I 

113TH CONGRESS 

2D SESSION H. R. 4574 

To maximize the access of individuals with mental illness to communitybased services, to strengthen the impact of such services, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 6, 2014 

Mr. BARBER (for himself, Ms. DEGETTE, Mr. TONKO, Ms. MATSUI, and Mrs. 

NAPOLITANO) introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committees 

on Ways and Means, the Judiciary, Armed Services, Veterans’ Affairs, 

Education and the Workforce, and Natural Resources, for a period to be 

subsequently determined by the Speaker, in each case for consideration 

of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To maximize the access of individuals with mental illness 

to community-based services, to strengthen the impact 

of such services, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

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

5 ‘‘Strengthening Mental Health in Our Communities Act 

6 of 2014’’. 


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

2 this Act is as follows: 

Sec. 1. Short title; table of contents. 

Sec. 2. Purpose. 

TITLE I—WHITE HOUSE OFFICE OF MENTAL HEALTH POLICY 

Sec. 101. White House Office of Mental Health Policy. 

Sec. 102. Appointment and duties of the Director. 

Sec. 103. National strategy for mental health. 

Sec. 104. Coordination with Federal departments and agencies. 

Sec. 105. National mental health advisory board. 

TITLE II—STRENGTHENING AND INVESTING IN SAMHSA 

PROGRAMS 

Sec. 201. Community mental health services block grant reauthorization. 

Sec. 202. Reporting requirements for block grants regarding mental health and 

substance use disorders. 

Sec. 203. Garrett Lee Smith Memorial Act reauthorization. 

Sec. 204. Priority mental health needs of regional and national significance reauthorization. 

Sec. 205. Grants for jail diversion programs reauthorization. 

Sec. 206. Projects for assistance in transition from homelessness. 

Sec. 207. Comprehensive community mental health services for children with 

serious emotional disturbances. 

Sec. 208. Children’s recovery from trauma. 

Sec. 209. Protection and advocacy for individuals with mental illness reauthorization. 

Sec. 210. Mental health awareness training grants. 

Sec. 211. National media campaign to reduce the stigma associated with mental illness. 

Sec. 212. SAMHSA and HRSA integration of behavioral health services into 

primary care settings. 

Sec. 213. Geriatric mental health disorders. 

Sec. 214. Assessing barriers to behavioral health integration. 

Sec. 215. Acute care bed registry grant for States. 

Sec. 216. Awards for co-locating primary and specialty care in communitybased mental health settings. 

Sec. 217. Grants for the benefit of homeless individuals. 

TITLE III—IMPROVING MEDICAID AND MEDICARE MENTAL 

HEALTH SERVICES 

Sec. 301. Access to mental health prescription drugs under Medicare. 

Sec. 302. Medicaid coverage of mental health services and primary care services 

furnished on the same day. 

Sec. 303. Elimination of 190-day lifetime limit on inpatient psychiatric hospital 

services. 

Sec. 304. Expanding the Medicaid home and community-based services waiver 

to include youth in need of services provided in a psychiatric 

residential treatment facility. 

Sec. 305. Application of Rosa’s Law for individuals with intellectual disabilities. 


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Sec. 306. Complete application of mental health and substance use parity rules 

under Medicaid and CHIP. 

Sec. 307. Coverage of marriage and family therapist services and mental health 

counselor services under part B of the Medicare program. 

TITLE IV—DEVELOPING THE BEHAVIORAL HEALTH WORKFORCE 

Sec. 401. National health service corps scholarship and loan repayment funding 

for behavioral and mental health professionals. 

Sec. 402. Reauthorization of HRSA’s mental and behavioral health education 

and training program. 

Sec. 403. SAMHSA grant program for development and implementation of curricula for continuing education on serious mental illness. 

Sec. 404. Demonstration grant program to recruit, train, deploy, and professionally support psychiatric physicians in Indian health programs. 

Sec. 405. Including occupational therapists as behavioral and mental health 

professionals for purposes of the National Health Service 

Corps. 

Sec. 406. Extension of certain health care workforce loan repayment programs 

through fiscal year 2019. 

TITLE V—IMPROVING MENTAL HEALTH RESEARCH AND 

COORDINATION 

Sec. 501. National Institute of Mental Health research program on serious 

mental illness and suicide prevention. 

Sec. 502. Youth mental health research network. 

Sec. 503. National violent death reporting system. 

TITLE VI—EDUCATION AND YOUTH 

Sec. 601. School-based mental health programs. 

Sec. 602. Examining mental health care for children. 

TITLE VII—JUSTICE AND MENTAL HEALTH COLLABORATION 

Sec. 701. Assisting veterans. 

Sec. 702. Correctional facilities. 

Sec. 703. High utilizers. 

Sec. 704. Academy training. 

Sec. 705. Evidence-based practices. 

Sec. 706. Safe communities. 

Sec. 707. Reauthorization of appropriations. 

TITLE VIII—BEHAVIORAL HEALTH INFORMATION TECHNOLOGY 

Sec. 801. Extension of health information technology assistance for behavioral 

and mental health and substance abuse. 

Sec. 802. Extension of eligibility for Medicare and Medicaid health information 

technology implementation assistance. 

TITLE IX—SERVICEMEMBERS AND VETERANS MENTAL HEALTH 

Sec. 901. Preliminary mental health assessments. 

Sec. 902. Unlimited eligibility for health care for mental illnesses for veterans 

of combat service during certain periods of hostilities and war. 

Sec. 903. Timeline for implementing integrated electronic health records. 


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Sec. 904. Pilot program for repayment of educational loans for certain psychiatrists of Veterans Health Administration. 

TITLE X—MAKING PARITY WORK 

Sec. 1001. GAO study on mental health and substance use disorder parity enforcement efforts. 

Sec. 1002. Report to Congress on Federal assistance to State insurance regulators regarding mental health parity enforcement. 

Sec. 1003. Annual report to Congress by Secretaries of Labor and Health and 

Human Services. 

1 SEC. 2. PURPOSE. 

2 The purposes of this Act are— 

3 (1) to improve the responsiveness, coordination, 

4 accountability, accessibility, and integration of per5 son-centered behavioral health services to provide 

6 timely and appropriate help to individuals, families, 

7 and communities; 

8 (2) to reduce mental health crises, homeless9 ness, and incarceration by strengthening community10 based services, including early intervention, out11 reach, engagement, prevention, crisis support, reha12 bilitation, and peer-run services for persons of all 

13 ages; 

14 (3) to ensure that all Americans with mental ill15 nesses and their families can— 

16 (A) gain access to evidence-based and 

17 emerging best practices based on the values and 

18 principles of trauma-informed care and mental 

19 health recovery, delivered in a culturally and 

20 linguistically competent manner; and 


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1 (B) fully participate in the most integrated 

2 settings within their chosen communities; 

3 (4) to develop an integrated behavioral health 

4 workforce through improved training and education, 

5 recruitment, and retention to meet the needs of all 

6 communities and populations; 

7 (5) to increase mental health awareness and re8 duce stigma and discrimination through mental 

9 health training, education, and literacy; and 

10 (6) to ensure the full implementation and en11 forcement of mental health parity for all Americans. 

12 TITLE I—WHITE HOUSE OFFICE 

13 OF MENTAL HEALTH POLICY 

14 SEC. 101. WHITE HOUSE OFFICE OF MENTAL HEALTH POL15 ICY. 

16 (a) ESTABLISHMENT OF OFFICE.—There is estab17 lished in the Executive Office of the President the White 

18 House Office of Mental Health Policy (hereafter referred 

19 to as the ‘‘Office’’), which shall— 

20 (1) monitor Federal activities with respect to 

21 mental health, serious mental illness, and serious 

22 emotional disturbances; 

23 (2) make recommendations to the Secretary of 

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1 ommendations with respect to the national strategy 

2 developed under paragraph (3); 

3 (3) develop and annually update a National 

4 Strategy for Mental Health to maximize the access 

5 of individuals with mental illness to community6 based services, strengthen the impact of such serv7 ices, and meet the comprehensive needs of individ8 uals with mental illness; 

9 (4) make recommendations to the Secretary of 

10 Health and Human Services regarding public par11 ticipation in decisions relating to mental health, seri12 ous mental illness, and serious emotional disturb13 ances; 

14 (5) review and make recommendations with re15 spect to the budgets for Federal mental health serv16 ices to ensure the adequacy of those budgets; 

17 (6) submit to the Congress the national strat18 egy and any updates to such strategy; 

19 (7) coordinate the mental health services pro20 vided by Federal departments and agencies and co21 ordinate Federal interagency mental health services; 

22 (8) consult, coordinate with, facilitate joint ef23 forts among, and support State, local, and tribal 

24 governments, nongovernmental entities, and individ25 uals with a mental illness, particularly individuals 


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1 with a serious mental illness and children and ado2 lescents with a serious emotional disturbance, with 

3 respect to improving community-based and other 

4 mental health services; and 

5 (9) develop and annually update a summary of 

6 advances in serious mental illness and serious emo7 tional disturbances research related to causes, pre8 vention, treatment, early screening, diagnosis or rule 

9 out, intervention, and access to services and sup10 ports for individuals with serious mental illness and 

11 children and adolescents with a serious emotional 

12 disturbance. 

13 (b) DIRECTOR.—There shall be a Director who shall 

14 head the Office (hereafter referred to as the ‘‘Director’’) 

15 and who shall hold the same rank and status as the head 

16 of an executive department listed in section 101 of title 

17 5, United States Code. 

18 (c) ACCESS BY CONGRESS.—The location of the Of19 fice in the Executive Office of the President shall not be 

20 construed as affecting access by Congress, or any com21 mittee of the House of Representatives or the Senate, to 

22 any— 

23 (1) information, document, or study in the pos24 session of, or conducted by or at the direction of, the 

25 Director; or 


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1 (2) personnel of the Office. 

2 SEC. 102. APPOINTMENT AND DUTIES OF THE DIRECTOR. 

3 (a) APPOINTMENT.— 

4 (1) IN GENERAL.—The President shall appoint 

5 the Director, by and with the advice and consent of 

6 the Senate. The Director shall serve at the pleasure 

7 of the President. 

8 (2) PROHIBITION.—No person shall serve as 

9 Director while serving in any other position in the 

10 Federal Government or while employed in a full-time 

11 position outside of the Federal Government. 

12 (b) RESPONSIBILITIES.—The Director shall— 

13 (1) assist the President— 

14 (A) to establish policies, goals, objectives, 

15 and priorities with respect to mental health, 

16 particularly serious mental illness and serious 

17 emotional disturbances; 

18 (B) to maximize the access of individuals 

19 with mental illness to community-based serv20 ices; 

21 (C) to strengthen the impact of such serv22 ices; and 

23 (D) to meet the comprehensive needs of in24 dividuals with mental illness; 


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1 (2) work with Federal departments and agen2 cies providing mental health services to strengthen 

3 the coordination of mental health services in order to 

4 maximize the access of individuals with a mental ill5 ness, particularly individuals with a serious mental 

6 illness and children and adolescents with a serious 

7 emotional disturbance, to community-based services, 

8 strengthen the impact of services, and meet the com9 prehensive needs of individuals with a mental illness; 

10 (3) coordinate and oversee the development, co11 ordination, implementation, and evaluation of the 

12 National Strategy for Mental Health; 

13 (4) promulgate the National Strategy for Men14 tal Health, ensuring its wide availability to govern15 ment officials and the public; 

16 (5) make such recommendations to the Presi17 dent as the Director determines are appropriate with 

18 respect to the organization, management, and budg19 ets of Federal departments and agencies providing 

20 mental health services, including changes in the allo21 cation of personnel to and within those departments 

22 and agencies to implement the policies, goals, objec23 tives, and priorities established under paragraph (1) 

24 and the National Strategy for Mental Health; 


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1 (6) consult, coordinate with, facilitate joint ef2 forts among, and support State, local, and tribal 

3 governments, nongovernmental entities, and individ4 uals with a mental illness, particularly individuals 

5 with a serious mental illness and children and ado6 lescents with a serious emotional disturbance, with 

7 respect to improving mental health services; 

8 (7) appear before duly constituted committees 

9 and subcommittees of the House of Representatives 

10 and of the Senate to represent the policies of the 

11 President related to mental health and serve as the 

12 spokesperson of the President, if the President de13 termines it appropriate, on issues related to mental 

14 health, and the National Strategy for Mental 

15 Health; 

16 (8) submit an annual report to Congress detail17 ing how the Director has consulted and coordinated 

18 with the National Mental Health Council described 

19 in section 104(d), the National Mental Health Advi20 sory Board described in section 105, State, local, 

21 and tribal governments, nongovernmental entities, 

22 and individuals with a mental illness, particularly in23 dividuals with a serious mental illness and children 

24 and adolescents with a serious emotional disturb25 ance; and 


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1 (9) ensure the Office meets each of its respon2 sibilities under this title. 

3 (c) BUDGET REVIEW AND RECOMMENDATIONS.— 

4 (1) REVIEW OF BUDGET REQUESTS.—Each de5 partment or agency of the Federal Government pro6 viding mental health services and benefits shall 

7 transmit each year to the Director a copy of the pro8 posed budget request of that department or agency 

9 with respect to mental health services and benefits 

10 at a time not later than that department or agency’s 

11 submitting of such budget request to the Office of 

12 Management and Budget for preparation of the 

13 budget of the President submitted to Congress 

14 under section 1105(a) of title 31, United States 

15 Code. The proposed budget request shall be trans16 mitted to the Director in such form as the Director, 

17 in consultation with the Office of Management and 

18 Budget, determines appropriate. 

19 (2) RECOMMENDATIONS WITH RESPECT TO

20 BUDGET REQUESTS.—After the receipt of proposed 

21 budget requests pursuant to paragraph (1), the Di22 rector shall provide budget recommendations with 

23 respect to Federal mental health services and bene24 fits to the Director of the Office of Management and 

25 Budget and to the President at a time that allows 


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1 such recommendations to be incorporated, as appro2 priate, into the budget of the President submitted to 

3 Congress under section 1105(a) of title 31, United 

4 States Code. The recommendations shall address 

5 funding priorities developed in the National Strategy 

6 for Mental Health and shall address future fiscal 

7 projections as determined by the Director. 

8 (d) POWERS OF THE DIRECTOR.—In carrying out 

9 this title, the Director may— 

10 (1) select, appoint, employ, and fix the com11 pensation of such officers and employees of the Of12 fice as may be necessary to carry out the functions 

13 of the Office under this title; 

14 (2) request the head of a department or agency 

15 of the Federal Government to place department or 

16 agency personnel who are engaged in activities with 

17 respect to mental health, on temporary detail to an18 other department or agency in order to implement 

19 the National Strategy for Mental Health, and the 

20 head of such department or agency shall comply 

21 with such request; 

22 (3) use for administrative purposes, on a reim23 bursable basis, the available services, equipment, 

24 personnel, and facilities of Federal, State, local, and 

25 tribal departments and agencies; 


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1 (4) procure the services of experts and consult2 ants in accordance with section 3109 of title 5, 

3 United States Code, relating to appointments in the 

4 Federal Service, at rates of compensation for indi5 viduals not to exceed the daily equivalent of the rate 

6 of pay payable under level IV of the Executive 

7 Schedule under section 5311 of title 5, United 

8 States Code; 

9 (5) use the mails in the same manner as any 

10 other department or agency of the executive branch; 

11 and 

12 (6) monitor implementation of the National 

13 Strategy for Mental Health, including— 

14 (A) conducting program and performance 

15 audits and evaluations; and 

16 (B) requesting assistance from the Inspec17 tor General of the relevant department or agen18 cy in such audits and evaluations. 

19 SEC. 103. NATIONAL STRATEGY FOR MENTAL HEALTH. 

20 (a) IN GENERAL.—Not later than February 1 of each 

21 year, the Director shall submit to the President and Con22 gress and make available to the public a National Strategy 

23 for Mental Health (in this title referred to as the ‘‘Na24 tional Strategy for Mental Health’’ or the ‘‘Strategy’’) set25 ting forth a comprehensive plan to maximize the access 


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1 of individuals with mental illness to community-based 

2 services, to strengthen the impact of such services, and 

3 to meet the comprehensive needs of individuals with men4 tal illness. 

5 (b) PROCESS.—In preparing the Strategy, the Direc6 tor shall actively consult and work in coordination with 

7 the following: 

8 (1) The heads of all Federal departments and 

9 agencies that provide mental health services. 

10 (2) The National Mental Health Council. 

11 (3) The National Mental Health Advisory 

12 Board. 

13 (4) Existing Federal interagency efforts related 

14 to mental health services, such as the Military and 

15 Veterans Mental Health Interagency Task Force. 

16 (5) State, local, and tribal governments. 

17 (6) Nongovernmental entities. 

18 (7) Individuals with mental illness, particularly 

19 individuals with a serious mental illness and children 

20 and adolescents with a serious emotional disturb21 ance. 

22 (c) CONTENTS.—The Director shall ensure the Strat23 egy meets the following requirements: 

24 (1) GOALS AND PERFORMANCE MEASURES.— 

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1 based goals and quantifiable performance measures 

2 that shall serve as targets for the year with respect 

3 to which the Strategy applies for— 

4 (A) improving the outcomes of and accessi5 bility to evidence-based mental programs and 

6 services; 

7 (B) promoting community integration of 

8 individuals with mental illness; 

9 (C) increasing access to prevention and 

10 early intervention services related to mental 

11 health; 

12 (D) promoting mental health awareness 

13 and reducing stigma; and 

14 (E) advancing mental health research. 

15 (2) ACCOUNTABILITY FOR PAST PERFORMANCE

16 MEASURES.—The Strategy shall contain a report on 

17 Federal effectiveness with respect to meeting those 

18 performance measures set by the Strategy for the 

19 preceding year, including an evaluation of whether 

20 or not such performance measures were met and the 

21 reasons therefore, including— 

22 (A) the extent of coordination between 

23 Federal departments and agencies providing 

24 mental health services; 


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1 (B) the extent to which the objectives and 

2 budgets of Federal departments and agencies 

3 providing mental health services were consistent 

4 with the recommendations of the Strategy for 

5 the preceding year; and 

6 (C) the efficiency and adequacy of Federal 

7 programs and policies with respect to mental 

8 health services. 

9 (3) REPORTING ON AND IDENTIFYING GAPS IN

10 MENTAL HEALTH SERVICES.—The Strategy shall 

11 contain a report on— 

12 (A) the mental health diagnoses, 

13 disaggregated by age, race, gender, geographic 

14 distribution, population density, socioeconomic 

15 status, and other target populations determined 

16 necessary for inclusion by the Director; 

17 (B) the quality and quantity of mental 

18 health services, including community-based 

19 services, for individuals with mental illness, 

20 disaggregated by age, race, gender, geographic 

21 distribution, population density, socioeconomic 

22 status, and other target populations determined 

23 necessary for inclusion by the Director; and 

24 (C) the size and allocation of Federal re25 sources devoted to supporting individuals with 


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1 mental illness, particularly serious mental ill2 ness, and children and adolescents with a seri3 ous emotional disturbance, disaggregated by 

4 age, race, gender, geographic distribution, pop5 ulation density, socioeconomic status, and other 

6 target populations determined necessary for in7 clusion by the Director. 

8 (4) COORDINATION EFFORTS.—The Strategy 

9 shall contain a report on Federal efforts to consult, 

10 coordinate with, facilitate joint efforts among, and 

11 support State, local, and tribal governments, non12 governmental entities, and individuals with mental 

13 illness, particularly serious mental illness, and chil14 dren and adolescents with a serious emotional dis15 turbance, including an evaluation of the effectiveness 

16 of those efforts. 

17 (5) GUIDANCE.—The Strategy shall contain re18 search-based guidance for assessing and improving 

19 the quality of mental health services that is respon20 sive to gaps identified in community-based and other 

21 mental health services, particularly for individuals 

22 with a serious mental illness and children and ado23 lescents with a serious emotional disturbance. 

24 (6) MENTAL HEALTH ADVOCATES AND PER25 SPECTIVES.—The Strategy shall contain the views 


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1 and perspectives of individuals with mental illness, 

2 particularly individuals with serious mental illness 

3 and children and adolescents with a serious emo4 tional disturbance, with respect to mental health 

5 services as prepared by the National Mental Health 

6 Advisory Board. 

7 (7) STRATEGIC PLAN.—The Strategy shall con8 tain a plan to achieve the goals and performance 

9 measures set for the year with respect to which the 

10 Strategy applies, including the following: 

11 (A) Program and budget priorities nec12 essary to achieve the performance measures. 

13 (B) Recommendations for improved Fed14 eral interagency coordination, such as shared 

15 grant application processes, grantee reporting 

16 requirements, training and technical assistance 

17 efforts, definitions, recipient eligibility require18 ments, research, evaluation efforts, and data 

19 collection, and recommendations for legislative 

20 changes necessary to achieve such interagency 

21 coordination and to facilitate the delivery of a 

22 comprehensive array of mental health services. 

