the same manner as 

18 such provisions apply to an eligible professional, ex19 cept in applying— 

20 ‘‘(A) paragraph (1)(A)(ii), the reference to 

21 2016 shall be deemed a reference to 2021; 

22 ‘‘(B) paragraph (1)(B)(ii), the references 

23 to 2011 and 2012 shall be deemed references to 

24 2016 and 2017, respectively; 


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1 ‘‘(C) paragraph (1)(B)(iii), the references 

2 to 2013 shall be deemed references to 2018; 

3 ‘‘(D) paragraph (1)(B)(v), the references 

4 to 2014 shall be deemed references to 2019; 

5 and 

6 ‘‘(E) paragraph (1)(E), the reference to 

7 2011 shall be deemed a reference to 2016.’’. 

8 (b) ELIGIBLE HOSPITALS.—Section 1886 of the So9 cial Security Act (42 U.S.C. 1395ww) is amended— 

10 (1) in subsection (b)(3)(B)(ix), by adding at the 

11 end the following new subclause: 

12 ‘‘(V) The Secretary shall apply 

13 the provisions of this subsection with 

14 respect to an additional eligible hos15 pital (as defined in subsection 

16 (n)(6)(C)) in the same manner as 

17 such provisions apply to an eligible 

18 hospital, except in applying— 

19 ‘‘(aa) subclause (I), the ref20 erences to 2015, 2016, and 2017 

21 shall be deemed references to 

22 2020, 2021, and 2022, respec23 tively; and 

24 ‘‘(bb) subclause (III), the 

25 reference to 2015 shall be 


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1 deemed a reference to 2020.’’; 

2 and 

3 (2) in subsection (n)— 

4 (A) in paragraph (6), by adding at the end 

5 the following new subparagraph: 

6 ‘‘(C) ADDITIONAL ELIGIBLE HOSPITAL.— 

7 The term ‘additional eligible hospital’ means an 

8 inpatient hospital that is a psychiatric hospital 

9 (as defined in section 1861(f)).’’; and 

10 (B) by adding at the end the following new 

11 paragraph: 

12 ‘‘(7) APPLICATION TO ADDITIONAL ELIGIBLE

13 HOSPITALS.—The Secretary shall apply the provi14 sions of this subsection with respect to an additional 

15 eligible hospital in the same manner as such provi16 sions apply to an eligible hospital, except in apply17 ing— 

18 ‘‘(A) paragraph (2)(E)(ii), the references 

19 to 2013 and 2015 shall be deemed references to 

20 2018 and 2020, respectively; and 

21 ‘‘(B) paragraph (2)(G)(i), the reference to 

22 2011 shall be deemed a reference to 2016.’’. 

23 (c) MEDICAID PROVIDERS.—Section 1903(t) of the 

24 Social Security Act (42 U.S.C. 1396b(t)) is amended— 

25 (1) in paragraph (2)(B)— 


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1 (A) in clause (i), by striking ‘‘, or’’ at the 

2 end and inserting a semicolon; 

3 (B) in clause (ii), by striking the period at 

4 the end and inserting a semicolon; and 

5 (C) by inserting after clause (ii) the fol6 lowing new clauses: 

7 ‘‘(iii) a public hospital that is principally a 

8 psychiatric hospital (as defined in section 

9 1861(f)); 

10 ‘‘(iv) a private hospital that is principally 

11 a psychiatric hospital (as defined in section 

12 1861(f)) and that has at least 10 percent of its 

13 patient volume (as estimated in accordance with 

14 a methodology established by the Secretary) at15 tributable to individuals receiving medical as16 sistance under this title; 

17 ‘‘(v) a community mental health center 

18 meeting the criteria specified in section 1913(c) 

19 of the Public Health Service Act; or 

20 ‘‘(vi) a residential or outpatient mental 

21 health or substance use treatment facility 

22 that— 

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1 tion of Rehabilitation Facilities, the Coun2 cil on Accreditation, or any other national 

3 accrediting agency recognized by the Sec4 retary; and 

5 ‘‘(II) has at least 10 percent of its pa6 tient volume (as estimated in accordance 

