I 

117TH CONGRESS 

2D SESSION H. R. 7116 

To provide for improvements in the implementation of the National Suicide 

Prevention Lifeline, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 17, 2022 

Mr. CA ́RDENAS (for himself, Mr. FITZPATRICK, Ms. MATSUI, Ms. BLUNT

ROCHESTER, Mr. MOULTON, Mrs. NAPOLITANO, Mr. BEYER, and Mr. 

RASKIN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on 

Ways and Means, Armed Services, Veterans’ Affairs, and Oversight and 

Reform, 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 provide for improvements in the implementation of the 

National Suicide Prevention Lifeline, 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. 

4 (a) SHORT TITLE.—This Act may be cited as the ‘‘9– 

5 8–8 Implementation Act of 2022’’. 

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

7 this Act is as follows: 


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Sec. 1. Short title. 

TITLE I—SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES 

ADMINISTRATION 

Sec. 101. Behavioral Health Crisis Coordinating Office. 

Sec. 102. National suicide prevention lifeline program. 

Sec. 103. Regional and local lifeline call center program. 

Sec. 104. Evidence-based and best practice crisis care programs. 

Sec. 105. Mental Health Crisis Response Partnership Pilot Program. 

Sec. 106. National suicide prevention media campaign. 

TITLE II—HEALTH RESOURCES AND SERVICES ADMINISTRATION 

Sec. 201. Health center capital grants. 

Sec. 202. Expanding behavioral health workforce training programs. 

TITLE III—BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION 

Sec. 301. Crisis response continuum of care. 

Sec. 302. Coverage of crisis response services. 

Sec. 303. Building the crisis continuum infrastructure. 

Sec. 304. Incident reporting. 

TITLE IV—MEDICAID AMENDMENTS 

Sec. 401. Revisions to the State option to provide qualifying community-based 

mobile crisis intervention services and other services under 

State plans under the Medicaid program. 

Sec. 402. Revisions to the IMD exclusion under Medicaid. 

Sec. 403. Excellence in Mental Health and Addiction Treatment. 

1 TITLE I—SUBSTANCE ABUSE 

2 AND MENTAL HEALTH SERV3 ICES ADMINISTRATION 

4 SEC. 101. BEHAVIORAL HEALTH CRISIS COORDINATING OF5 FICE. 

6 Part A of title V of the Public Health Service Act 

7 (42 U.S.C. 290aa et seq.) is amended by adding at the 

8 end the following: 

9 ‘‘SEC. 506B. BEHAVIORAL HEALTH CRISIS COORDINATING 

10 OFFICE. 

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

12 the Assistant Secretary for Mental Health and Substance 


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1 Use, shall establish an office to coordinate work relating 

2 to behavioral health crisis care across the operating divi3 sions of the Department of Health and Human Services, 

4 including the Centers for Medicare & Medicaid Services 

5 and the Health Resources and Services Administration 

6 and external stakeholders. 

7 ‘‘(b) DUTY.—The office established under subsection 

8 (a) shall— 

9 ‘‘(1) convene Federal, State, Tribal, local, and 

10 private partners; 

11 ‘‘(2) launch and manage Federal workgroups 

12 charged with making recommendations regarding be13 havioral health crisis financing, workforce, equity, 

14 data, and technology, program oversight, public 

15 awareness, and engagement; and 

16 ‘‘(3) support technical assistance, data analysis, 

17 and evaluation functions in order to develop a crisis 

18 care system to establish nationwide standards with 

19 the objective of expanding the capacity of, and ac20 cess to, local crisis call centers, mobile crisis care, 

21 crisis stabilization, psychiatric emergency services, 

22 and rapid post-crisis follow-up care provided by— 

23 ‘‘(A) the National Suicide Prevention and 

24 Mental Health Crisis Hotline and Response 

25 System; 


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1 ‘‘(B) community mental health centers (as 

2 defined in section 1861(ff)(3)(B) of the Social 

3 Security Act); 

4 ‘‘(C) certified community behavioral health 

5 clinics, as described in section 223 of the Pro6 tecting Access to Medicare Act of 2014; and 

7 ‘‘(D) other community mental health and 

8 substance use disorder providers. 