23 (C) Recommendations for improved coordi24 nation between the Federal Government and 

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1 mental entities, and individuals with mental ill2 ness, particularly individuals with serious men3 tal illness and children and adolescents with a 

4 serious emotional disturbance. 

5 (D) A strategic research, innovation, and 

6 demonstration agenda to guide the use of Fed7 eral research spending with respect to mental 

8 illness, particularly serious mental illness. 

9 (E) Recommendations to promote commu10 nity integration of individuals with mental ill11 ness, consistent with the Americans with Dis12 abilities Act of 1990, section 504 of the Reha13 bilitation Act of 1973, and the Supreme Court’s 

14 decision in Olmstead v. L.C. 

15 (F) Recommendations to enhance preven16 tion and early intervention services for children 

17 and adolescents with mental illness. 

18 (G) Recommendations concerning ways to 

19 ensure appropriate access to intensive commu20 nity-based services for Medicaid beneficiaries. 

21 (8) ADDITIONAL REPORTS.—The Strategy shall 

22 contain additional reports the Director determines 

23 necessary, such as reports on the unmet needs of in24 dividuals with mental illness, international compari25 sons of mental health services and outcomes, or the 


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1 status of implementation and enforcement of mental 

2 health parity. 

3 SEC. 104. COORDINATION WITH FEDERAL DEPARTMENTS 

4 AND AGENCIES. 

5 (a) FEDERAL DEPARTMENT AND AGENCY COOPERA6 TION.—Each department or agency of the Federal Gov7 ernment providing mental health services shall— 

8 (1) cooperate with the efforts of the Director 

9 under this title; 

10 (2) provide such assistance, statistics, studies, 

11 reports, information, and advice as the Director may 

12 request, to the extent permitted by law; 

13 (3) adjust department or agency staff job de14 scriptions and performance measures to support col15 laboration and implementation of the Strategy; and 

16 (4) assign department or agency liaisons to the 

17 Office to oversee and implement interagency coordi18 nation. 

19 (b) INTERAGENCY ALIGNMENT.—The Director, in 

20 collaboration with the heads of Federal departments and 

21 agencies providing mental health services, shall strengthen 

22 the coordination of Federal mental health services in order 

23 to maximize the access of individuals with mental illness, 

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1 pact of mental health services, and meet the comprehen2 sive needs of individuals with mental illness, particularly 

3 individuals with serious mental illness and children and 

4 adolescents with a serious emotional disturbance, by, 

5 where appropriate— 

6 (1) facilitating the development of shared grant 

7 application processes; 

8 (2) offering joint training and technical assist9 ance efforts; 

10 (3) improving opportunities for individuals with 

11 mental illness to maintain services as they transition 

12 from systems of care; 

13 (4) aligning— 

14 (A) grantee reporting requirements; 

15 (B) definitions; 

16 (C) eligibility requirements; 

17 (D) research; 

18 (E) evaluation efforts; and 

19 (F) data collection; 

20 (5) making recommendations with respect to 

21 the legislative changes necessary to achieve the 

22 interagency alignment and coordination necessary to 

23 facilitate the delivery of a comprehensive array of 

24 mental health services; and 


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1 (6) taking other steps necessary to improve col2 laboration between Federal departments and agen3 cies providing mental health services. 

4 (c) JOINT FUNDING AND COORDINATION.— 

5 (1) IN GENERAL.—The Director, in consulta6 tion with the heads of Federal departments and 

7 agencies, may oversee the development and adminis8 tration of initiatives involving multiple Federal de9 partments and agencies, including initiatives that in10 volve the integration of funding from different Fed11 eral departments and agencies to the extent per12 mitted by law. 

13 (2) ADMINISTRATION OF FUNDS.—With respect 

14 to an initiative that involves the integration of fund15 ing from different Federal departments and agen16 cies, the Federal department or agency principally 

17 involved in such an initiative, as determined by the 

18 Director, may be designated by the Director to act 

19 for all involved departments or agencies in admin20 istering funds for the initiative to the extent per21 mitted by law. 

22 (3) NONGOVERNMENTAL ENTITIES.—Initiatives 

23 developed under this subsection may involve non24 governmental entities to the extent permitted by law. 

25 (d) NATIONAL MENTAL HEALTH COUNCIL.— 


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1 (1) ESTABLISHMENT.—There is established 

2 within the Office the National Mental Health Coun3 cil (hereinafter referred to in this title as the ‘‘Coun4 cil’’). 

5 (2) MEMBERS AND TERMS.—The members of 

6 the Council shall include— 

7 (A) the President; 

8 (B) the Director; 

9 (C) the Secretary of Health and Human 

10 Services; 

11 (D) the Director of the National Institute 

12 of Mental Health; 

13 (E) the Attorney General of the United 

14 States; 

15 (F) the Secretary of Veterans Affairs; 

16 (G) the Assistant Secretary–Indian Affairs 

17 of the Department of the Interior; 

18 (H) the Director of the Centers for Dis19 ease Control and Prevention; 

20 (I) the Director of the National Institutes 

21 of Health; 

22 (J) the directors of such national research 

23 institutes of the National Institutes of Health 

24 as the Director determines appropriate; 


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1 (K) representatives, appointed by the Di2 rector, of Federal agencies that are outside of 

3 the Department of Health and Human Services 

4 and serve individuals with mental illness, such 

5 as the Department of Education; 

6 (L) the Administrator of Substance Abuse 

7 and Mental Health Services Administration; 

8 (M) the Secretary of Defense; and 

9 (N) other Federal officials as directed by 

10 the President. 

11 (3) CHAIRPERSON.—The Chairperson of the 

12 Council shall be the President. 

13 (4) DESIGNEES.—Members of the Council may 

14 select a designee to perform duties under this sub15 section, but it is the sense of Congress that such 

16 members should refrain from doing so whenever pos17 sible. 

18 (5) MEETINGS.— 

19 (A) IN GENERAL.—The full membership of 

20 the Council shall meet at the call of the Chair21 person, but at least once each year. The Chair22 person may call additional meetings composed 

23 of less than the full membership of the Council 

24 as needed. 


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1 (B) FIRST MEETING.—The first meeting of 

2 the Council shall be not more than four months 

3 after the date of the enactment of this title. 

4 (C) INCLUSION OF THE NATIONAL MENTAL

5 HEALTH ADVISORY BOARD.—At least two meet6 ings of the Council each year shall be opened to 

7 the participation of members of the National 

8 Mental Health Advisory Board. 

9 (6) RESPONSIBILITIES.—The Council shall— 

10 (A) assist the Director to coordinate the 

11 mental health services provided by Federal de12 partments and agencies and to coordinate Fed13 eral interagency mental health services; 

14 (B) assist the Director in the development, 

15 coordination, implementation, evaluation, and 

16 promulgation of the Strategy; 

17 (C) assist the Director in soliciting and 

18 documenting ongoing input and recommenda19 tions with respect to mental health services and 

20 mental health outcomes from State, local, and 

21 tribal governments, nongovernmental entities, 

22 and individuals with mental illness, particularly 

23 individuals with serious mental illness and chil24 dren and adolescents with a serious emotional 

25 disturbance; and 


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1 (D) ensure that members of the Council 

2 oversee the implementation of those sections of 

3 the Strategy for which each such member’s de4 partment or agency is responsible, as deter5 mined by the Director, and to report to the Di6 rector on such implementation and the results 

7 thereof. 

8 SEC. 105. NATIONAL MENTAL HEALTH ADVISORY BOARD. 

9 (a) ESTABLISHMENT.—There is established within 

10 the Office the National Mental Health Advisory Board 

11 (hereinafter referred to in this title as the ‘‘Board’’). 

12 (b) MEMBERS AND TERMS.— 

13 (1) IN GENERAL.—Except as provided in para14 graph (3), each member shall serve a two-year term. 

15 No member shall serve more than three terms. The 

16 Board shall be composed of non-Federal public 

17 members to be appointed by the Director, of 

18 which— 

(A) at least eight such members, or 1 19 ⁄3 of 

20 total membership, whichever is greater, shall be 

21 individuals with a diagnosis of serious mental 

22 illness; 

(B) at least six such members, or 1 23 ⁄4 of 

24 total membership, whichever is greater, shall be 

25 a parent or legal guardian of an individual with 


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1 a serious mental illness or a child or adolescent 

2 with a serious emotional disturbance; 

3 (C) at least one such member shall be a 

4 representative of a leading research organiza5 tion for individuals with serious mental illness; 

6 (D) at least one such member shall be a 

7 representative of a leading advocacy organiza8 tion for individuals with serious mental illness; 

9 (E) at least one such member shall be a 

10 representative of a leading community service 

11 organization for individuals with serious mental 

12 illness; 

13 (F) at least one member shall have served 

14 in a senior position in a State mental health 

15 system; 

16 (G) at least one member shall have served 

17 in a senior position in a local mental health sys18 tem; 

19 (H) at least one member shall be a psy20 chiatrist; 

21 (I) at least one member shall be a clinical 

22 psychologist; 

23 (J) at least one member shall be a law en24 forcement officer; 


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1 (K) at least one such member shall be a 

2 representative of a leading veterans service or3 ganization; and 

4 (L) at least one such member shall be a 

5 child or adolescent psychiatrist. 

6 (2) SELECTION PROCESS FOR THE INITIAL

7 MEMBERSHIP OF THE BOARD.—The Director shall 

8 design an application and selection process to fill the 

9 initial membership of the Board. Political affiliation 

10 or views may not be taken into account in such ap11 plication and selection process and relatives of elect12 ed officials shall not be eligible for membership. 

13 (3) SELECTION PROCESS FOR MEMBERSHIP OF

14 THE BOARD FOLLOWING THE INITIAL MEMBER15 SHIP.—The initial membership of the Board shall 

16 design an application and selection process to fill the 

17 membership of the Board for those terms following 

18 the term of the initial membership. Such application 

19 and selection process shall ensure that Board mem20 bers select the membership that will follow that 

21 Board membership’s term and, notwithstanding the 

22 two-year term requirement in paragraph (1), such 

23 application process shall ensure that not more than 

24 half of the terms of Board members expire in a 

25 given year. 


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1 (4) CHAIRPERSON.—The initial membership of 

2 the Board shall elect two members as co-chairs of 

3 the Board. Co-chairs shall serve a term of one year 

4 and the Board shall elect new co-chairs as vacancies 

5 arise. 

6 (c) MEETINGS.—The Board shall meet in person not 

7 fewer than four times each year. The Director shall re8 quest senior Federal Government officials to attend each 

9 of the four meetings, including requesting that the Council 

10 attend one of the four meetings. The co-chairs of the 

11 Board may call additional meetings online and by tele12 phone as determined necessary by the co-chairs. 

13 (d) DUTIES.—The Board shall— 

14 (1) advise the President, the heads of Federal 

15 departments and agencies providing mental health 

16 services, and other senior Federal Government offi17 cials on proposed and pending legislation, budget ex18 penditures, and other policy matters with respect to 

19 mental illness, particularly serious mental illness and 

20 children and adolescents with a serious emotional 

21 disturbance; 

22 (2) work in partnership with local organizations 

23 to solicit the views and perspectives of individuals 

24 with mental illness, particularly individuals with se25 rious mental illness, and parents or legal guardians 


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1 of individuals with mental illness, with respect to 

2 mental health services; 

3 (3) prepare a section of the Strategy outlining 

4 the views and perspectives of individuals with mental 

5 illness, particularly individuals with serious mental 

6 illness and children and adolescents with a serious 

7 emotional disturbance, with respect to mental health 

8 services; and 

9 (4) provide the Director evaluations of the staff 

10 support and training and technical assistance the 

11 Board has received. 

12 (e) PROCEDURES.—The membership of the Board 

13 shall, in consultation with the Director, determine the pro14 cedures of the Board. 

15 TITLE II—STRENGTHENING AND 

16 INVESTING IN SAMHSA PRO17 GRAMS 

18 SEC. 201. COMMUNITY MENTAL HEALTH SERVICES BLOCK 

19 GRANT REAUTHORIZATION. 

20 Section 1920(a) of the Public Health Service Act (42 

21 U.S.C. 300x–9(a)) is amended by striking ‘‘$450,000,000 

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

23 for each of the fiscal years 2002 and 2003’’ and inserting 

24 ‘‘$483,744,000 for fiscal year 2015 and such sums as may 

25 be necessary for each of fiscal years 2016 through 2019’’. 


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1 SEC. 202. REPORTING REQUIREMENTS FOR BLOCK GRANTS 

2 REGARDING MENTAL HEALTH AND SUB3 STANCE USE DISORDERS. 

4 Section 1942 of the Public Health Service Act (42 

5 U.S.C. 300x–52) is amended to read as follows: 

6 ‘‘SEC. 1942. REQUIREMENT OF REPORTS AND AUDITS BY 

7 STATES. 

8 ‘‘(a) ANNUAL REPORT.—A funding agreement for a 

9 grant under section 1911 is that— 

10 ‘‘(1) the State involved will prepare and submit 

11 to the Secretary an annual report on the activities 

12 funded through the grant; and 

13 ‘‘(2) each such report shall be prepared by, or 

14 in consultation with, the State agency responsible 

15 for community mental health programs and activi16 ties. 

17 ‘‘(b) STANDARDIZED FORM; CONTENTS.—In order to 

18 properly evaluate and to compare the performance of dif19 ferent States assisted under section 1911, reports under 

20 this section shall be in such standardized form and contain 

21 such information as the Secretary determines (after con22 sultation with the States) to be necessary— 

23 ‘‘(1) to secure an accurate description of the ac24 tivities funded through the grant under section 

25 1911; 


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1 ‘‘(2) to determine the extent to which funds 

2 were expended consistent with the State’s applica3 tion transmitted under section 1917(a); and 

4 ‘‘(3) to describe the extent to which the State 

5 has met the goals and objectives it set forth in its 

6 State plan under section 1912(b). 

7 ‘‘(c) MINIMUM CONTENTS.—Each report under this 

8 section shall, at a minimum, include the following informa9 tion: 

10 ‘‘(1)(A) The number of individuals served by 

11 the State under subpart I (by class of individuals). 

12 ‘‘(B) The proportion of each class of such indi13 viduals which has health coverage. 

14 ‘‘(C) The types of services (as defined by the 

15 Secretary) provided under subpart I to individuals 

16 within each such class. 

17 ‘‘(D) The amounts spent under subpart I on 

18 each type of service (by class of individuals served). 

19 ‘‘(2) Information on the status of mental health 

20 in the State, including information (by county and 

21 by racial and ethnic group) on each of the following: 

22 ‘‘(A) The proportion of adolescents with 

23 serious emotional disturbances. 

24 ‘‘(B) The proportion of adults with serious 

25 mental illness (including major depression). 


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1 ‘‘(C) The proportion of individuals with co2 occurring mental health and substance use dis3 orders. 

4 ‘‘(D) The proportion of children and ado5 lescents with mental health disorders who seek 

6 and receive treatment. 

7 ‘‘(E) The proportion of adults with mental 

8 health disorders who seek and receive treat9 ment. 

10 ‘‘(F) The proportion of individuals with co11 occurring mental health and substance use dis12 orders who seek and receive treatment. 

13 ‘‘(G) The proportion of homeless adults 

14 with mental health disorders who receive treat15 ment. 

16 ‘‘(H) The number of primary care facilities 

17 that provide mental health screening and treat18 ment services onsite or by paid referral. 

19 ‘‘(I) The number of primary care physician 

20 office visits that include mental health screen21 ing services. 

22 ‘‘(J) The number of juvenile residential fa23 cilities that screen admissions for mental health 

24 disorders. 


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1 ‘‘(K) The number of deaths attributable to 

2 suicide. 

3 ‘‘(3) Information on the number and type of 

4 health care practitioners licensed in the State and 

5 providing mental health-related services. 

6 ‘‘(d) AVAILABILITY OF REPORTS.—The Secretary 

7 shall, upon request, provide a copy of any report under 

8 this section to any interested public agency.’’. 

9 SEC. 203. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR10 IZATION. 

11 (a) SUICIDE PREVENTION TECHNICAL ASSISTANCE

12 CENTER.—Section 520C of the Public Health Service Act 

13 (42 U.S.C. 290bb–34) is amended— 

14 (1) in the section heading, by striking the sec15 tion heading and inserting ‘‘SUICIDE PREVENTION

16 TECHNICAL ASSISTANCE CENTER.’’; 

17 (2) in subsection (a), by striking ‘‘and in con18 sultation with’’ and all that follows through the pe19 riod at the end of paragraph (2) and inserting ‘‘shall 

20 establish a research, training, and technical assist21 ance resource center to provide appropriate informa22 tion, training, and technical assistance to States, po23 litical subdivisions of States, federally recognized In24 dian tribes, tribal organizations, institutions of high25 er education, public organizations, or private nonVerDate Mar 15 2010 23:55 May 13, 2014 Jkt 039200 PO 00000 Frm 00034 Fmt 6652 Sfmt 6201 E:\BILLS\H4574.IH H4574

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1 profit organizations regarding the prevention of sui2 cide among all ages, particularly among groups that 

3 are at high risk for suicide.’’; 

4 (3) by striking subsections (b) and (c); 

5 (4) by redesignating subsection (d) as sub6 section (b); 

7 (5) in subsection (b), as so redesignated— 

8 (A) by striking the subsection heading and 

9 inserting ‘‘RESPONSIBILITIES OF THE CEN10 TER.’’; 

11 (B) in the matter preceding paragraph (1), 

12 by striking ‘‘The additional research’’ and all 

13 that follows through ‘‘nonprofit organizations 

14 for’’ and inserting ‘‘The center established 

15 under subsection (a) shall conduct activities for 

16 the purpose of’’; 

17 (C) by striking ‘‘youth suicide’’ each place 

18 such term appears and inserting ‘‘suicide’’; 

19 (D) in paragraph (1)— 

20 (i) by striking ‘‘the development or 

21 continuation of’’ and inserting ‘‘developing 

22 and continuing’’; and 

23 (ii) by inserting ‘‘for all ages, particu24 larly among groups that are at high risk 


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1 for suicide’’ before the semicolon at the 

2 end; 

3 (E) in paragraph (2), by inserting ‘‘for all 

4 ages, particularly among groups that are at 

5 high risk for suicide’’ before the semicolon at 

6 the end; 

7 (F) in paragraph (3), by inserting ‘‘and 

8 tribal’’ after ‘‘statewide’’; 

9 (G) in paragraph (5), by inserting ‘‘and 

10 prevention’’ after ‘‘intervention’’; 

11 (H) in paragraph (8), by striking ‘‘in 

12 youth’’; 

13 (I) in paragraph (9), by striking ‘‘and be14 havioral health’’ and inserting ‘‘health and sub15 stance use disorder’’; and 

16 (J) in paragraph (10), by inserting ‘‘con17 ducting’’ before ‘‘other’’; and 

18 (6) by striking subsection (e) and inserting the 

19 following: 

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

21 purpose of carrying out this section, there are authorized 

22 to be appropriated $4,948,000 for each of fiscal years 

23 2015 through 2019.’’. 


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1 (b) YOUTH SUICIDE EARLY INTERVENTION AND

2 PREVENTION STRATEGIES.—Section 520E of the Public 

3 Health Service Act (42 U.S.C. 290bb–36) is amended— 

4 (1) in paragraph (1) of subsection (a) and in 

5 subsection (c), by striking ‘‘substance abuse’’ each 

6 place such term appears and inserting ‘‘substance 

7 use disorder’’; 

8 (2) in subsection (b)(2)— 

9 (A) by striking ‘‘each State is awarded 

10 only 1 grant or cooperative agreement under 

11 this section’’ and inserting ‘‘a State does not 

12 receive more than 1 grant or cooperative agree13 ment under this section at any 1 time’’; and 

14 (B) by striking ‘‘been awarded’’ and insert15 ing ‘‘received’’; and 

16 (3) by striking subsection (m) and inserting the 

17 following: 

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

19 the purpose of carrying out this section, there are author20 ized to be appropriated $29,682,000 for each of fiscal 

21 years 2015 through 2019.’’. 

22 (c) MENTAL HEALTH AND SUBSTANCE USE DIS23 ORDER SERVICES.—Section 520E–2 of the Public Health 

24 Service Act (42 U.S.C. 290bb–36b) is amended— 


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1 (1) in the section heading, by striking ‘‘AND

2 BEHAVIORAL HEALTH’’ and inserting ‘‘HEALTH

3 AND SUBSTANCE USE DISORDER SERVICES’’; 

4 (2) in subsection (a)— 

5 (A) by striking ‘‘Services,’’ and inserting 

6 ‘‘Services and’’; 

7 (B) by striking ‘‘and behavioral health 

8 problems’’ and inserting ‘‘health or substance 

9 use disorders’’; and 

10 (C) by striking ‘‘substance abuse’’ and in11 serting ‘‘substance use disorders’’; 

12 (3) in subsection (b)— 

13 (A) in the matter preceding paragraph (1), 

14 by striking ‘‘for—’’ and inserting ‘‘for one or 

15 more of the following:’’; and 

16 (B) by striking paragraphs (1) through (6) 

17 and inserting the following: 

18 ‘‘(1) Educating students, families, faculty, and 

19 staff to increase awareness of mental health and 

20 substance use disorders. 

