IIB 

114TH CONGRESS 

2D SESSION H. R. 2646 

IN THE SENATE OF THE UNITED STATES 

JULY 7, 2016 

Received 

JULY 14, 2016 

Read twice and referred to the Committee on Health, Education, Labor, and 

Pensions 

AN ACT 

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, 


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1 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

3 ‘‘Helping Families in Mental Health Crisis Act of 2016’’. 

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

5 this Act is as follows: 

Sec. 1. Short title; table of contents. 

TITLE I—ASSISTANT SECRETARY FOR MENTAL HEALTH AND 

SUBSTANCE USE 

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

Sec. 102. Improving oversight of mental health and substance use programs. 

Sec. 103. National Mental Health and Substance Use Policy Laboratory. 

Sec. 104. Peer-support specialist programs. 

Sec. 105. Prohibition against lobbying using Federal funds by systems accepting Federal funds to protect and advocate the rights of individuals with mental illness. 

Sec. 106. Reporting for protection and advocacy organizations. 

Sec. 107. Grievance procedure. 

Sec. 108. Center for Behavioral Health Statistics and Quality. 

Sec. 109. Strategic plan. 

Sec. 110. Authorities of centers for mental health services and substance abuse 

treatment. 

Sec. 111. Advisory councils. 

Sec. 112. Peer review. 

TITLE II—MEDICAID MENTAL HEALTH COVERAGE 

Sec. 201. Rule of construction related to Medicaid coverage of mental health 

services and primary care services furnished on the same day. 

Sec. 202. Optional limited coverage of inpatient services furnished in institutions for mental diseases. 

Sec. 203. Study and report related to Medicaid managed care regulation. 

Sec. 204. Guidance on opportunities for innovation. 

Sec. 205. Study and report on Medicaid emergency psychiatric demonstration 

project. 

Sec. 206. Providing EPSDT services to children in IMDs. 

Sec. 207. Electronic visit verification system required for personal care services 

and home health care services under Medicaid. 

TITLE III—INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS 

COORDINATING COMMITTEE 

Sec. 301. Interdepartmental Serious Mental Illness Coordinating Committee. 

TITLE IV—COMPASSIONATE COMMUNICATION ON HIPAA 

Sec. 401. Sense of Congress. 

Sec. 402. Confidentiality of records. 

Sec. 403. Clarification of circumstances under which disclosure of protected 

health information is permitted. 


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Sec. 404. Development and dissemination of model training programs. 

TITLE V—INCREASING ACCESS TO TREATMENT FOR SERIOUS 

MENTAL ILLNESS 

Sec. 501. Assertive community treatment grant program for individuals with 

serious mental illness. 

Sec. 502. Strengthening community crisis response systems. 

Sec. 503. Increased and extended funding for assisted outpatient grant program for individuals with serious mental illness. 

Sec. 504. Liability protections for health professional volunteers at community 

health centers. 

TITLE VI—SUPPORTING INNOVATIVE AND EVIDENCE-BASED 

PROGRAMS 

Subtitle A—Encouraging the Advancement, Incorporation, and Development 

of Evidence-Based Practices 

Sec. 601. Encouraging innovation and evidence-based programs. 

Sec. 602. Promoting access to information on evidence-based programs and 

practices. 

Sec. 603. Sense of Congress. 

Subtitle B—Supporting the State Response to Mental Health Needs 

Sec. 611. Community Mental Health Services Block Grant. 

Subtitle C—Strengthening Mental Health Care for Children and Adolescents 

Sec. 621. Tele-mental health care access grants. 

Sec. 622. Infant and early childhood mental health promotion, intervention, and 

treatment. 

Sec. 623. National Child Traumatic Stress Initiative. 

TITLE VII—GRANT PROGRAMS AND PROGRAM REAUTHORIZATION 

Subtitle A—Garrett Lee Smith Memorial Act Reauthorization 

Sec. 701. Youth interagency research, training, and technical assistance centers. 

Sec. 702. Youth suicide early intervention and prevention strategies. 

Sec. 703. Mental health and substance use disorder services on campus. 

Subtitle B—Other Provisions 

Sec. 711. National Suicide Prevention Lifeline Program. 

Sec. 712. Workforce development studies and reports. 

Sec. 713. Minority Fellowship Program. 

Sec. 714. Center and program repeals. 

Sec. 715. National violent death reporting system. 

Sec. 716. Sense of Congress on prioritizing Native American youth and suicide 

prevention programs. 

Sec. 717. Peer professional workforce development grant program. 

Sec. 718. National Health Service Corps. 

Sec. 719. Adult suicide prevention. 

Sec. 720. Crisis intervention grants for police officers and first responders. 


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Sec. 721. Demonstration grant program to train health service psychologists in 

community-based mental health. 

Sec. 722. Investment in tomorrow’s pediatric health care workforce. 

Sec. 723. CUTGO compliance. 

TITLE VIII—MENTAL HEALTH PARITY 

Sec. 801. Enhanced compliance with mental health and substance use disorder 

coverage requirements. 

Sec. 802. Action plan for enhanced enforcement of mental health and substance 

use disorder coverage. 

Sec. 803. Report on investigations regarding parity in mental health and substance use disorder benefits. 

Sec. 804. GAO study on parity in mental health and substance use disorder 

benefits. 

Sec. 805. Information and awareness on eating disorders. 

Sec. 806. Education and training on eating disorders. 

Sec. 807. GAO study on preventing discriminatory coverage limitations for individuals with serious mental illness and substance use disorders. 

Sec. 808. Clarification of existing parity rules. 

1 TITLE I—ASSISTANT SECRETARY 

2 FOR MENTAL HEALTH AND 

3 SUBSTANCE USE 

4 SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH 

5 AND SUBSTANCE USE. 

6 (a) ASSISTANT SECRETARY.—Section 501(c) of the 

7 Public Health Service Act (42 U.S.C. 290aa) is amended 

8 to read as follows: 

9 ‘‘(c) ASSISTANT SECRETARY AND DEPUTY ASSIST10 ANT SECRETARY.— 

11 ‘‘(1) ASSISTANT SECRETARY.— 

12 ‘‘(A) APPOINTMENT.—The Administration 

13 shall be headed by an official to be known as 

14 the Assistant Secretary for Mental Health and 

15 Substance Use (hereinafter in this title referred 

16 to as the ‘Assistant Secretary’) who shall be apVerDate Sep 11 2014 22:58 Jul 15, 2016 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H2646.RFS H2646

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1 pointed by the President, by and with the ad2 vice and consent of the Senate. 

3 ‘‘(B) QUALIFICATIONS.—In selecting the 

4 Assistant Secretary, the President shall give 

5 preference to individuals who have— 

6 ‘‘(i) a doctoral degree in medicine, os7 teopathic medicine, or psychology; 

8 ‘‘(ii) clinical and research experience 

9 regarding mental health and substance use 

10 disorders; and 

11 ‘‘(iii) an understanding of biological, 

12 psychosocial, and pharmaceutical treat13 ments of mental illness and substance use 

14 disorders. 

15 ‘‘(2) DEPUTY ASSISTANT SECRETARY.—The As16 sistant Secretary, with the approval of the Secretary, 

17 may appoint a Deputy Assistant Secretary and may 

18 employ and prescribe the functions of such officers 

19 and employees, including attorneys, as are necessary 

20 to administer the activities to be carried out through 

21 the Administration.’’. 

22 (b) TRANSFER OF AUTHORITIES.—The Secretary of 

23 Health and Human Services shall delegate to the Assist24 ant Secretary for Mental Health and Substance Use all 

25 duties and authorities that— 


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

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

3 Substance Abuse and Mental Health Services Ad4 ministration; and 

5 (2) are not terminated by this Act. 

6 (c) EVALUATION.—Section 501(d) of the Public 

7 Health Service Act (42 U.S.C. 290aa(d)) is amended— 

8 (1) in paragraph (17), by striking ‘‘and’’ at the 

9 end; 

10 (2) in paragraph (18), by striking the period at 

11 the end and inserting a semicolon; and 

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

13 ‘‘(19) evaluate, in consultation with the Assist14 ant Secretary for Financial Resources, the informa15 tion used for oversight of grants under programs re16 lated to mental illness and substance use disorders, 

17 including co-occurring illness or disorders, adminis18 tered by the Center for Mental Health Services; 

19 ‘‘(20) periodically review Federal programs and 

20 activities relating to the diagnosis or prevention of, 

21 or treatment or rehabilitation for, mental illness and 

22 substance use disorders to identify any such pro23 grams or activities that have proven to be effective 

24 or efficient in improving outcomes or increasing ac25 cess to evidence-based programs; 


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1 ‘‘(21) establish standards for the appointment 

2 of peer-review panels to evaluate grant applications 

3 and recommend standards for mental health grant 

4 programs; and’’. 

5 (d) STANDARDS FOR GRANT PROGRAMS.—Section 

6 501(d) of the Public Health Service Act (42 U.S.C. 

7 290aa(d)), as amended by subsection (c), is further 

8 amended by adding at the end the following: 

9 ‘‘(22) in consultation with the National Mental 

10 Health and Substance Use Policy Laboratory, and 

11 after providing an opportunity for public input, set 

12 standards for grant programs under this title for 

13 mental health and substance use services, which may 

14 address— 

15 ‘‘(A) the capacity of the grantee to imple16 ment the award; 

17 ‘‘(B) requirements for the description of 

18 the program implementation approach; 

19 ‘‘(C) the extent to which the grant plan 

20 submitted by the grantee as part of its applica21 tion must explain how the grantee will reach 

22 the population of focus and provide a statement 

23 of need, including to what extent the grantee 

24 will increase the number of clients served and 

25 the estimated percentage of clients receiving 


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1 services who report positive functioning after 6 

2 months or no past-month substance use, as ap3 plicable; 

4 ‘‘(D) the extent to which the grantee must 

5 collect and report on required performance 

6 measures; and 

7 ‘‘(E) the extent to which the grantee is 

8 proposing evidence-based practices and the ex9 tent to which— 

10 ‘‘(i) those evidence-based practices 

11 must be used with respect to a population 

12 similar to the population for which the evi13 dence-based practices were shown to be ef14 fective; or 

15 ‘‘(ii) if no evidence-based practice ex16 ists for a population of focus, the way in 

17 which the grantee will implement adapta18 tions of evidence-based practices, prom19 ising practices, or cultural practices.’’. 

20 (e) EMERGENCY RESPONSE.—Section 501(m) of the 

21 Public Health Service Act (42 U.S.C. 290aa(m)) is 

22 amended by adding at the end the following: 

23 ‘‘(4) AVAILABILITY OF FUNDS THROUGH FOL24 LOWING FISCAL YEAR.—Amounts made available for 

25 carrying out this subsection shall remain available 


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1 through the end of the fiscal year following the fiscal 

2 year for which such amounts are appropriated.’’. 

3 (f) MEMBER OF COUNCIL ON GRADUATE MEDICAL

4 EDUCATION.—Section 762 of the Public Health Service 

5 Act (42 U.S.C. 290o) is amended— 

6 (1) in subsection (b)— 

7 (A) by redesignating paragraphs (4), (5), 

8 and (6) as paragraphs (5), (6), and (7), respec9 tively; and 

10 (B) by inserting after paragraph (3) the 

11 following: 

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

13 and Substance Use;’’; and 

14 (2) in subsection (c), by striking ‘‘(4), (5), and 

15 (6)’’ each place it appears and inserting ‘‘(5), (6), 

16 and (7)’’. 

17 (g) CONFORMING AMENDMENTS.—Title V of the 

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

19 amended by the previous provisions of this section, is fur20 ther amended— 

21 (1) by striking ‘‘Administrator of the Substance 

22 Abuse and Mental Health Services Administration’’ 

23 each place it appears and inserting ‘‘Assistant Sec24 retary for Mental Health and Substance Use’’; and 


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1 (2) by striking ‘‘Administrator’’ each place it 

2 appears (including in any headings) and inserting 

3 ‘‘Assistant Secretary’’, except where the term ‘‘Ad4 ministrator’’ appears— 

5 (A) in each of subsections (e) and (f) of 

6 section 501 of such Act (42 U.S.C. 290aa), in7 cluding the headings of such subsections, within 

8 the term ‘‘Associate Administrator’’; 

9 (B) in section 507(b)(6) of such Act (42 

10 U.S.C. 290bb(b)(6)), within the term ‘‘Adminis11 trator of the Health Resources and Services Ad12 ministration’’; 

13 (C) in section 507(b)(6) of such Act (42 

14 U.S.C. 290bb(b)(6)), within the term ‘‘Adminis15 trator of the Centers for Medicare & Medicaid 

16 Services’’; 

17 (D) in section 519B(c)(1)(B) of such Act 

18 (42 U.S.C. 290bb–25b(c)(1)(B)), within the 

19 term ‘‘Administrator of the National Highway 

20 Traffic Safety Administration’’; or 

21 (E) in each of sections 519B(c)(1)(B), 

22 520C(a), and 520D(a) of such Act (42 U.S.C. 

23 290bb–25b(c)(1)(B), 290bb–34(a), 290bb– 

24 35(a)), within the term ‘‘Administrator of the 


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1 Office of Juvenile Justice and Delinquency Pre2 vention’’. 

3 (h) REFERENCES.—After executing subsections (a), 

4 (b), and (f), any reference in statute, regulation, or guid5 ance to the Administrator of the Substance Abuse and 

6 Mental Health Services Administration shall be construed 

7 to be a reference to the Assistant Secretary for Mental 

8 Health and Substance Use. 

9 SEC. 102. IMPROVING OVERSIGHT OF MENTAL HEALTH 

10 AND SUBSTANCE USE PROGRAMS. 

11 Title V of the Public Health Service Act is amended 

12 by inserting after section 501 of such Act (42 U.S.C. 

13 290aa) the following: 

14 ‘‘SEC. 501A. IMPROVING OVERSIGHT OF MENTAL HEALTH 

15 AND SUBSTANCE USE PROGRAMS. 

16 ‘‘(a) ACTIVITIES.—For the purpose of ensuring effi17 cient and effective planning and evaluation of mental ill18 ness and substance use disorder programs and related ac19 tivities, the Assistant Secretary for Planning and Evalua20 tion, in consultation with the Assistant Secretary for Men21 tal Health and Substance Use, shall— 

22 ‘‘(1) collect and organize relevant data on 

23 homelessness, involvement with the criminal justice 

24 system, hospitalizations, mortality outcomes, and 


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1 other measures the Secretary deems appropriate 

2 from across Federal departments and agencies; 

3 ‘‘(2) evaluate programs related to mental illness 

4 and substance use disorders, including co-occurring 

5 illness or disorders, across Federal departments and 

6 agencies, as appropriate, including programs related 

7 to— 

8 ‘‘(A) prevention, intervention, treatment, 

9 and recovery support services, including such 

10 services for individuals with a serious mental ill11 ness or serious emotional disturbance; 

12 ‘‘(B) the reduction of homelessness and in13 volvement with the criminal justice system 

14 among individuals with a mental illness or sub15 stance use disorder; and 

16 ‘‘(C) public health and health services; and 

17 ‘‘(3) consult, as appropriate, with the Assistant 

18 Secretary, the Behavioral Health Coordinating 

19 Council of the Department of Health and Human 

20 Services, other agencies within the Department of 

21 Health and Human Services, and other relevant 

22 Federal departments. 

23 ‘‘(b) RECOMMENDATIONS.—The Assistant Secretary 

24 for Planning and Evaluation shall develop an evaluation 

25 strategy that identifies priority programs to be evaluated 


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1 by the Assistant Secretary and priority programs to be 

2 evaluated by other relevant agencies within the Depart3 ment of Health and Human Services. The Assistant Sec4 retary for Planning and Evaluation shall provide rec5 ommendations on improving programs and activities based 

6 on the evaluation described in subsection (a)(2) as needing 

7 improvement.’’. 

8 SEC. 103. NATIONAL MENTAL HEALTH AND SUBSTANCE 

9 USE POLICY LABORATORY. 

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

11 290aa et seq.) is amended by inserting after section 501A, 

12 as added by section 102 of this Act, the following: 

13 ‘‘SEC. 501B. NATIONAL MENTAL HEALTH AND SUBSTANCE 

14 USE POLICY LABORATORY. 

15 ‘‘(a) IN GENERAL.—There shall be established within 

16 the Administration a National Mental Health and Sub17 stance Use Policy Laboratory (referred to in this section 

18 as the ‘Laboratory’). 

19 ‘‘(b) RESPONSIBILITIES.—The Laboratory shall— 

20 ‘‘(1) continue to carry out the authorities and 

21 activities that were in effect for the Office of Policy, 

22 Planning, and Innovation as such Office existed 

23 prior to the date of enactment of the Helping Fami24 lies in Mental Health Crisis Act of 2016; 


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1 ‘‘(2) identify, coordinate, and facilitate the im2 plementation of policy changes likely to have a sig3 nificant effect on mental health, mental illness, and 

4 the prevention and treatment of substance use dis5 order services; 

6 ‘‘(3) collect, as appropriate, information from 

7 grantees under programs operated by the Adminis8 tration in order to evaluate and disseminate infor9 mation on evidence-based practices, including cul10 turally and linguistically appropriate services, as ap11 propriate, and service delivery models; 

12 ‘‘(4) provide leadership in identifying and co13 ordinating policies and programs, including evidence14 based programs, related to mental illness and sub15 stance use disorders; 

16 ‘‘(5) recommend ways in which payers may im17 plement program and policy findings of the Adminis18 tration and the Laboratory to improve outcomes and 

19 reduce per capita program costs; 

20 ‘‘(6) in consultation with the Assistant Sec21 retary for Planning and Evaluation, as appropriate, 

22 periodically review Federal programs and activities 

23 relating to the diagnosis or prevention of, or treat24 ment or rehabilitation for, mental illness and sub25 stance use disorders, including by— 


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1 ‘‘(A) identifying any such programs or ac2 tivities that are duplicative; 

3 ‘‘(B) identifying any such programs or ac4 tivities that are not evidence-based, effective, or 

5 efficient; and 

6 ‘‘(C) formulating recommendations for co7 ordinating, eliminating, or improving programs 

8 or activities identified under subparagraph (A) 

9 or (B) and merging such programs or activities 

10 into other successful programs or activities; and 

11 ‘‘(7) carry out other activities as deemed nec12 essary to continue to encourage innovation and dis13 seminate evidence-based programs and practices, in14 cluding programs and practices with scientific merit. 

15 ‘‘(c) EVIDENCE-BASED PRACTICES AND SERVICE

16 DELIVERY MODELS.— 

17 ‘‘(1) IN GENERAL.—In selecting evidence-based 

18 best practices and service delivery models for evalua19 tion and dissemination, the Laboratory— 

20 ‘‘(A) shall give preference to models that 

21 improve— 

22 ‘‘(i) the coordination between mental 

23 health and physical health providers; 


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1 ‘‘(ii) the coordination among such pro2 viders and the justice and corrections sys3 tem; and 

4 ‘‘(iii) the cost effectiveness, quality, 

5 effectiveness, and efficiency of health care 

6 services furnished to individuals with seri7 ous mental illness or serious emotional dis8 turbance, in mental health crisis, or at risk 

9 to themselves, their families, and the gen10 eral public; and 

11 ‘‘(B) may include clinical protocols and 

12 practices used in the Recovery After Initial 

13 Schizophrenia Episode (RAISE) project and the 

14 North American Prodrome Longitudinal Study 

15 (NAPLS) of the National Institute of Mental 

16 Health. 

17 ‘‘(2) DEADLINE FOR BEGINNING IMPLEMENTA18 TION.—The Laboratory shall begin implementation 

19 of the duties described in this section not later than 

20 January 1, 2018. 

21 ‘‘(3) CONSULTATION.—In carrying out the du22 ties under this section, the Laboratory shall consult 

23 with— 

24 ‘‘(A) representatives of the National Insti25 tute of Mental Health, the National Institute 


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1 on Drug Abuse, and the National Institute on 

2 Alcohol Abuse and Alcoholism, on an ongoing 

3 basis; 

4 ‘‘(B) other appropriate Federal agencies; 

5 ‘‘(C) clinical and analytical experts with 

6 expertise in psychiatric medical care and clinical 

7 psychological care, health care management, 

8 education, corrections health care, and mental 

9 health court systems, as appropriate; and 

10 ‘‘(D) other individuals and agencies as de11 termined appropriate by the Assistant Sec12 retary.’’. 

13 SEC. 104. PEER-SUPPORT SPECIALIST PROGRAMS. 

14 (a) IN GENERAL.—Not later than 2 years after the 

15 date of enactment of this Act, the Comptroller General 

16 of the United States shall conduct a study on peer-support 

17 specialist programs in up to 10 States (to be selected by 

18 the Comptroller General) that receive funding from the 

19 Substance Abuse and Mental Health Services Administra20 tion and submit to the Committee on Health, Education, 

21 Labor, and Pensions of the Senate and the Committee on 

22 Energy and Commerce of the House of Representatives 

23 a report containing the results of such study. 

24 (b) CONTENTS OF STUDY.—In conducting the study 

25 under subsection (a), the Comptroller General of the 


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1 United States shall examine and identify best practices in 

2 the selected States related to training and credential re3 quirements for peer-support specialist programs, such 

4 as— 

5 (1) hours of formal work or volunteer experi6 ence related to mental illness and substance use dis7 orders conducted through such programs; 

8 (2) types of peer-support specialist exams re9 quired for such programs in the States; 

10 (3) codes of ethics used by such programs in 

11 the States; 

12 (4) required or recommended skill sets of such 

13 programs in the State; and 

14 (5) requirements for continuing education. 