9 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—There 

10 is authorized to be appropriated to carry out this section 

11 $10,000,000 for each of fiscal years 2023 through 2027.’’. 

12 SEC. 102. NATIONAL SUICIDE PREVENTION LIFELINE PRO13 GRAM. 

14 (a) AUTHORIZATION OF APPROPRIATIONS.—Section 

15 520E–3(c) of the Public Health Service Act (290bb– 

16 36c(c)) is amended by inserting before the period at the 

17 end the following: ‘‘, and $240,000,000 for each of fiscal 

18 years 2023 through 2027’’. 

19 (b) SPECIALIZED HOTLINE FOR UNDERSERVED POP20 ULATIONS.—Section 520E–3 of the Public Health Service 

21 Act (290bb–36c) is amended— 

22 (1) in subsection (b)— 

23 (A) in paragraph (2)— 

24 (i) by inserting after ‘‘suicide preven25 tion hotline’’ the following: ‘‘, under the 


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1 universal telephone number designated 

2 under section 251(e)(4) of the Communica3 tions Act of 1934,’’; and 

4 (ii) by striking ‘‘; and’’ at the end and 

5 inserting a semicolon; 

6 (B) in paragraph (3), by striking the pe7 riod at the end and inserting ‘‘; and’’; and 

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

9 ‘‘(4) providing for access by LGBTQ individ10 uals, people of color, and other underserved popu11 lations to specialized services through a range of dig12 ital and technology approaches, as determined by the 

13 Office of the Assistant Secretary.’’; 

14 (2) by redesignating subsection (c) as sub15 section (d); and 

16 (3) by inserting after subsection (b) the fol17 lowing: 

18 ‘‘(c) CONSULTATION.—Wherever possible, the Office 

19 of the Assistant Secretary shall, in determining which ap20 proaches to use to provide specialized services under sub21 section (b)(4) to the populations described in such sub22 section, consult with organizations that have experience— 

23 ‘‘(1) working with such populations; and 


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1 ‘‘(2) technological expertise in effective crisis 

2 response using such digital and technology ap3 proaches.’’. 

4 SEC. 103. REGIONAL AND LOCAL LIFELINE CALL CENTER 

5 PROGRAM. 

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

7 (42 U.S.C. 290bb et seq.) is amended by inserting after 

8 section 520E–4 (42 U.S.C. 290bb-36d) the following: 

9 ‘‘SEC. 520E–5. REGIONAL AND LOCAL LIFELINE CALL CEN10 TER PROGRAM. 

11 ‘‘(a) IN GENERAL.—The Secretary shall award 

12 grants to crisis call centers described in section 302(c)(1) 

13 of the 9–8–8 National Suicide Prevention Lifeline Imple14 mentation Act of 2022 to— 

15 ‘‘(1) purchase or upgrade call center tech16 nology; 

17 ‘‘(2) provide for training of call center staff; 

18 ‘‘(3) improve call center operations; and 

19 ‘‘(4) hiring of call center staff. 

20 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

21 are authorized to be appropriated to carry out this section 

22 $441,000,000 for fiscal year 2023, to remain available 

23 until expended.’’. 


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1 SEC. 104. EVIDENCE-BASED AND BEST PRACTICE CRISIS 

2 CARE PROGRAMS. 

3 (a) IN GENERAL.—Section 1912(b)(1) of the Public 

4 Health Service Act (42 U.S.C. 300x–1(b)(1)) is amend5 ed— 

6 (1) in subparagraph (A)— 

7 (A) by redesignating clauses (vi) and (vii) 

8 as clauses (vii) and (viii), respectively; and 

9 (B) by inserting after clause (v), the fol10 lowing: 

11 ‘‘(vi) include a description of how the 

12 State supports evidenced-based and best 

13 practice programs that address the crisis 

14 care needs of individuals with serious men15 tal illness, and children with serious emo16 tional disturbances, that include at least 

17 one of the core components specified in 

18 subparagraph (F);’’; and 

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

20 ‘‘(F) CORE COMPONENTS FOR CRISIS CARE

21 SERVICES.—The core components of a program 

22 referred to in subparagraph (A)(vi) include the 

23 following: 

24 ‘‘(i) Crisis call centers. 

