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[Congressional Bills 113th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1263 Introduced in House (IH)]

113th CONGRESS
  1st Session
                                H. R. 1263

  To increase access to community behavioral health services for all 
     Americans and to improve Medicaid reimbursement for community 
                      behavioral health services.

_______________________________________________________________________

                    IN THE HOUSE OF REPRESENTATIVES

                             March 19, 2013

Ms. Matsui (for herself, Mr. Lance, Mr. Waxman, Mr. Engel, Ms. DeGette, 
 and Ms. Jenkins) introduced the following bill; which was referred to 
                  the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL

 
  To increase access to community behavioral health services for all 
     Americans and to improve Medicaid reimbursement for community 
                      behavioral health services.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Excellence in Mental Health Act''.

SEC. 2. ESTABLISHING COMMUNITY BEHAVIORAL HEALTH CENTERS.

    (a) In General.--Section 1913 of the Public Health Service Act (42 
U.S.C. 300x-2) is amended--
            (1) in subsection (a)(2)(A), by striking ``community mental 
        health services'' and inserting ``behavioral health services 
        (of the type offered by a certified federally qualified 
        community behavioral health center)'';
            (2) in subsection (b)--
                    (A) in paragraph (1), by striking ``community 
                mental health centers'' and inserting ``certified 
                federally qualified community behavioral health 
                centers''; and
                    (B) in paragraph (2), by striking ``community 
                mental health centers'' and inserting ``certified 
                federally qualified community behavioral health 
                centers''; and
            (3) by striking subsection (c) and inserting the following:
    ``(c) Certified Federally Qualified Community Behavioral Health 
Centers.--
            ``(1) Definition.--For purposes of subsection (a)(2) and 
        subsection (b), the term `certified federally qualified 
        community behavioral health center' means a nonprofit or local 
        government center that is certified by the Secretary as 
        performing each of the following actions:
                    ``(A) Providing services in locations that ensure 
                services will be available and accessible promptly and 
                in a manner which preserves human dignity and assures 
                continuity of care.
                    ``(B) Providing services in a mode of service 
                delivery appropriate for the target population.
                    ``(C) Providing individuals with a choice of 
                service options where there is more than one 
                efficacious treatment.
                    ``(D) Employing a core staff of clinical staff that 
                is multidisciplinary and culturally and linguistically 
                competent.
                    ``(E) Providing services, within the limits of the 
                capacities of the center, to any individual residing or 
                employed in the service area of the center, regardless 
                of the ability of the individual to pay.
                    ``(F) Providing, directly or through contract, to 
                the extent covered for adults in the State Medicaid 
                plan under title XIX of the Social Security Act and for 
                children in accordance with section 1905(r) of such Act 
                regarding early and periodic screening, diagnosis, and 
                treatment, each of the following services:
                            ``(i) Screening, assessment, and diagnosis, 
                        including risk assessment.
                            ``(ii) Person-centered treatment planning 
                        or similar processes, including risk assessment 
                        and crisis planning.
                            ``(iii) Outpatient mental health and 
                        substance use services, including screening, 
                        assessment, diagnosis, psychotherapy, 
                        medication management, and integrated treatment 
                        for mental illness and substance abuse which 
                        shall be evidence-based (including cognitive 
                        behavioral therapy and other such therapies 
                        which are evidence-based).
                            ``(iv) Outpatient clinic primary care 
                        screening and monitoring of key health 
                        indicators and health risk (including screening 
                        for diabetes, hypertension, and cardiovascular 
                        disease and monitoring of weight, height, body 
                        mass index (BMI), blood pressure, blood glucose 
                        or HbA1C, and lipid profile).
                            ``(v) Crisis mental health services, 
                        including 24-hour mobile crisis teams, 
                        emergency crisis intervention services, and 
                        crisis stabilization.
                            ``(vi) Targeted case management (services 
                        to assist individuals gaining access to needed 
                        medical, social, educational, and other 
                        services and applying for income security and 
                        other benefits to which they may be entitled).
                            ``(vii) Psychiatric rehabilitation services 
                        including skills training, assertive community 
                        treatment, family psychoeducation, disability 
                        self-management, supported employment, 
                        supported housing services, therapeutic foster 
                        care services, and such other evidence-based 
                        practices as the Secretary may require.
                            ``(viii) Peer support and counselor 
                        services and family supports.
                    ``(G) Maintaining linkages, and where possible 
                entering into formal contracts with the following:
                            ``(i) Federally qualified health centers.
                            ``(ii) Inpatient psychiatric facilities and 
                        substance use detoxification, post 
                        detoxification step-down services, and 
                        residential programs.
                            ``(iii) Adult and youth peer support and 
                        counselor services.
                            ``(iv) Family support services for families 
                        of children with serious mental or substance 
                        abuse disorders.
                            ``(v) Other community or regional services, 
                        supports, and providers, including schools, 
                        child welfare agencies, juvenile and criminal 
                        justice agencies and facilities, housing 
                        agencies and programs, employers, and other 
                        social services.
                            ``(vi) Onsite or offsite access to primary 
                        care services.
                            ``(vii) Enabling services, including 
                        outreach, transportation, and translation.
                            ``(viii) Health and wellness services, 
                        including services for tobacco cessation.
            ``(2) Frequency of certification.--Certification under 
        paragraph (1) shall be for a 5-year period. The Administrator 
        shall provide an opportunity for recertification at the end of 
        each certification period.
            ``(3) Rule of construction.--Nothing in paragraph (1) shall 
        be construed as prohibiting any State receiving funds 
        appropriated through the Community Mental Health Services Block 
        Grant under this subpart from financing qualified community 
        programs (whether such programs meet the definition of eligible 
        programs prior to or after the date of enactment of the 
        Excellence in Mental Health Act).''.
    (b) Regulations.--Not later than 18 months after the date of the 
enactment of this Act, the Secretary of Health and Human Services, in 
consultation with State mental health and substance abuse authorities, 
shall issue final regulations for certifying nonprofit or local 
government centers under subsection (c) of section 1913 of the Public 
Health Service Act, as amended by this section.