21 ‘‘(2) The operation of hotlines. 

22 ‘‘(3) Preparing informational material. 

23 ‘‘(4) Providing outreach services to notify stu24 dents about available mental health and substance 

25 use disorder services. 


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1 ‘‘(5) Administering voluntary mental health and 

2 substance use disorder screenings and assessments. 

3 ‘‘(6) Supporting the training of students, fac4 ulty, and staff to respond effectively to students with 

5 mental health and substance use disorders. 

6 ‘‘(7) Creating a network infrastructure to link 

7 colleges and universities with health care providers 

8 who treat mental health and substance use dis9 orders.’’; 

10 (4) in subsection (c)(5), by striking ‘‘substance 

11 abuse’’ and inserting ‘‘substance use disorder’’; 

12 (5) in subsection (d)— 

13 (A) in the matter preceding paragraph (1), 

14 by striking ‘‘An institution of higher education 

15 desiring a grant under this section’’ and insert16 ing ‘‘To be eligible to receive a grant under this 

17 section, an institution of higher education’’; 

18 (B) in paragraph (1)— 

19 (i) by striking ‘‘and behavioral 

20 health’’ and inserting ‘‘health and sub21 stance use disorder’’; and 

22 (ii) by inserting ‘‘, including veterans 

23 whenever possible and appropriate,’’ after 

24 ‘‘students’’; and 


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1 (C) in paragraph (2), by inserting ‘‘, which 

2 may include, as appropriate and in accordance 

3 with subsection (b)(7), a plan to seek input 

4 from relevant stakeholders in the community, 

5 including appropriate public and private enti6 ties, in order to carry out the program under 

7 the grant’’ before the period at the end; 

8 (6) in subsection (e)(1), by striking ‘‘and behav9 ioral health problems’’ and inserting ‘‘health and 

10 substance use disorders’’; 

11 (7) in subsection (f)(2)— 

12 (A) by striking ‘‘and behavioral health’’ 

13 and inserting ‘‘health and substance use dis14 order’’; and 

15 (B) by striking ‘‘suicide and substance 

16 abuse’’ and inserting ‘‘suicide and substance 

17 use disorders’’; and 

18 (8) in subsection (h), by striking ‘‘$5,000,000 

19 for fiscal year 2005’’ and all that follows through 

20 the period at the end and inserting ‘‘$4,858,000 for 

21 each of fiscal years 2015 through 2019.’’. 


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1 SEC. 204. PRIORITY MENTAL HEALTH NEEDS OF REGIONAL 

2 AND NATIONAL SIGNIFICANCE REAUTHOR3 IZATION. 

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

5 (42 U.S.C. 290bb–32(f)(1)) is amended by striking 

6 ‘‘$300,000,000 for fiscal year 2001, and such sums as 

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

8 2003’’ and inserting ‘‘$216,632,000 for fiscal year 2015 

9 and such sums as may be necessary for each of fiscal years 

10 2016 through 2019’’. 

11 SEC. 205. GRANTS FOR JAIL DIVERSION PROGRAMS REAU12 THORIZATION. 

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

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

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

16 for fiscal years 2002 through 2003’’ and inserting 

17 ‘‘$4,280,000 for fiscal year 2015 and such sums as may 

18 be necessary for each of fiscal years 2016 through 2019’’. 

19 SEC. 206. PROJECTS FOR ASSISTANCE IN TRANSITION 

20 FROM HOMELESSNESS. 

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

22 U.S.C. 29cc–35(a)) is amended by striking ‘‘$75,000,000 

23 for each of the fiscal years 2001 through 2003’’ and in24 serting ‘‘$64,800,000 for fiscal year 2015 and such sums 

25 as may be necessary for each of fiscal years 2016 through 

26 2019’’. 


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1 SEC. 207. COMPREHENSIVE COMMUNITY MENTAL HEALTH 

2 SERVICES FOR CHILDREN WITH SERIOUS 

3 EMOTIONAL DISTURBANCES. 

4 Section 565 of the Public Health Service Act (42 

5 U.S.C. 290ff–4) is amended— 

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

7 a grant under section 561(a)’’ and inserting ‘‘(irre8 spective of whether the public entity is in receipt of 

9 a grant under section 561(a))’’; 

10 (2) in subsection (b)(1)(B), by striking ‘‘plan11 ning, development, and operation of systems of care 

12 pursuant to section 562’’ and inserting ‘‘planning, 

13 development, and operation of systems of care de14 scribed in section 562’’; and 

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

16 ‘‘$100,000,000 for fiscal year 2001, and such sums 

17 as may be necessary for each of the fiscal years 

18 2002 and 2003’’ and inserting ‘‘$117,315,000 for 

19 fiscal year 2015 and such sums as may be necessary 

20 for each of fiscal years 2016 through 2019’’. 

21 SEC. 208. CHILDREN’S RECOVERY FROM TRAUMA. 

22 Section 582 of the Public Health Service Act (42 

23 U.S.C. 290hh–1) is amended— 

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

25 programs’’ and all that follows and inserting ‘‘devel26 oping and maintaining programs that provide for— 


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

2 Child Traumatic Stress Initiative (referred to in this 

3 section as the ‘NCTSI’), which includes a coordi4 nating center, that focuses on the mental, behav5 ioral, and biological aspects of psychological trauma 

6 response; and 

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

8 to evidence-based practices for identifying and treat9 ing mental, behavioral, and biological disorders of 

10 children and youth resulting from witnessing or ex11 periencing a traumatic event.’’; 

12 (2) in subsection (b)— 

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

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

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

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

19 and 

20 (C) by striking ‘‘mental health agencies 

21 and programs that have established clinical and 

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

25 and research’’; 


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

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

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

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

8 the early identification and delivery of evidence-based 

9 treatment and services for children and families served by 

10 the NCTSI grantees. 

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

12 shall facilitate the coordination of training initiatives in 

13 evidence-based and trauma-informed treatments, interven14 tions, and practices offered to NCTSI grantees, providers, 

15 and partners. 

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

17 center shall, as appropriate, collaborate with the Secretary 

18 in the dissemination of evidence-based and trauma-in19 formed interventions, treatments, products and other re20 sources to appropriate stakeholders. 

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

22 the peer review process, ensure that NCTSI applications 

23 are reviewed by appropriate experts in the field as part 

24 of a consensus review process. The Secretary shall include 


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1 review criteria related to expertise and experience in child 

2 trauma and evidence-based practices.’’; 

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

4 striking ‘‘with respect to centers of excellence are 

5 distributed equitably among the regions of the coun6 try’’ and inserting ‘‘are distributed equitably among 

7 the regions of the United States’’; 

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

9 striking ‘‘recipient may not exceed 5 years’’ and in10 serting ‘‘recipient shall not be less than 4 years, but 

11 shall not exceed 5 years’’; and 

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

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

14 ‘‘2006’’ and inserting ‘‘$45,714,000 for each of fis15 cal years 2015 through 2019’’. 

16 SEC. 209. PROTECTION AND ADVOCACY FOR INDIVIDUALS 

17 WITH MENTAL ILLNESS REAUTHORIZATION. 

18 Section 117 of the Protection and Advocacy for Indi19 viduals with Mental Illness Act (42 U.S.C. 10827) is 

20 amended by striking ‘‘$19,500,000 for fiscal year 1992, 

21 and such sums as may be necessary for each of the fiscal 

22 years 1993 through 2003’’ and inserting ‘‘$36,238,000 for 

23 fiscal year 2015 and such sums as may be necessary for 

24 each of fiscal years 2016 through 2019’’. 


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1 SEC. 210. MENTAL HEALTH AWARENESS TRAINING GRANTS. 

2 Section 520J of the Public Health Service Act (42 

3 U.S.C. 290bb–41) is amended— 

4 (1) in the section heading, by inserting ‘‘MEN5 TAL HEALTH AWARENESS’’ before ‘‘TRAINING’’; 

6 and 

7 (2) in subsection (b)— 

8 (A) in the subsection heading, by striking 

9 ‘‘ILLNESS’’ and inserting ‘‘HEALTH’’; 

10 (B) in paragraph (1), by inserting ‘‘, and 

11 other categories of individuals listed in para12 graph (2),’’ after ‘‘emergency services per13 sonnel’’; and 

14 (C) by striking paragraph (2) and insert15 ing the following: 

16 ‘‘(2) CATEGORIES OF INDIVIDUALS TO BE

17 TRAINED.—The categories of individuals listed in 

18 this paragraph are the following: 

19 ‘‘(A) Emergency services personnel and 

20 other first responders. 

21 ‘‘(B) Police officers and other law enforce22 ment personnel. 

23 ‘‘(C) Teachers and school administrators. 

24 ‘‘(D) Human resources professionals. 

25 ‘‘(E) Faith community leaders. 


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1 ‘‘(F) Nurses and other primary care per2 sonnel. 

3 ‘‘(G) Students enrolled in an elementary 

4 school, a secondary school, or an institution of 

5 higher education. 

6 ‘‘(H) The parents of students described in 

7 subparagraph (G). 

8 ‘‘(I) Veterans. 

9 ‘‘(J) Other individuals, audiences, or train10 ing populations as determined appropriate by 

11 the Secretary.’’; 

12 (D) in paragraph (5)— 

13 (i) in the matter preceding subpara14 graph (A), by striking ‘‘to’’ and inserting 

15 ‘‘for evidence-based programs for the pur16 pose of’’; and 

17 (ii) by striking subparagraphs (A) 

18 through (C) and inserting the following: 

19 ‘‘(A) recognizing the signs and symptoms 

20 of mental illness; and 

21 ‘‘(B)(i) providing education to personnel 

22 regarding resources available in the community 

23 for individuals with a mental illness and other 

24 relevant resources; or 


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1 ‘‘(ii) the safe de-escalation of crisis situa2 tions involving individuals with a mental ill3 ness.’’; and 

4 (E) in paragraph (7), by striking ‘‘, 

5 $25,000,000’’ and all that follows through the 

6 period at the end and inserting ‘‘$20,000,000 

7 for each of fiscal years 2014 through 2018’’. 

8 SEC. 211. NATIONAL MEDIA CAMPAIGN TO REDUCE THE 

9 STIGMA ASSOCIATED WITH MENTAL ILLNESS. 

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

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

12 adding at the end the following new section: 

13 ‘‘SEC. 520L. NATIONAL MEDIA CAMPAIGN TO REDUCE THE 

14 STIGMA ASSOCIATED WITH MENTAL ILLNESS. 

15 ‘‘(a) SCOPE OF THE CAMPAIGN.—The Secretary, act16 ing through the Administrator of the Substance Abuse 

17 and Mental Health Services Administration, shall provide 

18 for the production, broadcasting, and evaluation of a na19 tional media public service campaign to reduce the stigma 

20 associated with mental illness. Such campaign shall seek 

21 to reach as wide and diverse an audience as possible and 

22 shall particularly target the population between the ages 

23 of 16 and 24 years of age. 

24 ‘‘(b) REPORT.—The Secretary shall provide a report 

25 to the Congress annually detailing— 


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1 ‘‘(1) the production, broadcasting, and evalua2 tion of the campaign under subsection (a); and 

3 ‘‘(2) the effectiveness of the campaign in reduc4 ing the stigma associated with mental illness, as 

5 measured using such methods as public attitude sur6 veys and mental health services utilization statistics. 

7 ‘‘(c) CONSULTATION REQUIREMENT.—In carrying 

8 out this section, the Secretary shall ensure that mental 

9 health professionals and patient advocates are consulted 

10 in carrying out the media campaign under this section. 

11 The progress of this consultative process is to be covered 

12 in the report under subsection (b). 

13 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

14 are authorized to be appropriated to carry out this section, 

15 $10,000,000 for each of the fiscal years 2015 through 

16 2019.’’. 

17 SEC. 212. SAMHSA AND HRSA INTEGRATION OF BEHAV18 IORAL HEALTH SERVICES INTO PRIMARY 

19 CARE SETTINGS. 

20 Title V of the Public Health Service Act is amended 

21 by inserting after section 520K (42 U.S.C. 290bb–42) the 

22 following: 


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1 ‘‘SEC. 520K–1. AWARDS FOR CO-LOCATING BEHAVIORAL 

2 HEALTH SERVICES IN PRIMARY CARE SET3 TINGS. 

4 ‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 

5 through the Administrators of the Substance Abuse and 

6 Mental Health Services Administration and the Health 

7 Resources and Services Administration, shall award 

8 grants, contracts, and cooperative agreements to eligible 

9 entities for the provision of coordinated and integrated be10 havioral health services and primary health care. 

11 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to seek a 

12 grant, contract, or cooperative agreement this section, an 

13 entity shall be a public or nonprofit entity. 

14 ‘‘(c) USE OF FUNDS.—An eligible entity receiving an 

15 award under this section shall use the award for the provi16 sion of coordinated and integrated behavioral health serv17 ices and primary health care through— 

18 ‘‘(1) the co-location of behavioral health services 

19 in primary care settings; 

20 ‘‘(2) the use of care management services to fa21 cilitate coordination between behavioral health and 

22 primary care providers; 

23 ‘‘(3) the use of information technology (such as 

24 telemedicine)— 

25 ‘‘(A) to facilitate coordination between be26 havioral health and primary care providers; or 


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1 ‘‘(B) to expand the availability of behav2 ioral health services; or 

3 ‘‘(4) the provision of training and technical as4 sistance to improve the delivery, effectiveness, and 

5 integration of behavioral health services into primary 

6 care settings. 

7 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 

8 carry out this section— 

9 ‘‘(1) there are authorized to be appropriated 

10 such sums as may be necessary for fiscal years 2015 

11 through 2019; and 

12 ‘‘(2) such sums as necessary are authorized to 

13 be transferred from the Substance Abuse and Men14 tal Health Services Administration to the Health Re15 sources and Services Administration.’’. 

16 SEC. 213. GERIATRIC MENTAL HEALTH DISORDERS. 

17 Section 520A(e) of the Public Health Service Act (42 

18 U.S.C. 290bb–32(e)) is amended by adding at the end the 

19 following: 

20 ‘‘(3) GERIATRIC MENTAL HEALTH DIS21 ORDERS.—The Secretary shall, as appropriate, pro22 vide technical assistance to grantees regarding evi23 dence-based practices for the prevention and treat24 ment of geriatric mental health disorders, as well as 

25 disseminate information about such evidence-based 


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1 practices to States and nongrantees throughout the 

2 United States.’’. 

3 SEC. 214. ASSESSING BARRIERS TO BEHAVIORAL HEALTH 

4 INTEGRATION. 

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

6 date of enactment of this Act, the Comptroller General 

7 of the United States shall submit a report to the Com8 mittee on Health, Education, Labor, and Pensions of the 

9 Senate and the Committee on Energy and Commerce of 

10 the House of Representatives concerning Federal require11 ments that impact access to treatment of mental health 

12 and substance use disorders related to integration with 

13 primary care, administrative and regulatory issues, quality 

14 measurement and accountability, and data sharing. 

15 (b) CONTENTS.—The report submitted under sub16 section (a) shall include the following: 

17 (1) An evaluation of the administrative or regu18 latory burden on behavioral health care providers. 

19 (2) The identification of outcome and quality 

20 measures relevant to integrated health care, evalua21 tion of the data collection burden on behavioral 

22 health care providers, and any alternative methods 

23 for evaluation. 

24 (3) An analysis of the degree to which elec25 tronic data standards, including interoperability and 


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1 meaningful use includes behavioral health measures, 

2 and an analysis of strategies to address barriers to 

3 health information exchange posed by part 2 of title 

4 42, Code of Federal Regulations. 

5 (4) An analysis of the degree to which Federal 

6 rules and regulations for behavioral and physical 

7 health care are aligned, including recommendations 

8 to address any identified barriers. 

9 SEC. 215. ACUTE CARE BED REGISTRY GRANT FOR STATES. 

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

11 Human Services, acting through Administrator of the 

12 Substance Abuse and Mental Health Services Administra13 tion, shall award grants to State mental health agencies 

14 to develop and administer a Web-based acute psychiatric 

15 bed registry to collect, aggregate, and display information 

16 about available acute beds in public and private inpatient 

17 psychiatric facilities and public and private residential cri18 sis stabilization units to facilitate the identification and 

19 designation of facilities for the temporary treatment of in20 dividuals in psychiatric crisis. 

21 (b) REGISTRY REQUIREMENTS.—An acute psy22 chiatric bed registry funded under this section shall— 

23 (1) include descriptive information for every 

24 public and private inpatient psychiatric facility and 

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1 tion unit in the State involved, including contact in2 formation for the facility or unit; 

3 (2) provide real-time information about the 

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

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

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

7 other information that may be necessary to allow for 

8 the proper identification of appropriate facilities for 

9 treatment of individuals in psychiatric crisis; and 

10 (3) allow employees and designees of commu11 nity mental health service providers, employees of in12 patient psychiatric facilities or public and private 

13 residential crisis stabilization units, and health care 

14 providers working in an emergency room of a hos15 pital or clinic or other facility rendering emergency 

16 medical care to perform searches of the registry to 

17 identify available beds that are appropriate for the 

18 treatment of individuals in psychiatric crisis. 

19 (c) AUTHORIZATION OF APPROPRIATIONS.—To carry 

20 out this section, there are authorized to be appropriated 

21 such sums as may be necessary for fiscal years 2015 

22 through 2019. 


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1 SEC. 216. AWARDS FOR CO-LOCATING PRIMARY AND SPE2 CIALTY CARE IN COMMUNITY-BASED MENTAL 

3 HEALTH SETTINGS. 

4 Section 520K(f) of the Public Health Service Act (42 

5 U.S.C. 290bb–42(f)) is amended by striking ‘‘$50,000,000 

6 for fiscal year 2010 and such sums as may be necessary 

7 for each of fiscal years 2011 through 2014’’ and inserting 

8 ‘‘$50,000,000 for fiscal year 2015 and such sums as may 

9 be necessary for each of fiscal years 2016 through 2019’’. 

10 SEC. 217. GRANTS FOR THE BENEFIT OF HOMELESS INDI11 VIDUALS. 

12 Section 506(e) of the Public Health Service Act (42 

13 U.S.C. 290aa–5(e)) is amended by striking ‘‘$50,000,000 

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

15 for each of the fiscal years 2002 and 2003’’ and inserting 

16 ‘‘$llllfor fiscal year 2015 and such sums as may 

17 be necessary for each of fiscal years 2016 through 2019’’. 

18 TITLE III—IMPROVING MED19 ICAID AND MEDICARE MEN20 TAL HEALTH SERVICES 

21 SEC. 301. ACCESS TO MENTAL HEALTH PRESCRIPTION 

22 DRUGS UNDER MEDICARE. 

23 Section 1860D–4(b)(3)(G)(ii)(I) of the Social Secu24 rity Act (42 U.S.C. 1395w–104(b)(3)(G)(ii)(I)) is amend25 ed by adding at the end the following: ‘‘Notwithstanding 

26 the previous sentence, categories and classes of drugs 


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1 specified in subclauses (II) and (IV) of clause (iv) shall 

2 be identified under this subclause.’’. 

3 SEC. 302. MEDICAID COVERAGE OF MENTAL HEALTH SERV4 ICES AND PRIMARY CARE SERVICES FUR5 NISHED ON THE SAME DAY. 

6 (a) IN GENERAL.—Not later than one year after the 

7 date of the enactment of this Act, the Secretary of Health 

8 and Human Services shall issue guidance to clarify that 

9 payment under a State plan is not prohibited for a mental 

10 health service or primary care service furnished to an indi11 vidual at a community mental health center that meets 

12 the criteria specified in section 1913(c) of the Public 

13 Health Service Act (42 U.S.C. 300x–2(c)) or a federally 

14 qualified health center (as defined in section 1861(aa)(3) 

15 of the Social Security Act (42 U.S.C. 1395x(aa)(3))) for 

16 which payment would otherwise be payable under the plan, 

17 with respect to such individual, if such service were not 

18 a same-day qualifying service. 

19 (b) SAME-DAY QUALIFYING SERVICE DEFINED.—In 

20 this section, the term ‘‘same-day qualifying service’’ 

21 means— 

22 (1) a primary care service furnished to an indi23 vidual by a provider at a facility on the same day 

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1 vidual by such provider (or another provider) at the 

2 facility; and 

3 (2) a mental health service furnished to an indi4 vidual by a provider at a facility on the same day 

5 a primary care service is furnished to such individual 

6 by such provider (or another provider) at the facil7 ity. 