7 with a methodology established by the Sec8 retary) attributable to individuals receiving 

9 medical assistance under this title.’’; and 

10 (2) in paragraph (3)(B)— 

11 (A) in clause (iv), by striking ‘‘; and’’ at 

12 the end and inserting a semicolon; 

13 (B) in clause (v), by striking the period at 

14 the end and inserting ‘‘; and’’; and 

15 (C) by adding at the end the following new 

16 clause: 

17 ‘‘(vi) clinical psychologist providing quali18 fied psychologist services (as defined in section 

19 1861(ii)), if such clinical psychologist is prac20 ticing in an outpatient clinic that— 

21 ‘‘(I) is led by a clinical psychologist; 

22 and 

23 ‘‘(II) is not otherwise receiving pay24 ment under paragraph (1) as a Medicaid 

25 provider described in paragraph (2)(B).’’. 


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1 (d) MEDICARE ADVANTAGE ORGANIZATIONS.—Sec2 tion 1853 of the Social Security Act (42 U.S.C. 1395w– 

3 23) is amended— 

4 (1) in subsection (l)— 

5 (A) in paragraph (1)— 

6 (i) by inserting ‘‘or additional eligible 

7 professionals (as described in paragraph 

8 (9))’’ after ‘‘paragraph (2)’’; and 

9 (ii) by inserting ‘‘and additional eligi10 ble professionals’’ before ‘‘under such sec11 tions’’; 

12 (B) in paragraph (3)(B)— 

13 (i) in clause (i) in the matter pre14 ceding subclause (I), by inserting ‘‘or an 

15 additional eligible professional described in 

16 paragraph (9)’’ after ‘‘paragraph (2)’’; and 

17 (ii) in clause (ii)— 

18 (I) in the matter preceding sub19 clause (I), by inserting ‘‘or an addi20 tional eligible professional described in 

21 paragraph (9)’’ after ‘‘paragraph 

22 (2)’’; and 

23 (II) in subclause (I), by inserting 

24 ‘‘or an additional eligible professional, 


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1 respectively,’’ after ‘‘eligible profes2 sional’’; 

3 (C) in paragraph (3)(C), by inserting ‘‘and 

4 additional eligible professionals’’ after ‘‘all eligi5 ble professionals’’; 

6 (D) in paragraph (4)(D), by adding at the 

7 end the following new sentence: ‘‘In the case 

8 that a qualifying MA organization attests that 

9 not all additional eligible professionals of the 

10 organization are meaningful EHR users with 

11 respect to an applicable year, the Secretary 

12 shall apply the payment adjustment under this 

13 paragraph based on the proportion of all such 

14 additional eligible professionals of the organiza15 tion that are not meaningful EHR users for 

16 such year.’’; 

17 (E) in paragraph (6)(A), by inserting 

18 ‘‘and, as applicable, each additional eligible pro19 fessional described in paragraph (9)’’ after 

20 ‘‘paragraph (2)’’; 

21 (F) in paragraph (6)(B), by inserting 

22 ‘‘and, as applicable, each additional eligible hos23 pital described in paragraph (9)’’ after ‘‘sub24 section (m)(1)’’; 


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1 (G) in paragraph (7)(A), by inserting 

2 ‘‘and, as applicable, additional eligible profes3 sionals’’ after ‘‘eligible professionals’’; 

4 (H) in paragraph (7)(B), by inserting 

5 ‘‘and, as applicable, additional eligible profes6 sionals’’ after ‘‘eligible professionals’’; 

7 (I) in paragraph (8)(B), by inserting ‘‘and 

8 additional eligible professionals described in 

9 paragraph (9)’’ after ‘‘paragraph (2)’’; and 

10 (J) by adding at the end the following new 

11 paragraph: 

12 ‘‘(9) ADDITIONAL ELIGIBLE PROFESSIONAL DE13 SCRIBED.—With respect to a qualifying MA organi14 zation, an additional eligible professional described 

15 in this paragraph is an additional eligible profes16 sional (as defined for purposes of section 1848(o)) 