SEC. 3. MEDICAID COVERAGE AND PAYMENT FOR COMMUNITY BEHAVIORAL HEALTH 
              CENTER SERVICES.

    (a) Payment for Services Provided by Federally Qualified Community 
Behavioral Health Centers.--Section 1902(bb) of the Social Security Act 
(42 U.S.C. 1396a(bb)) is amended--
            (1) in the heading, by striking ``and Rural Health 
        Clinics'' and inserting ``, Selected Certified FQCBHCs, and 
        Rural Health Clinics'';
            (2) in paragraph (1), by inserting ``(and beginning with 
        fiscal year 2014 with respect to services furnished on or after 
        January 1, 2014, and each succeeding fiscal year, for services 
        described in section 1905(a)(2)(D) furnished by a selected 
        certified FQCBHC)'' after ``by a rural health clinic'';
            (3) in paragraph (2)--
                    (A) by striking the heading and inserting ``Initial 
                fiscal year'';
                    (B) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                selected certified FQCBHC, for services furnished on 
                and after January 1, 2014, during fiscal year 2014)'' 
                after ``January 1, 2001, during fiscal year 2001'';
                    (C) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                selected certified FQCBHC, during fiscal years 2012 and 
                2013)'' after ``1999 and 2000''; and
                    (D) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                selected certified FQCBHC, during fiscal year 2014)'' 
                before the period;
            (4) in paragraph (3)--
                    (A) in the heading, by striking ``Fiscal year 2002 
                and succeeding'' and inserting ``Succeeding''; and
                    (B) by inserting ``(or, in the case of services 
                described in section 1905(a)(2)(D) furnished by a 
                selected certified FQCBHC, for services furnished 
                during fiscal year 2015 or a succeeding fiscal year)'' 
                after ``2002 or a succeeding fiscal year'';
            (5) in paragraph (4)--
                    (A) by inserting ``(or as a selected certified 
                FQCBHC after fiscal year 2013)'' after ``or rural 
                health clinic after fiscal year 2000'';
                    (B) by striking ``furnished by the center or'' and 
                inserting ``furnished by the federally qualified health 
                center, services described in section 1905(a)(2)(D) 
                furnished by the selected certified FQCBHC, or''; and
                    (C) in the second sentence, by striking ``or rural 
                health clinic'' and inserting ``, selected certified 
                FQCBHC, or rural health clinic'';
            (6) in paragraph (5), in each of subparagraphs (A) and (B), 
        by striking ``or rural health clinic'' and inserting ``, 
        selected certified FQCBHC, or rural health clinic'';
            (7) in paragraph (6), by striking ``or to a rural health 
        clinic'' and inserting ``, to a selected certified FQCBHC for 
        services described in section 1905(a)(2)(D), or to a rural 
        health clinic''; and
            (8) by adding at the end the following:
            ``(7) Selected certified fqcbhc.--For purposes of this 
        subsection, the term `selected certified FQCBHC' shall have the 
        meaning given such term in section 1905(l)(4)(B).''.
    (b) Inclusion of Community Behavioral Health Center Services in the 
Term Medical Assistance.--Section 1905(a)(2) of the Social Security Act 
(42 U.S.C. 1396d(a)(2)) is amended--
            (1) by striking ``and'' before ``(C)''; and
            (2) by inserting before the semicolon at the end the 
        following: ``, and (D) federally qualified community behavioral 
        health center services (as defined in subsection (l)(4))''.
    (c) Definition of Federally Qualified Community Behavioral Health 
Center Services.--Section 1905(l) of the Social Security Act (42 U.S.C. 
1396d(l)) is amended by adding at the end the following paragraph:
            ``(4)(A) The term `community behavioral health center 
        services' means services furnished to an individual at a 
        selected certified FQCBHC (as defined by subparagraph (B)).
            ``(B) The term `selected certified FQCBHC' means, with 
        respect to a fiscal year, a certified federally qualified 
        community behavioral health center that is selected by the 
        Secretary under subparagraph (D) for such fiscal year.
            ``(C) With respect to a fiscal year, for purposes of this 
        paragraph, an entity is a certified federally qualified 
        community behavioral health center for such fiscal year if the 
        entity is a certified federally qualified community behavioral 
        health center under section 1913(c) of the Public Health 
        Service Act for such fiscal year.
            ``(D)(i) For purposes of this section and section 
        1902(bb)--
                    ``(I) for fiscal years 2014 through 2018, the 
                Secretary shall select 20 percent of the total number 
                of certified federally qualified community behavioral 
                health centers;
                    ``(II) for fiscal years 2019 through 2023, the 
                Secretary shall select the certified federally 
                qualified community behavioral health centers selected 
                under subclause (II) and an additional 20 percent of 
                the total number of certified federally qualified 
                community behavioral health centers; and
                    ``(III) for fiscal year 2024 and subsequent fiscal 
                years, the Secretary shall select all certified 
                federally qualified community behavioral health 
                centers.
            ``(ii) In making the selections under subclauses (I) and 
        (II) of clause (i), the Secretary shall--
                    ``(I) ensure geographic diversity of the selected 
                certified FQCBHCs; and
                    ``(II) take into account the ability of such 
                centers to provide the services required by section 
                1913 of the Public Health Service Act and to report 
                data as required under this title.''.