15 SEC. 105. PROHIBITION AGAINST LOBBYING USING FED16 ERAL FUNDS BY SYSTEMS ACCEPTING FED17 ERAL FUNDS TO PROTECT AND ADVOCATE 

18 THE RIGHTS OF INDIVIDUALS WITH MENTAL 

19 ILLNESS. 

20 Section 105(a) of the Protection and Advocacy for 

21 Individuals with Mental Illness Act (42 U.S.C. 10805(a)) 

22 is amended— 

23 (1) in paragraph (9), by striking ‘‘and’’ at the 

24 end; 


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1 (2) in paragraph (10), by striking the period at 

2 the end and inserting ‘‘; and’’; and 

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

4 ‘‘(11) agree to refrain, during any period for 

5 which funding is provided to the system under this 

6 part, from using Federal funds to pay the salary or 

7 expenses of any grant or contract recipient, or agent 

8 acting for such recipient, related to any activity de9 signed to influence the enactment of legislation, ap10 propriations, regulation, administrative action, or 

11 Executive order proposed or pending before the Con12 gress or any State or local government, including 

13 any legislative body, other than for normal and rec14 ognized executive-legislative relationships or partici15 pation by an agency or officer of a State, local, or 

16 tribal government in policymaking and administra17 tive processes within the executive branch of that 

18 government.’’. 

19 SEC. 106. REPORTING FOR PROTECTION AND ADVOCACY 

20 ORGANIZATIONS. 

21 (a) PUBLIC AVAILABILITY OF REPORTS.—Section 

22 105(a)(7) of the Protection and Advocacy for Individuals 

23 with Mental Illness Act (42 U.S.C. 10805(a)(7)) is 

24 amended by striking ‘‘is located a report’’ and inserting 

25 ‘‘is located, and make publicly available, a report’’. 


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1 (b) DETAILED ACCOUNTING.—Section 114(a) of the 

2 Protection and Advocacy for Individuals with Mental Ill3 ness Act (42 U.S.C. 10824(a)) is amended— 

4 (1) in paragraph (3), by striking ‘‘and’’ at the 

5 end; 

6 (2) in paragraph (4), by striking the period at 

7 the end and inserting ‘‘; and’’; and 

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

9 ‘‘(5) using data from the existing required an10 nual program progress reports submitted by each 

11 system funded under this title, a detailed accounting 

12 for each such system of how funds are spent, 

13 disaggregated according to whether the funds were 

14 received from the Federal Government, the State 

15 government, a local government, or a private enti16 ty.’’. 

17 SEC. 107. GRIEVANCE PROCEDURE. 

18 Section 105 of the Protection and Advocacy for Indi19 viduals with Mental Illness Act (42 U.S.C. 10805), as 

20 amended, is further amended by adding at the end the 

21 following: 

22 ‘‘(d) GRIEVANCE PROCEDURE.—The Secretary shall 

23 establish an independent grievance procedure for persons 

24 described in subsection (a)(9).’’. 


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1 SEC. 108. CENTER FOR BEHAVIORAL HEALTH STATISTICS 

2 AND QUALITY. 

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

4 290aa et seq.) is amended— 

5 (1) in section 501(b) (42 U.S.C. 290aa(b)), by 

6 adding at the end the following: 

7 ‘‘(4) The Center for Behavioral Health Statis8 tics and Quality.’’; 

9 (2) in section 502(a)(1) (42 U.S.C. 290aa– 

10 1(a)(1))— 

11 (A) in subparagraph (C), by striking 

12 ‘‘and’’ at the end; 

13 (B) in subparagraph (D), by striking the 

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

15 (C) by inserting after subparagraph (D) 

16 the following: 

17 ‘‘(E) the Center for Behavioral Health 

18 Statistics and Quality.’’; and 

19 (3) in part B (42 U.S.C. 290bb et seq.) by add20 ing at the end the following new subpart: 

21 ‘‘Subpart 4—Center for Behavioral Health Statistics 

22 and Quality 

23 ‘‘SEC. 520L. CENTER FOR BEHAVIORAL HEALTH STATISTICS 

24 AND QUALITY. 

25 ‘‘(a) ESTABLISHMENT.—There is established in the 

26 Administration a Center for Behavioral Health Statistics 


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1 and Quality (in this section referred to as the ‘Center’). 

2 The Center shall be headed by a Director (in this section 

3 referred to as the ‘Director’) appointed by the Secretary 

4 from among individuals with extensive experience and aca5 demic qualifications in research and analysis in behavioral 

6 health care or related fields. 

7 ‘‘(b) DUTIES.—The Director of the Center shall— 

8 ‘‘(1) coordinate the Administration’s integrated 

9 data strategy by coordinating— 

10 ‘‘(A) surveillance and data collection (in11 cluding that authorized by section 505); 

12 ‘‘(B) evaluation; 

13 ‘‘(C) statistical and analytic support; 

14 ‘‘(D) service systems research; and 

15 ‘‘(E) performance and quality information 

16 systems; 

17 ‘‘(2) recommend a core set of measurement 

18 standards for grant programs administered by the 

19 Administration; and 

20 ‘‘(3) coordinate evaluation efforts for the grant 

21 programs, contracts, and collaborative agreements of 

22 the Administration. 

23 ‘‘(c) BIANNUAL REPORT TO CONGRESS.—Not later 

24 than 2 years after the date of enactment of this section, 

25 and every 2 years thereafter, the Director of the Center 


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1 shall submit to Congress a report on the quality of services 

2 furnished through grant programs of the Administration, 

3 including applicable measures of outcomes for individuals 

4 and public outcomes such as— 

5 ‘‘(1) the number of patients screened positive 

6 for unhealthy alcohol use who receive brief coun7 seling as appropriate; the number of patients 

8 screened positive for tobacco use and receiving 

9 smoking cessation interventions; the number of pa10 tients with a new diagnosis of major depressive epi11 sode who are assessed for suicide risk; the number 

12 of patients screened positive for clinical depression 

13 with a documented followup plan; and the number of 

14 patients with a documented pain assessment that 

15 have a followup treatment plan when pain is present; 

16 and satisfaction with care; 

17 ‘‘(2) the incidence and prevalence of mental ill18 ness and substance use disorders; the number of sui19 cide attempts and suicide completions; overdoses 

20 seen in emergency rooms resulting from alcohol and 

21 drug use; emergency room boarding; overdose 

22 deaths; emergency psychiatric hospitalizations; new 

23 criminal justice involvement while in treatment; sta24 ble housing; and rates of involvement in employ25 ment, education, and training; and 


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1 ‘‘(3) such other measures for outcomes of serv2 ices as the Director may determine. 

3 ‘‘(d) STAFFING COMPOSITION.—The staff of the Cen4 ter may include individuals with advanced degrees and 

5 field expertise as well as clinical and research experience 

6 in mental illness and substance use disorders such as— 

7 ‘‘(1) professionals with clinical and research ex8 pertise in the prevention and treatment of, and re9 covery from, mental illness and substance use dis10 orders; 

11 ‘‘(2) professionals with training and expertise in 

12 statistics or research and survey design and meth13 odologies; and 

14 ‘‘(3) other related fields in the social and behav15 ioral sciences, as specified by relevant position de16 scriptions. 

17 ‘‘(e) GRANTS AND CONTRACTS.—In carrying out the 

18 duties established in subsection (b), the Director may 

19 make grants to, and enter into contracts and cooperative 

20 agreements with, public and nonprofit private entities. 

21 ‘‘(f) DEFINITION.—In this section, the term ‘emer22 gency room boarding’ means the practice of admitting pa23 tients to an emergency department and holding such pa24 tients in the department until inpatient psychiatric beds 

25 become available.’’. 


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1 SEC. 109. STRATEGIC PLAN. 

2 Section 501 of the Public Health Service Act (42 

3 U.S.C. 290aa) is further amended— 

4 (1) by redesignating subsections (l) through (o) 

5 as subsections (m) through (p), respectively; and 

6 (2) by inserting after subsection (k) the fol7 lowing: 

8 ‘‘(l) STRATEGIC PLAN.— 

9 ‘‘(1) IN GENERAL.—Not later than December 1, 

10 2017, and every 5 years thereafter, the Assistant 

11 Secretary shall develop and carry out a strategic 

12 plan in accordance with this subsection for the plan13 ning and operation of evidence-based programs and 

14 grants carried out by the Administration. 

15 ‘‘(2) COORDINATION.—In developing and car16 rying out the strategic plan under this section, the 

17 Assistant Secretary shall take into consideration the 

18 report of the Interdepartmental Serious Mental Ill19 ness Coordinating Committee under section 301 of 

20 the Helping Families in Mental Health Crisis Act of 

21 2016. 

22 ‘‘(3) PUBLICATION OF PLAN.—Not later than 

23 December 1, 2017, and every 5 years thereafter, the 

24 Assistant Secretary shall— 


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1 ‘‘(A) submit the strategic plan developed 

2 under paragraph (1) to the appropriate commit3 tees of Congress; and 

4 ‘‘(B) post such plan on the Internet 

5 website of the Administration. 

6 ‘‘(4) CONTENTS.—The strategic plan developed 

7 under paragraph (1) shall— 

8 ‘‘(A) identify strategic priorities, goals, and 

9 measurable objectives for mental illness and 

10 substance use disorder activities and programs 

11 operated and supported by the Administration, 

12 including priorities to prevent or eliminate the 

13 burden of mental illness and substance use dis14 orders; 

15 ‘‘(B) identify ways to improve services for 

16 individuals with a mental illness or substance 

17 use disorder, including services related to the 

18 prevention of, diagnosis of, intervention in, 

19 treatment of, and recovery from, mental illness 

20 or substance use disorders, including serious 

21 mental illness or serious emotional disturbance, 

22 and access to services and supports for individ23 uals with a serious mental illness or serious 

24 emotional disturbance; 


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1 ‘‘(C) ensure that programs provide, as ap2 propriate, access to effective and evidence-based 

3 prevention, diagnosis, intervention, treatment, 

4 and recovery services, including culturally and 

5 linguistically appropriate services, as appro6 priate, for individuals with a mental illness or 

7 substance use disorder; 

8 ‘‘(D) identify opportunities to collaborate 

9 with the Health Resources and Services Admin10 istration to develop or improve— 

11 ‘‘(i) initiatives to encourage individ12 uals to pursue careers (especially in rural 

13 and underserved areas and populations) as 

14 psychiatrists, psychologists, psychiatric 

15 nurse practitioners, physician assistants, 

16 occupational therapists, clinical social 

17 workers, certified peer-support specialists, 

18 licensed professional counselors, or other 

19 licensed or certified mental health profes20 sionals, including such professionals spe21 cializing in the diagnosis, evaluation, or 

22 treatment of individuals with a serious 

23 mental illness or serious emotional disturb24 ance; and 


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1 ‘‘(ii) a strategy to improve the recruit2 ment, training, and retention of a work3 force for the treatment of individuals with 

4 mental illness or substance use disorders, 

5 or co-occurring illness or disorders; 

6 ‘‘(E) identify opportunities to improve col7 laboration with States, local governments, com8 munities, and Indian tribes and tribal organiza9 tions (as such terms are defined in section 4 of 

10 the Indian Self-Determination and Education 

11 Assistance Act (25 U.S.C. 450b)); and 

12 ‘‘(F) specify a strategy to disseminate evi13 denced-based and promising best practices re14 lated to prevention, diagnosis, early interven15 tion, treatment, and recovery services related to 

16 mental illness, particularly for individuals with 

17 a serious mental illness and children and ado18 lescents with a serious emotional disturbance, 

19 and substance use disorders.’’. 

20 SEC. 110. AUTHORITIES OF CENTERS FOR MENTAL HEALTH 

21 SERVICES AND SUBSTANCE ABUSE TREAT22 MENT. 

23 (a) CENTER FOR MENTAL HEALTH SERVICES.—Sec24 tion 520(b) of the Public Health Service Act (42 U.S.C. 

25 290bb–31(b)) is amended— 


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1 (1) by redesignating paragraphs (3) through 

2 (15) as paragraphs (4) through (16), respectively; 

3 (2) by inserting after paragraph (2) the fol4 lowing: 

5 ‘‘(3) collaborate with the Director of the Na6 tional Institute of Mental Health to ensure that, as 

7 appropriate, programs related to the prevention and 

8 treatment of mental illness and the promotion of 

9 mental health are carried out in a manner that re10 flects the best available science and evidence-based 

11 practices, including culturally and linguistically ap12 propriate services;’’; 

13 (3) in paragraph (5), as so redesignated, by in14 serting ‘‘through policies and programs that reduce 

15 risk and promote resiliency’’ before the semicolon; 

16 (4) in paragraph (6), as so redesignated, by in17 serting ‘‘in collaboration with the Director of the 

18 National Institute of Mental Health,’’ before ‘‘de19 velop’’; 

20 (5) in paragraph (8), as so redesignated, by in21 serting ‘‘, increase meaningful participation of indi22 viduals with mental illness in programs and activi23 ties of the Administration,’’ before ‘‘and protect the 

24 legal’’; 


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1 (6) in paragraph (10), as so redesignated, by 

2 striking ‘‘professional and paraprofessional per3 sonnel pursuant to section 303’’ and inserting 

4 ‘‘paraprofessional personnel and health profes5 sionals’’; 

6 (7) in paragraph (11), as so redesignated, by 

7 inserting ‘‘and telemental health,’’ after ‘‘rural men8 tal health,’’; 

9 (8) in paragraph (12), as so redesignated, by 

10 striking ‘‘establish a clearinghouse for mental health 

11 information to assure the widespread dissemination 

12 of such information’’ and inserting ‘‘disseminate 

13 mental health information, including evidenced-based 

14 practices,’’; 

15 (9) in paragraph (15), as so redesignated, by 

16 striking ‘‘and’’ at the end; 

17 (10) in paragraph (16), as so redesignated, by 

18 striking the period and inserting ‘‘; and’’; and 

19 (11) by adding at the end the following: 

20 ‘‘(17) consult with other agencies and offices of 

21 the Department of Health and Human Services to 

22 ensure, with respect to each grant awarded by the 

23 Center for Mental Health Services, the consistent 

24 documentation of the application of criteria when 


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1 awarding grants and the ongoing oversight of grant2 ees after such grants are awarded.’’. 

3 (b) DIRECTOR OF THE CENTER FOR SUBSTANCE

4 ABUSE TREATMENT.—Section 507 of the Public Health 

5 Service Act (42 U.S.C. 290bb) is amended— 

6 (1) in subsection (a)— 

7 (A) by striking ‘‘treatment of substance 

8 abuse’’ and inserting ‘‘treatment of substance 

9 use disorders’’; and 

10 (B) by striking ‘‘abuse treatment systems’’ 

11 and inserting ‘‘use disorder treatment systems’’; 

12 and 

13 (2) in subsection (b)— 

14 (A) in paragraph (3), by striking ‘‘abuse’’ 

15 and inserting ‘‘use disorder’’; 

16 (B) in paragraph (4), by striking ‘‘individ17 uals who abuse drugs’’ and inserting ‘‘individ18 uals who use drugs’’; 

19 (C) in paragraph (9), by striking ‘‘carried 

20 out by the Director’’; 

21 (D) by striking paragraph (10); 

22 (E) by redesignating paragraphs (11) 

23 through (14) as paragraphs (10) through (13), 

24 respectively; 


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1 (F) in paragraph (12), as so redesignated, 

2 by striking ‘‘; and’’ and inserting a semicolon; 

3 and 

4 (G) by striking paragraph (13), as so re5 designated, and inserting the following: 

6 ‘‘(13) ensure the consistent documentation of 

7 the application of criteria when awarding grants and 

8 the ongoing oversight of grantees after such grants 

9 are awarded; and 

10 ‘‘(14) work with States, providers, and individ11 uals in recovery, and their families, to promote the 

12 expansion of recovery support services and systems 

13 of care oriented towards recovery.’’. 

14 SEC. 111. ADVISORY COUNCILS. 

15 Section 502(b) of the Public Health Service Act (42 

16 U.S.C. 290aa–1(b)) is amended— 

17 (1) in paragraph (2)— 

18 (A) in subparagraph (E), by striking 

19 ‘‘and’’ after the semicolon; 

20 (B) by redesignating subparagraph (F) as 

21 subparagraph (I); and 

22 (C) by inserting after subparagraph (E), 

23 the following: 

24 ‘‘(F) for the advisory councils appointed 

25 under subsections (a)(1)(A) and (a)(1)(D), the 


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1 Director of the National Institute of Mental 

2 Health; 

3 ‘‘(G) for the advisory councils appointed 

4 under subsections (a)(1)(A), (a)(1)(B), and 

5 (a)(1)(C), the Director of the National Institute 

6 on Drug Abuse; 

7 ‘‘(H) for the advisory councils appointed 

8 under subsections (a)(1)(A), (a)(1)(B), and 

9 (a)(1)(C), the Director of the National Institute 

10 on Alcohol Abuse and Alcoholism; and’’; and 

11 (2) in paragraph (3), by adding at the end the 

12 following: 

13 ‘‘(C) Not less than half of the members of 

14 the advisory council appointed under subsection 

15 (a)(1)(D)— 

16 ‘‘(i) shall have— 

17 ‘‘(I) a medical degree; 

18 ‘‘(II) a doctoral degree in psy19 chology; or 

20 ‘‘(III) an advanced degree in 

21 nursing or social work from an ac22 credited graduate school or be a cer23 tified physician assistant; and 

24 ‘‘(ii) shall specialize in the mental 

25 health field.’’. 


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1 SEC. 112. PEER REVIEW. 

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

3 U.S.C. 290aa–3(b)) is amended by adding at the end the 

4 following: ‘‘In the case of any such peer review group that 

5 is reviewing a grant, cooperative agreement, or contract 

6 related to mental illness treatment, not less than half of 

7 the members of such peer review group shall be licensed 

8 and experienced professionals in the prevention, diagnosis, 

9 or treatment of, or recovery from, mental illness or sub10 stance use disorders and have a medical degree, a doctoral 

11 degree in psychology, or an advanced degree in nursing 

12 or social work from an accredited program.’’. 

13 TITLE II—MEDICAID MENTAL 

14 HEALTH COVERAGE 

15 SEC. 201. RULE OF CONSTRUCTION RELATED TO MEDICAID 

16 COVERAGE OF MENTAL HEALTH SERVICES 

17 AND PRIMARY CARE SERVICES FURNISHED 

18 ON THE SAME DAY. 

19 Nothing in title XIX of the Social Security Act (42 

20 U.S.C. 1396 et seq.) shall be construed as prohibiting sep21 arate payment under the State plan under such title (or 

22 under a waiver of the plan) for the provision of a mental 

23 health service or primary care service under such plan, 

24 with respect to an individual, because such service is— 

25 (1) a primary care service furnished to the indi26 vidual by a provider at a facility on the same day 


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1 a mental health service is furnished to such indi2 vidual by such provider (or another provider) at the 

3 facility; or 

4 (2) a mental health service furnished to the in5 dividual by a provider at a facility on the same day 

6 a primary care service is furnished to such individual 

7 by such provider (or another provider) at the facil8 ity. 

9 SEC. 202. OPTIONAL LIMITED COVERAGE OF INPATIENT 

10 SERVICES FURNISHED IN INSTITUTIONS FOR 

11 MENTAL DISEASES. 

12 (a) IN GENERAL.—Section 1903(m)(2) of the Social 

13 Security Act (42 U.S.C. 1396b(m)(2)) is amended by add14 ing at the end the following new subparagraph: 

15 ‘‘(I)(i) Notwithstanding the limitation specified in the 

16 subdivision (B) following paragraph (29) of section 

17 1905(a) and subject to clause (ii), a State may, under a 

18 risk contract entered into by the State under this title (or 

19 under section 1115) with a medicaid managed care organi20 zation or a prepaid inpatient health plan (as defined in 

21 section 438.2 of title 42, Code of Federal Regulations (or 

22 any successor regulation)), make a monthly capitation 

23 payment to such organization or plan for enrollees with 

24 the organization or plan who are over 21 years of age and 

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1 ment in an institution for mental diseases (as defined in 

2 section 1905(i)), so long as each of the following condi3 tions is met: 

4 ‘‘(I) The institution is a hospital providing in5 patient psychiatric or substance use disorder services 

6 or a sub-acute facility providing psychiatric or sub7 stance use disorder crisis residential services. 

8 ‘‘(II) The length of stay in such an institution 

9 for such treatment is for a short-term stay of no 

10 more than 15 days during the period of the monthly 

11 capitation payment. 

12 ‘‘(III) The provision of such treatment meets 

13 the following criteria for consideration as services or 

14 settings that are provided in lieu of services or set15 tings covered under the State plan: 

16 ‘‘(aa) The State determines that the alter17 native service or setting is a medically appro18 priate and cost-effective substitute for the serv19 ice or setting covered under the State plan. 

20 ‘‘(bb) The enrollee is not required by the 

21 managed care organization or prepaid inpatient 

22 health plan to use the alternative service or set23 ting. 

24 ‘‘(cc) Such treatment is authorized and 

25 identified in such contract, and will be offered 


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1 to such enrollees at the option of the managed 

2 care organization or prepaid inpatient health 

3 plan. 

