I 

111TH CONGRESS 

2D SESSION H. R. 5636 

To establish Federally Qualified Behavioral Health Centers and to require 

Medicaid coverage for services provided by such Centers. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 29, 2010 

Ms. MATSUI (for herself and Mr. ENGEL) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To establish Federally Qualified Behavioral Health Centers 

and to require Medicaid coverage for services provided 

by such Centers. 

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. 

4 This Act may be cited as the ‘‘Community Mental 

5 Health and Addiction Safety Net Equity Act of 2010’’. 

6 SEC. 2. FEDERALLY QUALIFIED BEHAVIORAL HEALTH CEN7 TERS. 

8 Section 1913 of the Public Health Service Act (42 

9 U.S.C. 300x–3) is amended— 


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1 (1) in subsection (a)(2)(A), by striking ‘‘com2 munity mental health services’’ and inserting ‘‘be3 havioral health services (of the type offered by feder4 ally qualified behavioral health centers consistent 

5 with subsection (c)(3))’’; 

6 (2) in subsection (b)— 

7 (A) by striking paragraph (1) and insert8 ing the following: 

9 ‘‘(1) services under the plan will be provided 

10 only through appropriate, qualified community pro11 grams (which may include federally qualified behav12 ioral health centers, child mental health programs, 

13 psychosocial rehabilitation programs, mental health 

14 peer-support programs, and mental health primary 

15 consumer-directed programs); and’’; and 

16 (B) in paragraph (2), by striking ‘‘commu17 nity mental health centers’’ and inserting ‘‘fed18 erally qualified behavioral health centers’’; and 

19 (3) by striking subsection (c) and inserting the 

20 following: 

21 ‘‘(c) CRITERIA FOR FEDERALLY QUALIFIED BEHAV22 IORAL HEALTH CENTERS.— 

23 ‘‘(1) IN GENERAL.—The Administrator shall 

24 certify, and recertify at least every 5 years, federally 


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1 qualified behavioral health centers as meeting the 

2 criteria specified in this subsection. 

3 ‘‘(2) REGULATIONS.—Not later than 18 months 

4 after the date of the enactment of the Community 

5 Mental Health and Addiction Safety Net Equity Act 

6 of 2010, the Administrator shall issue final regula7 tions for certifying non-profit or local government 

8 centers as centers under paragraph (1). 

9 ‘‘(3) CRITERIA.—The criteria referred to in 

10 subsection (b)(2) are that the center performs each 

11 of the following: 

12 ‘‘(A) Provide services in locations that en13 sure services will be available and accessible 

14 promptly and in a manner which preserves 

15 human dignity and assures continuity of care. 

16 ‘‘(B) Provide services in a mode of service 

17 delivery appropriate for the target population. 

18 ‘‘(C) Provide individuals with a choice of 

19 service options where there is more than one ef20 ficacious treatment. 

21 ‘‘(D) Employ a core staff of clinical staff 

22 that is multidisciplinary and culturally and lin23 guistically competent. 

24 ‘‘(E) Provide services, within the limits of 

25 the capacities of the center, to any individual 


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1 residing or employed in the service area of the 

2 center, regardless of the ability of the individual 

3 to pay. 

4 ‘‘(F) Provide, directly or through contract, 

5 to the extent covered for adults in the State 

6 Medicaid plan under title XIX of the Social Se7 curity Act and for children in accordance with 

8 section 1905(r) of such Act regarding early and 

9 periodic screening, diagnosis, and treatment, 

10 each of the following services: 

11 ‘‘(i) Screening, assessment, and diag12 nosis, including risk assessment. 

13 ‘‘(ii) Person-centered treatment plan14 ning or similar processes, including risk as15 sessment and crisis planning. 

16 ‘‘(iii) Outpatient clinic mental health 

17 services, including screening, assessment, 

18 diagnosis, psychotherapy, substance abuse 

19 counseling, medication management, and 

20 integrated treatment for mental illness and 

21 substance abuse which shall be evidence22 based (including cognitive behavioral ther23 apy and other such therapies which are 

24 evidence-based). 


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1 ‘‘(iv) Outpatient clinic primary care 

2 services, including screening and moni3 toring of key health indicators and health 

4 risk (including screening for diabetes, hy5 pertension, and cardiovascular disease and 

6 monitoring of weight, height, body mass 

7 index (BMI), blood pressure, blood glucose 

8 or HbA1C, and lipid profile). 

9 ‘‘(v) Crisis mental health services, in10 cluding 24-hour mobile crisis teams, emer11 gency crisis intervention services, and cri12 sis stabilization. 

13 ‘‘(vi) Targeted case management 

14 (services to assist individuals gaining ac15 cess to needed medical, social, educational, 

16 and other services and applying for income 

17 security and other benefits to which they 

18 may be entitled). 