25 ‘‘(ii) 24/7 mobile crisis services. 


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1 ‘‘(iii) Crisis stabilization programs of2 fering acute care or subacute care in a 

3 hospital or appropriately licensed facility, 

4 with referrals to inpatient or outpatient 

5 care, as determined by the Assistant Sec6 retary for Mental Health and Substance 

7 Use.’’. 

8 (b) SET-ASIDE FOR EVIDENCE-BASED AND BEST

9 PRACTICE CRISIS CARE SERVICES.—Section 1920 of the 

10 Public Health Service Act (42 U.S.C. 300x–9) is amend11 ed— 

12 (1) in subsection (a), by striking ‘‘be appro13 priated’’ and all that follows through ‘‘2022.’’ and 

14 inserting the following: ‘‘be appropriated— 

15 ‘‘(1) $532,571,000 for each of fiscal years 2018 

16 through 2022; and 

17 ‘‘(2) $2,235,000,000 for each of fiscal years 

18 2023 through 2027.’’; and 

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

20 ‘‘(d) CRISIS CARE.— 

21 ‘‘(1) IN GENERAL.—Except as provided in para22 graph (3), a State shall expend at least 10 percent 

23 of the allotment of the State pursuant to a funding 

24 agreement under section 1911 for each of fiscal 


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1 years 2023 through 2027 to support programs de2 scribed in section 1912(b)(1)(A)(vi). 

3 ‘‘(2) STATE FLEXIBILITY.—In lieu of expending 

4 10 percent of the State’s allotment for a fiscal year 

5 as required by paragraph (1), a State may elect to 

6 expend not less than 20 percent of such amount by 

7 the end of two consecutive fiscal years. 

8 ‘‘(3) FUNDING CONTINGENCY.—Paragraph (1) 

9 shall not apply with respect to a fiscal year unless 

10 the amount made available to carry out this section 

11 for that fiscal year exceeds the amount appropriated 

12 to carry out this section for fiscal year 2021 by at 

13 least $37,257,100. 

14 ‘‘(4) WAIVER.—A State may, pursuant to a 

15 waiver granted by the Secretary of any requirements 

16 under this subpart (including requirements imposed 

17 by a funding agreement under section 1911), use 

18 funds set aside under this subsection to provide serv19 ices described in section 1912(b)(1)(A)(vi) to indi20 viduals in such State who do not meet the criteria 

21 to be considered with serious mental illness or chil22 dren with serious emotional disturbances.’’. 


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1 SEC. 105. MENTAL HEALTH CRISIS RESPONSE PARTNER2 SHIP PILOT PROGRAM. 

3 Title V of the Public Health Service Act is amended 

4 (42 U.S.C. 290aa) by inserting after section 520F (42 

5 U.S.C. 290bb–37) the following: 

6 ‘‘SEC. 520F–1. MENTAL HEALTH CRISIS RESPONSE PART7 NERSHIP PILOT PROGRAM. 

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

9 pilot program under which the Secretary will award com10 petitive grants to eligible entities to establish new, or en11 hance existing, mobile crisis response teams that divert the 

12 response for mental health and substance use crises from 

13 law enforcement to mobile crisis teams, as described in 

14 subsection (b). 

15 ‘‘(b) MOBILE CRISIS TEAMS DESCRIBED.—A mobile 

16 crisis team described in this subsection is a team of indi17 viduals— 

18 ‘‘(1) that is available to respond to individuals 

19 in crisis and provide immediate stabilization, refer20 rals to community-based mental health and sub21 stance use disorder services and supports, and triage 

22 to a higher level of care if medically necessary; 

23 ‘‘(2) which may include licensed counselors, 

24 clinical social workers, physicians, paramedics, crisis 

25 workers, peer support specialists, or other qualified 

26 individuals; and 


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1 ‘‘(3) which may provide support to divert be2 havioral health crisis calls from the 9–1–1 system to 

3 the 9–8–8 system. 