4 ‘‘(ii) For purposes of setting the amount of such a 

5 monthly capitation payment, a State may use the utiliza6 tion of services provided to an individual under this sub7 paragraph when developing the inpatient psychiatric or 

8 substance use disorder component of such payment, but 

9 the amount of such payment for such services may not 

10 exceed the cost of the same services furnished through 

11 providers included under the State plan.’’. 

12 (b) EFFECTIVE DATE.—The amendment made by 

13 subsection (a) shall apply beginning on July 5, 2016, or 

14 the date of the enactment of this Act, whichever is later. 

15 SEC. 203. STUDY AND REPORT RELATED TO MEDICAID 

16 MANAGED CARE REGULATION. 

17 (a) STUDY.—The Secretary of Health and Human 

18 Services, acting through the Administrator of the Centers 

19 for Medicare & Medicaid Services, shall conduct a study 

20 on coverage under the Medicaid program under title XIX 

21 of the Social Security Act (42 U.S.C. 1396 et seq.) of serv22 ices provided through a medicaid managed care organiza23 tion (as defined in section 1903(m) of such Act (42 U.S.C. 

24 1396b(m)) or a prepaid inpatient health plan (as defined 

25 in section 438.2 of title 42, Code of Federal Regulations 


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1 (or any successor regulation)) with respect to individuals 

2 over the age of 21 and under the age of 65 for the treat3 ment of a mental health disorder in institutions for mental 

4 diseases (as defined in section 1905(i) of such Act (42 

5 U.S.C. 1396d(i))). Such study shall include information 

6 on the following: 

7 (1) The extent to which States, including the 

8 District of Columbia and each territory or possession 

9 of the United States, are providing capitated pay10 ments to such organizations or plans for enrollees 

11 who are receiving services in institutions for mental 

12 diseases. 

13 (2) The number of individuals receiving medical 

14 assistance under a State plan under such title XIX, 

15 or a waiver of such plan, who receive services in in16 stitutions for mental diseases through such organiza17 tions and plans. 

18 (3) The range of and average number of 

19 months, and the length of stay during such months, 

20 that such individuals are receiving such services in 

21 such institutions. 

22 (4) How such organizations or plans determine 

23 when to provide for the furnishing of such services 

24 through an institution for mental diseases in lieu of 

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1 nity-based services) under their contract with the 

2 State agency administering the State plan under 

3 such title XIX, or a waiver of such plan, to address 

4 psychiatric or substance use disorder treatment. 

5 (5) The extent to which the provision of serv6 ices within such institutions has affected the 

7 capitated payments for such organizations or plans. 

8 (b) REPORT.—Not later than 3 years after the date 

9 of the enactment of this Act, the Secretary shall submit 

10 to Congress a report on the study conducted under sub11 section (a). 

12 SEC. 204. GUIDANCE ON OPPORTUNITIES FOR INNOVATION. 

13 Not later than 1 year after the date of the enactment 

14 of this Act, the Administrator of the Centers for Medicare 

15 & Medicaid Services shall issue a State Medicaid Director 

16 letter regarding opportunities to design innovative service 

17 delivery systems, including systems for providing commu18 nity-based services, for individuals with serious mental ill19 ness or serious emotional disturbance who are receiving 

20 medical assistance under title XIX of the Social Security 

21 Act (42 U.S.C. 1396 et seq.). The letter shall include op22 portunities for demonstration projects under section 1115 

23 of such Act (42 U.S.C. 1315), to improve care for such 

24 individuals. 


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1 SEC. 205. STUDY AND REPORT ON MEDICAID EMERGENCY 

2 PSYCHIATRIC DEMONSTRATION PROJECT. 

3 (a) COLLECTION OF INFORMATION.—The Secretary 

4 of Health and Human Services, acting through the Ad5 ministrator of the Centers for Medicare & Medicaid Serv6 ices, shall, with respect to each State that has participated 

7 in the demonstration project established under section 

8 2707 of the Patient Protection and Affordable Care Act 

9 (42 U.S.C. 1396a note), collect from each such State in10 formation on the following: 

11 (1) The number of institutions for mental dis12 eases (as defined in section 1905(i) of the Social Se13 curity Act (42 U.S.C. 1396d(i))) and beds in such 

14 institutions that received payment for the provision 

15 of services to individuals who receive medical assist16 ance under a State plan under the Medicaid pro17 gram under title XIX of the Social Security Act (42 

18 U.S.C. 1396 et seq.) (or under a waiver of such 

19 plan) through the demonstration project in each 

20 such State as compared to the total number of insti21 tutions for mental diseases and beds in the State. 

22 (2) The extent to which there is a reduction in 

23 expenditures under the Medicaid program under title 

24 XIX of the Social Security Act (42 U.S.C. 1396 et 

25 seq.) or other spending on the full continuum of 

26 physical or mental health care for individuals who 


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1 receive treatment in an institution for mental dis2 eases under the demonstration project, including 

3 outpatient, inpatient, emergency, and ambulatory 

4 care, that is attributable to such individuals receiv5 ing treatment in institutions for mental diseases 

6 under the demonstration project. 

7 (3) The number of forensic psychiatric hos8 pitals, the number of beds in such hospitals, and the 

9 number of forensic psychiatric beds in other hos10 pitals in such State, based on the most recent data 

11 available, to the extent practical, as determined by 

12 such Administrator. 

13 (4) The amount of any disproportionate share 

14 hospital payments under section 1923 of the Social 

15 Security Act (42 U.S.C. 1396r–4) that institutions 

16 for mental diseases in the State received during the 

17 period beginning on July 1, 2012, and ending on 

18 June 30, 2015, and the extent to which the dem19 onstration project reduced the amount of such pay20 ments. 

21 (5) The most recent data regarding all facilities 

22 or sites in the State in which any individuals with 

23 serious mental illness who are receiving medical as24 sistance under a State plan under the Medicaid pro25 gram under title XIX of the Social Security Act (42 


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1 U.S.C. 1396 et seq.) (or under a waiver of such 

2 plan) are treated during the period referred to in 

3 paragraph (4), to the extent practical, as determined 

4 by the Administrator, including— 

5 (A) the types of such facilities or sites 

6 (such as an institution for mental diseases, a 

7 hospital emergency department, or other inpa8 tient hospital); 

9 (B) the average length of stay in such a 

10 facility or site by such an individual, 

11 disaggregated by facility type; and 

12 (C) the payment rate under the State plan 

13 (or a waivers of such plan) for services fur14 nished to such an individual for that treatment, 

15 disaggregated by facility type, during the period 

16 in which the demonstration project is in oper17 ation. 

18 (6) The extent to which the utilization of hos19 pital emergency departments during the period in 

20 which the demonstration project was is in operation 

21 differed, with respect to individuals who are receiv22 ing medical assistance under a State plan under the 

23 Medicaid program under title XIX of the Social Se24 curity Act (42 U.S.C. 1396 et seq.) (or under a 

25 waiver of such plan), between— 


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1 (A) those individuals who received treat2 ment in an institution for mental diseases 

3 under the demonstration project; 

4 (B) those individuals who met the eligi5 bility requirements for the demonstration 

6 project but who did not receive treatment in an 

7 institution for mental diseases under the dem8 onstration project; and 

9 (C) those individuals with serious mental 

10 illness who did not meet such eligibility require11 ments and did not receive treatment for such 

12 illness in an institution for mental diseases. 

13 (b) REPORT.—Not later than 2 years after the date 

14 of the enactment of this Act, the Secretary of Health and 

15 Human Services shall submit to Congress a report that 

16 summarizes and analyzes the information collected under 

17 subsection (a). Such report may be submitted as part of 

18 the report required under section 2707(f) of the Patient 

19 Protection and Affordable Care Act (42 U.S.C. 1396a 

20 note) or separately. 

21 SEC. 206. PROVIDING EPSDT SERVICES TO CHILDREN IN 

22 IMDS. 

23 (a) IN GENERAL.—Section 1905(a)(16) of the Social 

24 Security Act (42 U.S.C. 1396d(a)(16)) is amended— 


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1 (1) by striking ‘‘effective January 1, 1973’’ and 

2 inserting ‘‘(A) effective January 1, 1973’’; and 

3 (2) by inserting before the semicolon at the end 

4 the following: ‘‘, and, (B) for individuals receiving 

5 services described in subparagraph (A), early and 

6 periodic screening, diagnostic, and treatment serv7 ices (as defined in subsection (r)), whether or not 

8 such screening, diagnostic, and treatment services 

9 are furnished by the provider of the services de10 scribed in such subparagraph’’. 

11 (b) EFFECTIVE DATE.—The amendment made by 

12 subsection (a) shall apply with respect to items and serv13 ices furnished in calendar quarters beginning on or after 

14 January 1, 2019. 

15 SEC. 207. ELECTRONIC VISIT VERIFICATION SYSTEM RE16 QUIRED FOR PERSONAL CARE SERVICES AND 

17 HOME HEALTH CARE SERVICES UNDER MED18 ICAID. 

19 (a) IN GENERAL.—Section 1903 of the Social Secu20 rity Act (42 U.S.C. 1396b) is amended by inserting after 

21 subsection (k) the following new subsection: 

22 ‘‘(l)(1) Subject to paragraphs (3) and (4), with re23 spect to any amount expended for personal care services 

24 or home health care services requiring an in-home visit 

25 by a provider that are provided under a State plan under 


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1 this title (or under a waiver of the plan) and furnished 

2 in a calendar quarter beginning on or after January 1, 

3 2019 (or, in the case of home health care services, on or 

4 after January 1, 2023), unless a State requires the use 

5 of an electronic visit verification system for such services 

6 furnished in such quarter under the plan or such waiver, 

7 the Federal medical assistance percentage shall be re8 duced— 

9 ‘‘(A) in the case of personal care services— 

10 ‘‘(i) for calendar quarters in 2019 and 

11 2020, by .25 percentage points; 

12 ‘‘(ii) for calendar quarters in 2021, by .5 

13 percentage points; 

14 ‘‘(iii) for calendar quarters in 2022, by .75 

15 percentage points; and 

16 ‘‘(iv) for calendar quarters in 2023 and 

17 each year thereafter, by 1 percentage point; and 

18 ‘‘(B) in the case of home health care services— 

19 ‘‘(i) for calendar quarters in 2023 and 

20 2024, by .25 percentage points; 

21 ‘‘(ii) for calendar quarters in 2025, by .5 

22 percentage points; 

23 ‘‘(iii) for calendar quarters in 2026, by .75 

24 percentage points; and 


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1 ‘‘(iv) for calendar quarters in 2027 and 

2 each year thereafter, by 1 percentage point. 

3 ‘‘(2) Subject to paragraphs (3) and (4), in imple4 menting the requirement for the use of an electronic visit 

5 verification system under paragraph (1), a State shall— 

6 ‘‘(A) consult with agencies and entities that 

7 provide personal care services, home health care 

8 services, or both under the State plan (or under a 

9 waiver of the plan) to ensure that such system— 

10 ‘‘(i) is minimally burdensome; 

11 ‘‘(ii) takes into account existing best prac12 tices and electronic visit verification systems in 

13 use in the State; and 

14 ‘‘(iii) is conducted in accordance with the 

15 requirements of HIPAA privacy and security 

16 law (as defined in section 3009 of the Public 

17 Health Service Act); 

18 ‘‘(B) take into account a stakeholder process 

19 that includes input from beneficiaries, family care20 givers, individuals who furnish personal care services 

21 or home health care services, and other stakeholders, 

22 as determined by the State in accordance with guid23 ance from the Secretary; and 

24 ‘‘(C) ensure that individuals who furnish per25 sonal care services, home health care services, or 


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1 both under the State plan (or under a waiver of the 

2 plan) are provided the opportunity for training on 

3 the use of such system. 

4 ‘‘(3) Paragraphs (1) and (2) shall not apply in the 

5 case of a State that, as of the date of the enactment of 

6 this subsection, requires the use of any system for the elec7 tronic verification of visits conducted as part of both per8 sonal care services and home health care services, so long 

9 as the State continues to require the use of such system 

10 with respect to the electronic verification of such visits. 

11 ‘‘(4)(A) In the case of a State described in subpara12 graph (B), the reduction under paragraph (1) shall not 

13 apply— 

14 ‘‘(i) in the case of personal care services, for 

15 calendar quarters in 2019; and 

16 ‘‘(ii) in the case of home health care services, 

17 for calendar quarters in 2023. 

18 ‘‘(B) For purposes of subparagraph (A), a State de19 scribed in this subparagraph is a State that demonstrates 

20 to the Secretary that the State— 

21 ‘‘(i) has made a good faith effort to comply 

22 with the requirements of paragraphs (1) and (2) (in23 cluding by taking steps to adopt the technology used 

24 for an electronic visit verification system); or 


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1 ‘‘(ii) in implementing such a system, has en2 countered unavoidable system delays. 

3 ‘‘(5) In this subsection: 

4 ‘‘(A) The term ‘electronic visit verification sys5 tem’ means, with respect to personal care services or 

6 home health care services, a system under which vis7 its conducted as part of such services are electroni8 cally verified with respect to— 

9 ‘‘(i) the type of service performed; 

10 ‘‘(ii) the individual receiving the service; 

11 ‘‘(iii) the date of the service; 

12 ‘‘(iv) the location of service delivery; 

13 ‘‘(v) the individual providing the service; 

14 and 

15 ‘‘(vi) the time the service begins and ends. 

16 ‘‘(B) The term ‘home health care services’ 

17 means services described in section 1905(a)(7) pro18 vided under a State plan under this title (or under 

19 a waiver of the plan). 

20 ‘‘(C) The term ‘personal care services’ means 

21 personal care services provided under a State plan 

22 under this title (or under a waiver of the plan), in23 cluding services provided under section 1905(a)(24), 

24 1915(c), 1915(i), 1915(j), or 1915(k) or under a 

25 wavier under section 1115. 


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1 ‘‘(6)(A) In the case in which a State requires personal 

2 care service and home health care service providers to uti3 lize an electronic visit verification system operated by the 

4 State or a contractor on behalf of the State, the Secretary 

5 shall pay to the State, for each quarter, an amount equal 

6 to 90 per centum of so much of the sums expended during 

7 such quarter as are attributable to the design, develop8 ment, or installation of such system, and 75 per centum 

9 of so much of the sums for the operation and maintenance 

10 of such system. 

11 ‘‘(B) Subparagraph (A) shall not apply in the case 

12 in which a State requires personal care service and home 

13 health care service providers to utilize an electronic visit 

14 verification system that is not operated by the State or 

15 a contractor on behalf of the State.’’. 

16 (b) COLLECTION AND DISSEMINATION OF BEST

17 PRACTICES.—Not later than January 1, 2018, the Sec18 retary of Health and Human Services shall, with respect 

19 to electronic visit verification systems (as defined in sub20 section (l)(5) of section 1903 of the Social Security Act 

21 (42 U.S.C. 1396b), as inserted by subsection (a)), collect 

22 and disseminate best practices to State Medicaid Directors 

23 with respect to— 

24 (1) training individuals who furnish personal 

25 care services, home health care services, or both 


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1 under the State plan under title XIX of such Act (or 

2 under a waiver of the plan) on such systems and the 

3 operation of such systems and the prevention of 

4 fraud with respect to the provision of personal care 

5 services or home health care services (as defined in 

6 such subsection (l)(5)); and 

7 (2) the provision of notice and educational ma8 terials to family caregivers and beneficiaries with re9 spect to the use of such electronic visit verification 

10 systems and other means to prevent such fraud. 

11 (c) RULES OF CONSTRUCTION.— 

12 (1) NO EMPLOYER-EMPLOYEE RELATIONSHIP

13 ESTABLISHED.—Nothing in the amendment made by 

14 this section may be construed as establishing an em15 ployer-employee relationship between the agency or 

16 entity that provides for personal care services or 

17 home health care services and the individuals who, 

18 under a contract with such an agency or entity, fur19 nish such services for purposes of part 552 of title 

20 29, Code of Federal Regulations (or any successor 

21 regulations). 

22 (2) NO PARTICULAR OR UNIFORM ELECTRONIC

23 VISIT VERIFICATION SYSTEM REQUIRED.—Nothing 

24 in the amendment made by this section shall be con25 strued to require the use of a particular or uniform 


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1 electronic visit verification system (as defined in sub2 section (l)(5) of section 1903 of the Social Security 

3 Act (42 U.S.C. 1396b), as inserted by subsection 

4 (a)) by all agencies or entities that provide personal 

5 care services or home health care under a State plan 

6 under title XIX of the Social Security Act (or under 

7 a waiver of the plan) (42 U.S.C. 1396 et seq.). 

8 (3) NO LIMITS ON PROVISION OF CARE.—Noth9 ing in the amendment made by this section may be 

10 construed to limit, with respect to personal care 

11 services or home health care services provided under 

12 a State plan under title XIX of the Social Security 

13 Act (or under a waiver of the plan) (42 U.S.C. 1396 

14 et seq.), provider selection, constrain beneficiaries’ 

15 selection of a caregiver, or impede the manner in 

16 which care is delivered. 

17 (4) NO PROHIBITION ON STATE QUALITY MEAS18 URES REQUIREMENTS.—Nothing in the amendment 

19 made by this section shall be construed as prohib20 iting a State, in implementing an electronic visit 

21 verification system (as defined in subsection (l)(5) of 

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

23 1396b), as inserted by subsection (a)), from estab24 lishing requirements related to quality measures for 

25 such system. 


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1 TITLE III—INTERDEPART2 MENTAL SERIOUS MENTAL 

3 ILLNESS COORDINATING 

4 COMMITTEE 

5 SEC. 301. INTERDEPARTMENTAL SERIOUS MENTAL ILL6 NESS COORDINATING COMMITTEE. 

7 (a) ESTABLISHMENT.— 

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

9 after the date of enactment of this Act, the Sec10 retary of Health and Human Services, or the des11 ignee of the Secretary, shall establish a committee to 

12 be known as the ‘‘Interdepartmental Serious Mental 

13 Illness Coordinating Committee’’ (in this section re14 ferred to as the ‘‘Committee’’). 

15 (2) FEDERAL ADVISORY COMMITTEE ACT.—Ex16 cept as provided in this section, the provisions of the 

17 Federal Advisory Committee Act (5 U.S.C. App.) 

18 shall apply to the Committee. 

19 (b) MEETINGS.—The Committee shall meet not fewer 

20 than two times each year. 

21 (c) RESPONSIBILITIES.—Not later than 1 year after 

22 the date of enactment of this Act, and 5 years after such 

23 date of enactment, the Committee shall submit to Con24 gress a report including— 


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1 (1) a summary of advances in serious mental 

2 illness and serious emotional disturbance research 

3 related to the prevention of, diagnosis of, interven4 tion in, and treatment and recovery of, serious men5 tal illnesses, serious emotional disturbances, and ad6 vances in access to services and support for individ7 uals with a serious mental illness or serious emo8 tional disturbance; 

9 (2) an evaluation of the effect on public health 

10 of Federal programs related to serious mental illness 

11 or serious emotional disturbance, including measure12 ments of public health outcomes such as— 

13 (A) rates of suicide, suicide attempts, prev14 alence of serious mental illness, serious emo15 tional disturbances, and substance use dis16 orders, overdose, overdose deaths, emergency 

17 hospitalizations, emergency room boarding, pre18 ventable emergency room visits, involvement 

19 with the criminal justice system, crime, home20 lessness, and unemployment; 

21 (B) increased rates of employment and en22 rollment in educational and vocational pro23 grams; 

24 (C) quality of mental illness and substance 

25 use disorder treatment services; and 


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1 (D) any other criteria as may be deter2 mined by the Secretary; 

3 (3) a plan to improve outcomes for individuals 

4 with serious mental illness or serious emotional dis5 turbances, including reducing incarceration for such 

6 individuals, reducing homelessness, and increasing 

7 employment; and 

8 (4) specific recommendations for actions that 

9 agencies can take to better coordinate the adminis10 tration of mental health services for people with seri11 ous mental illness or serious emotional disturbances. 

12 (d) COMMITTEE EXTENSION.—Upon the submission 

13 of the second report under subsection (c), the Secretary 

14 shall submit a recommendation to Congress on whether 

15 to extend the operation of the Committee. 

16 (e) MEMBERSHIP.— 

17 (1) FEDERAL MEMBERS.—The Committee shall 

18 be composed of the following Federal representa19 tives, or their designees: 

20 (A) The Secretary of Health and Human 

21 Services, who shall serve as the Chair of the 

22 Committee. 

23 (B) The Director of the National Institutes 

24 of Health. 


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1 (C) The Assistant Secretary for Health of 

2 the Department of Health and Human Services. 

3 (D) The Assistant Secretary for Mental 

4 Health and Substance Use. 

5 (E) The Attorney General of the United 

6 States. 

7 (F) The Secretary of Veterans Affairs. 

8 (G) The Secretary of Defense. 

9 (H) The Secretary of Housing and Urban 

10 Development. 

11 (I) The Secretary of Education. 

12 (J) The Secretary of Labor. 

13 (K) The Commissioner of Social Security. 