17 who— 

18 ‘‘(A)(i) is employed by the organization; or 

19 ‘‘(ii)(I) is employed by, or is a partner of, 

20 an entity that through contract with the organi21 zation furnishes at least 80 percent of the enti22 ty’s Medicare patient care services to enrollees 

23 of such organization; and 

24 ‘‘(II) furnishes at least 80 percent of the 

25 professional services of the additional eligible 


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1 professional covered under this title to enrollees 

2 of the organization; and 

3 ‘‘(B) furnishes, on average, at least 20 

4 hours per week of patient care services.’’; and 

5 (2) in subsection (m)— 

6 (A) in paragraph (1)— 

7 (i) by inserting ‘‘or additional eligible 

8 hospitals (as described in paragraph (7))’’ 

9 after ‘‘paragraph (2)’’; and 

10 (ii) by inserting ‘‘and additional eligi11 ble hospitals’’ before ‘‘under such sec12 tions’’; 

13 (B) in paragraph (3)(A)(i), by inserting 

14 ‘‘or additional eligible hospital’’ after ‘‘eligible 

15 hospital’’; 

16 (C) in paragraph (3)(A)(ii), by inserting 

17 ‘‘or an additional eligible hospital’’ after ‘‘eligi18 ble hospital’’ in each place it occurs; 

19 (D) in paragraph (3)(B)— 

20 (i) in clause (i), by inserting ‘‘or an 

21 additional eligible hospital described in 

22 paragraph (7)’’ after ‘‘paragraph (2)’’; and 

23 (ii) in clause (ii)— 

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1 tional eligible hospital described in 

2 paragraph (7)’’ after ‘‘paragraph 

3 (2)’’; and 

4 (II) in subclause (I), by inserting 

5 ‘‘or an additional eligible hospital, re6 spectively,’’ after ‘‘eligible hospital’’; 

7 (E) in paragraph (4)(A), by inserting ‘‘or 

8 one or more additional eligible hospitals (as de9 fined in section 1886(n)), as appropriate,’’ after 

10 ‘‘section 1886(n)(6)(A))’’; 

11 (F) in paragraph (4)(D), by adding at the 

12 end the following new sentence: ‘‘In the case 

13 that a qualifying MA organization attests that 

14 not all additional eligible hospitals of the orga15 nization are meaningful EHR users with re16 spect to an applicable period, the Secretary 

17 shall apply the payment adjustment under this 

18 paragraph based on the methodology specified 

19 by the Secretary, taking into account the pro20 portion of such additional eligible hospitals, or 

21 discharges from such hospitals, that are not 

22 meaningful EHR users for such period.’’; 

23 (G) in paragraph (5)(A), by inserting 

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1 pital described in paragraph (7)’’ after ‘‘para2 graph (2)’’; 

3 (H) in paragraph (5)(B), by inserting 

4 ‘‘and additional eligible hospitals, as applica5 ble,’’ after ‘‘eligible hospitals’’; 

6 (I) in paragraph (6)(B), by inserting ‘‘and 

7 additional eligible hospitals described in para8 graph (7)’’ after ‘‘paragraph (2)’’; and 

9 (J) by adding at the end the following new 

10 paragraph: 

11 ‘‘(7) ADDITIONAL ELIGIBLE HOSPITAL DE12 SCRIBED.—With respect to a qualifying MA organi13 zation, an additional eligible hospital described in 

14 this paragraph is an additional eligible hospital (as 

15 defined in section 1886(n)(6)(C)) that is under com16 mon corporate governance with such organization 

17 and serves individuals enrolled under an MA plan of18 fered by such organization.’’. 

19 TITLE VIII—SAMHSA REAUTHOR20 IZATION AND REFORMS 

21 Subtitle A—Organization and 

22 General Authorities 

23 SEC. 801. IN GENERAL. 

24 Section 501 of the Public Health Service Act (42 

25 U.S.C. 290aa) is amended— 


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1 (1) in subsection (h), by inserting at the end 

2 the following: ‘‘For any such peer-review group re3 viewing a proposal or grant related to mental illness, 

4 no fewer than half of the members of the group shall 

5 have a medical degree, or a corresponding doctoral 

6 degree in psychology and clinical experience.’’; and 

7 (2) in subsection (l)— 

8 (A) in paragraph (2), by striking ‘‘and’’ at 

9 the end; 