4 ‘‘(c) PRIORITY.—In awarding grants under this sec5 tion, the Secretary shall prioritize applications which ac6 count for the specific needs of the communities to be 

7 served, including children and families, veterans, rural and 

8 underserved populations, and other groups at increased 

9 risk of death from suicide or overdose. 

10 ‘‘(d) REPORT.— 

11 ‘‘(1) INITIAL REPORT.—Not later than one year 

12 after the date of the enactment of this section, the 

13 Secretary shall submit to Congress a report on steps 

14 taken by eligible entities as of such date of enact15 ment to strengthen the partnerships among mental 

16 health providers, substance use disorder treatment 

17 providers, primary care physicians, mental health 

18 and substance use crisis teams, and paramedics, law 

19 enforcement officers, and other first responders. 

20 ‘‘(2) PROGRESS REPORTS.—Not later than one 

21 year after the date on which the first grant is 

22 awarded to carry out this section, and for each year 

23 thereafter, the Secretary shall submit to Congress a 

24 report on the grants made during the year covered 

25 by the report, which shall include— 


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1 ‘‘(A) data on the teams and people served 

2 by such programs, including demographic infor3 mation of individuals served, volume and types 

4 of service utilization, linkage to community5 based resources and diversion from law enforce6 ment settings, data consistent with the State 

7 block grant requirements for continuous evalua8 tion and quality improvement, and other rel9 evant data as determined by the Secretary; and 

10 ‘‘(B) the Secretary’s recommendations and 

11 best practices for— 

12 ‘‘(i) States and localities providing 

13 mobile crisis response and stabilization 

14 services for youth and adults; and 

15 ‘‘(ii) improvements to the program es16 tablished under this section. 

17 ‘‘(e) ELIGIBLE ENTITY.—In this section, the term 

18 ‘eligible entity’ means each of the following: 

19 ‘‘(1) Community mental health centers (as de20 fined in section 1861(ff)(3)(B) of the Social Security 

21 Act). 

22 ‘‘(2) Certified community behavioral health clin23 ics described in section 223 of the Protecting Access 

24 to Medicare Act of 2014. 


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1 ‘‘(3) An entity that operates citywide, Tribal2 wide, or county-wide crisis response systems, includ3 ing cities, counties, Tribes, or a department or agen4 cy of a city, county, or Tribe, including departments 

5 or agencies of social services, disability services, 

6 health services, public health, or mental health and 

7 substance disorder services. 

8 ‘‘(4) A program of the Indian Health Service, 

9 whether operated by such Service, an Indian Tribe 

10 (as that term is defined in section 4 of the Indian 

11 Health Care Improvement Act), or by a Tribal orga12 nization (as that term is defined in section 4 of the 

13 Indian Self-Determination and Education Assistance 

14 Act) or a facility of the Native Hawaiian health care 

15 systems authorized under the Native Hawaiian 

16 Health Care Improvement Act. 

17 ‘‘(5) A public, nonprofit, or other organization 

18 that— 

19 ‘‘(A) can demonstrate the ability of such 

20 organization to effectively provide community21 based alternatives to law enforcement; and 

22 ‘‘(B) has a demonstrated involvement with 

23 the identified communities to be served. 

24 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—There 

25 are authorized to be appropriated to carry out this section 


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1 $100,000,000 for each of fiscal years 2023 through 

2 2027.’’. 

3 SEC. 106. NATIONAL SUICIDE PREVENTION MEDIA CAM4 PAIGN. 

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

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

7 adding at the end the following: 

8 ‘‘SEC. 520N. NATIONAL SUICIDE PREVENTION MEDIA CAM9 PAIGN. 