14 (L) The Administrator of the Centers for 

15 Medicare & Medicaid Services. 

16 (2) NON-FEDERAL MEMBERS.—The Committee 

17 shall also include not less than 14 non-Federal pub18 lic members appointed by the Secretary of Health 

19 and Human Services, of which— 

20 (A) at least two members shall be individ21 uals with lived experience with serious mental 

22 illness or serious emotional disturbance; 

23 (B) at least one member shall be a parent 

24 or legal guardian of an individual with a history 


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1 of a serious mental illness or serious emotional 

2 disturbance; 

3 (C) at least one member shall be a rep4 resentative of a leading research, advocacy, or 

5 service organization for individuals with serious 

6 mental illness or serious emotional disturbance; 

7 (D) at least two members shall be— 

8 (i) a licensed psychiatrist with experi9 ence treating serious mental illnesses or se10 rious emotional disturbances; 

11 (ii) a licensed psychologist with expe12 rience treating serious mental illnesses or 

13 serious emotional disturbances; 

14 (iii) a licensed clinical social worker 

15 with experience treating serious mental ill16 ness or serious emotional disturbances; or 

17 (iv) a licensed psychiatric nurse, nurse 

18 practitioner, or physician assistant with ex19 perience treating serious mental illnesses 

20 or serious emotional disturbances; 

21 (E) at least one member shall be a licensed 

22 mental health professional with a specialty in 

23 treating children and adolescents with serious 

24 emotional disturbances; 


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1 (F) at least one member shall be a mental 

2 health professional who has research or clinical 

3 mental health experience working with minori4 ties; 

5 (G) at least one member shall be a mental 

6 health professional who has research or clinical 

7 mental health experience working with medi8 cally underserved populations; 

9 (H) at least one member shall be a State 

10 certified mental health peer-support specialist; 

11 (I) at least one member shall be a judge 

12 with experience adjudicating cases within a 

13 mental health court; 

14 (J) at least one member shall be a law en15 forcement officer or corrections officer with ex16 tensive experience in interfacing with individ17 uals with a serious mental illness or serious 

18 emotional disturbance, or in a mental health 

19 crisis; and 

20 (K) at least one member shall be a home21 less services provider with experience working 

22 with individuals with serious mental illness, 

23 with serious emotional disturbance, or having 

24 mental health crisis. 


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1 (3) TERMS.—A member of the Committee ap2 pointed under paragraph (2) shall serve for a term 

3 of 3 years, and may be reappointed for one or more 

4 additional 3-year terms. Any member appointed to 

5 fill a vacancy for an unexpired term shall be ap6 pointed for the remainder of such term. A member 

7 may serve after the expiration of the member’s term 

8 until a successor has been appointed. 

9 (f) WORKING GROUPS.—In carrying out its func10 tions, the Committee may establish working groups. Such 

11 working groups shall be composed of Committee members, 

12 or their designees, and may hold such meetings as are nec13 essary. 

14 (g) SUNSET.—The Committee shall terminate on the 

15 date that is 6 years after the date on which the Committee 

16 is established under subsection (a)(1). 

17 TITLE IV—COMPASSIONATE 

18 COMMUNICATION ON HIPAA 

19 SEC. 401. SENSE OF CONGRESS. 

20 (a) FINDINGS.—Congress finds the following: 

21 (1) The vast majority of individuals with mental 

22 illness are capable of understanding their illness and 

23 caring for themselves. 

24 (2) Persons with serious mental illness (in this 

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1 phrenia spectrum, bipolar disorders, and major de2 pressive disorder, may be significantly impaired in 

3 their ability to understand or make sound decisions 

4 for their care and needs. By nature of their illness, 

5 cognitive impairments in reasoning and judgment, as 

6 well as the presence of hallucinations, delusions, and 

7 severe emotional distortions, they may lack the 

8 awareness they even have a mental illness (a condi9 tion known as anosognosia), and thus may be unable 

10 to make sound decisions regarding their care, nor 

11 follow through consistently and effectively on their 

12 care needs. 

13 (3) Persons with mental illness or SMI may re14 quire and benefit from mental health treatment in 

15 order to recover to the fullest extent of their ability; 

16 these beneficial interventions may include psychiatric 

17 care, psychological care, medication, peer support, 

18 educational support, employment support, and hous19 ing support. 

20 (4) Persons with SMI who are provided with 

21 professional and supportive services may still experi22 ence times when their symptoms may greatly impair 

23 their abilities to make sound decisions for their per24 sonal care or may discontinue their care as a result 

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1 ther deterioration of their condition. They may expe2 rience a temporary or prolonged impairment as a re3 sult of their diminished capacity to care for them4 selves. 

5 (5) Episodes of psychiatric crises among those 

6 with SMI can result in neurological harm to the in7 dividual’s brain. 

8 (6) Persons with SMI— 

9 (A) are at high risk for other chronic phys10 ical illnesses, with approximately 50 percent 

11 having two or more co-occurring chronic phys12 ical illnesses such as cardiac, pulmonary, can13 cer, and endocrine disorders; and 

14 (B) have three times the odds of having 

15 chronic bronchitis, five times the odds of having 

16 emphysema, and four times the odds of having 

17 COPD, are more than four times as likely to 

18 have fluid and electrolyte disorders, and are 

19 nearly three times as likely to be nicotine de20 pendent. 

21 (7) Some psychotropic medications, such as sec22 ond generation antipsychotics, significantly increase 

23 risk for chronic illnesses such as diabetes and car24 diovascular disease. 


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1 (8) When the individual fails to seek or main2 tain treatment for these physical conditions over a 

3 long term, it can result in the individual becoming 

4 gravely disabled, or developing life-threatening ill5 nesses. Early and consistent treatment can amelio6 rate or reduce symptoms or cure the disease. 

7 (9) Persons with SMI die 7 to 24 years earlier 

8 than their age cohorts primarily because of com9 plications from their chronic physical illness and fail10 ure to seek or maintain treatment resulting from 

11 emotional and cognitive impairments from their 

12 SMI. 

13 (10) It is beneficial to the person with SMI and 

14 chronic illness to seek and maintain continuity of 

15 medical care and treatment for their mental illness 

16 to prevent further deterioration and harm to their 

17 own safety. 

18 (11) When the individual with SMI is signifi19 cantly diminished in their capacity to care for them20 selves long term or acutely, other supportive inter21 ventions to assist their care may be necessary to 

22 protect their health and safety. 

23 (12) Prognosis for the physical and psychiatric 

24 health of those with SMI may improve when respon25 sible caregivers facilitate and participate in care. 


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1 (13) When an individual with SMI is chron2 ically incapacitated in their ability to care for them3 selves, caregivers can pursue legal guardianship to 

4 facilitate care in appropriate areas while being mind5 ful to allow the individual to make decisions for 

6 themselves in areas where they are capable. 

7 (14) Individuals with SMI who have prolonged 

8 periods of being significantly functional can, during 

9 such periods, design and sign an advanced directive 

10 to predefine and choose medications, providers, 

11 treatment plans, and hospitals, and provide care12 givers with guardianship the ability to help in those 

13 times when a patient’s psychiatric symptoms worsen 

14 to the point of making them incapacitated or leaving 

15 them with a severely diminished capacity to make in16 formed decisions about their care which may result 

17 in harm to their physical and mental health. 

18 (15) All professional and support efforts should 

19 be made to help the individual with SMI and acute 

20 or chronic physical illnesses to understand and fol21 low through on treatment. 

22 (16) When individuals with SMI, even after ef23 forts to help them understand, have failed to care 

24 for themselves, there exists confusion in the health 

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1 sible under HIPAA rules. This confusion may hinder 

2 communication with responsible caregivers who may 

3 be able to facilitate care for the patient with SMI in 

4 instances when the individual does not give permis5 sion for disclosure. 

6 (b) SENSE OF CONGRESS.—It is the sense of the 

7 Congress that, for the sake of the health and safety of 

8 persons with serious mental illness, more clarity is needed 

9 surrounding the existing HIPAA privacy rule promulgated 

10 pursuant to section 264(c) of the Health Insurance Port11 ability and Accountability Act (42 U.S.C. 1320d–2 note) 

12 to permit health care professionals to communicate, when 

13 necessary, with responsible known caregivers of such per14 sons, the limited, appropriate protected health information 

15 of such persons in order to facilitate treatment, but not 

16 including psychotherapy notes. 

17 SEC. 402. CONFIDENTIALITY OF RECORDS. 

18 Not later than 1 year after the date on which the 

19 Secretary of Health and Human Services first finalizes 

20 regulations updating part 2 of title 42, Code of Federal 

21 Regulations (relating to confidentiality of alcohol and drug 

22 abuse patient records) after the date of enactment of this 

23 Act, the Secretary shall convene relevant stakeholders to 

24 determine the effect of such regulations on patient care, 

25 health outcomes, and patient privacy. The Secretary shall 


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1 submit to the Committee on Energy and Commerce of the 

2 House of Representatives and the Committee on Health, 

3 Education, Labor, and Pensions of the Senate, and make 

4 publicly available, a report on the findings of such stake5 holders. 

6 SEC. 403. CLARIFICATION OF CIRCUMSTANCES UNDER 

7 WHICH DISCLOSURE OF PROTECTED HEALTH 

8 INFORMATION IS PERMITTED. 

9 (a) IN GENERAL.—Not later than 1 year after the 

10 date of enactment of this section, the Secretary of Health 

11 and Human Services shall promulgate final regulations 

12 clarifying the circumstances under which, consistent with 

13 the provisions of subpart C of title XI of the Social Secu14 rity Act (42 U.S.C. 1320d et seq.) and regulations pro15 mulgated pursuant to section 264(c) of the Health Insur16 ance Portability and Accountability Act of 1996 (42 

17 U.S.C. 1320d–2 note), a health care provider or covered 

18 entity may disclose the protected health information of a 

19 patient with a mental illness, including for purposes of— 

20 (1) communicating (including with respect to 

21 treatment, side effects, risk factors, and the avail22 ability of community resources) with a family mem23 ber of such patient, caregiver of such patient, or 

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1 ber, caregiver, or individual is involved in the care 

2 of the patient; 

3 (2) communicating with a family member of the 

4 patient, caregiver of such patient, or other individual 

5 involved in the care of the patient in the case that 

6 the patient is an adult; 

7 (3) communicating with the parent or caregiver 

8 of a patient in the case that the patient is a minor; 

9 (4) considering the patient’s capacity to agree 

10 or object to the sharing of the protected health in11 formation of the patient; 

12 (5) communicating and sharing information 

13 with the family or caregivers of the patient when— 

14 (A) the patient consents; 

15 (B) the patient does not consent, but the 

16 patient lacks the capacity to agree or object and 

17 the communication or sharing of information is 

18 in the patient’s best interest; 

19 (C) the patient does not consent and the 

20 patient is not incapacitated or in an emergency 

21 circumstance, but the ability of the patient to 

22 make rational health care decisions is signifi23 cantly diminished by reason of the physical or 

24 mental health condition of the patient; and 


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1 (D) the patient does not consent, but such 

2 communication and sharing of information is 

3 necessary to prevent impending and serious de4 terioration of the patient’s mental or physical 

5 health; 

6 (6) involving a patient’s family members, care7 givers, or others involved in the patient’s care or 

8 care plan, including facilitating treatment and medi9 cation adherence, in dealing with patient failures to 

10 adhere to medication or other therapy; 

11 (7) listening to or receiving information with re12 spect to the patient from the family or caregiver of 

13 such patient receiving mental illness treatment; 

14 (8) communicating with family members of the 

15 patient, caregivers of the patient, law enforcement, 

16 or others when the patient presents a serious and 

17 imminent threat of harm to self or others; and 

18 (9) communicating to law enforcement and 

19 family members of the patient or caregivers of the 

20 patient about the admission of the patient to receive 

21 care at a facility or the release of a patient who was 

22 admitted to a facility for an emergency psychiatric 

23 hold or involuntary treatment. 

24 (b) COORDINATION.—The Secretary of Health and 

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1 tion with the Director of the Office for Civil Rights within 

2 the Department of Health and Human Services. 

3 (c) CONSISTENCY WITH GUIDANCE.—The Secretary 

4 of Health and Human Services shall ensure that the regu5 lations under this section are consistent with the guidance 

6 entitled ‘‘HIPAA Privacy Rule and Sharing Information 

7 Related to Mental Health’’, issued by the Department of 

8 Health and Human Services on February 20, 2014. 

9 SEC. 404. DEVELOPMENT AND DISSEMINATION OF MODEL 

10 TRAINING PROGRAMS. 

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

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

13 the Secretary of Health and Human Services (in this sec14 tion referred to as the ‘‘Secretary’’) shall develop and dis15 seminate— 

16 (1) a model program and materials for training 

17 health care providers (including physicians, emer18 gency medical personnel, psychologists, counselors, 

19 therapists, behavioral health facilities and clinics, 

20 care managers, and hospitals) regarding the cir21 cumstances under which, consistent with the stand22 ards governing the privacy and security of individ23 ually identifiable health information promulgated by 

24 the Secretary under subpart C of title XI of the So25 cial Security Act (42 U.S.C. 1320d et seq.) and regVerDate Sep 11 2014 22:58 Jul 15, 2016 Jkt 059200 PO 00000 Frm 00067 Fmt 6652 Sfmt 6201 E:\BILLS\H2646.RFS H2646

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1 ulations promulgated pursuant to section 264(c) of 

2 the Health Insurance Portability and Accountability 

3 Act of 1996 (42 U.S.C. 1320d–2 note), the pro4 tected health information of patients with a mental 

5 illness may be disclosed with and without patient 

6 consent; 

7 (2) a model program and materials for training 

8 lawyers and others in the legal profession on such 

9 circumstances; and 

10 (3) a model program and materials for training 

11 patients and their families regarding their rights to 

12 protect and obtain information under the standards 

13 specified in paragraph (1). 

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

15 (1) periodically review and update the model 

16 programs and materials developed under subsection 

17 (a); and 

18 (2) disseminate the updated model programs 

19 and materials. 

20 (c) CONTENTS.—The programs and materials devel21 oped under subsection (a) shall address the guidance enti22 tled ‘‘HIPAA Privacy Rule and Sharing Information Re23 lated to Mental Health’’, issued by the Department of 

24 Health and Human Services on February 20, 2014. 


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

2 this section in coordination with the Director of the Office 

3 for Civil Rights within the Department of Health and 

4 Human Services, the Assistant Secretary for Mental 

5 Health and Substance Use, the Administrator of the 

6 Health Resources and Services Administration, and the 

7 heads of other relevant agencies within the Department 

8 of Health and Human Services. 

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

10 model programs and materials required by subsections (a) 

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

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

13 and licensing boards. 

14 (f) FUNDING.—There are authorized to be appro15 priated to carry out this section $4,000,000 for fiscal year 

16 2018, $2,000,000 for each of fiscal years 2019 and 2020, 

17 and $1,000,000 for each of fiscal years 2021 and 2022. 


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1 TITLE V—INCREASING ACCESS 

2 TO TREATMENT FOR SERIOUS 

3 MENTAL ILLNESS 

4 SEC. 501. ASSERTIVE COMMUNITY TREATMENT GRANT 

5 PROGRAM FOR INDIVIDUALS WITH SERIOUS 

6 MENTAL ILLNESS. 

7 Part B of title V of the Public Health Service Act 

8 (42 U.S.C. 290bb et seq.) is amended by inserting after 

9 section 520L the following: 

10 ‘‘SEC. 520M. ASSERTIVE COMMUNITY TREATMENT GRANT 

11 PROGRAM FOR INDIVIDUALS WITH SERIOUS 

12 MENTAL ILLNESS. 

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

14 award grants to eligible entities— 

15 ‘‘(1) to establish assertive community treatment 

16 programs for individuals with serious mental illness; 

17 or 

18 ‘‘(2) to maintain or expand such programs. 

19 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 

20 a grant under this section, an entity shall be a State, coun21 ty, city, tribe, tribal organization, mental health system, 

22 health care facility, or any other entity the Assistant Sec23 retary deems appropriate. 

24 ‘‘(c) SPECIAL CONSIDERATION.—In selecting among 

25 applicants for a grant under this section, the Assistant 


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1 Secretary may give special consideration to the potential 

2 of the applicant’s program to reduce hospitalization, 

3 homelessness, and involvement with the criminal justice 

4 system while improving the health and social outcomes of 

5 the patient. 

6 ‘‘(d) ADDITIONAL ACTIVITIES.—The Assistant Sec7 retary shall— 

8 ‘‘(1) not later than the end of fiscal year 2021, 

9 submit a report to the appropriate congressional 

10 committees on the grant program under this section, 

11 including an evaluation of— 

12 ‘‘(A) cost savings and public health out13 comes such as mortality, suicide, substance 

14 abuse, hospitalization, and use of services; 

15 ‘‘(B) rates of involvement with the criminal 

16 justice system of patients; 

17 ‘‘(C) rates of homelessness among patients; 

18 and 

19 ‘‘(D) patient and family satisfaction with 

20 program participation; and 

21 ‘‘(2) provide appropriate information, training, 

22 and technical assistance to grant recipients under 

23 this section to help such recipients to establish, 

24 maintain, or expand their assertive community treat25 ment programs. 


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1 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

2 ‘‘(1) IN GENERAL.—To carry out this section, 

3 there is authorized to be appropriated $5,000,000 

4 for the period of fiscal years 2018 through 2022. 

5 ‘‘(2) USE OF CERTAIN FUNDS.—Of the funds 

6 appropriated to carry out this section in any fiscal 

7 year, no more than 5 percent shall be available to 

8 the Assistant Secretary for carrying out subsection 

9 (d).’’. 

10 SEC. 502. STRENGTHENING COMMUNITY CRISIS RESPONSE 

11 SYSTEMS. 

12 Section 520F of the Public Health Service Act (42 

13 U.S.C. 290bb–37) is amended to read as follows: 

14 ‘‘SEC. 520F. STRENGTHENING COMMUNITY CRISIS RE15 SPONSE SYSTEMS. 

16 ‘‘(a) IN GENERAL.—The Secretary shall award com17 petitive grants— 

18 ‘‘(1) to State and local governments and Indian 

19 tribes and tribal organizations to enhance commu20 nity-based crisis response systems; or 

21 ‘‘(2) to States to develop, maintain, or enhance 

22 a database of beds at inpatient psychiatric facilities, 

23 crisis stabilization units, and residential community 

24 mental health and residential substance use disorder 

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1 tal illness, serious emotional disturbance, or sub2 stance use disorders. 

3 ‘‘(b) APPLICATION.— 

4 ‘‘(1) IN GENERAL.—To receive a grant or coop5 erative agreement under subsection (a), an entity 

6 shall submit to the Secretary an application, at such 

7 time, in such manner, and containing such informa8 tion as the Secretary may require. 

9 ‘‘(2) COMMUNITY-BASED CRISIS RESPONSE

10 PLAN.—An application for a grant under subsection 

11 (a)(1) shall include a plan for— 

12 ‘‘(A) promoting integration and coordina13 tion between local public and private entities 

14 engaged in crisis response, including first re15 sponders, emergency health care providers, pri16 mary care providers, law enforcement, court 

17 systems, health care payers, social service pro18 viders, and behavioral health providers; 

19 ‘‘(B) developing a plan for entering into 

20 memoranda of understanding with public and 

21 private entities to implement crisis response 

22 services; 

23 ‘‘(C) expanding the continuum of commu24 nity-based services to address crisis intervention 

25 and prevention; and 


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1 ‘‘(D) developing models for minimizing 

2 hospital readmissions, including through appro3 priate discharge planning. 

4 ‘‘(3) BEDS DATABASE PLAN.—An application 

5 for a grant under subsection (a)(2) shall include a 

6 plan for developing, maintaining, or enhancing a 

7 real-time Internet-based bed database to collect, ag8 gregate, and display information about beds in inpa9 tient psychiatric facilities and crisis stabilization 

10 units, and residential community mental health and 

11 residential substance use disorder treatment facili12 ties, to facilitate the identification and designation of 

13 facilities for the temporary treatment of individuals 

14 in mental or substance use disorder crisis. 

15 ‘‘(c) DATABASE REQUIREMENTS.—A bed database 

16 described in this section is a database that— 

17 ‘‘(1) includes information on inpatient psy18 chiatric facilities, crisis stabilization units, and resi19 dential community mental health and residential 

20 substance use disorder facilities in the State in21 volved, including contact information for the facility 

22 or unit; 

23 ‘‘(2) provides real-time information about the 

24 number of beds available at each facility or unit and, 

25 for each available bed, the type of patient that may 


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1 be admitted, the level of security provided, and any 

2 other information that may be necessary to allow for 

3 the proper identification of appropriate facilities for 

4 treatment of individuals in mental or substance use 

5 disorder crisis; and 

6 ‘‘(3) enables searches of the database to iden7 tify available beds that are appropriate for the treat8 ment of individuals in mental or substance use dis9 order crisis. 

10 ‘‘(d) EVALUATION.—An entity receiving a grant 

11 under subsection (a)(1) shall submit to the Secretary, at 

12 such time, in such manner, and containing such informa13 tion as the Secretary may reasonably require, a report, 

14 including an evaluation of the effect of such grant on— 

15 ‘‘(1) local crisis response services and measures 

16 of individuals receiving crisis planning and early 

17 intervention supports; 

18 ‘‘(2) individuals reporting improved functional 

19 outcomes; and 

20 ‘‘(3) individuals receiving regular followup care 

21 following a crisis. 

22 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

23 is authorized to be appropriated to carry out this section, 

24 $5,000,000 for the period of fiscal years 2018 through 

25 2022.’’. 