SEC. 4. COMMUNITY-BASED MENTAL HEALTH INFRASTRUCTURE IMPROVEMENT.

    Title V of the Public Health Service Act (42 U.S.C. 280g et seq.) 
is amended--
            (1) by redesignating the second part G, as added by section 
        144 of the Community Renewal Tax Relief Act of 2000 (as enacted 
        into law by section 1(a)(7) of Public Law 106-554; 114 Stat. 
        2763A-619), as part J;
            (2) by redesignating sections 581 through 584 in such part 
        (42 U.S.C. 290kk through 290kk-3) as sections 595C through 
        595F, respectively; and
            (3) by inserting after part J, as so redesignated, the 
        following:

  ``PART K--COMMUNITY-BASED MENTAL HEALTH INFRASTRUCTURE IMPROVEMENTS

``SEC. 595G. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH INFRASTRUCTURE 
              IMPROVEMENTS.

    ``(a) Grants Authorized.--The Secretary may award grants to 
eligible entities to expend funds for the construction or modernization 
of facilities used to provide mental health and substance abuse 
services to individuals.
    ``(b) Eligible Entity.--In this section, the term `eligible entity' 
means--
            ``(1) a State that is the recipient of a Community Mental 
        Health Services Block Grant under subpart I of part B of title 
        XIX and a Substance Abuse Prevention and Treatment Block Grant 
        under subpart II of such part; or
            ``(2) an Indian tribe or a tribal organization (as such 
        terms are defined in sections 4(b) and 4(c) of the Indian Self-
        Determination and Education Assistance Act).
    ``(c) Application.--An eligible entity desiring a grant under this 
section shall submit to the Secretary an application at such time, in 
such manner, and containing--
            ``(1) a plan for the construction or modernization of 
        facilities used to provide mental health and substance abuse 
        services to individuals that--
                    ``(A) designates a single State or tribal agency as 
                the sole agency for the supervision and administration 
                of the grant;
                    ``(B) contains satisfactory evidence that such 
                agency so designated will have the authority to carry 
                out the plan;
                    ``(C) provides for the designation of an advisory 
                council, which shall include representatives of 
                nongovernmental organizations or groups, and of the 
                relevant State or tribal agencies, that aided in the 
                development of the plan and that will implement and 
                monitor any grant awarded to the eligible entity under 
                this section;
                    ``(D) in the case of an eligible entity that is a 
                State, includes a copy of the State plan under section 
                1912(b) and section 1932(b);
                    ``(E)(i) includes a listing of the projects to be 
                funded by the grant; and
                    ``(ii) in the case of an eligible entity that is a 
                State, explains how each listed project helps the State 
                in accomplishing its goals and objectives under the 
                Community Mental Health Services Block Grant under 
                subpart I of part B of title XIX and the Substance 
                Abuse Prevention and Treatment Block Grant under 
                subpart II of such part;
                    ``(F) includes assurances that the facilities will 
                be used for a period of not less than 10 years for the 
                provision of community-based mental health or substance 
                abuse services for those who cannot pay for such 
                services, subject to subsection (e); and
                    ``(G) in the case of a facility that is not a 
                public facility, includes the name and executive 
                director of the entity who will provide services in the 
                facility; and
            ``(2) with respect to each construction or modernization 
        project described in the application--
                    ``(A) a description of the site for the project;
                    ``(B) plans and specifications for the project and 
                State or tribal approval for the plans and 
                specifications;
                    ``(C) assurance that the title for the site is or 
                will be vested with either the public entity or private 
                nonprofit entity who will provide the services in the 
                facility;
                    ``(D) assurance that adequate financial resources 
                will be available for the construction or major 
                rehabilitation of the project and for the maintenance 
                and operation of the facility;
                    ``(E) estimates of the cost of the project; and
                    ``(F) the estimated length of time for completion 
                of the project.
    ``(d) Subgrants by States.--
            ``(1) In general.--A State that receives a grant under this 
        section may award a subgrant to a qualified community program 