10 ‘‘(a) NATIONAL SUICIDE PREVENTION MEDIA CAM11 PAIGN.— 

12 ‘‘(1) IN GENERAL.—Not later than the date 

13 that is 3 years after the date of the enactment of 

14 this Act, the Secretary, in consultation with the As15 sistant Secretary for Mental Health and Substance 

16 Use and the Director of the Centers for Disease 

17 Control and Prevention (referred to in this section 

18 as the ‘Director’), shall conduct a national suicide 

19 prevention media campaign (referred to in this sec20 tion as the ‘national media campaign’), for purposes 

21 of— 

22 ‘‘(A) preventing suicide in the United 

23 States; 

24 ‘‘(B) educating families, friends, and com25 munities on how to address suicide and suicidal 


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1 thoughts, including when to encourage individ2 uals with suicidal risk to seek help; and 

3 ‘‘(C) increasing awareness of suicide pre4 vention resources of the Centers for Disease 

5 Control and Prevention and the Substance 

6 Abuse and Mental Health Services Administra7 tion (including the suicide prevention hotline 

8 maintained under section 520E–3, any suicide 

9 prevention mobile application of the Centers for 

10 Disease Control and Prevention or the Sub11 stance Abuse Mental Health Services Adminis12 tration, and other support resources determined 

13 appropriate by the Secretary). 

14 ‘‘(2) ADDITIONAL CONSULTATION.—In addition 

15 to consulting with the Assistant Secretary and the 

16 Director under this section, the Secretary shall con17 sult with, as appropriate, State, local, Tribal, and 

18 territorial health departments, primary health care 

19 providers, hospitals with emergency departments, 

20 mental and behavioral health services providers, cri21 sis response services providers, paramedics, law en22 forcement, suicide prevention and mental health pro23 fessionals, patient advocacy groups, survivors of sui24 cide attempts, and representatives of television and 

25 social media platforms in planning the national 


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1 media campaign to be conducted under paragraph 

2 (1). 

3 ‘‘(b) TARGET AUDIENCES.— 

4 ‘‘(1) TAILORING ADVERTISEMENTS AND OTHER

5 COMMUNICATIONS.—In conducting the national 

6 media campaign under subsection (a)(1), the Sec7 retary may tailor culturally competent advertise8 ments and other communications of the campaign 

9 across all available media for a target audience 

10 (such as a particular geographic location or demo11 graphic) across the lifespan. 

12 ‘‘(2) TARGETING CERTAIN LOCAL AREAS.—The 

13 Secretary shall, to the maximum extent practicable, 

14 use amounts made available under subsection (f) for 

15 media that targets certain local areas or populations 

16 at disproportionate risk for suicide. 

17 ‘‘(c) USE OF FUNDS.— 

18 ‘‘(1) REQUIRED USES.— 

19 ‘‘(A) IN GENERAL.—The Secretary shall, if 

20 reasonably feasible with the funds made avail21 able under subsection (f), carry out the fol22 lowing, with respect to the national media cam23 paign: 

24 ‘‘(i) Testing and evaluation of adver25 tising. 


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1 ‘‘(ii) Evaluation of the effectiveness of 

2 the national media campaign. 

3 ‘‘(iii) Operational and management 

4 expenses. 

5 ‘‘(iv) The creation of an educational 

6 toolkit for television and social media plat7 forms to use in discussing suicide and rais8 ing awareness about how to prevent sui9 cide. 

10 ‘‘(B) SPECIFIC REQUIREMENTS.— 

11 ‘‘(i) TESTING AND EVALUATION OF

12 ADVERTISING.—In testing and evaluating 

13 advertising under subparagraph (A)(i), the 

14 Secretary shall test all advertisements 

15 after use in the national media campaign 

16 to evaluate the extent to which such adver17 tisements have been effective in carrying 

18 out the purposes of the national media 

19 campaign. 