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1 SEC. 503. INCREASED AND EXTENDED FUNDING FOR AS2 SISTED OUTPATIENT GRANT PROGRAM FOR 

3 INDIVIDUALS WITH SERIOUS MENTAL ILL4 NESS. 

5 Section 224(g) of the Protecting Access to Medicare 

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

7 (1) in paragraph (1), by striking ‘‘2018’’ and 

8 inserting ‘‘2022’’; and 

9 (2) in paragraph (2), by striking ‘‘is authorized 

10 to be appropriated to carry out this section 

11 $15,000,000 for each of fiscal years 2015 through 

12 2018’’ and inserting ‘‘are authorized to be appro13 priated to carry out this section $15,000,000 for 

14 each of fiscal years 2015 through 2017, 

15 $20,000,000 for fiscal year 2018, $19,000,000 for 

16 each of fiscal years 2019 and 2020, and 

17 $18,000,000 for each of fiscal years 2021 and 

18 2022’’. 

19 SEC. 504. LIABILITY PROTECTIONS FOR HEALTH PROFES20 SIONAL VOLUNTEERS AT COMMUNITY 

21 HEALTH CENTERS. 

22 Section 224 of the Public Health Service Act (42 

23 U.S.C. 233) is amended by adding at the end the fol24 lowing: 

25 ‘‘(q)(1) For purposes of this section, a health profes26 sional volunteer at an entity described in subsection (g)(4) 


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1 shall, in providing a health professional service eligible for 

2 funding under section 330 to an individual, be deemed to 

3 be an employee of the Public Health Service for a calendar 

4 year that begins during a fiscal year for which a transfer 

5 was made under paragraph (4)(C). The preceding sen6 tence is subject to the provisions of this subsection. 

7 ‘‘(2) In providing a health service to an individual, 

8 a health care practitioner shall for purposes of this sub9 section be considered to be a health professional volunteer 

10 at an entity described in subsection (g)(4) if the following 

11 conditions are met: 

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

13 the facilities of an entity described in subsection 

14 (g)(4), or through offsite programs or events carried 

15 out by the entity. 

16 ‘‘(B) The entity is sponsoring the health care 

17 practitioner pursuant to paragraph (3)(B). 

18 ‘‘(C) The health care practitioner does not re19 ceive any compensation for the service from the indi20 vidual or from any third-party payer (including re21 imbursement under any insurance policy or health 

22 plan, or under any Federal or State health benefits 

23 program), except that the health care practitioner 

24 may receive repayment from the entity described in 

25 subsection (g)(4) for reasonable expenses incurred 


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1 by the health care practitioner in the provision of 

2 the service to the individual. 

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

4 care practitioner or the entity described in sub5 section (g)(4) posts a clear and conspicuous notice 

6 at the site where the service is provided of the extent 

7 to which the legal liability of the health care practi8 tioner is limited pursuant to this subsection. 

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

10 health care practitioner is licensed or certified in ac11 cordance with applicable law regarding the provision 

12 of the service. 

13 ‘‘(3) Subsection (g) (other than paragraphs (3) and 

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

15 practitioner for purposes of this subsection to the same 

16 extent and in the same manner as such subsections apply 

17 to an officer, governing board member, employee, or con18 tractor of an entity described in subsection (g)(4), subject 

19 to paragraph (4) and subject to the following: 

20 ‘‘(A) The first sentence of paragraph (1) ap21 plies in lieu of the first sentence of subsection 

22 (g)(1)(A). 

23 ‘‘(B) With respect to an entity described in sub24 section (g)(4), a health care practitioner is not a 

25 health professional volunteer at such entity unless 


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1 the entity sponsors the health care practitioner. For 

2 purposes of this subsection, the entity shall be con3 sidered to be sponsoring the health care practitioner 

4 if— 

5 ‘‘(i) with respect to the health care practi6 tioner, the entity submits to the Secretary an 

7 application meeting the requirements of sub8 section (g)(1)(D); and 

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

10 (g)(1)(E), determines that the health care prac11 titioner is deemed to be an employee of the 

12 Public Health Service. 

13 ‘‘(C) In the case of a health care practitioner 

14 who is determined by the Secretary pursuant to sub15 section (g)(1)(E) to be a health professional volun16 teer at such entity, this subsection applies to the 

17 health care practitioner (with respect to services per18 formed on behalf of the entity sponsoring the health 

19 care practitioner pursuant to subparagraph (B)) for 

20 any cause of action arising from an act or omission 

21 of the health care practitioner occurring on or after 

22 the date on which the Secretary makes such deter23 mination. 

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

25 care practitioner for purposes of this subsection only 


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1 to the extent that, in providing health services to an 

2 individual, each of the conditions specified in para3 graph (2) is met. 

4 ‘‘(4)(A) Amounts in the fund established under sub5 section (k)(2) shall be available for transfer under sub6 paragraph (C) for purposes of carrying out this sub7 section. 

8 ‘‘(B) Not later May 1 of each fiscal year, the Attor9 ney General, in consultation with the Secretary, shall sub10 mit to the Congress a report providing an estimate of the 

11 amount of claims (together with related fees and expenses 

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

13 health professional volunteers, will be paid pursuant to 

14 this section during the calendar year that begins in the 

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

16 estimate under the preceding sentence regarding health 

17 professional volunteers to the same extent and in the same 

18 manner as such subsection applies to the estimate under 

19 such subsection regarding officers, governing board mem20 bers, employees, and contractors of entities described in 

21 subsection (g)(4). 

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

23 the Secretary shall transfer from the fund under sub24 section (k)(2) to the appropriate accounts in the Treasury 

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1 graph (B) for the calendar year beginning in such fiscal 

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

3 ‘‘(5)(A) This subsection takes effect on October 1, 

4 2017, except as provided in subparagraph (B). 

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

6 subsection— 

7 ‘‘(i) the Secretary may issue regulations for car8 rying out this subsection, and the Secretary may ac9 cept and consider applications submitted pursuant to 

10 paragraph (3)(B); and 

11 ‘‘(ii) reports under paragraph (4)(B) may be 

12 submitted to the Congress.’’. 

13 TITLE VI—SUPPORTING INNOVA14 TIVE AND EVIDENCE-BASED 

15 PROGRAMS 

16 Subtitle A—Encouraging the Ad17 vancement, Incorporation, and 

18 Development of Evidence-Based 

19 Practices 

20 SEC. 601. ENCOURAGING INNOVATION AND EVIDENCE21 BASED PROGRAMS. 

22 Section 501B of the Public Health Service Act, as 

23 inserted by section 103, is further amended, by inserting 

24 after subsection (c) the following new subsection: 

25 ‘‘(d) PROMOTING INNOVATION.— 


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1 ‘‘(1) IN GENERAL.—The Assistant Secretary, in 

2 coordination with the Laboratory, may award grants 

3 to States, local governments, Indian tribes or tribal 

4 organizations (as such terms are defined in section 

5 4 of the Indian Self-Determination and Education 

6 Assistance Act), educational institutions, and non7 profit organizations to develop evidence-based inter8 ventions, including culturally and linguistically ap9 propriate services, as appropriate, for— 

10 ‘‘(A) evaluating a model that has been sci11 entifically demonstrated to show promise, but 

12 would benefit from further applied development, 

13 for— 

14 ‘‘(i) enhancing the prevention, diag15 nosis, intervention, treatment, and recovery 

16 of mental illness, serious emotional dis17 turbance, substance use disorders, and co18 occurring illness or disorders; or 

19 ‘‘(ii) integrating or coordinating phys20 ical health services and mental illness and 

21 substance use disorder services; and 

22 ‘‘(B) expanding, replicating, or scaling evi23 dence-based programs across a wider area to 

24 enhance effective screening, early diagnosis, 

25 intervention, and treatment with respect to 


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1 mental illness, serious mental illness, and seri2 ous emotional disturbance, primarily by— 

3 ‘‘(i) applying delivery of care, includ4 ing training staff in effective evidence5 based treatment; or 

6 ‘‘(ii) integrating models of care across 

7 specialties and jurisdictions. 

8 ‘‘(2) CONSULTATION.—In awarding grants 

9 under this paragraph, the Assistant Secretary shall, 

10 as appropriate, consult with the advisory councils de11 scribed in section 502, the National Institute of 

12 Mental Health, the National Institute on Drug 

13 Abuse, and the National Institute on Alcohol Abuse 

14 and Alcoholism, as appropriate. 

15 ‘‘(3) AUTHORIZATION OF APPROPRIATIONS.— 

16 There are authorized to be appropriated— 

17 ‘‘(A) to carry out paragraph (1)(A), 

18 $7,000,000 for the period of fiscal years 2018 

19 through 2020; and 

20 ‘‘(B) to carry out paragraph (1)(B), 

21 $7,000,000 for the period of fiscal years 2018 

22 through 2020.’’. 


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1 SEC. 602. PROMOTING ACCESS TO INFORMATION ON EVI2 DENCE-BASED PROGRAMS AND PRACTICES. 

3 Part D of title V of the Public Health Service Act 

4 is amended by inserting after section 543 of such Act (42 

5 U.S.C. 290dd–2 ) the following: 

6 ‘‘SEC. 544. PROMOTING ACCESS TO INFORMATION ON EVI7 DENCE-BASED PROGRAMS AND PRACTICES. 

8 ‘‘(a) IN GENERAL.—The Assistant Secretary shall 

9 improve access to reliable and valid information on evi10 dence-based programs and practices, including informa11 tion on the strength of evidence associated with such pro12 grams and practices, related to mental illness and sub13 stance use disorders for States, local communities, non14 profit entities, and other stakeholders by posting on the 

15 website of the National Registry of Evidence-Based Pro16 grams and Practices evidence-based programs and prac17 tices that have been reviewed by the Assistant Secretary 

18 pursuant to the requirements of this section. 

19 ‘‘(b) NOTICE.— 

20 ‘‘(1) PERIODS.—In carrying out subsection (a), 

21 the Assistant Secretary may establish an initial pe22 riod for the submission of applications for evidence23 based programs and practices to be posted publicly 

24 in accordance with subsection (a) (and may establish 

25 subsequent such periods). The Assistant Secretary 


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1 shall publish notice of such application periods in 

2 the Federal Register. 

3 ‘‘(2) ADDRESSING GAPS.—Such notice may so4 licit applications for evidence-based practices and 

5 programs to address gaps in information identified 

6 by the Assistant Secretary, the Assistant Secretary 

7 for Planning and Evaluation, the Assistant Sec8 retary for Financial Resources, or the National Men9 tal Health and Substance Use Policy Laboratory, in10 cluding pursuant to priorities identified in the stra11 tegic plan established under section 501(l). 

12 ‘‘(c) REQUIREMENTS.—The Assistant Secretary shall 

13 establish minimum requirements for applications referred 

14 to in this section, including applications related to the sub15 mission of research and evaluation. 

16 ‘‘(d) REVIEW AND RATING.—The Assistant Secretary 

17 shall review applications prior to public posting, and may 

18 prioritize the review of applications for evidence-based 

19 practices and programs that are related to topics included 

20 in the notice established under subsection (b). The Assist21 ant Secretary shall utilize a rating and review system, 

22 which shall include information on the strength of evidence 

23 associated with such programs and practices and a rating 

24 of the methodological rigor of the research supporting the 

25 application. The Assistant Secretary shall make the 


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1 metrics used to evaluate applications and the resulting rat2 ings publicly available.’’. 

3 SEC. 603. SENSE OF CONGRESS. 

4 It is the sense of the Congress that the National In5 stitute of Mental Health should conduct or support re6 search on the determinants of self-directed and other vio7 lence connected to mental illness. 

8 Subtitle B—Supporting the State 

9 Response to Mental Health Needs 

10 SEC. 611. COMMUNITY MENTAL HEALTH SERVICES BLOCK 

11 GRANT. 

12 (a) FORMULA GRANTS.—Section 1911(b) of the Pub13 lic Health Service Act (42 U.S.C. 300x(b)) is amended— 

14 (1) by redesignating paragraphs (1) through 

15 (3) as paragraphs (2) through (4), respectively; and 

16 (2) by inserting before paragraph (2) (as so re17 designated), the following: 

18 ‘‘(1) providing community mental health serv19 ices for adults with a serious mental illness and chil20 dren with a serious emotional disturbance as defined 

21 in accordance with section 1912(c);’’. 

22 (b) STATE PLAN.—Subsection (b) of section 1912 of 

23 the Public Health Service Act (42 U.S.C. 300x–1) is 

24 amended to read as follows: 


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1 ‘‘(b) CRITERIA FOR PLAN.—The criteria specified in 

2 this subsection are as follows: 

3 ‘‘(1) SYSTEM OF CARE.—The plan provides a 

4 description of the system of care of the State, in5 cluding as follows: 

6 ‘‘(A) COMPREHENSIVE COMMUNITY-BASED

7 HEALTH SYSTEMS.—The plan shall— 

8 ‘‘(i) identify the single State agency to 

9 be responsible for the administration of the 

10 program under the grant and any third 

11 party with whom the agency will contract 

12 (subject to such third party complying with 

13 the requirements of this part) for admin14 istering mental health services through 

15 such program; 

16 ‘‘(ii) provide for an organized commu17 nity-based system of care for individuals 

18 with mental illness, and describe available 

19 services and resources in a comprehensive 

20 system of care, including services for indi21 viduals with mental health and behavioral 

22 health co-occurring illness or disorders; 

23 ‘‘(iii) include a description of the 

24 manner in which the State and local enti25 ties will coordinate services to maximize 


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1 the efficiency, effectiveness, quality, and 

2 cost effectiveness of services and programs 

3 to produce the best possible outcomes (in4 cluding health services, rehabilitation serv5 ices, employment services, housing services, 

6 educational services, substance use dis7 order services, legal services, law enforce8 ment services, social services, child welfare 

9 services, medical and dental care services, 

10 and other support services to be provided 

11 with Federal, State, and local public and 

12 private resources) with other agencies to 

13 enable individuals receiving services to 

14 function outside of inpatient or residential 

15 institutions, to the maximum extent of 

16 their capabilities, including services to be 

17 provided by local school systems under the 

18 Individuals with Disabilities Education 

19 Act; 

20 ‘‘(iv) include a description of how the 

21 State— 

22 ‘‘(I) promotes evidence-based 

23 practices, including those evidence24 based programs that address the 

25 needs of individuals with early serious 


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1 mental illness regardless of the age of 

2 the individual at onset; 

3 ‘‘(II) provides comprehensive in4 dividualized treatment; or 

5 ‘‘(III) integrates mental and 

6 physical health services; 

7 ‘‘(v) include a description of case 

8 management services in the State; 

9 ‘‘(vi) include a description of activities 

10 that seek to engage individuals with seri11 ous mental illness or serious emotional dis12 turbance and their caregivers where appro13 priate in making health care decisions, in14 cluding activities that enhance communica15 tion between individuals, families, care16 givers, and treatment providers; and 

17 ‘‘(vii) as appropriate to and reflective 

18 of the uses the State proposes for the block 

19 grant monies— 

20 ‘‘(I) a description of the activities 

21 intended to reduce hospitalizations 

22 and hospital stays using the block 

23 grant monies; 

24 ‘‘(II) a description of the activi25 ties intended to reduce incidents of 


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1 suicide using the block grant monies; 

2 and 

3 ‘‘(III) a description of how the 

4 State integrates mental health and 

5 primary care using the block grant 

6 monies. 

7 ‘‘(B) MENTAL HEALTH SYSTEM DATA AND

8 EPIDEMIOLOGY.—The plan shall contain an es9 timate of the incidence and prevalence in the 

10 State of serious mental illness among adults 

11 and serious emotional disturbance among chil12 dren and presents quantitative targets and out13 come measures for programs and services pro14 vided under this subpart. 

15 ‘‘(C) CHILDREN’S SERVICES.—In the case 

16 of children with serious emotional disturbance 

17 (as defined in accordance with subsection (c)), 

18 the plan shall provide for a system of integrated 

19 social services, educational services, child wel20 fare services, juvenile justice services, law en21 forcement services, and substance use disorder 

22 services that, together with health and mental 

23 health services, will be provided in order for 

24 such children to receive care appropriate for 

25 their multiple needs (such system to include 


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1 services provided under the Individuals with 

2 Disabilities Education Act). 

3 ‘‘(D) TARGETED SERVICES TO RURAL AND

4 HOMELESS POPULATIONS.—The plan shall de5 scribe the State’s outreach to and services for 

6 individuals who are homeless and how commu7 nity-based services will be provided to individ8 uals residing in rural areas. 

9 ‘‘(E) MANAGEMENT SERVICES.—The plan 

10 shall— 

11 ‘‘(i) describe the financial resources 

12 available, the existing mental health work13 force, and the workforce trained in treating 

14 individuals with co-occurring mental illness 

15 and substance use disorders; 

16 ‘‘(ii) provide for the training of pro17 viders of emergency health services regard18 ing mental health; 

19 ‘‘(iii) describe the manner in which 

20 the State intends to expend the grant 

21 under section 1911 for the fiscal year in22 volved; and 

23 ‘‘(iv) describe the manner in which 

24 the State intends to comply with each of 


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1 the funding agreements in this subpart 

2 and subpart III. 

3 ‘‘(2) GOALS AND OBJECTIVES.—The plan estab4 lishes goals and objectives for the period of the plan, 

5 including targets and milestones that are intended to 

6 be met, and the activities that will be undertaken to 

7 achieve those goals and objectives.’’. 

8 (c) BEST PRACTICES IN CLINICAL CARE MODELS.— 

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

10 300x–9) is amended by adding at the end the following: 

11 ‘‘(c) BEST PRACTICES IN CLINICAL CARE MOD12 ELS.—A State shall expend not less than 10 percent of 

13 the amount the State receives for carrying out this sub14 part in each fiscal year to support evidence-based pro15 grams that address the needs of individuals with early se16 rious mental illness, including psychotic disorders, regard17 less of the age of the individual at the onset of such ill18 ness.’’. 

19 (d) ADDITIONAL PROVISIONS.—Section 1915(b) of 

20 the Public Health Service Act (42 U.S.C. 300x–4(b)) is 

21 amended— 

22 (1) by amending paragraph (1) to read as fol23 lows: 

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

25 grant under section 1911 is that the State involved 


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1 will maintain State expenditures for community 

2 mental health services at a level that is not less than 

3 the average of the amounts prescribed by this para4 graph (prior to any waiver under paragraph (3)) for 

5 such expenditures by such State for each of the 2 

6 fiscal years immediately preceding the fiscal year for 

7 which the State is applying for the grant.’’; 

8 (2) in paragraph (2)— 

9 (A) by striking ‘‘under subsection (a)’’ and 

10 inserting ‘‘specified in paragraph (1)’’; and 

11 (B) by striking ‘‘principle’’ and inserting 

12 ‘‘principal’’; 

13 (3) by amending paragraph (3) to read as fol14 lows: 

15 ‘‘(3) WAIVER.— 

16 ‘‘(A) IN GENERAL.—The Secretary may, 

17 upon the request of a State, waive the require18 ment established in paragraph (1) in whole or 

19 in part, if the Secretary determines that ex20 traordinary economic conditions in the State in 

21 the fiscal year involved or in the previous fiscal 

22 year justify the waiver. 

23 ‘‘(B) DATE CERTAIN FOR ACTION UPON

24 REQUEST.—The Secretary shall approve or 

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1 graph not later than 120 days after the date on 

2 which the request is made. 

3 ‘‘(C) APPLICABILITY OF WAIVER.—A waiv4 er provided by the Secretary under this para5 graph shall be applicable only to the fiscal year 

6 involved.’’; and 

7 (4) in paragraph (4)— 

8 (A) by amending subparagraph (A) to read 

9 as follows: 

10 ‘‘(A) IN GENERAL.— 

11 ‘‘(i) DETERMINATION AND REDUC12 TION.—The Secretary shall determine, in 

13 the case of each State, and for each fiscal 

14 year, whether the State maintained mate15 rial compliance with the agreement made 

16 under paragraph (1). If the Secretary de17 termines that a State has failed to main18 tain such compliance for a fiscal year, the 

19 Secretary shall reduce the amount of the 

20 allotment under section 1911 for the State, 

21 for the first fiscal year beginning after 

22 such determination is final, by an amount 

23 equal to the amount constituting such fail24 ure for the previous fiscal year about 

25 which the determination was made. 


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1 ‘‘(ii) ALTERNATIVE SANCTION.—The 

2 Secretary may by regulation provide for an 

3 alternative method of imposing a sanction 

4 for a failure by a State to maintain mate5 rial compliance with the agreement under 

6 paragraph (1) if the Secretary determines 

7 that such alternative method would be 

8 more equitable and would be a more effec9 tive incentive for States to maintain such 

10 material compliance.’’; and 

11 (B) in subparagraph (B)— 

12 (i) by inserting after the subpara13 graph designation the following: ‘‘SUBMIS14 SION OF INFORMATION TO THE SEC15 RETARY.—’’; and 

16 (ii) by striking ‘‘subparagraph (A)’’ 

17 and inserting ‘‘subparagraph (A)(i)’’. 

18 (e) APPLICATION FOR GRANT.—Section 1917(a) of 

19 the Public Health Service Act (42 U.S.C. 300x–6(a)) is 

20 amended— 

21 (1) in paragraph (1), by striking ‘‘1941’’ and 

22 inserting ‘‘1942(a)’’; and 

23 (2) in paragraph (5), by striking 

24 ‘‘1915(b)(3)(B)’’ and inserting ‘‘1915(b)’’. 