19 ‘‘(vii) Psychiatric rehabilitation serv20 ices including skills training, assertive com21 munity treatment, family psychoeducation, 

22 disability self-management, supported em23 ployment, supported housing services, 

24 therapeutic foster care services, and such 


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1 other evidence-based practices as the Sec2 retary may require. 

3 ‘‘(viii) Peer support and counselor 

4 services and family supports. 

5 ‘‘(G) Maintain linkages, and where possible 

6 enter into formal contracts with the following: 

7 ‘‘(i) Inpatient psychiatric facilities and 

8 substance abuse detoxification and residen9 tial programs. 

10 ‘‘(ii) Adult and youth peer support 

11 and counselor services. 

12 ‘‘(iii) Family support services for fam13 ilies of children with serious mental dis14 orders. 

15 ‘‘(iv) Other community or regional 

16 services, supports, and providers, including 

17 schools, child welfare agencies, juvenile and 

18 criminal justice agencies and facilities, 

19 housing agencies and programs, employers, 

20 and other social services. 

21 ‘‘(v) Onsite or offsite access to pri22 mary care services. 

23 ‘‘(vi) Enabling services, including out24 reach, transportation, and translation. 


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1 ‘‘(vii) Health and wellness services, in2 cluding services for tobacco cessation.’’. 

3 SEC. 3. MEDICAID COVERAGE AND PAYMENT FOR FEDER4 ALLY QUALIFIED BEHAVIORAL HEALTH CEN5 TER SERVICES. 

6 (a) PAYMENT FOR SERVICES PROVIDED BY FEDER7 ALLY QUALIFIED BEHAVIORAL HEALTH CENTERS.—Sec8 tion 1902(bb) of the Social Security Act (42 U.S.C. 

9 1396a(bb)) is amended— 

10 (1) in the heading, by striking ‘‘AND RURAL

11 HEALTH CLINICS’’ and inserting ‘‘, FEDERALLY

12 QUALIFIED BEHAVIORAL HEALTH CENTERS, AND

13 RURAL HEALTH CLINICS’’; 

14 (2) in paragraph (1), by inserting ‘‘(and begin15 ning with fiscal year 2011 with respect to services 

16 furnished on or after January 1, 2011, and each 

17 succeeding fiscal year, for services described in sec18 tion 1905(a)(2)(D) furnished by a federally qualified 

19 behavioral health center)’’ after ‘‘by a rural health 

20 clinic’’; 

21 (3) in paragraph (2)— 

22 (A) by striking the heading and inserting 

23 ‘‘INITIAL FISCAL YEAR’’; 

24 (B) by inserting ‘‘(or, in the case of serv25 ices described in section 1905(a)(2)(D) furVerDate Mar 15 2010 23:59 Jun 30, 2010 Jkt 089200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\H5636.IH H5636

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1 nished by a federally qualified behavioral health 

2 center, for services furnished on and after Jan3 uary 1, 2011, during fiscal year 2011)’’ after 

4 ‘‘January 1, 2001, during fiscal year 2001’’; 

5 (C) by inserting ‘‘(or, in the case of serv6 ices described in section 1905(a)(2)(D) fur7 nished by a federally qualified behavioral health 

8 center, during fiscal years 2009 and 2010)’’ 

9 after ‘‘1999 and 2000’’; and 

10 (D) by inserting ‘‘(or, in the case of serv11 ices described in section 1905(a)(2)(D) fur12 nished by a federally qualified behavioral health 

13 center, during fiscal year 2011)’’ before the pe14 riod; 

15 (4) in paragraph (3)— 

16 (A) in the heading, by striking ‘‘FISCAL

17 YEAR 2002 AND SUCCEEDING’’ and inserting 

18 ‘‘SUCCEEDING’’; and 

19 (B) by inserting ‘‘(or, in the case of serv20 ices described in section 1905(a)(2)(D) fur21 nished by a federally qualified behavioral health 

22 center, for services furnished during fiscal year 

23 2012 or a succeeding fiscal year)’’ after ‘‘2002 

24 or a succeeding fiscal year’’; 

25 (5) in paragraph (4)— 


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1 (A) by inserting ‘‘(or as a federally quali2 fied behavioral health center after fiscal year 

3 2010)’’ after ‘‘or rural health clinic after fiscal 

4 year 2000’’; 

5 (B) by striking ‘‘furnished by the center 

6 or’’ and inserting ‘‘furnished by the federally 

7 qualified health center, services described in 

8 section 1905(a)(2)(D) furnished by the feder9 ally qualified behavioral health center, or’’; 

10 (C) in the second sentence, by striking ‘‘or 

11 rural health clinic’’ and inserting ‘‘, federally 

12 qualified behavioral health center, or rural 

13 health clinic’’; 

14 (6) in paragraph (5), in each of subparagraphs 

15 (A) and (B), by striking ‘‘or rural health clinic’’ and 

16 inserting ‘‘, federally qualified behavioral health cen17 ter, or rural health clinic’’; and 

18 (7) in paragraph (6), by striking ‘‘or to a rural 

19 health clinic’’ and inserting ‘‘, to a federally quali20 fied behavioral health center for services described in 

21 section 1905(a)(2)(D), or to a rural health clinic’’. 