8 SEC. 303. ELIMINATION OF 190-DAY LIFETIME LIMIT ON IN9 PATIENT PSYCHIATRIC HOSPITAL SERVICES. 

10 (a) IN GENERAL.—Section 1812 of the Social Secu11 rity Act (42 U.S.C. 1395d) is amended— 

12 (1) in subsection (b)— 

13 (A) in paragraph (1), by adding ‘‘or’’ at 

14 the end; 

15 (B) in paragraph (2), by striking ‘‘; or’’ at 

16 the end and inserting a period; and 

17 (C) by striking paragraph (3); and 

18 (2) in subsection (c), by striking ‘‘or in deter19 mining the 190-day limit under subsection (b)(3)’’. 

20 (b) EFFECTIVE DATE.—The amendments made by 

21 subsection (a) shall apply to items and services furnished 

22 on or after January 1, 2016. 


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1 SEC. 304. EXPANDING THE MEDICAID HOME AND COMMU2 NITY-BASED SERVICES WAIVER TO INCLUDE 

3 YOUTH IN NEED OF SERVICES PROVIDED IN 

4 A PSYCHIATRIC RESIDENTIAL TREATMENT 

5 FACILITY. 

6 (a) IN GENERAL.—Section 1915(c) of the Social Se7 curity Act (42 U.S.C. 1396n(c)) is amended— 

8 (1) in paragraph (1)— 

9 (A) by striking ‘‘a hospital or a nursing fa10 cility or intermediate care facility for the men11 tally retarded’’ and inserting ‘‘a hospital, a 

12 nursing facility, an intermediate care facility for 

13 the intellectually disabled, or a psychiatric resi14 dential treatment facility,’’; and 

15 (B) by striking ‘‘a hospital, nursing facil16 ity, or intermediate care facility for the men17 tally retarded’’ and inserting ‘‘a hospital, nurs18 ing facility, intermediate care facility for the in19 tellectually disabled, or psychiatric residential 

20 treatment facility’’; 

21 (2) in paragraph (2)(B), by striking ‘‘or serv22 ices in an intermediate care facility for the mentally 

23 retarded’’ each place it appears and inserting ‘‘serv24 ices in an intermediate care facility for the intellec25 tually disabled, or services in a psychiatric residen26 tial treatment facility’’; 


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1 (3) in paragraph (2)(C)— 

2 (A) by striking ‘‘or intermediate care facil3 ity for the mentally retarded’’ and inserting 

4 ‘‘intermediate care facility for the intellectually 

5 disabled, or psychiatric residential treatment fa6 cility’’; and 

7 (B) by striking ‘‘or services in an inter8 mediate care facility for the mentally retarded’’ 

9 and inserting ‘‘services in an intermediate care 

10 facility for the intellectually disabled, or services 

11 in a psychiatric residential treatment facility’’; 

12 (4) in paragraph (7)(A), by striking ‘‘or inter13 mediate care facilities for the mentally retarded,’’ 

14 and inserting ‘‘intermediate care facilities for the in15 tellectually disabled, or psychiatric residential treat16 ment facilities,’’; and 

17 (5) by adding at the end the following new 

18 paragraph: 

19 ‘‘(11) For purposes of this subsection, the term ‘psy20 chiatric residential treatment facility’ means a facility 

21 other than a hospital that is certified as meeting the re22 quirements specified in regulations promulgated for such 

23 facilities under section 1905(h)(1) and that provides psy24 chiatric services in an inpatient setting to individuals 


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1 under age 21 for which medical assistance is available 

2 under a State plan under this title.’’. 

3 (b) WAIVER LIMITATION.—Section 1915(c) of such 

4 Act, as amended by subsection (a), is further amended— 

5 (1) in paragraph (2)— 

6 (A) in subparagraph (D), by striking ‘‘; 

7 and’’ and inserting a semicolon; 

8 (B) in subparagraph (E), by striking the 

9 period at the end and inserting a semicolon; 

10 and 

11 (C) by adding at the end the following new 

12 subparagraphs: 

13 ‘‘(F) under the waiver, the total number of 

14 Medicaid inpatient bed days at psychiatric residen15 tial treatment facilities during each fiscal year with16 in the waiver period will not exceed the total number 

17 of Medicaid inpatient bed days at such facilities for 

18 the previous fiscal year as increased by the esti19 mated percentage increase (if any) in the population 

20 of individuals under age 21 residing in the State 

21 over the preceding 12-month period; and 

22 ‘‘(G) the State will provide to the Secretary an23 nually, subject to such requirements as the Sec24 retary determines appropriate, relevant information 

25 and evidence as to the manner in which the State 


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1 will satisfy the requirements described in subpara2 graph (F).’’; and 

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

4 paragraph: 

5 ‘‘(12) For purposes of paragraph (2)(F), an indi6 vidual who is under age 21 and is an inpatient in a bed 

7 in a psychiatric residential treatment facility for a single 

8 day shall be counted as one inpatient bed day.’’. 

9 SEC. 305. APPLICATION OF ROSA’S LAW FOR INDIVIDUALS 

10 WITH INTELLECTUAL DISABILITIES. 

11 (a) REFERENCES IN THE SOCIAL SECURITY ACT.— 

12 (1) IN GENERAL.—With the exception of sec13 tion 1930(b) of the Social Security Act (42 U.S.C. 

14 1396u(b)), as amended by section 305, such Act is 

15 further amended— 

16 (A) by striking, wherever it appears, 

17 ‘‘State mental retardation or developmental dis18 ability authority’’ and inserting ‘‘State intellec19 tual disability or developmental disability au20 thority’’; 

21 (B) by striking, wherever it appears, 

22 ‘‘mental retardation’’ and inserting ‘‘intellectual 

23 disabilities’’; and 


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1 (C) by striking, wherever it appears, ‘‘men2 tally retarded’’ and inserting ‘‘intellectually dis3 abled’’. 

4 (2) CONFORMING AMENDMENT.— 

5 (A) IN GENERAL.—Section 1902(e)(14)(F) 

6 of such Act is amended by striking ‘‘mentally 

7 retarded’’ and inserting ‘‘intellectually dis8 abled’’. 

9 (B) EFFECTIVE DATE.—The amendment 

10 made under subparagraph (A) shall take effect 

11 on January 2, 2015. 

12 (b) REFERENCES.— 

13 (1) IN GENERAL.—For purposes of each provi14 sion amended by this section, issuing or amending 

15 regulations to carry out a provision amended by this 

16 section, or issuing any publication or other official 

17 communication in regards to any provision of the 

18 Social Security Act— 

19 (A) a reference to an intellectual disability 

20 shall mean a condition previously referred to as 

21 mental retardation, or a variation of such term, 

22 and shall have the same meaning with respect 

23 to programs, or qualifications for such pro24 grams, for individuals with such a condition; 


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1 (B) a reference to an individual who is in2 tellectually disabled shall mean an individual 

3 who was previously referred to as an individual 

4 who is mentally retarded, an individual with 

5 mental retardation, or variations of such terms; 

6 (C) a reference to an intermediate care fa7 cility for the intellectually disabled shall mean 

8 a facility that was previously referred to as an 

9 intermediate care facility for the mentally re10 tarded; and 

11 (D) a reference to a State intellectual dis12 ability or developmental disability authority 

13 shall mean an entity that was previously re14 ferred to as a State mental retardation or de15 velopmental disability authority. 

16 (2) REGULATIONS.—For purposes of amending 

17 regulations to carry out this section, a Federal agen18 cy shall ensure that the regulations clearly state— 

19 (A) that an intellectual disability was for20 merly termed mental retardation; 

21 (B) that individuals with intellectual dis22 abilities were formerly termed individuals who 

23 are mentally retarded; 

24 (C) that an intermediate care facility for 

25 the intellectually disabled was formerly termed 


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1 an intermediate care facility for the mentally 

2 retarded; and 

3 (D) that a State intellectual disability or 

4 developmental disability authority was formerly 

5 termed a State mental retardation or develop6 mental disability authority. 

7 (c) RULE OF CONSTRUCTION.—This section shall be 

8 construed to make amendments to provisions of Federal 

9 law to substitute the term ‘‘intellectual disability’’ for 

10 ‘‘mental retardation’’ or any variation of such term with11 out any intent to— 

12 (1) change the coverage, eligibility, rights, re13 sponsibilities, or definitions referred to in the 

14 amended provisions; or 

15 (2) compel States to change terminology in 

16 State laws for individuals covered by a provision 

17 amended by this section. 

18 SEC. 306. COMPLETE APPLICATION OF MENTAL HEALTH 

19 AND SUBSTANCE USE PARITY RULES UNDER 

20 MEDICAID AND CHIP. 

21 Not later than January 1, 2015, the Secretary of 

22 Health and Human Services shall issue a final rule to 

23 carry out the following provisions of law: 

24 (1) Section 1932(b)(8) of the Social Security 

25 Act (42 U.S.C. 1396u–2(b)(8)) (requiring Medicaid 


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1 managed care organizations to comply with the men2 tal health and substance use requirements under 

3 certain provisions of part A of title XXVII of the 

4 Public Health Service Act (42 U.S.C. 300gg et 

5 seq.)). 

6 (2) Section 1937(b)(6) of such Act (42 U.S.C. 

7 1396u–7(b)(6)) (requiring benchmark benefit pack8 ages or benchmark equivalent coverage to comply 

9 with the mental health and substance use parity re10 quirements under section 2705(a) of the Public 

11 Health Service Act (42 U.S.C. 300gg–4)). 

12 (3) Section 2103(c)(6) of such Act (42 U.S.C. 

13 1937cc(c)(6)) (requiring State child health plans to 

14 comply with mental health and substance use parity 

15 requirements under section 2705(a) of the Public 

16 Health Service Act (42 U.S.C. 300gg–4)). 

17 SEC. 307. COVERAGE OF MARRIAGE AND FAMILY THERA18 PIST SERVICES AND MENTAL HEALTH COUN19 SELOR SERVICES UNDER PART B OF THE 

20 MEDICARE PROGRAM. 

21 (a) COVERAGE OF SERVICES.— 

22 (1) IN GENERAL.—Section 1861(s)(2) of the 

23 Social Security Act (42 U.S.C. 1395x(s)(2)) is 

24 amended— 


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1 (A) in subparagraph (EE), by striking 

2 ‘‘and’’ after the semicolon at the end; 

3 (B) in subparagraph (FF), by inserting 

4 ‘‘and’’ after the semicolon at the end; and 

5 (C) by adding at the end the following new 

6 subparagraph: 

7 ‘‘(GG) marriage and family therapist services 

8 (as defined in subsection (iii)(1)) and mental health 

9 counselor services (as defined in subsection 

10 (iii)(3));’’. 

11 (2) DEFINITIONS.—Section 1861 of the Social 

12 Security Act (42 U.S.C. 1395x) is amended by add13 ing at the end the following new subsection: 

14 ‘‘Marriage and Family Therapist Services; Marriage and 

15 Family Therapist; Mental Health Counselor Serv16 ices; Mental Health Counselor 

17 ‘‘(iii)(1) The term ‘marriage and family therapist 

18 services’ means services performed by a marriage and 

19 family therapist (as defined in paragraph (2)) for the diag20 nosis and treatment of mental illnesses, which the mar21 riage and family therapist is legally authorized to perform 

22 under State law (or the State regulatory mechanism pro23 vided by State law) of the State in which such services 

24 are performed, as would otherwise be covered if furnished 

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1 sional service, but only if no facility or other provider 

2 charges or is paid any amounts with respect to the fur3 nishing of such services. 

4 ‘‘(2) The term ‘marriage and family therapist’ means 

5 an individual who— 

6 ‘‘(A) possesses a master’s or doctoral degree 

7 which qualifies for licensure or certification as a 

8 marriage and family therapist pursuant to State 

9 law; 

10 ‘‘(B) after obtaining such degree has performed 

11 at least 2 years of clinical supervised experience in 

12 marriage and family therapy; and 

13 ‘‘(C) is licensed or certified as a marriage and 

14 family therapist in the State in which marriage and 

15 family therapist services are performed. 

16 ‘‘(3) The term ‘mental health counselor services’ 

17 means services performed by a mental health counselor (as 

18 defined in paragraph (4)) for the diagnosis and treatment 

19 of mental illnesses which the mental health counselor is 

20 legally authorized to perform under State law (or the 

21 State regulatory mechanism provided by the State law) of 

22 the State in which such services are performed, as would 

23 otherwise be covered if furnished by a physician or as inci24 dent to a physician’s professional service, but only if no 


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1 facility or other provider charges or is paid any amounts 

2 with respect to the furnishing of such services. 

3 ‘‘(4) The term ‘mental health counselor’ means an 

4 individual who— 

5 ‘‘(A) possesses a master’s or doctoral degree in 

6 mental health counseling or a related field; 

7 ‘‘(B) after obtaining such a degree has per8 formed at least 2 years of supervised mental health 

9 counselor practice; and 

10 ‘‘(C) in the case of an individual performing 

11 services in a State that provides for licensure or cer12 tification of mental health counselors or professional 

13 counselors, is licensed or certified as a mental health 

14 counselor or professional counselor in such State.’’. 

15 (3) PROVISION FOR PAYMENT UNDER PART

16 B.—Section 1832(a)(2)(B) of the Social Security 

17 Act (42 U.S.C. 1395k(a)(2)(B)) is amended by add18 ing at the end the following new clause: 

19 ‘‘(v) marriage and family therapist 

20 services (as defined in section 1861(iii)(1)) 

21 and mental health counselor services (as 

22 defined in section 1861(iii)(3));’’. 

23 (4) AMOUNT OF PAYMENT.— 


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1 (A) IN GENERAL.—Section 1833(a)(1) of 

2 the Social Security Act (42 U.S.C. 1395l(a)(1)) 

3 is amended— 

4 (i) by striking ‘‘and (Z)’’ and insert5 ing ‘‘(Z)’’; and 

6 (ii) by inserting before the semicolon 

7 at the end the following: ‘‘, and (AA) with 

8 respect to marriage and family therapist 

9 services and mental health counselor serv10 ices under section 1861(s)(2)(GG), the 

11 amounts paid shall be 80 percent of the 

12 lesser of the actual charge for the services 

13 or 75 percent of the amount determined 

14 for payment of a psychologist under sub15 paragraph (L)’’. 

16 (B) DEVELOPMENT OF CRITERIA WITH RE17 SPECT TO CONSULTATION WITH A HEALTH

18 CARE PROFESSIONAL.—The Secretary of Health 

19 and Human Services shall, taking into consider20 ation concerns for patient confidentiality, de21 velop criteria with respect to payment for mar22 riage and family therapist services for which 

23 payment may be made directly to the marriage 

24 and family therapist under part B of title 

25 XVIII of the Social Security Act (42 U.S.C. 


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1 1395j et seq.) under which such a therapist 

2 must agree to consult with a patient’s attending 

3 or primary care physician or nurse practitioner 

4 in accordance with such criteria. 

5 (5) EXCLUSION OF MARRIAGE AND FAMILY

6 THERAPIST SERVICES AND MENTAL HEALTH COUN7 SELOR SERVICES FROM SKILLED NURSING FACILITY

8 PROSPECTIVE PAYMENT SYSTEM.—Section 

9 1888(e)(2)(A)(ii) of the Social Security Act (42 

10 U.S.C. 1395yy(e)(2)(A)(ii)) is amended by inserting 

11 ‘‘marriage and family therapist services (as defined 

12 in section 1861(iii)(1)), mental health counselor 

13 services (as defined in section 1861(iii)(3)),’’ after 

14 ‘‘qualified psychologist services,’’. 

15 (6) INCLUSION OF MARRIAGE AND FAMILY

16 THERAPISTS AND MENTAL HEALTH COUNSELORS AS

17 PRACTITIONERS FOR ASSIGNMENT OF CLAIMS.—Sec18 tion 1842(b)(18)(C) of the Social Security Act (42 

19 U.S.C. 1395u(b)(18)(C)) is amended by adding at 

20 the end the following new clauses: 

21 ‘‘(vii) A marriage and family therapist (as de22 fined in section 1861(iii)(2)). 

23 ‘‘(viii) A mental health counselor (as defined in 

24 section 1861(iii)(4)).’’. 


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1 (b) COVERAGE OF CERTAIN MENTAL HEALTH SERV2 ICES PROVIDED IN CERTAIN SETTINGS.— 

3 (1) RURAL HEALTH CLINICS AND FEDERALLY

4 QUALIFIED HEALTH CENTERS.—Section 

5 1861(aa)(1)(B) of the Social Security Act (42 

6 U.S.C. 1395x(aa)(1)(B)) is amended by striking ‘‘or 

7 by a clinical social worker (as defined in subsection 

8 (hh)(1))’’ and inserting ‘‘, by a clinical social worker 

9 (as defined in subsection (hh)(1)), by a marriage 

10 and family therapist (as defined in subsection 

11 (iii)(2)), or by a mental health counselor (as defined 

12 in subsection (iii)(4))’’. 

13 (2) HOSPICE PROGRAMS.—Section 

14 1861(dd)(2)(B)(i)(III) of the Social Security Act (42 

15 U.S.C. 1395x(dd)(2)(B)(i)(III)) is amended by in16 serting ‘‘(and may, in addition, include a marriage 

17 and family therapist and mental health counselor)’’ 

18 after ‘‘social worker’’. 

19 (c) AUTHORIZATION OF MARRIAGE AND FAMILY

20 THERAPISTS AND MENTAL HEALTH COUNSELORS TO

21 DEVELOP DISCHARGE PLANS FOR POST-HOSPITAL SERV22 ICES.—Section 1861(ee)(2)(G) of the Social Security Act 

23 (42 U.S.C. 1395x(ee)(2)(G)) is amended by inserting ‘‘, 

24 including a marriage and family therapist and a mental 


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1 health counselor who meets qualification standards estab2 lished by the Secretary’’ before the period at the end. 

3 (d) EFFECTIVE DATE.—The amendments made by 

4 this section shall apply with respect to services furnished 

5 on or after the date that is one year after the date of 

6 the enactment of this Act. 

7 TITLE IV—DEVELOPING THE BE8 HAVIORAL HEALTH WORK9 FORCE 

10 SEC. 401. NATIONAL HEALTH SERVICE CORPS SCHOLAR11 SHIP AND LOAN REPAYMENT FUNDING FOR 

12 BEHAVIORAL AND MENTAL HEALTH PROFES13 SIONALS. 

14 Section 338H of the Public Health Service Act (42 

15 U.S.C. 254q) is amended— 

16 (1) by redesignating subsections (b) and (c) as 

17 subsections (c) and (d), respectively; and 

18 (2) by inserting after subsection (a) the fol19 lowing: 

20 ‘‘(b) ADDITIONAL FUNDING FOR BEHAVIORAL AND

21 MENTAL HEALTH PROFESSIONALS.—In addition to the 

22 amounts authorized to be appropriated under subsection 

23 (a), and in addition to the amounts appropriated under 

24 section 10503 of Public Law 111–148, there are author25 ized to be appropriated such sums as may be necessary 


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1 for fiscal years 2015 through 2019 for scholarships and 

2 loan repayments under this subpart for ensuring, as de3 scribed in sections 338A(a) and 338B(a), an adequate 

4 supply of behavioral and mental health professionals.’’. 

5 SEC. 402. REAUTHORIZATION OF HRSA’S MENTAL AND BE6 HAVIORAL HEALTH EDUCATION AND TRAIN7 ING PROGRAM. 

8 Subsection (e) of section 756 of the Public Health 

9 Service Act (42 U.S.C. 294e–1) is amended to read as 

10 follows: 

11 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

12 carry out this section, there are authorized to be appro13 priated such sums as may be necessary for fiscal years 

14 2015 through 2019.’’. 

15 SEC. 403. SAMHSA GRANT PROGRAM FOR DEVELOPMENT 

16 AND IMPLEMENTATION OF CURRICULA FOR 

17 CONTINUING EDUCATION ON SERIOUS MEN18 TAL ILLNESS. 

19 Title V of the Public Health Service Act is amended 

20 by inserting after section 520I (42 U.S.C. 290bb–40) the 

21 following: 

22 ‘‘SEC. 520I–1. CURRICULA FOR CONTINUING EDUCATION ON 

23 SERIOUS MENTAL ILLNESS. 

24 ‘‘(a) GRANTS.—The Secretary may award grants to 

25 eligible entities for the development and implementation 


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1 of curricula for providing continuing education and train2 ing to health care professionals on identifying, referring, 

3 and treating individuals with serious mental illness. 

4 ‘‘(b) ELIGIBLE ENTITIES.—To be eligible to seek a 

5 grant under this section, an entity shall be a public or 

6 nonprofit entity that— 

7 ‘‘(1) provides continuing education or training 

8 to health care professionals; or 

9 ‘‘(2) applies for the grant in partnership with 

10 another entity that provides such education and 

11 training. 

12 ‘‘(c) PREFERENCE.—In awarding grants under this 

13 section, the Secretary shall give preference to eligible enti14 ties proposing to develop and implement curricula for pro15 viding continuing education and training to— 

16 ‘‘(1) health care professionals in primary care 

17 specialities; or 

18 ‘‘(2) health care professionals who are required, 

19 as a condition of State licensure, to participate in 

20 continuing education or training specific to mental 

21 health. 