10 (B) in paragraph (3), by striking the pe11 riod at the end and inserting ‘‘; and’’; and 

12 (C) by adding at the end the following: 

13 ‘‘(4) At least 60 days before awarding a grant, 

14 cooperative agreement, or contract, the Assistant 

15 Secretary shall give written notice of the award to 

16 the Committee on Energy and Commerce of the 

17 House of Representatives and the Committee on 

18 Health, Education, Labor, and Pensions of the Sen19 ate.’’. 

20 SEC. 802. ADVISORY COUNCILS. 

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

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

23 at the end the following: 


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1 ‘‘(C) No fewer than half of the members of 

2 an advisory council shall be mental health care 

3 providers with— 

4 ‘‘(i) experience in mental health re5 search or treatment; and 

6 ‘‘(ii) expertise in the fields on which 

7 they are advising. 

8 ‘‘(D) None of the appointed members may 

9 have at any point been a recipient of any grant, 

10 or participated in any program, about which the 

11 members are to advise. 

12 ‘‘(E) None of the appointed members may 

13 be related to anyone who has been a recipient 

14 of any grant, or participated in any program, 

15 about which the members are to advise. 

16 ‘‘(F) None of the appointed members may 

17 have a financial interest in any grant or pro18 gram with respect to which they advise, or re19 ceive funding separately through the Office of 

20 Assistant Secretary. 

21 ‘‘(G) Each advisory committee must in22 clude at least one member of the National Insti23 tute of Mental Health and one member from 

24 any Federal agency that has a program serving 

25 a similar population.’’. 


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1 SEC. 803. PEER REVIEW. 

2 Section 504 of the Public Health Service Act (42 

3 U.S.C. 290aa–3) is amended— 

4 (1) by adding at the end of subsection (b) the 

5 following: ‘‘At least half of the members of any peer6 review group established under subsection (a) shall 

7 have a degree in medicine, or a corresponding doc8 toral degree in psychology, or be a licensed mental 

9 health professional. Before awarding a grant, coop10 erative agreement, or contract, the Secretary shall 

11 provide a list of the members of the peer-review 

12 group responsible for reviewing the award to the 

13 Committee on Energy and Commerce of the House 

14 of Representatives and the Committee on Health, 

15 Education, Labor, and Pensions of the Senate.’’; 

16 and 

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

18 ‘‘(e) SCIENTIFIC CONTROLS AND STANDARDS.—Peer 

19 review under this section shall ensure that any research 

20 concerning an intervention is based on scientific controls 

21 and standards indicating whether the intervention reduces 

22 symptoms, improves medical or behavioral outcomes, and 

23 improves social functioning.’’. 


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1 Subtitle B—Protection and Advo2 cacy for Individuals With Men3 tal Illness 

4 SEC. 811. PROHIBITION AGAINST LOBBYING BY SYSTEMS 

5 ACCEPTING FEDERAL FUNDS TO PROTECT 

6 AND ADVOCATE THE RIGHTS OF INDIVID7 UALS WITH MENTAL ILLNESS. 

8 Section 105(a) of the Protection and Advocacy for 

9 Individuals with Mental Illness Act (42 U.S.C. 10805(a)) 

10 is amended— 

11 (1) in paragraph (9), by striking ‘‘and’’ at the 

12 end; 

13 (2) in paragraph (10), by striking the period at 

14 the end and inserting a semicolon; and 

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

16 ‘‘(11) agree to refrain, during any period for 

17 which funding is provided to the system under this 

18 part, from— 

19 ‘‘(A) lobbying or retaining a lobbyist for 

20 the purpose of influencing a Federal, State, or 

21 local governmental entity or officer; and 

22 ‘‘(B) counseling an individual with a seri23 ous mental illness who lacks insight into their 

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1 ing against the wishes of such individual’s care2 giver;’’. 