20 ‘‘(ii) EVALUATION OF EFFECTIVENESS

21 OF NATIONAL MEDIA CAMPAIGN.—In eval22 uating the effectiveness of the national 

23 media campaign under subparagraph 

24 (A)(ii), the Secretary shall— 


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1 ‘‘(I) take into account the num2 ber of unique calls that are made to 

3 the suicide prevention hotline main4 tained under section 520E–3 and as5 sess whether there are any State and 

6 regional variations with respect to the 

7 capacity to answer such calls; 

8 ‘‘(II) take into account the num9 ber of unique encounters with suicide 

10 prevention and support resources of 

11 the Centers for Disease Control and 

12 Prevention and the Substance Abuse 

13 and Mental Health Services Adminis14 tration and assess engagement with 

15 such suicide prevention and support 

16 resources; 

17 ‘‘(III) assess whether the na18 tional media campaign has contrib19 uted to increased awareness that sui20 cidal individuals should be engaged, 

21 rather than ignored; and 

22 ‘‘(IV) take into account such 

23 other measures of evaluation as the 

24 Secretary determines are appropriate. 


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1 ‘‘(2) OPTIONAL USES.—The Secretary may use 

2 amounts made available under subsection (f) for the 

3 following, with respect to the national media cam4 paign: 

5 ‘‘(A) Partnerships with professional and 

6 civic groups, community-based organizations, 

7 including faith-based organizations, and Fed8 eral agencies or Tribal organizations that the 

9 Secretary determines have experience in suicide 

10 prevention, including the Substance Abuse and 

11 Mental Health Services Administration and the 

12 Centers for Disease Control and Prevention. 

13 ‘‘(B) Entertainment industry outreach, 

14 interactive outreach, media projects and activi15 ties, the dissemination of public information, 

16 news media outreach, outreach through tele17 vision programs, and corporate sponsorship and 

18 participation. 

19 ‘‘(d) PROHIBITIONS.—None of the amounts made 

20 available under subsection (f) may be obligated or ex21 pended for any of the following: 

22 ‘‘(1) To supplant Federal suicide prevention 

23 campaigns in effect as of the date of the enactment 

24 of this section. 


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1 ‘‘(2) For partisan political purposes, or to ex2 press advocacy in support of or to defeat any clearly 

3 identified candidate, clearly identified ballot initia4 tive, or clearly identified legislative or regulatory 

5 proposal. 

6 ‘‘(e) REPORT TO CONGRESS.—Not later than 18 

7 months after implementation of the national media cam8 paign has begun, the Secretary, in coordination with the 

9 Assistant Secretary and the Director, shall, with respect 

10 to the first year of the national media campaign, submit 

11 to Congress a report that describes— 

12 ‘‘(1) the strategy of the national media cam13 paign and whether specific objectives of such cam14 paign were accomplished, including whether such 

15 campaign impacted the number of calls made to life16 line crisis centers and the capacity of such centers 

17 to manage such calls; 

18 ‘‘(2) steps taken to ensure that the national 

19 media campaign operates in an effective and effi20 cient manner consistent with the overall strategy 

21 and focus of the national media campaign; 

22 ‘‘(3) plans to purchase advertising time and 

23 space; 

24 ‘‘(4) policies and practices implemented to en25 sure that Federal funds are used responsibly to purVerDate Sep 11 2014 17:03 Mar 23, 2022 Jkt 029200 PO 00000 Frm 00020 Fmt 6652 Sfmt 6201 E:\BILLS\H7116.IH H7116

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1 chase advertising time and space and eliminate the 

2 potential for waste, fraud, and abuse; and 

3 ‘‘(5) all contracts entered into with a corpora4 tion, a partnership, or an individual working on be5 half of the national media campaign. 

6 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—For 

7 purposes of carrying out this section, there is authorized 

8 to be appropriated $10,000,000 for each of fiscal years 

9 2022 through 2026.’’. 

10 TITLE II—HEALTH RESOURCES 

11 AND SERVICES ADMINISTRA12 TION 

13 SEC. 201. HEALTH CENTER CAPITAL GRANTS. 

14 Subpart 1 of part D of title III of the Public Health 

15 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

16 at the end the following: 

17 ‘‘SEC. 330O. HEALTH CENTER CAPITAL GRANTS. 