22 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 

23 carry out this section, there are authorized to be appro24 priated such sums as may be necessary for fiscal years 

25 2015 through 2019.’’. 


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1 SEC. 404. DEMONSTRATION GRANT PROGRAM TO RECRUIT, 

2 TRAIN, DEPLOY, AND PROFESSIONALLY SUP3 PORT PSYCHIATRIC PHYSICIANS IN INDIAN 

4 HEALTH PROGRAMS. 

5 (a) SHORT TITLE.—This section may be cited as the 

6 ‘‘Native American Psychiatric and Mental Health Care 

7 Improvement Act’’. 

8 (b) DEMONSTRATION GRANT PROGRAM TO RECRUIT, 

9 TRAIN, DEPLOY, AND PROFESSIONALLY SUPPORT PSY10 CHIATRIC PHYSICIANS IN INDIAN HEALTH PROGRAMS.— 

11 (1) ESTABLISHMENT.—The Secretary of Health 

12 and Human Services (in this subsection referred to 

13 as the ‘‘Secretary’’), in consultation with the Direc14 tor of the Indian Health Service and demonstration 

15 programs established under section 123 of the In16 dian Health Care Improvement Act (25 U.S.C. 

17 1616p), shall award one 5-year grant to one eligible 

18 entity to carry out a demonstration program (in this 

19 Act referred to as the ‘‘Program’’) under which the 

20 eligible entity shall carry out the activities described 

21 in paragraph (2). 

22 (2) ACTIVITIES TO BE CARRIED OUT BY RECIPI23 ENT OF GRANT UNDER PROGRAM.—Under the Pro24 gram, the grant recipient shall— 

25 (A) create a nationally replicable workforce 

26 model that identifies and incorporates best 


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1 practices for recruiting, training, deploying, and 

2 professionally supporting Native American and 

3 non-Native American psychiatric physicians to 

4 be fully integrated into medical, mental, and be5 havioral health systems in Indian health pro6 grams; 

7 (B) recruit to participate in the Program 

8 Native American and non-Native American psy9 chiatric physicians who demonstrate interest in 

10 providing specialty health care services (as de11 fined in section 313(a)(3) of the Indian Health 

12 Care Improvement Act (25 U.S.C. 

13 1638g(a)(3))) and primary care services to 

14 American Indians and Alaska Natives; 

15 (C) provide such psychiatric physicians 

16 participating in the Program with not more 

17 than 1 year of supplemental clinical and cul18 tural competency training to enable such physi19 cians to provide such specialty health care serv20 ices and primary care services in Indian health 

21 programs; 

22 (D) with respect to such psychiatric physi23 cians who are participating in the Program and 

24 trained under subparagraph (C), deploy such 

25 physicians to practice specialty care or primary 


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1 care in Indian health programs for a period of 

2 not less than 2 years and professionally support 

3 such physicians for such period with respect to 

4 practicing such care in such programs; and 

5 (E) not later than 1 year after the last day 

6 of the 5-year period for which the grant is 

7 awarded under paragraph (1), submit to the 

8 Secretary and to the appropriate committees of 

9 Congress a report that shall include— 

10 (i) the workforce model created under 

11 subparagraph (A); 

12 (ii) strategies for disseminating the 

13 workforce model to other entities with the 

14 capability of adopting it; and 

15 (iii) recommendations for the Sec16 retary and Congress with respect to sup17 porting an effective and stable psychiatric 

18 and mental health workforce that serves 

19 American Indians and Alaska Natives. 

20 (3) ELIGIBLE ENTITIES.— 

21 (A) REQUIREMENTS.—To be eligible to re22 ceive the grant under this section, an entity 

23 shall— 

24 (i) submit to the Secretary an applica25 tion at such time, in such manner, and 


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1 containing such information as the Sec2 retary may require; 

3 (ii) be a department of psychiatry 

4 within a medical school in the United 

5 States that is accredited by the Liaison 

6 Committee on Medical Education or a pub7 lic or private nonprofit entity affiliated 

8 with a medical school in the United States 

9 that is accredited by the Liaison Com10 mittee on Medical Education; and 

11 (iii) have in existence, as of the time 

12 of submission of the application under sub13 paragraph (A), a relationship with Indian 

14 health programs in at least two States with 

15 a demonstrated need for psychiatric physi16 cians and provide assurances that the 

17 grant will be used to serve rural and non18 rural American Indian and Alaska Native 

19 populations in at least two States. 

20 (B) PRIORITY IN SELECTING GRANT RE21 CIPIENT.—In awarding the grant under this 

22 section, the Secretary shall give priority to an 

23 eligible entity that satisfies each of the fol24 lowing: 


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1 (i) Demonstrates sufficient infrastruc2 ture in size, scope, and capacity to under3 take the supplemental clinical and cultural 

4 competency training of a minimum of 5 

5 psychiatric physicians, and to provide on6 going professional support to psychiatric 

7 physicians during the deployment period to 

8 an Indian health program. 

9 (ii) Demonstrates a record in success10 fully recruiting, training, and deploying 

11 physicians who are American Indians and 

12 Alaska Natives. 

13 (iii) Demonstrates the ability to estab14 lish a program advisory board, which may 

15 be primarily composed of representatives of 

16 federally recognized tribes, Alaska Natives, 

17 and Indian health programs to be served 

18 by the Program. 

19 (4) ELIGIBILITY OF PSYCHIATRIC PHYSICIANS

20 TO PARTICIPATE IN THE PROGRAM.— 

21 (A) IN GENERAL.—To be eligible to par22 ticipate in the Program, as described in para23 graph (2), a psychiatric physician shall— 

24 (i) be licensed or eligible for licensure 

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1 cian is to be deployed under paragraph 

2 (2)(D); and 

3 (ii) demonstrate a commitment be4 yond the one year of training described in 

5 paragraph (2)(C) and two years of deploy6 ment described in paragraph (2)(D) to a 

7 career as a specialty care physician or pri8 mary care physician providing mental 

9 health services in Indian health programs. 

10 (B) PREFERENCE.—In selecting physicians 

11 to participate under the Program, as described 

12 in paragraph (2)(B), the grant recipient shall 

13 give preference to physicians who are American 

14 Indians and Alaska Natives. 

15 (5) LOAN FORGIVENESS.—Under the Program, 

16 any psychiatric physician accepted to participate in 

17 the Program shall, notwithstanding the provisions of 

18 subsection (b) of section 108 of the Indian Health 

19 Care Improvement Act (25 U.S.C. 1616a) and upon 

20 acceptance into the Program, be deemed eligible and 

21 enrolled to participate in the Indian Health Service 

22 Loan Repayment Program under such section 108. 

23 Under such Loan Repayment Program, the Sec24 retary shall pay on behalf of the physician for each 

25 year of deployment under the Program under this 


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1 section up to $35,000 for loans described in sub2 section (g)(1) of such section 108. 

3 (6) DEFERRAL OF CERTAIN SERVICE.—The 

4 starting date of required service of individuals in the 

5 National Health Service Corps Service Program 

6 under title II of the Public Health Service Act (42 

7 U.S.C. 202 et seq.) who are psychiatric physicians 

8 participating under the Program under this section 

9 shall be deferred until the date that is 30 days after 

10 the date of completion of the participation of such 

11 a physician in the Program under this section. 

12 (7) DEFINITIONS.—For purposes of this Act: 

13 (A) AMERICAN INDIANS AND ALASKA NA14 TIVES.—The term ‘‘American Indians and Alas15 ka Natives’’ has the meaning given the term 

16 ‘‘Indian’’ in section 447.50(b)(1) of title 42, 

17 Code of Federal Regulations, as in existence as 

18 of the date of the enactment of this Act. 

19 (B) INDIAN HEALTH PROGRAM.—The term 

20 ‘‘Indian health program’’ has the meaning given 

21 such term in section 104(12) of the Indian 

22 Health Care Improvement Act (25 U.S.C. 

23 1603(12)). 

24 (C) PROFESSIONALLY SUPPORT.—The 

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1 spect to psychiatric physicians participating in 

2 the Program and deployed to practice specialty 

3 care or primary care in Indian health programs, 

4 the provision of compensation to such physi5 cians for the provision of such care during such 

6 deployment and may include the provision, dis7 semination, or sharing of best practices, field 

8 training, and other activities deemed appro9 priate by the recipient of the grant under this 

10 section. 

11 (D) PSYCHIATRIC PHYSICIAN.—The term 

12 ‘‘psychiatric physician’’ means a medical doctor 

13 or doctor of osteopathy in good standing who 

14 has successfully completed four-year psychiatric 

15 residency training or who is enrolled in four16 year psychiatric residency training in a resi17 dency program accredited by the Accreditation 

18 Council for Graduate Medical Education. 

19 (8) AUTHORIZATION OF APPROPRIATIONS.— 

20 There is authorized to be appropriated to carry out 

21 this section $1,000,000 for each of the fiscal years 

22 2015 through 2019. 


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1 SEC. 405. INCLUDING OCCUPATIONAL THERAPISTS AS BE2 HAVIORAL AND MENTAL HEALTH PROFES3 SIONALS FOR PURPOSES OF THE NATIONAL 

4 HEALTH SERVICE CORPS. 

5 (a) INCLUSION OF OCCUPATIONAL THERAPIST.— 

6 Section 331(a)(3)(E)(i) of the Public Health Service Act 

7 (42 U.S.C. 254d(a)(3)(E)(i)) is amended by inserting 

8 ‘‘subject to section 405(b)(2) of the Strengthening Mental 

9 Health in Our Communities Act of 2014, occupational 

10 therapists,’’ after ‘‘psychiatric nurse specialists;’’. 

11 (b) EFFECTIVE DATE; CONTINGENT IMPLEMENTA12 TION.— 

13 (1) EFFECTIVE DATE.—Subject to paragraph 

14 (2), the amendment made by subsection (a) shall 

15 apply beginning on October 1, 2014. 

16 (2) CONTINGENT IMPLEMENTATION.—The 

17 amendment made by subsection (a) shall apply with 

18 respect to obligations entered into for a fiscal year 

19 after fiscal year 2014 only if the total amount made 

20 available for the purpose of carrying out subparts II 

21 and III of part D of title III of the Public Health 

22 Service Act (42 U.S.C. 254d et seq.) for such fiscal 

23 year is greater than the total amount made available 

24 for such purpose for fiscal year 2014. 


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1 SEC. 406. EXTENSION OF CERTAIN HEALTH CARE WORK2 FORCE LOAN REPAYMENT PROGRAMS 

3 THROUGH FISCAL YEAR 2019. 

4 Section 775(e) of the Public Health Service Act (42 

5 U.S.C. 295f(e)) is amended— 

6 (1) by striking ‘‘2014’’ and inserting ‘‘2019’’; 

7 and 

8 (2) by striking ‘‘2013’’ and inserting ‘‘2019’’. 

9 TITLE V—IMPROVING MENTAL 

10 HEALTH RESEARCH AND CO11 ORDINATION 

12 SEC. 501. NATIONAL INSTITUTE OF MENTAL HEALTH RE13 SEARCH PROGRAM ON SERIOUS MENTAL ILL14 NESS AND SUICIDE PREVENTION. 

15 (a) PURPOSE OF INSTITUTE.—Section 464R(a) of 

16 the Public Health Service Act (42 U.S.C. 285p(a)) is 

17 amended by inserting ‘‘serious mental illness research,’’ 

18 after ‘‘biomedical and behavioral research,’’. 

19 (b) RESEARCH PROGRAM.—Section 464R(b) of the 

20 Public Health Service Act (42 U.S.C. 285p(b)) is amend21 ed— 

22 (1) by striking ‘‘The research program’’ and in23 serting the following: 

24 ‘‘(1) IN GENERAL.—The research program’’; 

25 (2) by striking ‘‘to further the treatment and 

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1 ther the treatment and prevention of mental illness 

2 (including serious mental illness)’’; and 

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

4 ‘‘(2) RESEARCH WITH RESPECT TO SERIOUS

5 MENTAL ILLNESS.—As part of the research program 

6 established under this subpart, the Director of the 

7 Institute shall conduct or support research on seri8 ous mental illness, including with respect to— 

9 ‘‘(A) the causes, prevention, and treatment 

10 of serious mental illness; and 

11 ‘‘(B) interventions to improve early identi12 fication of individuals with serious mental ill13 ness. 

14 ‘‘(3) RESEARCH WITH RESPECT TO VIOLENCE

15 ASSOCIATED WITH MENTAL ILLNESS.—As part of 

16 the research program established under this subpart, 

17 the Director of the Institute shall conduct or support 

18 research on self-directed and other-directed violence 

19 associated with mental illness, including with respect 

20 to— 

21 ‘‘(A) the causes of such violence; and 

22 ‘‘(B) interventions to reduce the risk of 

23 self-harm, suicide, and interpersonal violence, 

24 including in rural and other underserved com25 munities.’’. 


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1 (c) BIENNIAL REPORT.—Section 403(a)(5) of the 

2 Public Health Service Act (42 U.S.C. 283(a)(5)) is 

3 amended— 

4 (1) by redesignating subparagraph (L) as sub5 paragraph (M); and 

6 (2) by inserting after subparagraph (K) the fol7 lowing: 

8 ‘‘(L) Serious mental illness.’’. 

9 (d) AUTHORIZATION OF APPROPRIATIONS.—Section 

10 464R of the Public Health Service Act (42 U.S.C. 285p) 

11 is amended by adding at the end the following: 

12 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—In addi13 tion to amounts otherwise made available to the National 

14 Institute of Mental Health, including amounts appro15 priated pursuant to section 402A(a), there are authorized 

16 to be appropriated to such Institute $40,000,000 for each 

17 of fiscal years 2015 through 2019 to carry out subsection 

18 (b)(3) (relating to research with respect to violence associ19 ated with mental illness).’’. 

20 SEC. 502. YOUTH MENTAL HEALTH RESEARCH NETWORK. 

21 (a) YOUTH MENTAL HEALTH RESEARCH NET22 WORK.— 

23 (1) NETWORK.—The Director of the National 

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1 ment of a Youth Mental Health Research Network 

2 for the conduct or support of— 

3 (A) youth mental health research; and 

4 (B) youth mental health intervention serv5 ices. 

6 (2) COLLABORATION BY INSTITUTES AND CEN7 TERS.—The Director of NIH shall carry out this 

8 Act acting— 

9 (A) through the Director of the National 

10 Institute of Mental Health; and 

11 (B) in collaboration with other appropriate 

12 national research institutes and national centers 

13 that carry out activities involving youth mental 

14 health research. 

15 (3) MENTAL HEALTH RESEARCH.— 

16 (A) IN GENERAL.—In carrying out para17 graph (1), the Director of NIH may award co18 operative agreements, grants, and contracts to 

19 State, local, and tribal governments and private 

20 nonprofit entities for— 

21 (i) conducting, or entering into con22 sortia with other entities to conduct— 

23 (I) basic, clinical, behavioral, or 

24 translational research to meet unmet 


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1 needs for youth mental health re2 search; or 

3 (II) training for researchers in 

4 youth mental health research tech5 niques; 

6 (ii) providing, or partnering with non7 research institutions or community-based 

8 groups with existing connections to youth 

9 to provide, youth mental health interven10 tion services; and 

11 (iii) collaborating with the National 

12 Institute of Mental Health to make use of, 

13 and build on, the scientific findings and 

14 clinical techniques of the Institute’s earlier 

15 programs, studies, and demonstration 

16 projects. 

17 (B) RESEARCH.—The Director of NIH 

18 shall ensure that— 

19 (i) each recipient of an award under 

20 subparagraph (A)(i) conducts or supports 

21 at least one category of research described 

22 in subparagraph (A)(i)(I) and collectively 

23 such recipients conduct or support all such 

24 categories of research; and 


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1 (ii) one or more such recipients pro2 vide training described in subparagraph 

3 (A)(i)(II). 

4 (C) NUMBER OF AWARD RECIPIENTS.— 

5 The Director of NIH may make awards under 

6 this paragraph for not more than 70 entities. 

7 (D) SUPPLEMENT, NOT SUPPLANT.—Any 

8 support received by an entity under subpara9 graph (A) shall be used to supplement, and not 

10 supplant, other public or private support for ac11 tivities authorized to be supported under this 

12 paragraph. 

13 (E) DURATION OF SUPPORT.—Support of 

14 an entity under subparagraph (A) may be for a 

15 period of not to exceed 5 years. Such period 

16 may be extended by the Director of NIH for 

17 additional periods of not more than 5 years. 

18 (4) COORDINATION.—The Director of NIH 

19 shall— 

20 (A) as appropriate, provide for the coordi21 nation of activities (including the exchange of 

22 information and regular communication) among 

23 the recipients of awards under this subsection; 

24 and 


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1 (B) require the periodic preparation and 

2 submission to the Director of reports on the ac3 tivities of each such recipient. 

4 (b) INTERVENTION SERVICES FOR, AND RESEARCH

5 ON, SERIOUS EMOTIONAL DISTURBANCE.— 

6 (1) IN GENERAL.—In making awards under 

7 subsection (a)(3), the Director of NIH shall ensure 

8 that an appropriate number of such awards are 

9 awarded to entities that agree to— 

10 (A) focus primarily on the early detection 

11 of and interventions for serious emotional dis12 turbances in children and adolescents; 

13 (B) conduct or coordinate one or more 

14 multisite clinical trials of therapies for, or ap15 proaches to, the prevention, diagnosis, or treat16 ment of early serious emotional disturbance in 

17 a community setting; 

18 (C) rapidly and efficiently disseminate sci19 entific findings resulting from such trials; and 

20 (D) adhere to the guidelines, protocols, 

21 and practices used in the North American Pro22 drome Longitudinal Study (NAPLS) and the 

23 Recovery After an Initial Schizophrenia Episode 

24 (RAISE) initiative. 

25 (2) DATA COORDINATING CENTER.— 


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1 (A) ESTABLISHMENT.—In connection with 

2 awards to entities described in paragraph (1), 

3 the Director of NIH shall establish a data co4 ordinating center for the following purposes: 

5 (i) To distribute the scientific findings 

6 referred to in paragraph (1)(C). 

7 (ii) To provide assistance in the de8 sign and conduct of collaborative research 

9 projects and the management, analysis, 

10 and storage of data associated with such 

11 projects. 

12 (iii) To organize and conduct multisite 

13 monitoring activities. 

14 (iv) To provide assistance to the Cen15 ters for Disease Control and Prevention in 

16 the establishment of patient registries. 

17 (B) REPORTING.—The Director of NIH 

18 shall— 

19 (i) require the data coordinating cen20 ter established under subparagraph (A) to 

21 provide regular reports to the Director of 

22 NIH on research conducted by entities de23 scribed in paragraph (1), including infor24 mation on enrollment in clinical trials and 


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1 the allocation of resources with respect to 

2 such research; and 

3 (ii) as appropriate, incorporate infor4 mation reported under clause (i) into the 

5 Director’s biennial reports under section 

6 403 of the Public Health Service Act (42 

7 U.S.C. 283). 

8 (c) DEFINITIONS.—In this Act, the terms ‘‘Director 

9 of NIH’’, ‘‘national center’’, and ‘‘national research insti10 tute’’ have the meanings given to such terms in section 

11 401 of the Public Health Service Act (42 U.S.C. 281). 

12 (d) AUTHORIZATION OF APPROPRIATIONS.—To carry 

13 out this Act, there is authorized to be appropriated 

14 $25,000,000 for each of fiscal years 2015 through 2019. 

15 SEC. 503. NATIONAL VIOLENT DEATH REPORTING SYSTEM. 

16 The Secretary of Health and Human Services, acting 

17 through the Director of the Centers for Disease Control 

18 and Prevention, shall improve, particularly through the in19 clusion of additional States, the National Violent Death 

20 Reporting System, as authorized by title III of the Public 

21 Health Service Act (42 U.S.C. 241 et seq.). Participation 

22 in the system by the States shall be voluntary. 


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1 TITLE VI—EDUCATION AND 

2 YOUTH 

3 SEC. 601. SCHOOL-BASED MENTAL HEALTH PROGRAMS. 

4 (a) PURPOSES.—It is the purpose of this section to— 

5 (1) revise, increase funding for, and expand the 

6 scope of the Safe Schools-Healthy Students program 

7 in order to provide access to more comprehensive 

8 school-based mental health services and supports; 

9 (2) increase access to school employed mental 

10 health professionals; 

11 (3) provide for comprehensive staff development 

12 for school and community service personnel working 

13 in the school; and 

14 (4) provide for comprehensive training for chil15 dren with mental health disorders, for parents, sib16 lings, and other family members of such children, 

17 and for concerned members of the community. 

18 (b) AMENDMENTS TO THE PUBLIC HEALTH SERVICE

19 ACT.— 

20 (1) TECHNICAL AMENDMENTS.—The second 

21 part G (relating to services provided through reli22 gious organizations) of title V of the Public Health 

23 Service Act (42 U.S.C. 290kk et seq.) is amended— 

24 (A) by redesignating such part as part J; 

25 and 


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1 (B) by redesignating sections 581 through 

2 584 as sections 596 through 596C, respectively. 