3 SEC. 812. ENSURING THAT CAREGIVERS OF INDIVIDUALS 

4 WITH SERIOUS MENTAL ILLNESS HAVE AC5 CESS TO THE PROTECTED HEALTH INFORMA6 TION OF SUCH INDIVIDUALS. 

7 Section 105(a) of the Protection and Advocacy for 

8 Individuals with Mental Illness Act (42 U.S.C. 10805(a)), 

9 as amended by section 811, is further amended by adding 

10 at the end the following: 

11 ‘‘(12) ensure that caregivers (as defined in sec12 tion 201 of the Helping Families in Mental Health 

13 Crisis Act of 2015) of individuals with serious men14 tal illness (as defined in such section 201) have ac15 cess to the protected health information of such indi16 viduals consistent with such section 201;’’. 

17 SEC. 813. PROTECTION AND ADVOCACY ACTIVITIES TO 

18 FOCUS EXCLUSIVELY ON SAFEGUARDING 

19 RIGHTS TO BE FREE FROM ABUSE AND NE20 GLECT. 

21 (a) PURPOSES.—Section 101(b) of the Protection 

22 and Advocacy for Individuals with Mental Illness Act (42 

23 U.S.C. 10801(b)) is amended— 

24 (1) in paragraph (1), by inserting ‘‘to be free 

25 from abuse and neglect’’ before ‘‘are protected’’; and 


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1 (2) in paragraph (2)(A), by inserting ‘‘to be 

2 free from abuse and neglect’’ before ‘‘through activi3 ties to ensure’’. 

4 (b) ALLOTMENTS.—Section 103(2)(A) of the Protec5 tion and Advocacy for Individuals with Mental Illness Act 

6 (42 U.S.C. 10803(2)(A)) is amended by inserting ‘‘to be 

7 free from abuse and neglect’’ before the semicolon. 

8 (c) USE OF ALLOTMENTS.—Section 104(a)(1) of the 

9 Protection and Advocacy for Individuals with Mental Ill10 ness Act (42 U.S.C. 10804(a)(1)) is amended— 

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

12 the end; 

13 (2) in subparagraph (B), by striking the semi14 colon at the end and inserting ‘‘to be free from 

15 abuse and neglect; and’’; and 

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

17 ‘‘(C) the protection and advocacy activities 

18 of such an agency or organization shall be ex19 clusively focused on safeguarding the rights of 

20 individuals with mental illness to be free from 

21 abuse and neglect.’’. 

22 (d) SYSTEM REQUIREMENTS.—Section 105 of the 

23 Protection and Advocacy for Individuals with Mental Ill24 ness Act (42 U.S.C. 10805), as amended by sections 811 

25 and 812, is further amended— 


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1 (1) in subsection (a)— 

2 (A) in the matter before paragraph (1), by 

3 inserting ‘‘to be free from abuse and neglect’’ 

4 before ‘‘shall’’; 

5 (B) in paragraph (6)(A), by inserting ‘‘to 

6 be free from abuse and neglect’’ before the 

7 semicolon; and 

8 (C) by adding at the end the following: 

9 ‘‘(13) be exclusively focused on safeguarding 

10 the rights of individuals with mental illness to be 

11 free from abuse and neglect; and’’; and 

12 (2) in subsection (c)(1)(A), by inserting ‘‘to be 

13 free from abuse and neglect’’ before ‘‘shall have a 

14 governing authority’’. 

15 (e) APPLICATIONS.—Section 111(a) of the Protection 

16 and Advocacy for Individuals with Mental Illness Act (42 

17 U.S.C. 10821(a)) is amended— 

18 (1) in paragraph (1), by inserting ‘‘to be free 

19 from abuse and neglect’’ before the semicolon; 

20 (2) in paragraph (3), by striking ‘‘and’’ at the 

21 end; 

22 (3) by redesignating paragraph (4) as para23 graph (5); and 

24 (4) by inserting after paragraph (3) the fol25 lowing: 


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1 ‘‘(4) assurances that such system, and any 

2 State agency or nonprofit organization with which 

3 such system may enter into a contract under section 

4 10804(a), will be exclusively focused on safeguarding 

5 the rights of individuals with mental illness to be 

6 free from abuse and neglect; and’’. 