18 ‘‘(a) IN GENERAL.—The Secretary shall award 

19 grants to eligible entities for capital projects. 

20 ‘‘(b) ELIGIBLE ENTITY.—In this section, the term 

21 ‘eligible entity’ is an entity that is— 

22 ‘‘(1) a health center funded under section 330, 

23 or in the case of a Tribe or Tribal organization, eli24 gible, to be awarded without regard to the time limi25 tation in subsection (e)(3) and subsections 


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1 (e)(6)(A)(iii), (e)(6)(B)(iii), and (r)(2)(B) of such 

2 section; or 

3 ‘‘(2) a mental health and substance use crisis 

4 receiving and stabilization program and crisis call 

5 center described in section 302(c)(1) of the 9–8–8 

6 Implementation Act of 2022 that have a working re7 lationship with one or more local community mental 

8 health and substance use organizations, community 

9 mental health centers, and certified community be10 havioral health clinics, or other local mental health 

11 and substance use care providers, including inpatient 

12 and residential treatment settings. 

13 ‘‘(c) USE OF FUNDS.—Amounts made available to a 

14 recipient of a grant or cooperative agreement pursuant to 

15 subsection (a) shall be used for crisis response program 

16 facility alteration, renovation, remodeling, expansion, con17 struction, and other capital improvement costs, including 

18 the costs of amortizing the principal of, and paying inter19 est on, loans for such purposes. 

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

21 are authorized to be appropriated to carry out this section 

22 $1,000,000,000, to remain available until expended.’’. 


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1 SEC. 202. EXPANDING BEHAVIORAL HEALTH WORKFORCE 

2 TRAINING PROGRAMS. 

3 (a) NATIONAL HEALTH SERVICE CORPS.—Section 

4 331(a)(3)(E)(i) of the Public Health Service Act 

5 (254d(a)(3)(E)(i)) is amended by striking ‘‘and psychia6 trists’’ and inserting ‘‘psychiatrists and professionals who 

7 provide crisis management services (such as at a crisis call 

8 center, as part of a mobile crisis team, or through crisis 

9 receiving and stabilization program)’’. 

10 (b) MINORITY FELLOWSHIP PROGRAM.—Section 

11 597(b) of the Public Health Service Act (42 U.S.C. 

12 290ll(b)) is amended by inserting ‘‘crisis management 

13 services (such as at a crisis call center, as part of a mobile 

14 crisis team, or through crisis receiving and stabilization 

15 program),’’ after ‘‘mental health counseling,’’. 

16 (c) BEHAVIORAL HEALTH WORKFORCE EDUCATION

17 AND TRAINING.—Section 756 of the Public Health Service 

18 Act (42 U.S.C. 294e–1) is amended— 

19 (1) in subsection (a)— 

20 (A) in paragraph (1), by inserting ‘‘crisis 

21 management (such as at a crisis call center, as 

22 part of a mobile crisis team, or through crisis 

23 receiving and stabilization program),’’ after 

24 ‘‘occupational therapy,’’; 

25 (B) in paragraph (2), by inserting ‘‘and 

26 providing crisis management services (such as 


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1 at a crisis call center, as part of a mobile crisis 

2 team, or through crisis receiving and stabiliza3 tion program)’’ after ‘‘treatment services,’’; 

4 (C) in paragraph (3), by inserting ‘‘and 

5 providing crisis management services (such as 

6 at a crisis call center, as part of a mobile crisis 

7 team, or through crisis receiving and stabiliza8 tion program),’’ after ‘‘behavioral health serv9 ices’’; and 

10 (D) in paragraph (4), by inserting ‘‘includ11 ing for the provision of crisis management serv12 ices (such as at a crisis call center, as part of 

13 a mobile crisis team, or through crisis receiving 

14 and stabilization program),’’ after ‘‘paraprofes15 sional field’’; 

16 (2) in subsection (d)(2), by inserting ‘‘or that 

17 emphasize training in crisis management and meet18 ing the crisis needs of diverse populations specified 

19 in (b)(2), including effective outreach and engage20 ment’’ after ‘‘partnerships’’; and 

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

22 ‘‘(g) ADDITIONAL FUNDING.— 

23 ‘‘(1) IN GENERAL.—For each of fiscal years 

24 2023 through 2027, in addition to funding made 

25 available under subsection (f), there are authorized 


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1 to be appropriated $15,000,000 for workforce devel2 opment for crisis management, as specified in para3 graphs (1) through (4) of subsection (a). 