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1 Subtitle C—Strengthening Mental 

2 Health Care for Children and 

3 Adolescents 

4 SEC. 621. TELE-MENTAL HEALTH CARE ACCESS GRANTS. 

5 Title III of the Public Health Service Act is amended 

6 by inserting after section 330L of such Act (42 U.S.C. 

7 254c–18) the following new section: 

8 ‘‘SEC. 330M. TELE-MENTAL HEALTH CARE ACCESS GRANTS. 

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

10 the Administrator of the Health Resources and Services 

11 Administration and in coordination with other relevant 

12 Federal agencies, shall award grants to States, political 

13 subdivisions of States, Indian tribes, and tribal organiza14 tions (for purposes of this section, as such terms are de15 fined in section 4 of the Indian Self-Determination and 

16 Education Assistance Act (25 U.S.C. 450b)) to promote 

17 behavioral health integration in pediatric primary care 

18 by— 

19 ‘‘(1) supporting the development of statewide 

20 child mental health care access programs; and 

21 ‘‘(2) supporting the improvement of existing 

22 statewide child mental health care access programs. 

23 ‘‘(b) PROGRAM REQUIREMENTS.— 

24 ‘‘(1) IN GENERAL.—A child mental health care 

25 access program referred to in subsection (a), with 


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1 respect to which a grant under such subsection may 

2 be used, shall— 

3 ‘‘(A) be a statewide network of pediatric 

4 mental health teams that provide support to pe5 diatric primary care sites as an integrated 

6 team; 

7 ‘‘(B) support and further develop orga8 nized State networks of child and adolescent 

9 psychiatrists and psychologists to provide con10 sultative support to pediatric primary care sites; 

11 ‘‘(C) conduct an assessment of critical be12 havioral consultation needs among pediatric 

13 providers and such providers’ preferred mecha14 nisms for receiving consultation and training 

15 and technical assistance; 

16 ‘‘(D) develop an online database and com17 munication mechanisms, including telehealth, to 

18 facilitate consultation support to pediatric prac19 tices; 

20 ‘‘(E) provide rapid statewide clinical tele21 phone or telehealth consultations when re22 quested between the pediatric mental health 

23 teams and pediatric primary care providers; 

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1 viders to support the early identification, diag2 nosis, treatment, and referral of children with 

3 behavioral health conditions or co-occurring in4 tellectual and other developmental disabilities; 

5 ‘‘(G) provide information to pediatric pro6 viders about, and assist pediatric providers in 

7 accessing, child psychiatry and psychology con8 sultations and in scheduling and conducting 

9 technical assistance; 

10 ‘‘(H) assist with referrals to specialty care 

11 and community or behavioral health resources; 

12 and 

13 ‘‘(I) establish mechanisms for measuring 

14 and monitoring increased access to child and 

15 adolescent psychiatric and psychology services 

16 by pediatric primary care providers and ex17 panded capacity of pediatric primary care pro18 viders to identify, treat, and refer children with 

19 mental health problems. 

20 ‘‘(2) PEDIATRIC MENTAL HEALTH TEAMS.—In 

21 this subsection, the term ‘pediatric mental health 

22 team’ means a team of case coordinators, child and 

23 adolescent psychiatrists, and licensed clinical mental 

24 health professionals, such as a psychologist, social 

25 worker, or mental health counselor. 


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

2 a State, Indian tribe, or tribal organization seeking a 

3 grant under this section shall submit an application to the 

4 Secretary at such time, in such manner, and containing 

5 such information as the Secretary may require, including 

6 a plan for the rigorous evaluation of activities that are 

7 carried out with funds received under such grant. 

8 ‘‘(d) EVALUATION.—A State, political subdivision of 

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

10 a grant under this section shall prepare and submit an 

11 evaluation of activities carried out with funds received 

12 under such grant to the Secretary at such time, in such 

13 manner, and containing such information as the Secretary 

14 may reasonably require, including a process and outcome 

15 evaluation. 

16 ‘‘(e) MATCHING REQUIREMENT.—The Secretary may 

17 not award a grant under this section unless the State, po18 litical subdivision of a State, Indian tribe, or tribal organi19 zation involved agrees, with respect to the costs to be in20 curred by the State, political subdivision of a State, Indian 

21 tribe, or tribal organization in carrying out the purpose 

22 described in this section, to make available non-Federal 

23 contributions (in cash or in kind) toward such costs in 

24 an amount that is not less than 20 percent of Federal 

25 funds provided in the grant. 


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

2 carry this section, there are authorized to be appropriated 

3 $9,000,000 for the period of fiscal years 2018 through 

4 2020.’’. 

5 SEC. 622. INFANT AND EARLY CHILDHOOD MENTAL 

6 HEALTH PROMOTION, INTERVENTION, AND 

7 TREATMENT. 

8 Part Q of title III of the Public Health Service Act 

9 (42 U.S.C. 290h et seq.) is amended by adding at the end 

10 the following: 

11 ‘‘SEC. 399Z–2. INFANT AND EARLY CHILDHOOD MENTAL 

12 HEALTH PROMOTION, INTERVENTION, AND 

13 TREATMENT. 

14 ‘‘(a) GRANTS.—The Secretary shall— 

15 ‘‘(1) award grants to eligible entities, including 

16 human services agencies, to develop, maintain, or en17 hance infant and early childhood mental health pro18 motion, intervention, and treatment programs, in19 cluding— 

20 ‘‘(A) programs for infants and children at 

21 significant risk of developing, showing early 

22 signs of, or having been diagnosed with mental 

23 illness including serious emotional disturbance; 

24 and 


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1 ‘‘(B) multigenerational therapy and other 

2 services that support the caregiving relation3 ship; and 

4 ‘‘(2) ensure that programs funded through 

5 grants under this section are evidence-informed or 

6 evidence-based models, practices, and methods that 

7 are, as appropriate, culturally and linguistically ap8 propriate, and can be replicated in other appropriate 

9 settings. 

10 ‘‘(b) ELIGIBLE CHILDREN AND ENTITIES.—In this 

11 section: 

12 ‘‘(1) ELIGIBLE CHILD.—The term ‘eligible 

13 child’ means a child from birth to not more than 5 

14 years of age who— 

15 ‘‘(A) is at risk for, shows early signs of, or 

16 has been diagnosed with a mental illness, in17 cluding serious emotional disturbance; and 

18 ‘‘(B) may benefit from infant and early 

19 childhood intervention or treatment programs 

20 or specialized preschool or elementary school 

21 programs that are evidence-based or that have 

22 been scientifically demonstrated to show prom23 ise but would benefit from further applied de24 velopment. 


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1 ‘‘(2) ELIGIBLE ENTITY.—The term ‘eligible en2 tity’ means a nonprofit institution that— 

3 ‘‘(A) is accredited or approved by a State 

4 mental health or education agency, as applica5 ble, to provide for children from infancy to 5 

6 years of age mental health promotion, interven7 tion, or treatment services that are evidence8 based or that have been scientifically dem9 onstrated to show promise but would benefit 

10 from further applied development; and 

11 ‘‘(B) provides programs described in sub12 section (a) that are evidence-based or that have 

13 been scientifically demonstrated to show prom14 ise but would benefit from further applied de15 velopment. 

16 ‘‘(c) APPLICATION.—An eligible entity seeking a 

17 grant under subsection (a) shall submit to the Secretary 

18 an application at such time, in such manner, and con19 taining such information as the Secretary may require. 

20 ‘‘(d) USE OF FUNDS FOR EARLY INTERVENTION AND

21 TREATMENT PROGRAMS.—An eligible entity may use 

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

23 to carry out the following: 

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1 ness treatment services, which may include special2 ized programs, for eligible children at significant 

3 risk of developing, showing early signs of, or having 

4 been diagnosed with a mental illness, including seri5 ous emotional disturbance. Such services may in6 clude social and behavioral services as well as 

7 multigenerational therapy and other services ?that 

8 support the caregiving relationship. 

9 ‘‘(2) Provide training for health care profes10 sionals with expertise in infant and early childhood 

11 mental health care with respect to appropriate and 

12 relevant integration with other disciplines such as 

13 primary care clinicians, early intervention specialists, 

14 child welfare staff, home visitors, early care and edu15 cation providers, and others who work with young 

16 children and families. 

17 ‘‘(3) Provide mental health consultation to per18 sonnel of early care and education programs (includ19 ing licensed or regulated center-based and home20 based child care, home visiting, preschool special 

21 education, and early intervention programs) who 

22 work with children and families. 

23 ‘‘(4) Provide training for mental health clini24 cians in infant and early childhood in promising and 

25 evidence-based practices and models for infant and 


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1 early childhood mental health treatment and early 

2 intervention, including with regard to practices for 

3 identifying and treating mental illness and behav4 ioral disorders of infants and children resulting from 

5 exposure or repeated exposure to adverse childhood 

6 experiences or childhood trauma. 

7 ‘‘(5) Provide age-appropriate assessment, diag8 nostic, and intervention services for eligible children, 

9 including early mental health promotion, interven10 tion, and treatment services. 

11 ‘‘(e) MATCHING FUNDS.—The Secretary may not 

12 award a grant under this section to an eligible entity un13 less the eligible entity agrees, with respect to the costs to 

14 be incurred by the eligible entity in carrying out the activi15 ties described in subsection (d), to make available non16 Federal contributions (in cash or in kind) toward such 

17 costs in an amount that is not less than 10 percent of 

18 the total amount of Federal funds provided in the grant. 

19 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

20 carry this section, there are authorized to be appropriated 

21 $20,000,000 for the period of fiscal years 2018 through 

22 2022.’’. 


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1 SEC. 623. NATIONAL CHILD TRAUMATIC STRESS INITIA2 TIVE. 

3 Section 582 of the Public Health Service Act (42 

4 U.S.C. 290hh–1; relating to grants to address the prob5 lems of persons who experience violence related stress) is 

6 amended— 

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

8 programs’’ and all that follows and inserting the fol9 lowing: ‘‘developing and maintaining programs that 

10 provide for— 

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

12 Child Traumatic Stress Initiative (referred to in this 

13 section as the ‘NCTSI’), which includes a coordi14 nating center that focuses on the mental, behavioral, 

15 and biological aspects of psychological trauma re16 sponse; and 

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

18 to evidence-based practices for identifying and treat19 ing mental illness, behavioral disorders, and physical 

20 health conditions of children and youth resulting 

21 from witnessing or experiencing a traumatic event.’’; 

22 (2) in subsection (b)— 

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

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

25 (B) by striking ‘‘treating disorders associ26 ated with psychological trauma’’ and inserting 


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1 ‘‘treating mental illness and behavioral and bio2 logical disorders associated with psychological 

3 trauma)’’; and 

4 (C) by striking ‘‘mental health agencies 

5 and programs that have established clinical and 

6 basic research’’ and inserting ‘‘universities, hos7 pitals, mental health agencies, and other pro8 grams that have established clinical expertise 

9 and research’’; 

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

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

12 (4) by inserting after subsection (b), the fol13 lowing: 

14 ‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi15 nating center shall collect, analyze, report, and make pub16 licly available NCTSI-wide child treatment process and 

17 outcome data regarding the early identification and deliv18 ery of evidence-based treatment and services for children 

19 and families served by the NCTSI grantees. 

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

21 shall facilitate the coordination of training initiatives in 

22 evidence-based and trauma-informed treatments, interven23 tions, and practices offered to NCTSI grantees, providers, 

24 and partners. 


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

2 center shall, as appropriate, collaborate with the Secretary 

3 in the dissemination of evidence-based and trauma-in4 formed interventions, treatments, products, and other re5 sources to appropriate stakeholders. 

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

7 the peer-review process, ensure that NCTSI applications 

8 are reviewed by appropriate experts in the field as part 

9 of a consensus review process. The Secretary shall include 

10 review criteria related to expertise and experience in child 

11 trauma and evidence-based practices.’’; 

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

13 striking ‘‘with respect to centers of excellence are 

14 distributed equitably among the regions of the coun15 try’’ and inserting ‘‘are distributed equitably among 

16 the regions of the United States’’; 

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

18 striking ‘‘recipient may not exceed 5 years’’ and in19 serting ‘‘recipient shall not be less than 4 years, but 

20 shall not exceed 5 years’’; and 

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

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

23 ‘‘2006’’ and inserting ‘‘$46,887,000 for each of fis24 cal years 2017 through 2021’’. 


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1 TITLE VII—GRANT PROGRAMS 

2 AND PROGRAM REAUTHOR3 IZATION 

4 Subtitle A—Garrett Lee Smith 

5 Memorial Act Reauthorization 

6 SEC. 701. YOUTH INTERAGENCY RESEARCH, TRAINING, AND 

7 TECHNICAL ASSISTANCE CENTERS. 

8 Section 520C of the Public Health Service Act (42 

9 U.S.C. 290bb–34) is amended— 

10 (1) by striking the section heading and insert11 ing ‘‘SUICIDE PREVENTION TECHNICAL ASSIST12 ANCE CENTER.’’; 

13 (2) in subsection (a), by striking ‘‘and in con14 sultation with’’ and all that follows through the pe15 riod at the end of paragraph (2) and inserting ‘‘shall 

16 establish a research, training, and technical assist17 ance resource center to provide appropriate informa18 tion, training, and technical assistance to States, po19 litical subdivisions of States, federally recognized In20 dian tribes, tribal organizations, institutions of high21 er education, public organizations, or private non22 profit organizations regarding the prevention of sui23 cide among all ages, particularly among groups that 

24 are at high risk for suicide.’’; 

25 (3) by striking subsections (b) and (c); 


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1 (4) by redesignating subsection (d) as sub2 section (b); 

3 (5) in subsection (b), as so redesignated— 

4 (A) by striking the subsection heading and 

5 inserting ‘‘RESPONSIBILITIES OF THE CEN6 TER.—’’; 

7 (B) in the matter preceding paragraph (1), 

8 by striking ‘‘The additional research’’ and all 

9 that follows through ‘‘nonprofit organizations 

10 for’’ and inserting ‘‘The center established 

11 under subsection (a) shall conduct activities for 

12 the purpose of’’; 

13 (C) by striking ‘‘youth suicide’’ each place 

14 such term appears and inserting ‘‘suicide’’; 

15 (D) in paragraph (1)— 

16 (i) by striking ‘‘the development or 

17 continuation of’’ and inserting ‘‘developing 

18 and continuing’’; and 

19 (ii) by inserting ‘‘for all ages, particu20 larly among groups that are at high risk 

21 for suicide’’ before the semicolon at the 

22 end; 

23 (E) in paragraph (2), by inserting ‘‘for all 

24 ages, particularly among groups that are at 


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1 high risk for suicide’’ before the semicolon at 

2 the end; 

3 (F) in paragraph (3), by inserting ‘‘and 

4 tribal’’ after ‘‘statewide’’; 

5 (G) in paragraph (5), by inserting ‘‘and 

6 prevention’’ after ‘‘intervention’’; 

7 (H) in paragraph (8), by striking ‘‘in 

8 youth’’; 

9 (I) in paragraph (9), by striking ‘‘and be10 havioral health’’ and inserting ‘‘health and sub11 stance use disorder’’; and 

12 (J) in paragraph (10), by inserting ‘‘con13 ducting’’ before ‘‘other’’; and 

14 (6) by striking subsection (e) and inserting the 

15 following: 

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

17 purpose of carrying out this section, there are authorized 

18 to be appropriated $5,988,000 for each of fiscal years 

19 2017 through 2021. 

20 ‘‘(d) REPORT.—Not later than 2 years after the date 

21 of enactment of the Helping Families in Mental Health 

22 Crisis Act of 2016, the Secretary shall submit to Congress 

23 a report on the activities carried out by the center estab24 lished under subsection (a) during the year involved, in25 cluding the potential effects of such activities, and the 


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1 States, organizations, and institutions that have worked 

2 with the center.’’. 

3 SEC. 702. YOUTH SUICIDE EARLY INTERVENTION AND PRE4 VENTION STRATEGIES. 

5 Section 520E of the Public Health Service Act (42 

6 U.S.C. 290bb–36) is amended— 

7 (1) in paragraph (1) of subsection (a) and in 

8 subsection (c), by striking ‘‘substance abuse’’ each 

9 place such term appears and inserting ‘‘substance 

10 use disorder’’; 

11 (2) in subsection (b)(2)— 

12 (A) by striking ‘‘each State is awarded 

13 only 1 grant or cooperative agreement under 

14 this section’’ and inserting ‘‘a State does not 

15 receive more than one grant or cooperative 

16 agreement under this section at any one time’’; 

17 and 

18 (B) by striking ‘‘been awarded’’ and insert19 ing ‘‘received’’; and 

20 (3) by striking subsection (m) and inserting the 

21 following: 

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

23 the purpose of carrying out this section, there are author24 ized to be appropriated $35,427,000 for each of fiscal 

25 years 2017 through 2021.’’. 


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1 SEC. 703. MENTAL HEALTH AND SUBSTANCE USE DIS2 ORDER SERVICES ON CAMPUS. 

3 Section 520E–2 of the Public Health Service Act (42 

4 U.S.C. 290bb–36b) is amended— 

5 (1) in the section heading, by striking ‘‘AND

6 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

7 AND SUBSTANCE USE DISORDER’’; 

8 (2) in subsection (a)— 

9 (A) by striking ‘‘Services,’’ and inserting 

10 ‘‘Services and’’; 

11 (B) by striking ‘‘and behavioral health 

12 problems’’ and inserting ‘‘health or substance 

13 use disorders’’; and 

14 (C) by striking ‘‘substance abuse’’ and in15 serting ‘‘substance use disorders’’; 

16 (3) in subsection (b)— 

17 (A) in the matter preceding paragraph (1), 

18 by striking ‘‘for—’’ and inserting ‘‘for one or 

19 more of the following:’’; and 

20 (B) by striking paragraphs (1) through (6) 

21 and inserting the following: 

22 ‘‘(1) Educating students, families, faculty, and 

23 staff to increase awareness of mental health and 

24 substance use disorders. 

25 ‘‘(2) The operation of hotlines. 

26 ‘‘(3) Preparing informational material. 


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1 ‘‘(4) Providing outreach services to notify stu2 dents about available mental health and substance 

3 use disorder services. 

4 ‘‘(5) Administering voluntary mental health and 

5 substance use disorder screenings and assessments. 

6 ‘‘(6) Supporting the training of students, fac7 ulty, and staff to respond effectively to students with 

8 mental health and substance use disorders. 

9 ‘‘(7) Creating a network infrastructure to link 

10 colleges and universities with health care providers 

11 who treat mental health and substance use dis12 orders.’’; 

13 (4) in subsection (c)(5), by striking ‘‘substance 

14 abuse’’ and inserting ‘‘substance use disorder’’; 

15 (5) in subsection (d)— 

16 (A) in the matter preceding paragraph (1), 

17 by striking ‘‘An institution of higher education 

18 desiring a grant under this section’’ and insert19 ing ‘‘To be eligible to receive a grant under this 

20 section, an institution of higher education’’; 

21 (B) in paragraph (1)— 

22 (i) by striking ‘‘and behavioral 

23 health’’ and inserting ‘‘health and sub24 stance use disorder’’; and 


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1 (ii) by inserting ‘‘, including veterans 

2 whenever possible and appropriate,’’ after 

3 ‘‘students’’; and 

4 (C) in paragraph (2), by inserting ‘‘, which 

5 may include, as appropriate and in accordance 

6 with subsection (b)(7), a plan to seek input 

7 from relevant stakeholders in the community, 

8 including appropriate public and private enti9 ties, in order to carry out the program under 

10 the grant’’ before the period at the end; 

11 (6) in subsection (e)(1), by striking ‘‘and behav12 ioral health problems’’ and inserting ‘‘health and 

13 substance use disorders’’; 

14 (7) in subsection (f)(2)— 

15 (A) by striking ‘‘and behavioral health’’ 

16 and inserting ‘‘health and substance use dis17 order’’; and 

18 (B) by striking ‘‘suicide and substance 

19 abuse’’ and inserting ‘‘suicide and substance 

20 use disorders’’; and 

21 (8) in subsection (h), by striking ‘‘$5,000,000 

22 for fiscal year 2005’’ and all that follows through 

23 the period at the end and inserting ‘‘$6,488,000 for 

24 each of fiscal years 2017 through 2021.’’. 


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1 Subtitle B—Other Provisions 

2 SEC. 711. NATIONAL SUICIDE PREVENTION LIFELINE PRO3 GRAM. 

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

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

6 inserting after section 520E–2 (42 U.S.C. 290bb–36b) the 

7 following: 

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

9 PROGRAM. 

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

11 the Assistant Secretary, shall maintain the National Sui12 cide Prevention Lifeline Program (referred to in this sec13 tion as the ‘Program’), authorized under section 520A and 

14 in effect prior to the date of enactment of the Helping 

15 Families in Mental Health Crisis Act of 2016. 

16 ‘‘(b) ACTIVITIES.—In maintaining the Program, the 

17 activities of the Secretary shall include— 

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

19 across the United States for providing suicide pre20 vention and crisis intervention services to individuals 

21 seeking help at any time, day or night; 

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

23 link callers to local emergency, mental health, and 

24 social services resources; and 


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

2 Affairs to ensure that veterans calling the suicide 

3 prevention hotline have access to a specialized vet4 erans’ suicide prevention hotline. 

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

6 carry out this section, there are authorized to be appro7 priated $7,198,000 for each of fiscal years 2017 through 

8 2021.’’. 