22 (b) INCLUSION OF FEDERALLY QUALIFIED BEHAV23 IORAL HEALTH CENTER SERVICES IN THE TERM MED24 ICAL ASSISTANCE.—Section 1905(a)(2) of the Social Se25 curity Act (42 U.S.C. 1396d(a)(2)) is amended— 


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1 (1) by striking ‘‘and’’ before ‘‘(C)’’; and 

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

3 the following: ‘‘, and (D) federally qualified behav4 ioral health center services (as defined in subsection 

5 (l)(4))’’. 

6 (c) DEFINITION OF FEDERALLY QUALIFIED BEHAV7 IORAL HEALTH CENTER SERVICES.—Section 1905(l) of 

8 the Social Security Act (42 U.S.C. 1396d(l)) is amended 

9 by adding at the end the following paragraph: 

10 ‘‘(4)(A) The term ‘federally qualified behavioral 

11 health center services’ means services furnished to 

12 an individual at a federally qualified behavioral 

13 health center (as defined by subparagraph (B). 

14 ‘‘(B) The term ‘federally qualified behavioral 

15 health center’ means an entity that is certified under 

16 section 1913(c) of the Public Health Service Act as 

17 meeting the criteria described in paragraph (3) of 

18 such section.’’. 

19 SEC. 4. MENTAL HEALTH AND ADDICTION SAFETY NET 

20 STUDIES. 

21 (a) PAPERWORK REDUCTION STUDY.— 

22 (1) IN GENERAL.—Not later than 12 months 

23 after the date of the enactment of this Act, the In24 stitute of Medicine shall submit to the appropriate 

25 committees of Congress a report that evaluates the 


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1 combined paperwork burden of federally qualified be2 havioral health centers certified section 1913(c) of 

3 the Public Health Service Act, as inserted by section 

4 2. 

5 (2) SCOPE.—In preparing the report under 

6 paragraph (1), the Institute of Medicine shall exam7 ine licensing, certification, service definitions, claims 

8 payment, billing codes, and financial auditing re9 quirements utilized by the Office of Management 

10 and Budget, the Centers for Medicare & Medicaid 

11 Services, the Health Resources and Services Admin12 istration, the Substance Abuse and Mental Health 

13 Services Administration, the Office of the Inspector 

14 General, State Medicaid agencies, State departments 

15 of health, State departments of education, and State 

16 and local juvenile justice and social services agencies 

17 to— 

18 (A) establish an estimate of the combined 

19 nationwide cost of complying with the require20 ments described in this paragraph, in terms of 

21 both administrative funding and staff time; 

22 (B) establish an estimate of the per capita 

23 cost to each federally qualified behavioral health 

24 center certified under section 1913(c) of the 

25 Public Health Service Act to comply with the 


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1 requirements described in this paragraph, in 

2 terms of both administrative funding and staff 

3 time; and 

4 (C) make administrative and statutory rec5 ommendations to Congress, which may include 

6 a uniform methodology, to reduce the paper7 work burden experienced by such federally 

8 qualified behavioral health centers. 

9 (3) AUTHORIZATION OF APPROPRIATIONS.— 

10 There are authorized to be appropriated to carry out 

11 this subsection $550,000 for each of the fiscal years 

12 2012 and 2013. 

13 (b) WAGE STUDY.— 

14 (1) IN GENERAL.—Not later than 12 months 

15 after the date of the enactment of this Act, the In16 stitute of Medicine shall conduct a nationwide anal17 ysis, and submit a report to the appropriate commit18 tees of Congress, concerning the compensation struc19 ture of professional and paraprofessional personnel 

20 employed by federally qualified behavioral health 

21 centers certified under section 1913(c) of the Public 

22 Health Service Act, as inserted by section 2, as com23 pared with the compensation structure of com24 parable health safety net providers and relevant pri25 vate sector health care employers. 


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1 (2) SCOPE.—In preparing the report under 

2 paragraph (1), the Institute of Medicine shall exam3 ine compensation disparities, if such disparities are 

4 determined to exist, by type of personnel, type of 

5 provider or private sector employer, and by geo6 graphic region. 

7 (3) AUTHORIZATION OF APPROPRIATIONS.— 

8 There are authorized to be appropriated to carry out 

9 this subsection, $550,000 for each of the fiscal years 

10 2012 and 2013. 

Æ 


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