7 (f) REPORTS BY SECRETARY.—Section 114(a) of the 

8 Protection and Advocacy for Individuals with Mental Ill9 ness Act (42 U.S.C. 10824(a)) is amended— 

10 (1) in paragraph (1) in the matter before sub11 paragraph (A), by inserting ‘‘to be free from abuse 

12 and neglect’’ before ‘‘supported with payments’’; 

13 (2) in paragraph (2)(A), by inserting ‘‘to be 

14 free from abuse and neglect’’ before ‘‘supported with 

15 payments’’; and 

16 (3) in paragraph (4), by inserting ‘‘to be free 

17 from abuse and neglect’’ before ‘‘and a description’’. 

18 SEC. 814. REPORTING. 

19 (a) PUBLIC AVAILABILITY OF REPORTS.—Section 

20 105(a)(7) of the Protection and Advocacy for Individuals 

21 with Mental Illness Act (42 U.S.C. 10805(a)(7)) is 

22 amended by striking ‘‘is located a report’’ and inserting 

23 ‘‘is located, and make publicly available, a report’’. 

24 (b) DETAILED ACCOUNTING.—Section 114(a) of the 

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1 ness Act (42 U.S.C. 10824(a)), as amended, is further 

2 amended— 

3 (1) in paragraph (3), by striking ‘‘and’’ at the 

4 end; 

5 (2) in paragraph (4), by striking the period at 

6 the end and inserting ‘‘; and’’; and 

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

8 ‘‘(5) a detailed accounting, for each system 

9 funded under this title, of how funds are spent, 

10 disaggregated according to whether the funds were 

11 received from the Federal Government, the State 

12 government, a local government, or a private enti13 ty.’’. 

14 SEC. 815. GRIEVANCE PROCEDURE. 

15 Section 105 of the Protection and Advocacy for Indi16 viduals with Mental Illness Act (42 U.S.C. 10805), as 

17 amended, is further amended by adding at the end the 

18 following: 

19 ‘‘(d) GRIEVANCE PROCEDURE.—The Assistant Sec20 retary shall establish an independent grievance procedure 

21 for the types of claims to be adjudicated, at the request 

22 of persons described in subsection (a)(9), through a sys23 tem’s grievance procedure established under such sub24 section.’’. 


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1 SEC. 816. EVIDENCE-BASED TREATMENT FOR INDIVIDUALS 

2 WITH SERIOUS MENTAL ILLNESS. 

3 Section 105(a) of the Protection and Advocacy for 

4 Individuals with Mental Illness Act (42 U.S.C. 10805(a)), 

5 as amended by sections 811, 812, and 813, is further 

6 amended by adding at the end the following: 

7 ‘‘(14) ensure that individuals with serious men8 tal illness have access to and can obtain evidence9 based treatment for their serious mental illness.’’. 

10 TITLE IX—REPORTING 

11 SEC. 901. GAO STUDY ON PREVENTING DISCRIMINATORY 

12 COVERAGE LIMITATIONS FOR INDIVIDUALS 

13 WITH SERIOUS MENTAL ILLNESS AND SUB14 STANCE USE DISORDERS. 

15 Not later than 1 year after the date of the enactment 

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

17 in consultation with the Assistant Secretary for Mental 

18 Health and Substance Use Disorders, the Secretary of 

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

20 the Secretary of the Treasury, shall submit to Congress 

21 a report detailing the extent to which covered group health 

22 plans (or health insurance coverage offered in connection 

23 with such plans), including Medicaid managed care plans 

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

25 1396b), comply with the Paul Wellstone and Pete Domen26 ici Mental Health Parity and Addiction Equity Act of 


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1 2008 (subtitle B of title V of division C of Public Law 

2 110–343) (in this section referred to as the ‘‘law’’), includ3 ing— 

4 (1) how nonquantitative treatment limitations, 

5 including medical necessity criteria, of covered group 

6 health plans comply with the law; 

7 (2) how the responsible Federal departments 

8 and agencies ensure that plans comply with the law; 

9 and 

10 (3) how proper enforcement, education, and co11 ordination activities within responsible Federal de12 partments and agencies can be used to ensure full 

13 compliance with the law, including educational ac14 tivities directed to State insurance commissioners. 

Æ 


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