9 SEC. 712. WORKFORCE DEVELOPMENT STUDIES AND RE10 PORTS. 

11 (a) IN GENERAL.—Not later than 2 years after the 

12 date of enactment of this Act, the Assistant Secretary for 

13 Mental Health and Substance Use, in consultation with 

14 the Administrator of the Health Resources and Services 

15 Administration, shall conduct a study, and publicly post 

16 on the appropriate Internet website of the Department of 

17 Health and Human Services a report, on the mental 

18 health and substance use disorder workforce in order to 

19 inform Federal, State, and local efforts related to work20 force enhancement. 

21 (b) CONTENTS.—The report under this section shall 

22 contain— 

23 (1) national and State-level projections of the 

24 supply and demand of mental health and substance 

25 use disorder health workers, including the number of 


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1 individuals practicing in fields deemed relevant by 

2 the Secretary; 

3 (2) an assessment of the mental health and 

4 substance use disorder workforce capacity, strengths, 

5 and weaknesses as of the date of the report, includ6 ing the capacity of primary care to prevent, screen, 

7 treat, or refer for mental health and substance use 

8 disorders; 

9 (3) information on trends within the mental 

10 health and substance use disorder provider work11 force, including the number of individuals entering 

12 the mental health workforce over the next 5 years; 

13 (4) information on the gaps in workforce devel14 opment for mental health providers and profes15 sionals, including those who serve pediatric, adult, 

16 and geriatric patients; and 

17 (5) any additional information determined by 

18 the Assistant Secretary for Mental Health and Sub19 stance Use, in consultation with the Administrator 

20 of the Health Resources and Services Administra21 tion, to be relevant to the mental health and sub22 stance use disorder provider workforce. 


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1 SEC. 713. MINORITY FELLOWSHIP PROGRAM. 

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

3 290aa et seq.) is amended by adding at the end the fol4 lowing: 

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 illness and sub14 stance use disorders among racial and ethnic minor15 ity populations; 

16 ‘‘(2) improving the quality of mental illness and 

17 substance use disorder prevention and treatment de18 livered to racial and ethnic minorities; and 

19 ‘‘(3) increasing the number of culturally com20 petent behavioral health professionals and school 

21 personnel who teach, administer, conduct services re22 search, and provide direct mental health or sub23 stance use services to racial and ethnic minority 

24 populations. 

25 ‘‘(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, mental health counseling, and substance use and 

5 addiction counseling. 

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

7 carry out this section, there are authorized to be appro8 priated $12,669,000 for each of fiscal years 2017, 2018, 

9 and 2019 and $13,669,000 for each of fiscal years 2020 

10 and 2021.’’. 

11 SEC. 714. CENTER AND PROGRAM REPEALS. 

12 Part B of title V of the Public Health Service Act 

13 (42 U.S.C. 290bb et seq.) is amended by striking the sec14 ond section 514 (42 U.S.C. 290bb–9), relating to meth15 amphetamine and amphetamine treatment initiatives, and 

16 sections 514A, 517, 519A, 519C, 519E, 520D, and 520H 

17 (42 U.S.C. 290bb–8, 290bb–23, 290bb–25a, 290bb–25c, 

18 290bb–25e, 290bb–35, and 290bb–39). 

19 SEC. 715. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

20 The Secretary of Health and Human Services, acting 

21 through the Director of the Centers for Disease Control 

22 and Prevention, is encouraged to improve, particularly 

23 through the inclusion of additional States, the National 

24 Violent Death Reporting System as authorized by title III 

25 of the Public Health Service Act (42 U.S.C. 241 et seq.). 


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1 Participation in the system by the States shall be vol2 untary. 

3 SEC. 716. SENSE OF CONGRESS ON PRIORITIZING NATIVE 

4 AMERICAN YOUTH AND SUICIDE PREVEN5 TION PROGRAMS. 

6 (a) FINDINGS.—The Congress finds as follows: 

7 (1) Suicide is the eighth leading cause of death 

8 among American Indians and Alaska Natives across 

9 all ages. 

10 (2) Among American Indians and Alaska Na11 tives who are 10 to 34 years of age, suicide is the 

12 second leading cause of death. 

13 (3) The suicide rate among American Indian 

14 and Alaska Native adolescents and young adults 

15 ages 15 to 34 (19.5 per 100,000) is 1.5 times higher 

16 than the national average for that age group (12.9 

17 per 100,000). 

18 (b) SENSE OF CONGRESS.—It is the sense of Con19 gress that the Secretary of Health and Human Services, 

20 in carrying out programs for Native American youth and 

21 suicide prevention programs for youth suicide interven22 tion, should prioritize programs and activities for individ23 uals who have a high risk or disproportional burden of 

24 suicide, such as Native Americans. 


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1 SEC. 717. PEER PROFESSIONAL WORKFORCE DEVELOP2 MENT GRANT PROGRAM. 

3 (a) IN GENERAL.—For the purposes described in 

4 subsection (b), the Secretary of Health and Human Serv5 ices shall award grants to develop and sustain behavioral 

6 health paraprofessional training and education programs, 

7 including through tuition support. 

8 (b) PURPOSES.—The purposes of grants under this 

9 section are— 

10 (1) to increase the number of behavioral health 

11 paraprofessionals, including trained peers, recovery 

12 coaches, mental health and addiction specialists, pre13 vention specialists, and pre-masters-level addiction 

14 counselors; and 

15 (2) to help communities develop the infrastruc16 ture to train and certify peers as behavioral health 

17 paraprofessionals. 

18 (c) ELIGIBLE ENTITIES.—To be eligible to receive a 

19 grant under this section, an entity shall be a community 

20 college or other entity the Secretary deems appropriate. 

21 (d) GEOGRAPHIC DISTRIBUTION.—In awarding 

22 grants under this section, the Secretary shall seek to 

23 achieve an appropriate national balance in the geographic 

24 distribution of such awards. 

25 (e) SPECIAL CONSIDERATION.—In awarding grants 

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1 eration to proposed and existing programs targeting peer 

2 professionals serving youth ages 16 to 25. 

3 (f) AUTHORIZATION OF APPROPRIATIONS.—To carry 

4 out this section, there is authorized to be appropriated 

5 $10,000,000 for the period of fiscal years 2018 through 

6 2022. 

7 SEC. 718. NATIONAL HEALTH SERVICE CORPS. 

8 (a) DEFINITIONS.— 

9 (1) PRIMARY HEALTH SERVICES.—Section 

10 331(a)(3)(D) of the Public Health Service Act (42 

11 U.S.C. 254d(a)(3)) is amended by inserting ‘‘(in12 cluding pediatric mental health subspecialty serv13 ices)’’ after ‘‘pediatrics’’. 

14 (2) BEHAVIORAL AND MENTAL HEALTH PRO15 FESSIONALS.—Clause (i) of section 331(a)(3)(E) of 

16 the Public Health Service Act (42 U.S.C. 

17 254d(a)(3)(E)) is amended by inserting ‘‘(and pedi18 atric subspecialists thereof)’’ before the period at the 

19 end. 

20 (b) ELIGIBILITY TO PARTICIPATE IN LOAN REPAY21 MENT PROGRAM.—Section 338B(b)(1)(B) of the Public 

22 Health Service Act (42 U.S.C. 254l–1(b)(1)(B)) is amend23 ed by inserting ‘‘, including any physician child and ado24 lescent psychiatry residency or fellowship training pro25 gram’’ after ‘‘be enrolled in an approved graduate training 


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1 program in medicine, osteopathic medicine, dentistry, be2 havioral and mental health, or other health profession’’. 

3 SEC. 719. ADULT SUICIDE PREVENTION. 

4 (a) GRANTS.— 

5 (1) AUTHORITY.—The Assistant Secretary for 

6 Mental Health and Substance Use (referred to in 

7 this section as the ‘‘Assistant Secretary’’) may 

8 award grants to eligible entities in order to imple9 ment suicide prevention efforts amongst adults 25 

10 and older. 

11 (2) PURPOSE.—The grant program under this 

12 section shall be designed to raise suicide awareness, 

13 establish referral processes, and improve clinical care 

14 practice standards for treating suicide ideation, 

15 plans, and attempts among adults. 

16 (3) RECIPIENTS.—To be eligible to receive a 

17 grant under this section, an entity shall be a com18 munity-based primary care or behavioral health care 

19 setting, an emergency department, a State mental 

20 health agency, an Indian tribe, a tribal organization, 

21 or any other entity the Assistant Secretary deems 

22 appropriate. 

23 (4) NATURE OF ACTIVITIES.—The grants 

24 awarded under paragraph (1) shall be used to imple25 ment programs that— 


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1 (A) screen for suicide risk in adults and 

2 provide intervention and referral to treatment; 

3 (B) implement evidence-based practices to 

4 treat individuals who are at suicide risk, includ5 ing appropriate followup services; and 

6 (C) raise awareness, reduce stigma, and 

7 foster open dialogue about suicide prevention. 

8 (b) ADDITIONAL ACTIVITIES.—The Assistant Sec9 retary shall— 

10 (1) evaluate the activities supported by grants 

11 awarded under subsection (a) in order to further the 

12 Nation’s understanding of effective interventions to 

13 prevent suicide in adults; 

14 (2) disseminate the findings from the evaluation 

15 as the Assistant Secretary considers appropriate; 

16 and 

17 (3) provide appropriate information, training, 

18 and technical assistance to eligible entities that re19 ceive a grant under this section, in order to help 

20 such entities to meet the requirements of this sec21 tion, including assistance with— 

22 (A) selection and implementation of evi23 dence-based interventions and frameworks to 

24 prevent suicide, such as the Zero Suicide frame25 work; and 


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1 (B) other activities as the Assistant Sec2 retary determines appropriate. 

3 (c) DURATION.—A grant under this section shall be 

4 for a period of not more than 5 years. 

5 (d) AUTHORIZATION OF APPROPRIATIONS.— 

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

7 appropriated to carry out this section $30,000,000 

8 for the period of fiscal years 2018 through 2022. 

9 (2) USE OF CERTAIN FUNDS.—Of the funds ap10 propriated to carry out this section in any fiscal 

11 year, the lesser of 5 percent of such funds or 

12 $500,000 shall be available to the Assistant Sec13 retary for purposes of carrying out subsection (b). 

14 SEC. 720. CRISIS INTERVENTION GRANTS FOR POLICE OF15 FICERS AND FIRST RESPONDERS. 

16 (a) IN GENERAL.—The Assistant Secretary for Men17 tal Health and Substance Use may award grants to enti18 ties such as law enforcement agencies and first respond19 ers— 

20 (1) to provide specialized training to law en21 forcement officers, corrections officers, paramedics, 

22 emergency medical services workers, and other first 

23 responders (including village public safety officers 

24 (as defined in section 247 of the Indian Arts and 


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1 Crafts Amendments Act of 2010 (42 U.S.C. 3796dd 

2 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; and 

11 (2) to establish collaborative law enforcement 

12 and mental health programs, including behavioral 

13 health response teams and mental health crisis inter14 vention teams comprised of mental health profes15 sionals, law enforcement officers, and other first re16 sponders, as appropriate, to provide on-site, face-to17 face, mental and behavioral health care services dur18 ing a mental health crisis, and to connect the indi19 vidual in crisis to appropriate community-based 

20 treatment services in lieu of unnecessary hospitaliza21 tion or further involvement with the criminal justice 

22 system. 

23 (b) AUTHORIZATION OF APPROPRIATIONS.—There 

24 are authorized to be appropriated to carry out this section 


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1 $9,000,000 for the period of fiscal years 2018 through 

2 2020. 

3 SEC. 721. DEMONSTRATION GRANT PROGRAM TO TRAIN 

4 HEALTH SERVICE PSYCHOLOGISTS IN COM5 MUNITY-BASED MENTAL HEALTH. 

6 (a) ESTABLISHMENT.—The Secretary of Health and 

7 Human Services shall establish a grant program under 

8 which the Assistant Secretary of Mental Health and Sub9 stance Use Disorders may award grants to eligible institu10 tions to support the recruitment, education, and clinical 

11 training experiences of health services psychology stu12 dents, interns, and postdoctoral residents for education 

13 and clinical experience in community mental health set14 tings. 

15 (b) ELIGIBLE INSTITUTIONS.—For purposes of this 

16 section, the term ‘‘eligible institutions’’ includes American 

17 Psychological Association-accredited doctoral, internship, 

18 and postdoctoral residency schools or programs in health 

19 service psychology that— 

20 (1) are focused on the development and imple21 mentation of interdisciplinary training of psychology 

22 graduate students and postdoctoral fellows in pro23 viding mental and behavioral health services to ad24 dress substance use disorders, serious emotional dis25 turbance, and serious illness, as well as developing 


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1 faculty and implementing curriculum to prepare psy2 chologists to work with underserved populations; and 

3 (2) demonstrate an ability to train health serv4 ice psychologists in psychiatric hospitals, forensic 

5 hospitals, community mental health centers, commu6 nity health centers, federally qualified health centers, 

7 or adult and juvenile correctional facilities. 

8 (c) PRIORITIES.—In selecting grant recipients under 

9 this section, the Secretary shall give priority to eligible in10 stitutions in which training focuses on the needs of indi11 viduals with serious mental illness, serious emotional dis12 turbance, justice-involved youth, and individuals with or 

13 at high risk for substance use disorders. 

14 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

15 authorized to be appropriated to carry out this section 

16 $12,000,000 for the period of fiscal years 2018 through 

17 2022. 

18 SEC. 722. INVESTMENT IN TOMORROW’S PEDIATRIC 

19 HEALTH CARE WORKFORCE. 

20 Section 775(e) of the Public Health Service Act (42 

21 U.S.C. 295f(e)) is amended to read as follows: 

22 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

23 carry out this section, there is authorized to be appro24 priated $12,000,000 for the period of fiscal years 2018 

25 through 2022.’’. 


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1 SEC. 723. CUTGO COMPLIANCE. 

2 Section 319D(f) of the Public Health Service Act (42 

3 U.S.C. 247d–4(f)) is amended by striking ‘‘$138,300,000 

4 for each of fiscal years 2014 through 2018’’ and inserting 

5 ‘‘$138,300,000 for each of fiscal years 2014 through 2016 

6 and $58,000,000 for each of fiscal years 2017 and 2018’’. 

7 TITLE VIII—MENTAL HEALTH 

8 PARITY 

9 SEC. 801. ENHANCED COMPLIANCE WITH MENTAL HEALTH 

10 AND SUBSTANCE USE DISORDER COVERAGE 

11 REQUIREMENTS. 

12 (a) COMPLIANCE PROGRAM GUIDANCE DOCU13 MENT.—Section 2726(a) of the Public Health Service Act 

14 (42 U.S.C. 300gg–26(a)) is amended by adding at the end 

15 the following: 

16 ‘‘(6) COMPLIANCE PROGRAM GUIDANCE DOCU17 MENT.— 

18 ‘‘(A) IN GENERAL.—Not later than 12 

19 months after the date of enactment of the 

20 Helping Families in Mental Health Crisis Act 

21 of 2016, the Secretary, the Secretary of Labor, 

22 and the Secretary of the Treasury, in consulta23 tion with the Inspector General of the Depart24 ment of Health and Human Services, shall 

25 issue a compliance program guidance document 

26 to help improve compliance with this section, 


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1 section 712 of the Employee Retirement Income 

2 Security Act of 1974, and section 9812 of the 

3 Internal Revenue Code of 1986, as applicable. 

4 ‘‘(B) EXAMPLES ILLUSTRATING COMPLI5 ANCE AND NONCOMPLIANCE.— 

6 ‘‘(i) IN GENERAL.—The compliance 

7 program guidance document required 

8 under this paragraph shall provide illus9 trative, de-identified examples (that do not 

10 disclose any protected health information 

11 or individually identifiable information) of 

12 previous findings of compliance and non13 compliance with this section, section 712 of 

14 the Employee Retirement Income Security 

15 Act of 1974, or section 9812 of the Inter16 nal Revenue Code of 1986, as applicable, 

17 based on investigations of violations of 

18 such sections, including— 

19 ‘‘(I) examples illustrating re20 quirements for information disclosures 

21 and nonquantitative treatment limita22 tions; and 

23 ‘‘(II) descriptions of the viola24 tions uncovered during the course of 

25 such investigations. 


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1 ‘‘(ii) NONQUANTITATIVE TREATMENT

2 LIMITATIONS.—To the extent that any ex3 ample described in clause (i) involves a 

4 finding of compliance or noncompliance 

5 with regard to any requirement for non6 quantitative treatment limitations, the ex7 ample shall provide sufficient detail to fully 

8 explain such finding, including a full de9 scription of the criteria involved for med10 ical and surgical benefits and the criteria 

11 involved for mental health and substance 

12 use disorder benefits. 

13 ‘‘(iii) ACCESS TO ADDITIONAL INFOR14 MATION REGARDING COMPLIANCE.—In de15 veloping and issuing the compliance pro16 gram guidance document required under 

17 this paragraph, the Secretaries specified in 

18 subparagraph (A)— 

19 ‘‘(I) shall enter into interagency 

20 agreements with the Inspector Gen21 eral of the Department of Health and 

22 Human Services, the Inspector Gen23 eral of the Department of Labor, and 

24 the Inspector General of the Depart25 ment of the Treasury to share findVerDate Sep 11 2014 22:58 Jul 15, 2016 Jkt 059200 PO 00000 Frm 00131 Fmt 6652 Sfmt 6201 E:\BILLS\H2646.RFS H2646

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1 ings of compliance and noncompliance 

2 with this section, section 712 of the 

3 Employee Retirement Income Security 

4 Act of 1974, or section 9812 of the 

5 Internal Revenue Code of 1986, as 

6 applicable; and 

7 ‘‘(II) shall seek to enter into an 

8 agreement with a State to share infor9 mation on findings of compliance and 

10 noncompliance with this section, sec11 tion 712 of the Employee Retirement 

12 Income Security Act of 1974, or sec13 tion 9812 of the Internal Revenue 

14 Code of 1986, as applicable. 

15 ‘‘(C) RECOMMENDATIONS.—The compli16 ance program guidance document shall include 

17 recommendations to comply with this section, 

18 section 712 of the Employee Retirement Income 

19 Security Act of 1974, or section 9812 of the In20 ternal Revenue Code of 1986, as applicable, and 

21 encourage the development and use of internal 

22 controls to monitor adherence to applicable 

23 statutes, regulations, and program require24 ments. Such internal controls may include a 

25 compliance checklist with illustrative examples 


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1 of nonquantitative treatment limitations on 

2 mental health and substance use disorder bene3 fits, which may fail to comply with this section, 

4 section 712 of the Employee Retirement Income 

5 Security Act of 1974, or section 9812 of the In6 ternal Revenue Code of 1986, as applicable, in 

7 relation to nonquantitative treatment limita8 tions on medical and surgical benefits. 

9 ‘‘(D) UPDATING THE COMPLIANCE PRO10 GRAM GUIDANCE DOCUMENT.—The compliance 

11 program guidance document shall be updated 

12 every 2 years to include illustrative, de-identi13 fied examples (that do not disclose any pro14 tected health information or individually identi15 fiable information) of previous findings of com16 pliance and noncompliance with this section, 

17 section 712 of the Employee Retirement Income 

18 Security Act of 1974, or section 9812 of the In19 ternal Revenue Code of 1986, as applicable.’’. 

20 (b) ADDITIONAL GUIDANCE.—Section 2726(a) of the 

21 Public Health Service Act (42 U.S.C. 300gg–26(a)), as 

22 amended by subsection (a), is further amended by adding 

23 at the end the following: 

24 ‘‘(7) ADDITIONAL GUIDANCE.— 


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1 ‘‘(A) IN GENERAL.—Not later than 1 year 

2 after the date of enactment of the Helping 

3 Families in Mental Health Crisis Act of 2016, 

4 the Secretary, in coordination with the Sec5 retary of Labor and the Secretary of the Treas6 ury, shall issue guidance to group health plans 

7 and health insurance issuers offering group or 

8 individual health insurance coverage to assist 

9 such plans and issuers in satisfying the require10 ments of this section, section 712 of the Em11 ployee Retirement Income Security Act of 1974, 

12 or section 9812 of the Internal Revenue Code 

13 of 1986, as applicable,. 

14 ‘‘(B) DISCLOSURE.— 

15 ‘‘(i) GUIDANCE FOR PLANS AND

16 ISSUERS.—The guidance issued under this 

17 paragraph shall include clarifying informa18 tion and illustrative examples of methods 

19 that group health plans and health insur20 ance issuers offering group or individual 

21 health insurance coverage may use for dis22 closing information to ensure compliance 

23 with the requirements under this section, 

24 section 712 of the Employee Retirement 

25 Income Security Act of 1974, or section 


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1 9812 of the Internal Revenue Code of 

2 1986, as applicable, (and any regulations 

3 promulgated pursuant to such sections, as 

4 applicable). 