3 (2) SCHOOL-BASED MENTAL HEALTH AND

4 CHILDREN AND VIOLENCE.—Section 581 of the Pub5 lic Health Service Act (42 U.S.C. 290hh) is amend6 ed to read as follows: 

7 ‘‘SEC. 581. SCHOOL-BASED MENTAL HEALTH AND CHIL8 DREN AND VIOLENCE. 

9 ‘‘(a) IN GENERAL.—The Secretary, in collaboration 

10 with the Secretary of Education and in consultation with 

11 the Attorney General, shall, directly or through grants, 

12 contracts, or cooperative agreements awarded to States, 

13 assist local communities and schools in applying a public 

14 health approach to mental health services both in schools 

15 and in the community. Such an approach should provide 

16 comprehensive, age-appropriate services and supports, be 

17 linguistically and culturally appropriate, be trauma-in18 formed, and incorporate age appropriate strategies of posi19 tive behavioral interventions and supports. 

20 ‘‘(b) ACTIVITIES.—Under the program under sub21 section (a), the Secretary may— 

22 ‘‘(1) provide financial support to enable local 

23 communities to implement a comprehensive cul24 turally and linguistically appropriate, trauma-in25 formed, and age-appropriate, school mental health 


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1 program that incorporates positive behavioral inter2 ventions, client treatment, and supports to foster the 

3 health and development of children; 

4 ‘‘(2) provide technical assistance to local com5 munities with respect to the development of pro6 grams described in paragraph (1); 

7 ‘‘(3) provide assistance to local communities in 

8 the development of policies to address child and ado9 lescent trauma and mental health issues and violence 

10 when and if it occurs; 

11 ‘‘(4) facilitate community partnerships among 

12 families, students, law enforcement agencies, edu13 cation systems, school-based health centers, mental 

14 health and substance use disorder service systems, 

15 family-based mental health service systems, welfare 

16 agencies, health care service systems (including phy17 sicians), faith-based programs, trauma networks, 

18 and other community-based systems; and 

19 ‘‘(5) establish mechanisms for children and ado20 lescents to report incidents of violence or plans by 

21 other children, adolescents, or adults to commit vio22 lence. 

23 ‘‘(c) REQUIREMENTS.— 


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1 ‘‘(1) IN GENERAL.—To be eligible for a grant, 

2 contract, or cooperative agreement under subsection 

3 (a), an entity shall— 

4 ‘‘(A) be a State, in partnership with at 

5 least three local education agencies; and 

6 ‘‘(B) submit an application, that is en7 dorsed by all members of the partnership, that 

8 contains the assurances described in paragraph 

9 (2). 

10 ‘‘(2) REQUIRED ASSURANCES.—An application 

11 under paragraph (1) shall contain assurances as fol12 lows: 

13 ‘‘(A) That the applicant will ensure that, 

14 in carrying out activities under this section, the 

15 local educational agency involved will enter into 

16 a memorandum of understanding— 

17 ‘‘(i) with, at least one, public or pri18 vate mental health entity, health care enti19 ty, law enforcement or juvenile justice enti20 ty, child welfare agency, family-based men21 tal health entity, family or family organiza22 tion, trauma network, or other community23 based entity; and 

24 ‘‘(ii) that clearly states— 


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1 ‘‘(I) how school employed mental 

2 health professionals will be utilized for 

3 carrying out such responsibilities; 

4 ‘‘(II) the responsibilities of each 

5 partner with respect to the activities 

6 to be carried out; 

7 ‘‘(III) how each such partner will 

8 be accountable for carrying out such 

9 responsibilities; and 

10 ‘‘(IV) the amount of non-Federal 

11 funding or in-kind contributions that 

12 each such partner will contribute in 

13 order to sustain the program. 

14 ‘‘(B) That the comprehensive school-based 

15 mental health program carried out under this 

16 section supports the flexible use of funds to ad17 dress— 

18 ‘‘(i) the promotion of the social, emo19 tional, and behavioral health of all students 

20 in an environment that is conducive to 

21 learning; 

22 ‘‘(ii) the reduction in the likelihood of 

23 at-risk students developing social, emo24 tional, behavioral health problems, or sub25 stance use disorders; 


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1 ‘‘(iii) the early identification of social, 

2 emotional, behavioral problems, or sub3 stance use disorders and the provision of 

4 early intervention services; 

5 ‘‘(iv) the treatment or referral for 

6 treatment of students with existing social, 

7 emotional, behavioral health problems, or 

8 substance use disorders; and 

9 ‘‘(v) the development and implementa10 tion of programs to assist children in deal11 ing with trauma and violence. 

12 ‘‘(C) That the comprehensive school-based 

13 mental health program carried out under this 

14 section will provide for in-service training of all 

15 school personnel, including ancillary staff and 

16 volunteers, in— 

17 ‘‘(i) the techniques and supports need18 ed to identify early children with trauma 

19 histories and children with, or at risk of, 

20 mental illness; 

21 ‘‘(ii) the use of referral mechanisms 

22 that effectively link such children to appro23 priate treatment and intervention services 

24 in the school and in the community and to 

25 follow up when services are not available; 


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1 ‘‘(iii) strategies that promote a school2 wide positive environment; 

3 ‘‘(iv) strategies for promoting the so4 cial, emotional, mental, and behavioral 

5 health of all students; and 

6 ‘‘(v) strategies to increase the knowl7 edge and skills of school and community 

8 leaders about the impact of trauma and vi9 olence and on the application of a public 

10 health approach to comprehensive school11 based mental health programs. 

12 ‘‘(D) That the comprehensive school-based 

13 mental health program carried out under this 

14 section will include comprehensive training for 

15 parents, siblings, and other family members of 

16 children with mental health disorders, and for 

17 concerned members of the community in— 

18 ‘‘(i) the techniques and supports need19 ed to identify early children with trauma 

20 histories, and children with, or at risk of, 

21 mental illness; 

22 ‘‘(ii) the use of referral mechanisms 

23 that effectively link such children to appro24 priate treatment and intervention services 

25 in the school and in the community and 


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1 follow up when such services are not avail2 able; and 

3 ‘‘(iii) strategies that promote a school4 wide positive environment. 

5 ‘‘(E) That the comprehensive school-based 

6 mental health program carried out under this 

7 section will demonstrate the measures to be 

8 taken to sustain the program after funding 

9 under this section terminates. 

10 ‘‘(F) That the local educational agency 

11 partnership involved is supported by the State 

12 educational and mental health system to ensure 

13 that the sustainability of the program is estab14 lished after funding under this section termi15 nates. 

16 ‘‘(G) That the comprehensive school-based 

17 mental health program carried out under this 

18 section will be based on trauma-informed and 

19 evidence-based practices. 

20 ‘‘(H) That the comprehensive school-based 

21 mental health program carried out under this 

22 section will be coordinated with early inter23 vening activities carried out under the Individ24 uals with Disabilities Education Act. 


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1 ‘‘(I) That the comprehensive school-based 

2 mental health program carried out under this 

3 section will be trauma-informed and culturally 

4 and linguistically appropriate. 

5 ‘‘(J) That the comprehensive school-based 

6 mental health program carried out under this 

7 section will include a broad needs assessment of 

8 youth who drop out of school due to policies of 

9 ‘zero tolerance’ with respect to drugs, alcohol, 

10 or weapons and an inability to obtain appro11 priate services. 

12 ‘‘(K) That the mental health services pro13 vided through the comprehensive school-based 

14 mental health program carried out under this 

15 section will be provided by qualified mental and 

16 behavioral health professionals who are certified 

17 or licensed by the State involved and practicing 

18 within their area of expertise. 

19 ‘‘(3) COORDINATOR.—Any entity that is a 

20 member of a partnership described in paragraph 

21 (1)(A) may serve as the coordinator of funding and 

22 activities under the grant if all members of the part23 nership agree. 

24 ‘‘(4) COMPLIANCE WITH HIPAA.—A grantee 

25 under this section shall be deemed to be a covered 


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1 entity for purposes of compliance with the regula2 tions promulgated under section 264(c) of the 

3 Health Insurance Portability and Accountability Act 

4 of 1996 with respect to any patient records devel5 oped through activities under the grant. 

6 ‘‘(d) GEOGRAPHICAL DISTRIBUTION.—The Secretary 

7 shall ensure that grants, contracts, or cooperative agree8 ments under subsection (a) will be distributed equitably 

9 among the regions of the country and among urban and 

10 rural areas. 

11 ‘‘(e) DURATION OF AWARDS.—With respect to a 

12 grant, contract, or cooperative agreement under sub13 section (a), the period during which payments under such 

14 an award will be made to the recipient shall be 6 years. 

15 An entity may receive only one award under this section, 

16 except that an entity that is providing services and sup17 ports on a regional basis may receive additional funding 

18 after the expiration of the preceding grant period. 

19 ‘‘(f) EVALUATION AND MEASURES OF OUTCOMES.— 

20 ‘‘(1) DEVELOPMENT OF PROCESS.—The Ad21 ministrator shall develop a fiscally appropriate proc22 ess for evaluating activities carried out under this 

23 section. Such process shall include— 


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1 ‘‘(A) the development of guidelines for the 

2 submission of program data by grant, contract, 

3 or cooperative agreement recipients; 

4 ‘‘(B) the development of measures of out5 comes (in accordance with paragraph (2)) to be 

6 applied by such recipients in evaluating pro7 grams carried out under this section; and 

8 ‘‘(C) the submission of annual reports by 

9 such recipients concerning the effectiveness of 

10 programs carried out under this section. 

11 ‘‘(2) MEASURES OF OUTCOMES.— 

12 ‘‘(A) IN GENERAL.—The Administrator 

13 shall develop measures of outcomes to be ap14 plied by recipients of assistance under this sec15 tion, and the Administrator, in evaluating the 

16 effectiveness of programs carried out under this 

17 section. Such measures shall include student 

18 and family measures as provided for in sub19 paragraph (B) and local educational measures 

20 as provided for under subparagraph (C). 

21 ‘‘(B) STUDENT AND FAMILY MEASURES OF

22 OUTCOMES.—The measures of outcomes devel23 oped under paragraph (1)(B) relating to stu24 dents and families shall, with respect to activi25 ties carried out under a program under this 


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1 section, at a minimum include provisions to 

2 evaluate whether the program is effective in— 

3 ‘‘(i) increasing social and emotional 

4 competency; 

5 ‘‘(ii) increasing academic competency 

6 (as defined by Secretary); 

7 ‘‘(iii) reducing disruptive and aggres8 sive behaviors; 

9 ‘‘(iv) improving child functioning; 

10 ‘‘(v) reducing substance use disorders; 

11 ‘‘(vi) reducing suspensions, truancy, 

12 expulsions and violence; 

13 ‘‘(vii) increasing graduation rates (as 

14 defined in section 1111(b)(2)(C)(vi) of the 

15 Elementary and Secondary Education Act 

16 of 1965); and 

17 ‘‘(viii) improving access to care for 

18 mental health disorders. 

19 ‘‘(C) LOCAL EDUCATIONAL OUTCOMES.— 

20 The outcome measures developed under para21 graph (1)(B) relating to local educational sys22 tems shall, with respect to activities carried out 

23 under a program under this section, at a min24 imum include provisions to evaluate— 


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1 ‘‘(i) the effectiveness of comprehensive 

2 school mental health programs established 

3 under this section; 

4 ‘‘(ii) the effectiveness of formal part5 nership linkages among child and family 

6 serving institutions, community support 

7 systems, and the educational system; 

8 ‘‘(iii) the progress made in sustaining 

9 the program once funding under the grant 

10 has expired; 

11 ‘‘(iv) the effectiveness of training and 

12 professional development programs for all 

13 school personnel that incorporate indica14 tors that measure cultural and linguistic 

15 competencies under the program in a man16 ner that incorporates appropriate cultural 

17 and linguistic training; 

18 ‘‘(v) the improvement in perception of 

19 a safe and supportive learning environment 

20 among school staff, students, and parents; 

21 ‘‘(vi) the improvement in case-finding 

22 of students in need of more intensive serv23 ices and referral of identified students to 

24 early intervention and clinical services; 


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1 ‘‘(vii) the improvement in the imme2 diate availability of clinical assessment and 

3 treatment services within the context of 

4 the local community to students posing a 

5 danger to themselves or others; 

6 ‘‘(viii) the increased successful matric7 ulation to postsecondary school; and 

8 ‘‘(ix) reduced referrals to juvenile jus9 tice. 

10 ‘‘(3) SUBMISSION OF ANNUAL DATA.—An entity 

11 that receives a grant, contract, or cooperative agree12 ment under this section shall annually submit to the 

13 Administrator a report that includes data to evalu14 ate the success of the program carried out by the en15 tity based on whether such program is achieving the 

16 purposes of the program. Such reports shall utilize 

17 the measures of outcomes under paragraph (2) in a 

18 reasonable manner to demonstrate the progress of 

19 the program in achieving such purposes. 

20 ‘‘(4) EVALUATION BY ADMINISTRATOR.—Based 

21 on the data submitted under paragraph (3), the Ad22 ministrator shall annually submit to Congress a re23 port concerning the results and effectiveness of the 

24 programs carried out with assistance received under 

25 this section. 


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1 ‘‘(5) LIMITATION.—A grantee shall use not to 

2 exceed 10 percent of amounts received under a grant 

3 under this section to carry out evaluation activities 

4 under this subsection. 

5 ‘‘(g) INFORMATION AND EDUCATION.—The Sec6 retary shall establish comprehensive information and edu7 cation programs to disseminate the findings of the knowl8 edge development and application under this section to the 

9 general public and to health care professionals. 

10 ‘‘(h) AMOUNT OF GRANTS AND AUTHORIZATION OF

11 APPROPRIATIONS.— 

12 ‘‘(1) AMOUNT OF GRANTS.—A grant under this 

13 section shall be in an amount that is not more than 

14 $1,000,000 for each of grant years 2015 through 

15 2019. The Secretary shall determine the amount of 

16 each such grant based on the population of children 

17 up to age 21 of the area to be served under the 

18 grant. 

19 ‘‘(2) AUTHORIZATION OF APPROPRIATIONS.— 

20 There is authorized to be appropriated to carry out 

21 this section, $200,000,000 for each of fiscal years 

22 2015 through 2019.’’. 

23 (3) CONFORMING AMENDMENT.—Part G of title 

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

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1 ther amended by striking the part heading and in2 serting the following: 

3 ‘‘PART G—SCHOOL-BASED MENTAL HEALTH’’. 

4 SEC. 602. EXAMINING MENTAL HEALTH CARE FOR CHIL5 DREN. 

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

7 date of enactment of this Act, the Comptroller General 

8 of the United States shall conduct an independent evalua9 tion, and submit to the Committee on Health, Education, 

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

11 Energy and Commerce of the House of Representatives, 

12 a report concerning the utilization of mental health serv13 ices for children, including the usage of psychotropic medi14 cations. 

15 (b) CONTENT.—The report submitted under sub16 section (a) shall review and assess— 

17 (1) the ways in which children access mental 

18 health care, including information on whether chil19 dren are screened and treated by primary care or 

20 specialty physicians or other health care providers, 

21 what types of referrals for additional care are rec22 ommended, and any barriers to accessing this care; 

23 (2) the extent to which children prescribed psy24 chotropic medications in the United States face barVerDate Mar 15 2010 23:55 May 13, 2014 Jkt 039200 PO 00000 Frm 00108 Fmt 6652 Sfmt 6201 E:\BILLS\H4574.IH H4574

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1 riers to more comprehensive or other mental health 

2 services, interventions, and treatments; 

3 (3) the extent to which children are prescribed 

4 psychotropic medications in the United States in5 cluding the frequency of concurrent medication 

6 usage; and 

7 (4) the tools, assessments, and medications that 

8 are available and used to diagnose and treat children 

9 with mental health disorders. 

10 TITLE VII—JUSTICE AND MEN11 TAL HEALTH COLLABORA12 TION 

13 SEC. 701. ASSISTING VETERANS. 

14 (a) REDESIGNATION.—Section 2991 of the Omnibus 

15 Crime Control and Safe Streets Act of 1968 (42 U.S.C. 

16 3797aa) is amended by redesignating subsection (i) as 

17 subsection (l). 

18 (b) ASSISTING VETERANS.—Section 2991 of the Om19 nibus Crime Control and Safe Streets Act of 1968 (42 

20 U.S.C. 3797aa) is amended by inserting after subsection 

21 (h) the following: 

22 ‘‘(i) ASSISTING VETERANS.— 

23 ‘‘(1) DEFINITIONS.—In this subsection: 

24 ‘‘(A) PEER-TO-PEER SERVICES OR PRO25 GRAMS.—The term ‘peer-to-peer services or proVerDate Mar 15 2010 23:55 May 13, 2014 Jkt 039200 PO 00000 Frm 00109 Fmt 6652 Sfmt 6201 E:\BILLS\H4574.IH H4574

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1 grams’ means services or programs that connect 

2 qualified veterans with other veterans for the 

3 purpose of providing support and mentorship to 

4 assist qualified veterans in obtaining treatment, 

5 recovery, stabilization, or rehabilitation. 

6 ‘‘(B) QUALIFIED VETERAN.—The term 

7 ‘qualified veteran’ means a preliminarily quali8 fied offender who— 

9 ‘‘(i) has served on active duty in any 

10 branch of the Armed Forces, including the 

11 National Guard and reserve components; 

12 and 

13 ‘‘(ii) was discharged or released from 

14 such service under conditions other than 

15 dishonorable. 

16 ‘‘(C) VETERANS TREATMENT COURT PRO17 GRAM.—The term ‘veterans treatment court 

18 program’ means a court program involving col19 laboration among criminal justice, veterans, and 

20 mental health and substance abuse agencies 

21 that provides qualified veterans with— 

22 ‘‘(i) intensive judicial supervision and 

23 case management, which may include ran24 dom and frequent drug testing where ap25 propriate; 


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1 ‘‘(ii) a full continuum of treatment 

2 services, including mental health services, 

3 substance abuse services, medical services, 

4 and services to address trauma; 

5 ‘‘(iii) alternatives to incarceration; 

6 and 

7 ‘‘(iv) other appropriate services, in8 cluding housing, transportation, mentoring, 

9 employment, job training, education, and 

10 assistance in applying for and obtaining 

11 available benefits. 

12 ‘‘(2) VETERANS ASSISTANCE PROGRAM.— 

13 ‘‘(A) IN GENERAL.—The Attorney General, 

14 in consultation with the Secretary of Veterans 

15 Affairs, may award grants under this sub16 section to applicants to establish or expand— 

17 ‘‘(i) veterans treatment court pro18 grams; 

19 ‘‘(ii) peer-to-peer services or programs 

20 for qualified veterans; 

21 ‘‘(iii) practices that identify and pro22 vide treatment, rehabilitation, legal, transi23 tional, and other appropriate services to 

24 qualified veterans who have been incarcer25 ated; and 


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1 ‘‘(iv) training programs to teach 

2 criminal justice, law enforcement, correc3 tions, mental health, and substance abuse 

4 personnel how to identify and appro5 priately respond to incidents involving 

6 qualified veterans. 

7 ‘‘(B) PRIORITY.—In awarding grants 

8 under this subsection, the Attorney General 

9 shall give priority to applications that— 

10 ‘‘(i) demonstrate collaboration be11 tween and joint investments by criminal 

12 justice, mental health, substance abuse, 

13 and veterans service agencies; 

14 ‘‘(ii) promote effective strategies to 

15 identify and reduce the risk of harm to 

16 qualified veterans and public safety; and 

17 ‘‘(iii) propose interventions with em18 pirical support to improve outcomes for 

19 qualified veterans.’’. 

20 SEC. 702. CORRECTIONAL FACILITIES. 

21 Section 2991 of the Omnibus Crime Control and Safe 

22 Streets Act of 1968 (42 U.S.C. 3797aa) is amended by 

23 inserting after subsection (i), as so added by section 701, 

24 the following: 

25 ‘‘(j) CORRECTIONAL FACILITIES.— 


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1 ‘‘(1) DEFINITIONS.— 

2 ‘‘(A) CORRECTIONAL FACILITY.—The term 

3 ‘correctional facility’ means a jail, prison, or 

4 other detention facility used to house people 

5 who have been arrested, detained, held, or con6 victed by a criminal justice agency or a court. 

7 ‘‘(B) ELIGIBLE INMATE.—The term ‘eligi8 ble inmate’ means an individual who— 

9 ‘‘(i) is being held, detained, or incar10 cerated in a correctional facility; and 

11 ‘‘(ii) manifests obvious signs of a 

12 mental illness or has been diagnosed by a 

13 qualified mental health professional as hav14 ing a mental illness. 