        (as such term is used in section 1913(b)(1)).
            ``(2) Use of funds.--Subgrants awarded pursuant to 
        paragraph (1) may be used for activities such as--
                    ``(A) the construction, expansion, and 
                modernization of facilities used to provide mental 
                health and substance abuse services to individuals;
                    ``(B) acquiring and leasing facilities and 
                equipment (including paying the costs of amortizing the 
                principal of, and paying the interest on, loans for 
                such facilities and equipment) to support or further 
                the operation of the subgrantee;
                    ``(C) the construction and structural modification 
                (including equipment acquisition) of facilities to 
                permit the integrated delivery of behavioral health and 
                primary care of specialty medical services to 
                individuals with co-occurring mental illnesses and 
                chronic medical or surgical diseases at a single 
                service site; and
                    ``(D) acquiring information technology required to 
                accommodate the clinical needs of primary and specialty 
                care professionals.
            ``(3) Limitation.--Not to exceed 15 percent of grant funds 
        may be used for activities described in paragraph (2)(D).
    ``(e) Request To Transfer Obligation.--An eligible entity that 
receives a grant under this section may submit a request to the 
Secretary for permission to transfer the 10-year obligation of facility 
use, as described in subsection (c)(1)(F), to another facility.
    ``(f) Agreement to Federal Share.--As a condition of receipt of a 
grant under this section, an eligible entity shall agree, with respect 
to the costs to be incurred by the entity in carrying out the 
activities for which such grant is awarded, that the entity will make 
available non-Federal contributions (which may include State or local 
funds, or funds from the qualified community program) in an amount 
equal to not less than $1 for every $1 of Federal funds provided under 
the grant.
    ``(g) Reporting.--
            ``(1) Reporting by states.--During the 10-year period 
        referred to in subsection (c)(1)(F), the Secretary shall 
        require that a State that receives a grant under this section 
        submit, as part of the report of the State required under the 
        Community Mental Health Services Block Grant under subpart I of 
        part B of title XIX and the Substance Abuse Prevention and 
        Treatment Block Grant under subpart II of such part, a 
        description of the progress on--
                    ``(A) the projects carried out pursuant to the 
                grant under this section; and
                    ``(B) the assurances that the facilities involved 
                continue to be used for the purpose for which they were 
                funded under such grant during such 10-year period.
            ``(2) Reporting by indian tribes and tribal 
        organizations.--The Secretary shall establish reporting 
        requirements for Indian tribes and tribal organizations that 
        receive a grant under this section. Such reporting requirements 
        shall include that such Indian tribe or tribal organization 
        provide a description of the progress on--
                    ``(A) the projects carried out pursuant to the 
                grant under this section; and
                    ``(B) the assurances that the facilities involved 
                continue to be used for the purpose for which they were 
                funded under such grant during the 10-year period 
                referred to in subsection (c)(1)(F).
    ``(h) Failure To Meet Obligations.--
            ``(1) In general.--If an eligible entity that receives a 
        grant under this section fails to meet any of the obligations 
        of the entity required under this section, the Secretary shall 
        take appropriate steps, which may include--
                    ``(A) requiring that the entity return the unused 
                portion of the funds awarded under this section for the 
                projects that are incomplete; and
                    ``(B) extending the length of time that the entity 
                must ensure that the facility involved is used for the 
                purposes for which it is intended, as described in 
                subsection (c)(1)(F).
            ``(2) Hearing.--Prior to requesting the return of the funds 
        under paragraph (1)(B), the Secretary shall provide the entity 
        notice and opportunity for a hearing.
    ``(i) Collaboration.--The Secretary may establish intergovernmental 
and interdepartmental memoranda of agreement as necessary to carry out 
this section.
    ``(j) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section such sums as may be necessary 
for each of fiscal years 2014 through 2018.''.
                                 <all>
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