5 ‘‘(ii) DOCUMENTS FOR PARTICIPANTS, 

6 BENEFICIARIES, CONTRACTING PROVIDERS, 

7 OR AUTHORIZED REPRESENTATIVES.—The 

8 guidance issued under this paragraph shall 

9 include clarifying information and illus10 trative examples of methods that group 

11 health plans and health insurance issuers 

12 offering group or individual health insur13 ance coverage may use to provide any par14 ticipant, beneficiary, contracting provider, 

15 or authorized representative, as applicable, 

16 with documents containing information 

17 that the health plans or issuers are re18 quired to disclose to participants, bene19 ficiaries, contracting providers, or author20 ized representatives to ensure compliance 

21 with this section, section 712 of the Em22 ployee Retirement Income Security Act of 

23 1974, or section 9812 of the Internal Rev24 enue Code of 1986, as applicable; any reg25 ulation issued pursuant to such respective 


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1 section, or any other applicable law or reg2 ulation, including information that is com3 parative in nature with respect to— 

4 ‘‘(I) nonquantitative treatment 

5 limitations for both medical and sur6 gical benefits and mental health and 

7 substance use disorder benefits; 

8 ‘‘(II) the processes, strategies, 

9 evidentiary standards, and other fac10 tors used to apply the limitations de11 scribed in subclause (I); and 

12 ‘‘(III) the application of the limi13 tations described in subclause (I) to 

14 ensure that such limitations are ap15 plied in parity with respect to both 

16 medical and surgical benefits and 

17 mental health and substance use dis18 order benefits. 

19 ‘‘(C) NONQUANTITATIVE TREATMENT LIM20 ITATIONS.—The guidance issued under this 

21 paragraph shall include clarifying information 

22 and illustrative examples of methods, processes, 

23 strategies, evidentiary standards, and other fac24 tors that group health plans and health insur25 ance issuers offering group or individual health 


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1 insurance coverage may use regarding the de2 velopment and application of nonquantitative 

3 treatment limitations to ensure compliance with 

4 this section, section 712 of the Employee Re5 tirement Income Security Act of 1974, or sec6 tion 9812 of the Internal Revenue Code of 

7 1986, as applicable, (and any regulations pro8 mulgated pursuant to such respective section), 

9 including— 

10 ‘‘(i) examples of methods of deter11 mining appropriate types of nonquantita12 tive treatment limitations with respect to 

13 both medical and surgical benefits and 

14 mental health and substance use disorder 

15 benefits, including nonquantitative treat16 ment limitations pertaining to— 

17 ‘‘(I) medical management stand18 ards based on medical necessity or ap19 propriateness, or whether a treatment 

20 is experimental or investigative; 

21 ‘‘(II) limitations with respect to 

22 prescription drug formulary design; 

23 and 

24 ‘‘(III) use of fail-first or step 

25 therapy protocols; 


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1 ‘‘(ii) examples of methods of deter2 mining— 

3 ‘‘(I) network admission standards 

4 (such as credentialing); and 

5 ‘‘(II) factors used in provider re6 imbursement methodologies (such as 

7 service type, geographic market, de8 mand for services, and provider sup9 ply, practice size, training, experience, 

10 and licensure) as such factors apply to 

11 network adequacy; 

12 ‘‘(iii) examples of sources of informa13 tion that may serve as evidentiary stand14 ards for the purposes of making deter15 minations regarding the development and 

16 application of nonquantitative treatment 

17 limitations; 

18 ‘‘(iv) examples of specific factors, and 

19 the evidentiary standards used to evaluate 

20 such factors, used by such plans or issuers 

21 in performing a nonquantitative treatment 

22 limitation analysis; 

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1 mine whether treatments are considered 

2 experimental or investigative; 

3 ‘‘(vi) examples of how specific evi4 dentiary standards may be applied to each 

5 service category or classification of bene6 fits; 

7 ‘‘(vii) examples of methods of reach8 ing appropriate coverage determinations 

9 for new mental health or substance use 

10 disorder treatments, such as evidence11 based early intervention programs for indi12 viduals with a serious mental illness and 

13 types of medical management techniques; 

14 ‘‘(viii) examples of methods of reach15 ing appropriate coverage determinations 

16 for which there is an indirect relationship 

17 between the covered mental health or sub18 stance use disorder benefit and a tradi19 tional covered medical and surgical benefit, 

20 such as residential treatment or hos21 pitalizations involving voluntary or involun22 tary commitment; and 

23 ‘‘(ix) additional illustrative examples 

24 of methods, processes, strategies, evi25 dentiary standards, and other factors for 


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1 which the Secretary determines that addi2 tional guidance is necessary to improve 

3 compliance with this section, section 712 of 

4 the Employee Retirement Income Security 

5 Act of 1974, or section 9812 of the Inter6 nal Revenue Code of 1986, as applicable. 

7 ‘‘(D) PUBLIC COMMENT.—Prior to issuing 

8 any final guidance under this paragraph, the 

9 Secretary shall provide a public comment period 

10 of not less than 60 days during which any 

11 member of the public may provide comments on 

12 a draft of the guidance.’’. 

13 (c) AVAILABILITY OF PLAN INFORMATION.— 

14 (1) PHSA AMENDMENT.—Paragraph (4) of 

15 section 2726(a) of the Public Health Service Act (42 

16 U.S.C. 300gg–26(a)) is amended to read as follows: 

17 ‘‘(4) AVAILABILITY OF PLAN INFORMATION.— 

18 The criteria for medical necessity determinations 

19 made under the plan or health insurance coverage 

20 with respect to mental health or substance use dis21 order benefits or medical or surgical benefits, the 

22 reason for denial of any such benefits, and any other 

23 information appropriate to demonstrate compliance 

24 under this section (including any such medical and 

25 surgical information) shall be made available by the 


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1 plan administrator (or the health insurance issuer 

2 offering such coverage) in accordance with applicable 

3 regulations to the current or potential participant, 

4 beneficiary, or contracting provider involved upon re5 quest. The Secretary may promulgate any such reg6 ulations, including interim final regulations or tem7 porary regulations, as may be appropriate to carry 

8 out this paragraph.’’. 

9 (2) ERISA AMENDMENT.—Paragraph (4) of 

10 section 712(a) of the Employee Retirement Income 

11 Security Act of 1974 (29 U.S.C. 1185a(a)) is 

12 amended to read as follows: 

13 ‘‘(4) AVAILABILITY OF PLAN INFORMATION.— 

14 The criteria for medical necessity determinations 

15 made under the plan with respect to mental health 

16 or substance use disorder benefits or medical or sur17 gical benefits (or the health insurance coverage of18 fered in connection with the plan with respect to 

19 such benefits), the reason for denial of any such 

20 benefits, and any other information appropriate to 

21 demonstrate compliance under this section (includ22 ing any such medical and surgical information) shall 

23 be made available by the plan administrator (or the 

24 health insurance issuer offering such coverage) in 

25 accordance with applicable regulations to the current 


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1 or potential participant, beneficiary, or contracting 

2 provider involved upon request. The Secretary may 

3 promulgate any such regulations, including interim 

4 final regulations or temporary regulations, as may 

5 be appropriate to carry out this paragraph.’’. 

6 (3) IRC AMENDMENT.—Paragraph (4) of sec7 tion 9812(a) of the Internal Revenue Code of 1986 

8 is amended to read as follows: 

9 ‘‘(4) AVAILABILITY OF PLAN INFORMATION.— 

10 The criteria for medical necessity determinations 

11 made under the plan with respect to mental health 

12 or substance use disorder benefits or medical or sur13 gical benefits, the reason for denial of any such ben14 efits, and any other information appropriate to dem15 onstrate compliance under this section (including 

16 any such medical and surgical information) shall be 

17 made available by the plan administrator in accord18 ance with applicable regulations to the current or 

19 potential participant, beneficiary, or contracting pro20 vider involved upon request. The Secretary may pro21 mulgate any such regulations, including interim final 

22 regulations or temporary regulations, as may be ap23 propriate to carry out this paragraph.’’. 

24 (d) IMPROVING COMPLIANCE.— 


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1 (1) IN GENERAL.—In the case that the Sec2 retary of Health and Human Services, the Secretary 

3 of Labor, or the Secretary of the Treasury deter4 mines that a group health plan or health insurance 

5 issuer offering group or individual health insurance 

6 coverage has violated, at least five times, section 

7 2726 of the Public Health Service Act (42 U.S.C. 

8 300gg–26), section 712 of the Employee Retirement 

9 Income Security Act of 1974 (29 U.S.C. 1185a), or 

10 section 9812 of the Internal Revenue Code of 1986, 

11 respectively, the appropriate Secretary shall audit 

12 plan documents for such health plan or issuer in the 

13 plan year following the Secretary’s determination in 

14 order to help improve compliance with such section. 

15 (2) RULE OF CONSTRUCTION.—Nothing in this 

16 subsection shall be construed to limit the authority, 

17 as in effect on the day before the date of enactment 

18 of this Act, of the Secretary of Health and Human 

19 Services, the Secretary of Labor, or the Secretary of 

20 the Treasury to audit documents of health plans or 

21 health insurance issuers. 

22 SEC. 802. ACTION PLAN FOR ENHANCED ENFORCEMENT OF 

23 MENTAL HEALTH AND SUBSTANCE USE DIS24 ORDER COVERAGE. 

25 (a) PUBLIC MEETING.— 


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1 (1) IN GENERAL.—Not later than 6 months 

2 after the date of enactment of this Act, the Sec3 retary of Health and Human Services shall convene 

4 a public meeting of stakeholders described in para5 graph (2) to produce an action plan for improved 

6 Federal and State coordination related to the en7 forcement of section 2726 of the Public Health Serv8 ice Act (42 U.S.C. 300gg–26), section 712 of the 

9 Employee Retirement Income Security Act of 1974 

10 (29 U.S.C. 1185a), and section 9812 of the Internal 

11 Revenue Code of 1986, and any comparable provi12 sions of State law (in this section collectively re13 ferred to as ‘‘mental health parity and addiction eq14 uity requirements’’). 

15 (2) STAKEHOLDERS.—The stakeholders de16 scribed in this paragraph shall include each of the 

17 following: 

18 (A) The Federal Government, including 

19 representatives from— 

20 (i) the Department of Health and 

21 Human Services; 

22 (ii) the Department of the Treasury; 

23 (iii) the Department of Labor; and 

24 (iv) the Department of Justice. 

25 (B) State governments, including— 


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1 (i) State health insurance commis2 sioners; 

3 (ii) appropriate State agencies, includ4 ing agencies on public health or mental 

5 health; and 

6 (iii) State attorneys general or other 

7 representatives of State entities involved in 

8 the enforcement of mental health parity 

9 and addiction equity requirements. 

10 (C) Representatives from key stakeholder 

11 groups, including— 

12 (i) the National Association of Insur13 ance Commissioners; 

14 (ii) health insurance providers; 

15 (iii) providers of mental health and 

16 substance use disorder treatment; 

17 (iv) employers; and 

18 (v) patients or their advocates. 

19 (b) ACTION PLAN.—Not later than 6 months after 

20 the conclusion of the public meeting under subsection (a), 

21 the Secretary of Health and Human Services shall finalize 

22 the action plan described in such subsection and make it 

23 plainly available on the Internet website of the Depart24 ment of Health and Human Services. 


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1 (c) CONTENT.—The action plan under this section 

2 shall— 

3 (1) reflect the input of the stakeholders partici4 pating in the public meeting under subsection (a); 

5 (2) identify specific strategic objectives regard6 ing how the various Federal and State agencies 

7 charged with enforcement of mental health parity 

8 and addiction equity requirements will collaborate to 

9 improve enforcement of such requirements; 

10 (3) provide a timeline for implementing the ac11 tion plan; and 

12 (4) provide specific examples of how such objec13 tives may be met, which may include— 

14 (A) providing common educational infor15 mation and documents to patients about their 

16 rights under mental health parity and addiction 

17 equity requirements; 

18 (B) facilitating the centralized collection 

19 of, monitoring of, and response to patient com20 plaints or inquiries relating to mental health 

21 parity and addiction equity requirements, which 

22 may be through the development and adminis23 tration of a single, toll-free telephone number 

24 and an Internet website portal; 


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1 (C) Federal and State law enforcement 

2 agencies entering into memoranda of under3 standing to better coordinate enforcement re4 sponsibilities and information sharing, including 

5 whether such agencies should make the results 

6 of enforcement actions related to mental health 

7 parity and addiction equity requirements pub8 licly available; and 

9 (D) recommendations to the Congress re10 garding the need for additional legal authority 

11 to improve enforcement of mental health parity 

12 and addiction equity requirements, including 

13 the need for additional legal authority to ensure 

14 that nonquantitative treatment limitations are 

15 applied, and the extent and frequency of the ap16 plications of such limitations, both to medical 

17 and surgical benefits and to mental health and 

18 substance use disorder benefits in a comparable 

19 manner. 

20 SEC. 803. REPORT ON INVESTIGATIONS REGARDING PAR21 ITY IN MENTAL HEALTH AND SUBSTANCE 

22 USE DISORDER BENEFITS. 

23 (a) IN GENERAL.—Not later than 1 year after the 

24 date of enactment of this Act, and annually thereafter for 

25 the subsequent 5 years, the Administrator of the Centers 


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1 for Medicare & Medicaid Services, in collaboration with 

2 the Assistant Secretary of Labor of the Employee Benefits 

3 Security Administration and the Secretary of the Treas4 ury, shall submit to the Committee on Energy and Com5 merce of the House of Representatives and the Committee 

6 on Health, Education, Labor, and Pensions of the Senate 

7 a report summarizing the results of all closed Federal in8 vestigations completed during the preceding 12-month pe9 riod with findings of any serious violation regarding com10 pliance with mental health and substance use disorder cov11 erage requirements under section 2726 of the Public 

12 Health Service Act (42 U.S.C. 300gg–26), section 712 of 

13 the Employee Retirement Income Security Act of 1974 

14 (29 U.S.C. 1185a), and section 9812 of the Internal Rev15 enue Code of 1986. 

16 (b) CONTENTS.—Subject to subsection (c), a report 

17 under subsection (a) shall, with respect to investigations 

18 described in such subsection, include each of the following: 

19 (1) The number of closed Federal investigations 

20 conducted during the covered reporting period. 

21 (2) Each benefit classification examined by any 

22 such investigation conducted during the covered re23 porting period. 

24 (3) Each subject matter, including compliance 

25 with requirements for quantitative and nonquantitaVerDate Sep 11 2014 22:58 Jul 15, 2016 Jkt 059200 PO 00000 Frm 00148 Fmt 6652 Sfmt 6201 E:\BILLS\H2646.RFS H2646

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1 tive treatment limitations, of any such investigation 

2 conducted during the covered reporting period. 

3 (4) A summary of the basis of the final decision 

4 rendered for each closed investigation conducted 

5 during the covered reporting period that resulted in 

6 a finding of a serious violation. 

7 (c) LIMITATION.—Any individually identifiable infor8 mation shall be excluded from reports under subsection 

9 (a) consistent with protections under the health privacy 

10 and security rules promulgated under section 264(c) of the 

11 Health Insurance Portability and Accountability Act of 

12 1996 (42 U.S.C. 1320d–2 note). 

13 SEC. 804. GAO STUDY ON PARITY IN MENTAL HEALTH AND 

14 SUBSTANCE USE DISORDER BENEFITS. 

15 Not later than 3 years after the date of enactment 

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

17 in consultation with the Secretary of Health and Human 

18 Services, the Secretary of Labor, and the Secretary of the 

19 Treasury, shall submit to the Committee on Energy and 

20 Commerce of the House of Representatives and the Com21 mittee on Health, Education, Labor, and Pensions of the 

22 Senate a report detailing the extent to which group health 

23 plans or health insurance issuers offering group or indi24 vidual health insurance coverage that provides both med25 ical and surgical benefits and mental health or substance 


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1 use disorder benefits, medicaid managed care organiza2 tions with a contract under section 1903(m) of the Social 

3 Security Act (42 U.S.C. 1396b(m)), and health plans pro4 vided under the State Children’s Health Insurance Pro5 gram under title XXI of the Social Security Act (42 

6 U.S.C. 1397aa et seq.) comply with section 2726 of the 

7 Public Health Service Act (42 U.S.C. 300gg–26), section 

8 712 of the Employee Retirement Income Security Act of 

9 1974 (29 U.S.C. 1185a), and section 9812 of the Internal 

10 Revenue Code of 1986, including— 

11 (1) how nonquantitative treatment limitations, 

12 including medical necessity criteria, of such plans or 

13 issuers comply with such sections; 

14 (2) how the responsible Federal departments 

15 and agencies ensure that such plans or issuers com16 ply with such sections, including an assessment of 

17 how the Secretary of Health and Human Services 

18 has used its authority to conduct audits of such 

19 plans to ensure compliance; 

20 (3) a review of how the various Federal and 

21 State agencies responsible for enforcing mental 

22 health parity requirements have improved enforce23 ment of such requirements in accordance with the 

24 objectives and timeline described in the action plan 

25 under section 802; and 


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1 (4) recommendations for how additional en2 forcement, education, and coordination activities by 

3 responsible Federal and State departments and 

4 agencies could better ensure compliance with such 

5 sections, including recommendations regarding the 

6 need for additional legal authority. 

7 SEC. 805. INFORMATION AND AWARENESS ON EATING DIS8 ORDERS. 

9 (a) INFORMATION.—The Secretary of Health and 

10 Human Services (in this section referred to as the ‘‘Sec11 retary’’) may— 

12 (1) update information, related fact sheets, and 

13 resource lists related to eating disorders that are 

14 available on the public Internet website of the Na15 tional Women’s Health Information Center spon16 sored by the Office on Women’s Health, to include— 

17 (A) updated findings and current research 

18 related to eating disorders, as appropriate; and 

19 (B) information about eating disorders, in20 cluding information related to males and fe21 males; 

22 (2) incorporate, as appropriate, and in coordi23 nation with the Secretary of Education, information 

24 from publicly available resources into appropriate 


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1 obesity prevention programs developed by the Office 

2 on Women’s Health; and 

3 (3) make publicly available (through a public 

4 Internet website or other method) information, re5 lated fact sheets and resource lists, as updated 

6 under paragraph (1), and the information incor7 porated into appropriate obesity prevention pro8 grams, as updated under paragraph (2). 

9 (b) AWARENESS.—The Secretary may advance public 

10 awareness on— 

11 (1) the types of eating disorders; 

12 (2) the seriousness of eating disorders, includ13 ing prevalence, comorbidities, and physical and men14 tal health consequences; 

15 (3) methods to identify, intervene, refer for 

16 treatment, and prevent behaviors that may lead to 

17 the development of eating disorders; 

18 (4) discrimination and bullying based on body 

19 size; 

20 (5) the effects of media on self-esteem and body 

21 image; and 

22 (6) the signs and symptoms of eating disorders. 


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1 SEC. 806. EDUCATION AND TRAINING ON EATING DIS2 ORDERS. 

3 The Secretary of Health and Human Services may 

4 facilitate the identification of programs to educate and 

5 train health professionals and school personnel in effective 

6 strategies to— 

7 (1) identify individuals with eating disorders; 

8 (2) provide early intervention services for indi9 viduals with eating disorders; 

10 (3) refer patients with eating disorders for ap11 propriate treatment; 

12 (4) prevent the development of eating disorders; 

13 or 

14 (5) provide appropriate treatment services for 

15 individuals with eating disorders. 

16 SEC. 807. GAO STUDY ON PREVENTING DISCRIMINATORY 

17 COVERAGE LIMITATIONS FOR INDIVIDUALS 

18 WITH SERIOUS MENTAL ILLNESS AND SUB19 STANCE USE DISORDERS. 

20 Not later than 2 years after the date of the enact21 ment of this Act, the Comptroller General of the United 

22 States shall submit to Congress and make publicly avail23 able a report detailing Federal oversight of group health 

24 plans and health insurance coverage offered in the indi25 vidual or group market (as such terms are defined in sec26 tion 2791 of the Public Health Service Act (42 U.S.C. 


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1 300gg–91)), including Medicaid managed care plans 

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

3 1396b), to ensure compliance of such plans and coverage 

4 with sections 2726 of the Public Health Service Act (42 

5 U.S.C. 300gg–26), 712 of the Employee Retirement In6 come Security Act of 1974 (29 U.S.C. 1185a), and 9812 

7 of the Internal Revenue Code of 1986 (in this section col8 lectively referred to as the ‘‘parity law’’), including— 

9 (1) a description of how Federal regulations 

10 and guidance consider nonquantitative treatment 

11 limitations, including medical necessity criteria and 

12 application of such criteria to medical, surgical, and 

13 primary care, of such plans and coverage in ensuring 

14 compliance by such plans and coverage with the par15 ity law; 

16 (2) a description of actions that Federal depart17 ments and agencies are taking to ensure that such 

18 plans and coverage comply with the parity law; and 

19 (3) the identification of enforcement, education, 

20 and coordination activities within Federal depart21 ments and agencies, including educational activities 

22 directed to State insurance commissioners, and a de23 scription of how such proper activities can be used 

24 to ensure full compliance with the parity law. 


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1 SEC. 808. CLARIFICATION OF EXISTING PARITY RULES. 

2 If a group health plan or a health insurance issuer 

3 offering group or individual health insurance coverage pro4 vides coverage for eating disorder benefits, including resi5 dential treatment, such group health plan or health insur6 ance issuer shall provide such benefits consistent with the 

7 requirements of section 2726 of the Public Health Service 

8 Act (42 U.S.C. 300gg–26), section 712 of the Employee 

9 Retirement Income Security Act of 1974 (29 U.S.C. 

10 1185a), and section 9812 of the Internal Revenue Code 

11 of 1986. 

Passed the House of Representatives July 6, 2016. 

Attest: KAREN L. HAAS, 

Clerk. 


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