15 ‘‘(2) CORRECTIONAL FACILITY GRANTS.—The 

16 Attorney General may award grants to applicants to 

17 enhance the capabilities of a correctional facility— 

18 ‘‘(A) to identify and screen for eligible in19 mates; 

20 ‘‘(B) to plan and provide— 

21 ‘‘(i) initial and periodic assessments of 

22 the clinical, medical, and social needs of in23 mates; and 


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1 ‘‘(ii) appropriate treatment and serv2 ices that address the mental health and 

3 substance abuse needs of inmates; 

4 ‘‘(C) to develop, implement, and enhance— 

5 ‘‘(i) post-release transition plans for 

6 eligible inmates that, in a comprehensive 

7 manner, coordinate health, housing, med8 ical, employment, and other appropriate 

9 services and public benefits; 

10 ‘‘(ii) the availability of mental health 

11 care services and substance abuse treat12 ment services; and 

13 ‘‘(iii) alternatives to solitary confine14 ment and segregated housing and mental 

15 health screening and treatment for inmates 

16 placed in solitary confinement or seg17 regated housing; and 

18 ‘‘(D) to train each employee of the correc19 tional facility to identify and appropriately re20 spond to incidents involving inmates with men21 tal health or co-occurring mental health and 

22 substance abuse disorders.’’. 

23 SEC. 703. HIGH UTILIZERS. 

24 Section 2991 of the Omnibus Crime Control and Safe 

25 Streets Act of 1968 (42 U.S.C. 3797aa) is amended by 


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1 inserting after subsection (j), as added by section 702, the 

2 following: 

3 ‘‘(k) DEMONSTRATION GRANTS RESPONDING TO

4 HIGH UTILIZERS.— 

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

6 ‘high utilizer’ means an individual who— 

7 ‘‘(A) manifests obvious signs of mental ill8 ness or has been diagnosed by a qualified men9 tal health professional as having a mental ill10 ness; and 

11 ‘‘(B) consumes a significantly dispropor12 tionate quantity of public resources, such as 

13 emergency, housing, judicial, corrections, and 

14 law enforcement services. 

15 ‘‘(2) DEMONSTRATION GRANTS RESPONDING TO

16 HIGH UTILIZERS.— 

17 ‘‘(A) IN GENERAL.—The Attorney General 

18 may award not more than 6 grants per year 

19 under this subsection to applicants for the pur20 pose of reducing the use of public services by 

21 high utilizers. 

22 ‘‘(B) USE OF GRANTS.—A recipient of a 

23 grant awarded under this subsection may use 

24 the grant— 


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1 ‘‘(i) to develop or support multidisci2 plinary teams that coordinate, implement, 

3 and administer community-based crisis re4 sponses and long-term plans for high uti5 lizers; 

6 ‘‘(ii) to provide training on how to re7 spond appropriately to the unique issues 

8 involving high utilizers for public service 

9 personnel, including criminal justice, men10 tal health, substance abuse, emergency 

11 room, health care, law enforcement, correc12 tions, and housing personnel; 

13 ‘‘(iii) to develop or support alter14 natives to hospital and jail admissions for 

15 high utilizers that provide treatment, sta16 bilization, and other appropriate supports 

17 in the least restrictive, yet appropriate, en18 vironment; or 

19 ‘‘(iv) to develop protocols and systems 

20 among law enforcement, mental health, 

21 substance abuse, housing, corrections, and 

22 emergency medical service operations to 

23 provide coordinated assistance to high uti24 lizers. 


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1 ‘‘(C) REPORT.—Not later than the last 

2 day of the first year following the fiscal year in 

3 which a grant is awarded under this subsection, 

4 the recipient of the grant shall submit to the 

5 Attorney General a report that— 

6 ‘‘(i) measures the performance of the 

7 grant recipient in reducing the use of pub8 lic services by high utilizers; and 

9 ‘‘(ii) provides a model set of practices, 

10 systems, or procedures that other jurisdic11 tions can adopt to reduce the use of public 

12 services by high utilizers.’’. 

13 SEC. 704. ACADEMY TRAINING. 

14 Section 2991(h) of the Omnibus Crime Control and 

15 Safe Streets Act of 1968 (42 U.S.C. 3797aa(h)) is amend16 ed— 

17 (1) in paragraph (1), by adding at the end the 

18 following: 

19 ‘‘(F) ACADEMY TRAINING.—To provide 

20 support for academy curricula, law enforcement 

21 officer orientation programs, continuing edu22 cation training, and other programs that teach 

23 law enforcement personnel how to identify and 

24 respond to incidents involving individuals with 


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1 mental illness or co-occurring mental illness and 

2 substance abuse disorders.’’; and 

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

4 ‘‘(4) PRIORITY CONSIDERATION.—The Attorney 

5 General, in awarding grants under this subsection, 

6 shall give priority to programs that law enforcement 

7 personnel and members of the mental health and 

8 substance abuse professions develop and administer 

9 cooperatively.’’. 

10 SEC. 705. EVIDENCE-BASED PRACTICES. 

11 Section 2991(c) of the Omnibus Crime Control and 

12 Safe Streets Act of 1968 (42 U.S.C. 3797aa(c)) is amend13 ed— 

14 (1) in paragraph (3), by striking ‘‘or’’ at the 

15 end; 

16 (2) by redesignating paragraph (4) as para17 graph (6); and 

18 (3) by inserting after paragraph (3), the fol19 lowing: 

20 ‘‘(4) propose interventions that have been 

21 shown by empirical evidence to reduce recidivism; 

22 ‘‘(5) when appropriate, use validated assess23 ment tools to target preliminarily qualified offenders 

24 with a moderate or high risk of recidivism and a 

25 need for treatment and services; or’’. 


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1 SEC. 706. SAFE COMMUNITIES. 

2 (a) IN GENERAL.—Section 2991(a) of the Omnibus 

3 Crime Control and Safe Streets Act of 1968 (42 U.S.C. 

4 3797aa(a)) is amended by striking paragraph (9) and in5 serting the following: 

6 ‘‘(9) PRELIMINARILY QUALIFIED OFFENDER.— 

7 ‘‘(A) IN GENERAL.—The term ‘prelimi8 narily qualified offender’ means an adult or ju9 venile accused of an offense who— 

10 ‘‘(i)(I) previously or currently has 

11 been diagnosed by a qualified mental 

12 health professional as having a mental ill13 ness or co-occurring mental illness and 

14 substance abuse disorders; 

15 ‘‘(II) manifests obvious signs of men16 tal illness or co-occurring mental illness 

17 and substance abuse disorders during ar18 rest or confinement or before any court; or 

19 ‘‘(III) in the case of a veterans treat20 ment court provided under subsection (i), 

21 has been diagnosed with, or manifests ob22 vious signs of, mental illness or a sub23 stance abuse disorder or co-occurring men24 tal illness and substance abuse disorder; 

25 and 


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1 ‘‘(ii) has been unanimously approved 

2 for participation in a program funded 

3 under this section by, when appropriate, 

4 the relevant— 

5 ‘‘(I) prosecuting attorney; 

6 ‘‘(II) defense attorney; 

7 ‘‘(III) probation or corrections 

8 official; 

9 ‘‘(IV) judge; and 

10 ‘‘(V) a representative from the 

11 relevant mental health agency de12 scribed in subsection (b)(5)(B)(i). 

13 ‘‘(B) DETERMINATION.—In determining 

14 whether to designate an individual as a prelimi15 narily qualified offender, the relevant pros16 ecuting attorney, defense attorney, probation or 

17 corrections official, judge, and mental health or 

18 substance abuse agency representative shall 

19 take into account— 

20 ‘‘(i) whether the participation of the 

21 individual in the program would pose a 

22 substantial risk of violence to the commu23 nity; 


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1 ‘‘(ii) the criminal history of the indi2 vidual and the nature and severity of the 

3 offense for which the individual is charged; 

4 ‘‘(iii) the views of any relevant victims 

5 to the offense; 

6 ‘‘(iv) the extent to which the indi7 vidual would benefit from participation in 

8 the program; 

9 ‘‘(v) the extent to which the commu10 nity would realize cost savings because of 

11 the individual’s participation in the pro12 gram; and 

13 ‘‘(vi) whether the individual satisfies 

14 the eligibility criteria for program partici15 pation unanimously established by the rel16 evant prosecuting attorney, defense attor17 ney, probation or corrections official, judge 

18 and mental health or substance abuse 

19 agency representative.’’. 

20 (b) TECHNICAL AND CONFORMING AMENDMENT.— 

21 Section 2927(2) of the Omnibus Crime Control and Safe 

22 Streets Act of 1968 (42 U.S.C. 3797s–6(2)) is amended 

23 by striking ‘‘has the meaning given that term in section 

24 2991(a).’’ and inserting ‘‘means an offense that— 


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1 ‘‘(A) does not have as an element the use, 

2 attempted use, or threatened use of physical 

3 force against the person or property of another; 

4 or 

5 ‘‘(B) is not a felony that by its nature in6 volves a substantial risk that physical force 

7 against the person or property of another may 

8 be used in the course of committing the of9 fense.’’. 

10 SEC. 707. REAUTHORIZATION OF APPROPRIATIONS. 

11 Subsection (l) of section 2991 of the Omnibus Crime 

12 Control and Safe Streets Act of 1968 (42 U.S.C. 3797aa), 

13 as redesignated in section 701(a), is amended— 

14 (1) in paragraph (1)— 

15 (A) in subparagraph (B), by striking 

16 ‘‘and’’ at the end; 

17 (B) in subparagraph (C), by striking the 

18 period and inserting ‘‘; and’’; and 

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

20 ‘‘(D) $40,000,000 for each of fiscal years 

21 2015 through 2019.’’; and 

22 (2) by adding at the end the following: 

23 ‘‘(3) LIMITATION.—Not more than 20 percent 

24 of the funds authorized to be appropriated under 


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1 this section may be used for purposes described in 

2 subsection (i) (relating to veterans).’’. 

3 TITLE VIII—BEHAVIORAL 

4 HEALTH INFORMATION TECH5 NOLOGY 

6 SEC. 801. EXTENSION OF HEALTH INFORMATION TECH7 NOLOGY ASSISTANCE FOR BEHAVIORAL AND 

8 MENTAL HEALTH AND SUBSTANCE ABUSE. 

9 Section 3000(3) of the Public Health Service Act (42 

10 U.S.C. 300jj(3)) is amended by inserting before ‘‘and any 

11 other category’’ the following: ‘‘behavioral and mental 

12 health professionals (as defined in section 

13 331(a)(3)(E)(i)), a substance abuse professional, a psy14 chiatric hospital (as defined in section 1861(f) of the So15 cial Security Act), a community mental health center 

16 meeting the criteria specified in section 1913(c), a residen17 tial or outpatient mental health or substance abuse treat18 ment facility,’’. 

19 SEC. 802. EXTENSION OF ELIGIBILITY FOR MEDICARE AND 

20 MEDICAID HEALTH INFORMATION TECH21 NOLOGY IMPLEMENTATION ASSISTANCE. 

22 (a) PAYMENT INCENTIVES FOR ELIGIBLE PROFES23 SIONALS UNDER MEDICARE.—Section 1848 of the Social 

24 Security Act (42 U.S.C. 1395w–4) is amended— 

25 (1) in subsection (a)(7)— 


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1 (A) in subparagraph (E), by adding at the 

2 end the following new clause: 

3 ‘‘(iv) ADDITIONAL ELIGIBLE PROFES4 SIONAL.—The term ‘additional eligible pro5 fessional’ means a clinical psychologist pro6 viding qualified psychologist services (as 

7 defined in section 1861(ii)).’’; and 

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

9 subparagraph: 

10 ‘‘(F) APPLICATION TO ADDITIONAL ELIGI11 BLE PROFESSIONALS.—The Secretary shall 

12 apply the provisions of this paragraph with re13 spect to an additional eligible professional in 

14 the same manner as such provisions apply to an 

15 eligible professional, except in applying sub16 paragraph (A)— 

17 ‘‘(i) in clause (i), the reference to 

18 2015 shall be deemed a reference to 2019; 

19 ‘‘(ii) in clause (ii), the references to 

20 2015, 2016, and 2017 shall be deemed ref21 erences to 2019, 2020, and 2021, respec22 tively; and 

23 ‘‘(iii) in clause (iii), the reference to 

24 2018 shall be deemed a reference to 

25 2022.’’; and 


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1 (2) in subsection (o)— 

2 (A) in paragraph (5), by adding at the end 

3 the following new subparagraph: 

4 ‘‘(D) ADDITIONAL ELIGIBLE PROFES5 SIONAL.—The term ‘additional eligible profes6 sional’ means a clinical psychologist providing 

7 qualified psychologist services (as defined in 

8 section 1861(ii)).’’; and 

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

10 paragraph: 

11 ‘‘(6) APPLICATION TO ADDITIONAL ELIGIBLE

12 PROFESSIONALS.—The Secretary shall apply the 

13 provisions of this subsection with respect to an addi14 tional eligible professional in the same manner as 

15 such provisions apply to an eligible professional, ex16 cept in applying— 

17 ‘‘(A) paragraph (1)(A)(ii), the reference to 

18 2016 shall be deemed a reference to 2020; 

19 ‘‘(B) paragraph (1)(B)(ii), the references 

20 to 2011 and 2012 shall be deemed references to 

21 2015 and 2016, respectively; 

22 ‘‘(C) paragraph (1)(B)(iii), the references 

23 to 2013 shall be deemed references to 2017; 


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1 ‘‘(D) paragraph (1)(B)(v), the references 

2 to 2014 shall be deemed references to 2018; 

3 and 

4 ‘‘(E) paragraph (1)(E), the reference to 

5 2011 shall be deemed a reference to 2015.’’. 

6 (b) ELIGIBLE HOSPITALS.—Section 1886 of the So7 cial Security Act (42 U.S.C. 1395ww) is amended— 

8 (1) in subsection (b)(3)(B)(ix), by adding at the 

9 end the following new subclause: 

10 ‘‘(V) The Secretary shall apply 

11 the provisions of this subsection with 

12 respect to an additional eligible hos13 pital (as defined in subsection 

14 (n)(6)(C)) in the same manner as 

15 such provisions apply to an eligible 

16 hospital, except in applying— 

17 ‘‘(aa) subclause (I), the ref18 erences to 2015, 2016, and 2017 

19 shall be deemed references to 

20 2019, 2020, and 2021, respec21 tively; and 

22 ‘‘(bb) subclause (III), the 

23 reference to 2015 shall be 

24 deemed a reference to 2019.’’; 

25 and 


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1 (2) in subsection (n)— 

2 (A) in paragraph (6), by adding at the end 

3 the following new subparagraph: 

4 ‘‘(C) ADDITIONAL ELIGIBLE HOSPITAL.— 

5 The term ‘additional eligible hospital’ means an 

6 inpatient hospital that is a psychiatric hospital 

7 (as defined in section 1861(f)).’’; and 

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

9 paragraph: 

10 ‘‘(7) APPLICATION TO ADDITIONAL ELIGIBLE

11 HOSPITALS.—The Secretary shall apply the provi12 sions of this subsection with respect to an additional 

13 eligible hospital in the same manner as such provi14 sions apply to an eligible hospital, except in applying 

15 paragraph (2)— 

16 ‘‘(A) the Secretary shall adjust the base 

17 amount specified in subparagraph (B) of such 

18 paragraph, in a manner specified by the Sec19 retary, to reflect the smaller size of such addi20 tional eligible hospitals relative to eligible hos21 pitals; 

22 ‘‘(B) the Secretary shall adjust the dis23 charge related amount specified in subpara24 graph (C) of such paragraph for each 12-month 

25 period selected by the Secretary under such 


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1 subparagraph, in a manner specified by the 

2 Secretary, to reflect the smaller size such addi3 tional hospitals relative to eligible hospitals, in4 cluding by adjusting the ranges of discharges 

5 specified in such subparagraph and the amount 

6 specified in such subparagraph for each dis7 charge within such a specified range; 

8 ‘‘(C) the references in subparagraph 

9 (E)(ii) of such paragraph to 2013 and 2015 

10 shall be deemed references to 2017 and 2019, 

11 respectively; and 

12 ‘‘(D) the reference in subparagraph (G)(i) 

13 of such paragraph to 2011 shall be deemed a 

14 reference to 2015.’’. 

15 (c) MEDICAID PROVIDERS.—Section 1903(t) of the 

16 Social Security Act (42 U.S.C. 1396b(t)) is amended— 

17 (1) in paragraph (2)(B)— 

18 (A) in clause (i), by striking ‘‘, or’’ and in19 serting a semicolon; 

20 (B) in clause (ii), by striking the period 

21 and inserting a semicolon; and 

22 (C) by adding after clause (ii) the following 

23 new clauses: 


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1 ‘‘(iii) a public hospital that is prin2 cipally a psychiatric hospital (as defined in 

3 section 1861(f)); 

4 ‘‘(iv) a private hospital that is prin5 cipally a psychiatric hospital (as defined in 

6 section 1861(f)) and that has at least 10 

7 percent of its patient volume (as estimated 

8 in accordance with a methodology estab9 lished by the Secretary) attributable to in10 dividuals receiving medical assistance 

11 under this title; 

12 ‘‘(v) a community mental health cen13 ter meeting the criteria specified in section 

14 1913(c) of the Public Health Service Act; 

15 or 

16 ‘‘(vi) a residential or outpatient men17 tal health or substance abuse treatment fa18 cility that— 

19 ‘‘(I) is accredited by the Joint 

20 Commission on Accreditation of 

21 Healthcare Organizations, the Com22 mission on Accreditation of Rehabili23 tation Facilities, the Council on Ac24 creditation, or any other national acVerDate Mar 15 2010 23:55 May 13, 2014 Jkt 039200 PO 00000 Frm 00129 Fmt 6652 Sfmt 6201 E:\BILLS\H4574.IH H4574

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1 crediting agency recognized by the 

2 Secretary; and 

3 ‘‘(II) has at least 10 percent of 

4 its patient volume (as estimated in ac5 cordance with a methodology estab6 lished by the Secretary) attributable 

7 to individuals receiving medical assist8 ance under this title.’’; 

9 (2) in paragraph (3)(B)— 

10 (A) in clause (iv), by striking ‘‘and’’ after 

11 the semicolon; 

12 (B) in clause (v), by striking the period 

13 and inserting ‘‘; and’’; and 

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

15 clause: 

16 ‘‘(vi) clinical psychologist providing 

17 qualified psychologist services (as defined 

18 in section 1861(ii)), if such clinical psy19 chologist is practicing in an outpatient 

20 clinic that— 

21 ‘‘(I) is led by a clinical psycholo22 gist; and 

23 ‘‘(II) is not otherwise receiving 

24 payment under paragraph (1) as a 


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1 Medicaid provider described in para2 graph (2)(B).’’; and 

3 (3) in paragraph (5)(B), by adding at the end 

4 the following new sentence: ‘‘For purposes of this 

5 subparagraph in computing the amounts under sec6 tion 1886(n)(2)(C) for payment years after 2015, 

7 with respect to a Medicaid provider described in 

8 clause (iii), (iv), (v), or (vi) of paragraph (2)(B), in 

9 order to reflect the smaller size of Medicaid pro10 viders described in such clauses relative to Medicaid 

11 providers described in clauses (i) and (ii) of such 

12 paragraph (2)(B), the Secretary shall, in a manner 

13 specified by the Secretary, adjust the base amount 

14 specified in subparagraph (B) of section 1886(n)(2) 

15 and the discharge related amount calculated under 

16 subparagraph (C) of such section, including by ad17 justing the ranges of discharges specified in such 

18 subparagraph (C) and the amount specified in such 

19 subparagraph (C) for each discharge within such a 

20 specified range.’’. 

21 (d) MEDICARE ADVANTAGE ORGANIZATIONS.—Sec22 tion 1853 of the Social Security Act (42 U.S.C. 1395w– 

23 23) is amended— 

24 (1) in subsection (l)— 

25 (A) in paragraph (1)— 


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1 (i) by inserting ‘‘or additional eligible 

2 professionals (as described in paragraph 

3 (9))’’ after ‘‘paragraph (2)’’; and 

4 (ii) by inserting ‘‘and additional eligi5 ble professionals’’ before ‘‘under such sec6 tions’’; 

7 (B) in paragraph (3)(B)— 

8 (i) in clause (i) in the matter pre9 ceding subclause (I), by inserting ‘‘or an 

10 additional eligible professional described in 

11 paragraph (9)’’ after ‘‘paragraph (2)’’; and 

12 (ii) in clause (ii)— 

13 (I) in the matter preceding sub14 clause (I), by inserting ‘‘or an addi15 tional eligible professional described in 

16 paragraph (9)’’ after ‘‘paragraph 

17 (2)’’; and 

18 (II) in subclause (I), by inserting 

19 ‘‘or an additional eligible professional, 

20 respectively,’’ after ‘‘eligible profes21 sional’’; 

22 (C) in paragraph (3)(C), by inserting ‘‘and 

23 additional eligible professionals’’ after ‘‘all eligi24 ble professionals’’; 


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1 (D) in paragraph (4)(D), by adding at the 

2 end the following new sentence: ‘‘In the case 

3 that a qualifying MA organization attests that 

4 not all additional eligible professionals of the 

5 organization are meaningful EHR users with 

6 respect to an applicable year, the Secretary 

7 shall apply the payment adjustment under this 

8 paragraph based on the proportion of all such 

9 additional eligible professionals of the organiza10 tion that are not meaningful EHR users for 

11 such year.’’; 

12 (E) in paragraph (6)(A), by inserting 

13 ‘‘and, as applicable, each additional eligible pro14 fessional described in paragraph (9)’’ after 

15 ‘‘paragraph (2)’’; 

16 (F) in paragraph (6)(B), by inserting 

17 ‘‘and, as applicable, each additional eligible hos18 pital described in paragraph (9)’’ after ‘‘sub19 section (m)(1)’’; 

20 (G) in paragraph (7)(A), by inserting 

21 ‘‘and, as applicable, additional eligible profes22 sionals’’ after ‘‘eligible professionals’’; 

23 (H) in paragraph (7)(B), by inserting 

24 ‘‘and, as applicable, additional eligible profes25 sionals’’ after ‘‘eligible professionals’’; 


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1 (I) in paragraph (8)(B), by inserting ‘‘and 

2 additional eligible professionals described in 

3 paragraph (9)’’ after ‘‘paragraph (2)’’; and 

4 (J) by adding at the end the following new 

5 paragraph: 

6 ‘‘(9) ADDITIONAL ELIGIBLE PROFESSIONAL DE7 SCRIBED.—With respect to a qualifying MA organi8 zation, an additional eligible professional described 

9 in this paragraph is an additional eligible profes10 sional (as defined for purposes of section 1848(o)) 

11 who— 

12 ‘‘(A)(i) is employed by the organization; or 

13 ‘‘(ii)(I) is employed by, or is a partner of, 

14 an entity that through contract with the organi15 zation furnishes at least 80 percent of the enti16 ty’s Medicare patient care services to enrollees 

17 of such organization; and 

18 ‘‘(II) furnishes at least 80 percent of the 

19 professional services of the additional eligible 

20 professional covered under this title to enrollees 

21 of the organization; and 

22 ‘‘(B) furnishes, on average, at least 20 

23 hours per week of patient care services.’’; and 

24 (2) in subsection (m)— 

25 (A) in paragraph (1)— 


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1 (i) by inserting ‘‘or additional eligible 

2 hospitals (as described in paragraph (7))’’ 

3 after ‘‘paragraph (2)’’; and 

4 (ii) by inserting ‘‘and additional eligi5 ble hospitals’’ before ‘‘under such sec6 tions’’; 

7 (B) in paragraph (3)(A)(i), by inserting 

8 ‘‘or additional eligible hospital’’ after ‘‘eligible 

9 hospital’’; 

10 (C) in paragraph (3)(A)(ii), by inserting 

11 ‘‘or an additional eligible hospital’’ after ‘‘eligi12 ble hospital’’ in each place it occurs; 

13 (D) in paragraph (3)(B)— 

14 (i) in clause (i), by inserting ‘‘or an 

15 additional eligible hospital described in 

16 paragraph (7)’’ after ‘‘paragraph (2)’’; and 

17 (ii) in clause (ii)— 

18 (I) in the matter preceding sub19 clause (I), by inserting ‘‘or an addi20 tional eligible hospital described in 

21 paragraph (7)’’ after ‘‘paragraph 

22 (2)’’; and 

23 (II) in subclause (I), by inserting 

24 ‘‘or an additional eligible hospital, re25 spectively,’’ after ‘‘eligible hospital’’; 


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1 (E) in paragraph (4)(A), by inserting ‘‘or 

2 one or more additional eligible hospitals (as de3 fined in section 1886(n)), as appropriate,’’ after 

4 ‘‘section 1886(n)(6)(A))’’; 

5 (F) in paragraph (4)(D), by adding at the 

6 end the following new sentence: ‘‘In the case 

7 that a qualifying MA organization attests that 

8 not all additional eligible hospitals of the orga9 nization are meaningful EHR users with re10 spect to an applicable period, the Secretary 

11 shall apply the payment adjustment under this 

12 paragraph based on the methodology specified 

13 by the Secretary, taking into account the pro14 portion of such additional eligible hospitals, or 

15 discharges from such hospitals, that are not 

16 meaningful EHR users for such period.’’; 

17 (G) in paragraph (5)(A), by inserting 

18 ‘‘and, as applicable, each additional eligible hos19 pital described in paragraph (7)’’ after ‘‘para20 graph (2)’’; 

21 (H) in paragraph (5)(B), by inserting 

22 ‘‘and additional eligible hospitals, as applica23 ble,’’ after ‘‘eligible hospitals’’; 


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1 (I) in paragraph (6)(B), by inserting ‘‘and 

2 additional eligible hospitals described in para3 graph (7)’’ after ‘‘paragraph (2)’’; and 

4 (J) by adding at the end the following new 

5 paragraph: 

6 ‘‘(7) ADDITIONAL ELIGIBLE HOSPITAL DE7 SCRIBED.—With respect to a qualifying MA organi8 zation, an additional eligible hospital described in 

9 this paragraph is an additional eligible hospital (as 

10 defined in section 1886(n)(6)(C)) that is under com11 mon corporate governance with such organization 

12 and serves individuals enrolled under an MA plan of13 fered by such organization.’’. 

14 TITLE IX—SERVICEMEMBERS 

15 AND VETERANS MENTAL 

16 HEALTH 

17 SEC. 901. PRELIMINARY MENTAL HEALTH ASSESSMENTS. 

18 (a) IN GENERAL.—Chapter 31 of title 10, United 

19 States Code, is amended by adding at the end the fol20 lowing new section: 

21 ‘‘SEC. 520d. PRELIMINARY MENTAL HEALTH ASSESSMENTS. 

22 ‘‘(a) PROVISION OF MENTAL HEALTH ASSESS23 MENT.—Before any individual enlists in an Armed Force 

24 or is commissioned as an officer in an Armed Force, the 

25 Secretary concerned shall provide the individual with a 


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1 mental health assessment. The Secretary shall use such 

2 results as a baseline for any subsequent mental health ex3 aminations, including such examinations provided under 

4 sections 1074f and 1074m of this title. 

5 ‘‘(b) USE OF ASSESSMENT.—The Secretary may not 

6 consider the results of a mental health assessment con7 ducted under subsection (a) in determining the assign8 ment or promotion of a member of the Armed Forces. 

9 ‘‘(c) APPLICATION OF PRIVACY LAWS.—With respect 

10 to applicable laws and regulations relating to the privacy 

11 of information, the Secretary shall treat a mental health 

12 assessment conducted under subsection (a) in the same 

13 manner as the medical records of a member of the Armed 

14 Forces.’’. 

15 (b) CLERICAL AMENDMENT.—The table of sections 

16 at the beginning of such chapter is amended by adding 

17 after the item relating to section 520c the following new 

18 item: 

‘‘520d. Preliminary mental health assessments.’’. 

19 (c) REPORT.— 

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

21 after the date of the enactment of this Act, the Sec22 retary of Defense shall submit to Congress a report 

23 on preliminary mental health assessments of mem24 bers of the Armed Forces. 


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1 (2) MATTERS INCLUDED.—The report under 

2 paragraph (1) shall include the following: 

3 (A) Recommendations with respect to es4 tablishing a preliminary mental health assess5 ment of members of the Armed Forces to bring 

6 mental health screenings to parity with physical 

7 screenings of members. 

8 (B) Recommendations with respect to the 

9 composition of the mental health assessment, 

10 best practices, and how to track assessment 

11 changes relating to traumatic brain injuries, 

12 post-traumatic stress disorder, and other condi13 tions. 

14 (3) COORDINATION.—The Secretary shall carry 

15 out paragraph (1) in coordination with the Secretary 

16 of Veterans Affairs, the Uniformed Services Univer17 sity of the Health Sciences, the surgeons general of 

18 the military departments, and other relevant experts. 

19 SEC. 902. UNLIMITED ELIGIBILITY FOR HEALTH CARE FOR 

20 MENTAL ILLNESSES FOR VETERANS OF COM21 BAT SERVICE DURING CERTAIN PERIODS OF 

22 HOSTILITIES AND WAR. 

23 (a) ELIGIBILITY.—Section 1710(e)(1) of title 38, 

24 United States Code, is amended by adding at the end the 

25 following new subparagraph: 


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1 ‘‘(G) Notwithstanding paragraphs (2) and 

2 (3), a veteran who served on active duty in a 

3 theater of combat operations (as determined by 

4 the Secretary in consultation with the Secretary 

5 of Defense) during World War II, the Korean 

6 conflict, the Vietnam Era, the Persian Gulf 

7 war, Operation Iraqi Freedom, Operation En8 during Freedom, or any other period of war 

9 after the Persian Gulf war, or in combat 

10 against a hostile force during a period of hos11 tilities (as defined in section 1712A(a)(2)(B) of 

12 this title), is eligible for hospital care, medical 

13 services, and nursing home care under sub14 section (a)(2)(F) for any mental illness, not15 withstanding that there is insufficient medical 

16 evidence to conclude that such illness is attrib17 utable to such service.’’. 

18 (b) EFFECTIVE DATE.—Subparagraph (G) of section 

19 1710(e)(1) of title 38, United States Code, as added by 

20 subsection (a), shall apply with respect to hospital care, 

21 medical services, and nursing home care provided on or 

22 after the date of the enactment of this Act. 


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1 SEC. 903. TIMELINE FOR IMPLEMENTING INTEGRATED 

2 ELECTRONIC HEALTH RECORDS. 

3 (a) ESTABLISHMENT OF TIMELINE.—Section 1635 

4 of the Wounded Warrior Act (10 U.S.C. 1071 note) is 

5 amended by adding at the end the following new sub6 section: 

7 ‘‘(k) TIMELINE.—In carrying out this section, the 

8 Secretary of Defense and the Secretary of Veterans Af9 fairs shall ensure that— 

10 ‘‘(1) the creation of a health data authoritative 

11 source is achieved by not later than 180 days after 

12 the date of the enactment of this subsection; 

13 ‘‘(2) the ability of patients of both the Depart14 ment of Defense and the Department of Veterans 

15 Affairs to download the medical records of the pa16 tient (commonly referred to as the ‘Blue Button Ini17 tiative’) is achieved by not later than 365 days after 

18 the date of the enactment of this subsection; 

19 ‘‘(3) the seamless integration of personal health 

20 care information between the Departments is 

21 achieved by not later than 365 days after the date 

22 of the enactment of this subsection; 

23 ‘‘(4) the standardization of health care data of 

24 the Departments is achieved by not later than 365 

25 days after the date of the enactment of this sub26 section; 


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1 ‘‘(5) the acceleration of the exchange of real2 time data between the Departments is achieved by 

3 not later than 365 days after the date of the enact4 ment of this subsection; 

5 ‘‘(6) the upgrade of the graphical user interface 

6 to display the new standardized health care data of 

7 the Departments is achieved by not later than 365 

8 days after the date of the enactment of this sub9 section; 

10 ‘‘(7) each incoming member of the Armed 

11 Forces and the dependent of such a member may 

12 elect to receive an electronic copy of the health care 

13 record of the individual beginning not later than Oc14 tober 1, 2014; and 

15 ‘‘(8) each current member of the Armed Forces 

16 and the dependent of such a member may elect to 

17 receive an electronic copy of the health care record 

18 of the individual beginning not later than October 1, 

19 2015.’’. 

20 (b) CLOUD STORAGE.—Section 1635 of such Act is 

21 further amended by adding at the end the following new 

22 subsection: 

23 ‘‘(l) CLOUD STORAGE.—The Secretary of Defense 

24 and the Secretary of Veterans Affairs shall study the fea25 sibility of establishing a secure, remote, network-accessible 


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1 computer storage system (commonly referred to as ‘cloud 

2 storage’) to— 

3 ‘‘(1) provide members of the Armed Forces and 

4 veterans the ability to upload the health care records 

5 of the member or veteran if the member or veteran 

6 elects to do so; and 

7 ‘‘(2) allow medical providers of the Department 

8 of Defense and the Department of Veterans Affairs 

9 to access such records in the course of providing 

10 care to the member or veteran.’’. 

11 (c) CONFORMING AMENDMENTS.—Section 1635 of 

12 such Act is further amended— 

13 (1) in subsection (a), by striking ‘‘The Sec14 retary’’ and inserting ‘‘In accordance with the 

15 timeline described in subsection (k), the Secretary’’; 

16 and 

17 (2) in the matter preceding paragraph (1) of 

18 subsection (e), by inserting ‘‘in accordance with sub19 section (k)’’ after ‘‘under this section’’. 

20 SEC. 904. PILOT PROGRAM FOR REPAYMENT OF EDU21 CATIONAL LOANS FOR CERTAIN PSYCHIA22 TRISTS OF VETERANS HEALTH ADMINISTRA23 TION. 

24 (a) PILOT PROGRAM.— 


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1 (1) ESTABLISHMENT.—The Secretary of Vet2 erans Affairs shall carry out a pilot program to 

3 repay a loan of an individual described in paragraph 

4 (2) that— 

5 (A) was used by the individual to finance 

6 education regarding psychiatric medicine, in7 cluding education leading to an undergraduate 

8 degree and education leading to the degree of 

9 doctor of medicine or of doctor of osteopathy; 

10 and 

11 (B) was obtained from a governmental en12 tity, private financial institution, school, or 

13 other authorized entity, as determined by the 

14 Secretary. 

15 (2) ELIGIBLE INDIVIDUALS.—To be eligible to 

16 obtain a loan repayment under this subsection, an 

17 individual shall— 

18 (A) either— 

19 (i) be licensed or eligible for licensure 

20 to practice psychiatric medicine in the Vet21 erans Health Administration of the De22 partment of Veterans Affairs; or 

23 (ii) be enrolled in the final year of a 

24 residency program leading to a specialty 

25 qualification in psychiatric medicine that is 


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1 approved by the Accreditation Council for 

2 Graduate Medical Education; and 

3 (B) as determined appropriate by the Sec4 retary, demonstrate a commitment to a long5 term career as a psychiatrist in the Veterans 

6 Health Administration, including by requiring a 

7 set number of years of obligated service. 

8 (3) SELECTION.—The Secretary shall select not 

9 less than 10 individuals described in paragraph (2) 

10 to participate in the pilot program for each year in 

11 which the Secretary carries out the pilot program. 

12 (4) LOAN REPAYMENTS.— 

13 (A) AMOUNTS.—Subject to the limits es14 tablished by subparagraph (B), a loan repay15 ment under this subsection may consist of pay16 ment of the principal, interest, and related ex17 penses of a loan obtained by an individual de18 scribed in paragraph (2) for all educational ex19 penses (including tuition, fees, books, and lab20 oratory expenses) relating to a degree described 

21 in paragraph (1)(A). 

22 (B) LIMIT.—For each year of obligated 

23 service that an individual agrees to serve in an 

24 agreement described in paragraph (2)(B), the 


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1 Secretary may pay not more than $60,000 on 

2 behalf of the individual. 

3 (5) BREACH.— 

4 (A) LIABILITY.—An individual who partici5 pates in the pilot program under paragraph (1) 

6 who fails to satisfy the commitment described 

7 in paragraph (2)(B) shall be liable to the 

8 United States, in lieu of any service obligation 

9 arising from such participation, for the amount 

10 which has been paid or is payable to or on be11 half of the individual under the program, re12 duced by the proportion that the number of 

13 days served for completion of the service obliga14 tion bears to the total number of days in the 

15 period of obligated service of the individual. 

16 (B) REPAYMENT PERIOD.—Any amount of 

17 damages which the United States is entitled to 

18 recover under this paragraph shall be paid to 

19 the United States within the one-year period 

20 beginning on the date of the breach of the 

21 agreement. 

22 (6) PROHIBITION ON SIMULTANEOUS ELIGI23 BILITY.—An individual who is participating in any 

24 other program of the Federal Government that re25 pays the educational loans of the individual may not 


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1 participate in the pilot program under paragraph 

2 (1). 

3 (7) REPORT.—Not later than 90 days after the 

4 date on which the pilot program terminates under 

5 paragraph (7), the Secretary shall submit to the 

6 Committees on Veterans’ Affairs of the House of 

7 Representatives and the Senate a report on the pilot 

8 program. The report shall include the overall effect 

9 of the pilot program on the psychiatric workforce 

10 shortage of the Veterans Health Administration, the 

11 long-term stability of such workforce, and overall 

12 workforce strategies of the Veterans Health Admin13 istration that seek to promote the physical and men14 tal resiliency of all veterans. 

15 (8) REGULATIONS.—The Secretary shall pre16 scribe regulations to carry out this subsection, in17 cluding standards for qualified loans and authorized 

18 payees and other terms and conditions for the mak19 ing of loan repayments. 

20 (9) TERMINATION.—The authority to carry out 

21 the pilot program shall expire on the date that is 

22 three years after the date on which the Secretary 

23 commences the pilot program. 


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1 (b) COMPTROLLER GENERAL STUDY ON PAY DIS2 PARITIES OF PSYCHIATRISTS OF VETERANS HEALTH AD3 MINISTRATION.— 

4 (1) STUDY.—Not later than one year after the 

5 date of the enactment of this Act, the Comptroller 

6 General of the United States shall conduct a study 

7 of pay disparities among psychiatrists of the Vet8 erans Health Administration of the Department of 

9 Veterans Affairs. The study shall include— 

10 (A) an examination of laws, regulations, 

11 practices, and policies, including salary flexibili12 ties, that contribute to such disparities; and 

13 (B) recommendations with respect to legis14 lative or regulatory actions to improve equity in 

15 pay among such psychiatrists. 

16 (2) REPORT.—Not later than one year after the 

17 date on which the Comptroller General completes the 

18 study under paragraph (1), the Comptroller General 

19 shall submit to the Committees on Veterans’ Affairs 

20 of the House of Representatives and the Senate a 

21 report containing the results of the study. 


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1 TITLE X—MAKING PARITY WORK 

2 SEC. 1001. GAO STUDY ON MENTAL HEALTH AND SUB3 STANCE USE DISORDER PARITY ENFORCE4 MENT EFFORTS. 

5 Not later than one year after the date of enactment 

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

7 in consultation with the Secretary of Health and Human 

8 Services and the Secretary of Labor, shall submit to Con9 gress a report detailing the enforcement efforts of the re10 sponsible departments and agencies in implementing the 

11 Paul Wellstone and Pete Domenici Mental Health Parity 

12 and Addiction Equity Act (subtitle B of title V of division 

13 C of Public Law 110–343), including— 

14 (1) the number of investigations that have been 

15 conducted into potential parity violations; and 

16 (2) details on the investigation or enforcement 

17 action that was carried out as a result of such inves18 tigations that would not identify the subject of such 

19 investigation or enforcement. 


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1 SEC. 1002. REPORT TO CONGRESS ON FEDERAL ASSIST2 ANCE TO STATE INSURANCE REGULATORS 

3 REGARDING MENTAL HEALTH PARITY EN4 FORCEMENT. 

5 Not later than one year after the date of enactment 

6 of this Act, the Secretary of Health and Human Services 

7 shall submit to Congress a report detailing— 

8 (1) the ways in which State governments and 

9 State insurance regulators are either empowered or 

10 required to enforce the Paul Wellstone and Pete 

11 Domenici Mental Health Parity and Addiction Eq12 uity Act of 2008 (subtitle B of title V of division C 

13 of Public Law 110–343); 

14 (2) their capability to carry out these enforce15 ment powers or requirements; and 

16 (3) any technical assistance to State govern17 ment and State insurance regulators that has been 

18 communicated by the Department of Health and 

19 Human Services. 

20 SEC. 1003. ANNUAL REPORT TO CONGRESS BY SECRE21 TARIES OF LABOR AND HEALTH AND HUMAN 

22 SERVICES. 

23 Not later than one year after the date of enactment 

24 of this Act, and annually thereafter, the Secretary of 

25 Labor, in coordination with the Secretary of Health and 

26 Human Services, shall submit to Congress a report— 


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1 (1) describing the actions taken by the Federal 

2 Government and the States to ensure compliance 

3 with the Paul Wellstone and Pete Domenici Mental 

4 Health Parity and Addiction Equity Act of 2008 

5 (subtitle B of title V of division C of Public Law 

6 110–343); 

7 (2) including a collection and classification of 

8 inquiries and complaints regarding the implementa9 tion or enforcement of such Act; 

10 (3) including a transparent de-identified report 

11 of all Federal and State actions to enforce such Act; 

12 and 

13 (4) include a compliance guide that includes— 

14 (A) detailed answers to relevant questions 

15 raised during the previous year concerning im16 plementation or enforcement of such Act; and 

17 (B) specific guidelines providing clear in18 terpretations of such Act and the regulations 

19 thereunder. 

Æ 


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