4 ‘‘(2) PRIORITY.—In making grants for the pur5 pose specified in paragraph (1), the Secretary shall 

6 give priority to programs demonstrating effective re7 cruitment and retention efforts for individuals and 

8 groups from different racial, ethnic, cultural, geo9 graphic, religious, linguistic, and class backgrounds, 

10 and different genders and sexual orientations, as 

11 specified in subsection (b)(2).’’. 

12 TITLE III—BEHAVIORAL HEALTH 

13 CRISIS SERVICES EXPANSION 

14 SEC. 301. CRISIS RESPONSE CONTINUUM OF CARE. 

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

16 Service Act (42 U.S.C. 290bb–31 et seq.), as amended by 

17 section 106, is further amended by adding at the end the 

18 following: 

19 ‘‘SEC. 520O. CRISIS RESPONSE CONTINUUM OF CARE. 

20 ‘‘(a) IN GENERAL.—The Secretary shall establish 

21 standards for a continuum of care for use by health care 

22 providers and communities in responding to individuals, 

23 including children and adolescents, experiencing mental 

24 health crises, substance related crises, and crises arising 


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1 from co-occurring disorders (referred to in this section as 

2 the ‘crisis response continuum’). 

3 ‘‘(b) REQUIREMENTS.— 

4 ‘‘(1) SCOPE OF STANDARDS.—The standards 

5 established under subsection (a) shall define— 

6 ‘‘(A) minimum requirements of core crisis 

7 services, as determined by the Secretary, to in8 clude requirements that each entity that fur9 nishes such services should— 

10 ‘‘(i) not require prior authorization 

11 from an insurance provider nor referral 

12 from a health care provider prior to the de13 livery of services; 

14 ‘‘(ii) serve all individuals regardless of 

15 age or ability to pay; 

16 ‘‘(iii) operate 24 hours a day, 7 days 

17 a week, and provide care to all individuals; 

18 and 

19 ‘‘(iv) provide care and support 

20 through resources described in paragraph 

21 (2)(A) until the individual has been sta22 bilized or transfer the individual to the 

23 next level of crisis care; and 

24 ‘‘(B) psychiatric stabilization, including the 

25 point at which a case may be closed for— 


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1 ‘‘(i) individuals screened over the 

2 phone; and 

3 ‘‘(ii) individuals stabilized on the 

4 scene by mobile teams. 

5 ‘‘(2) IDENTIFICATION OF ESSENTIAL FUNC6 TIONS.—The Secretary shall identify the essential 

7 functions of each service in the crisis response con8 tinuum, which shall include at least the following: 

9 ‘‘(A) Identification of resources for referral 

10 and enrollment in continuing mental health, 

11 substance use, or other human services relevant 

12 for the individual in crisis where necessary. 

13 ‘‘(B) Delineation of access and entry 

14 points to services within the crisis response con15 tinuum. 

16 ‘‘(C) Development of and adherence to pro17 tocols and agreements for the transfer and re18 ceipt of individuals to and from other segments 

19 of the crisis response continuum segments as 

20 needed, and from outside referrals including 

21 health care providers, law enforcement, EMS, 

22 fire, education institutions, and community23 based organizations. 

24 ‘‘(D) Description of the qualifications of 

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1 cians, licensed clinicians, case managers, and 

2 peers (in accordance with State licensing re3 quirements or requirements applicable to Tribal 

4 health professionals). 

5 ‘‘(E) Requirements for the convening of 

6 collaborative meetings of crisis response service 

7 providers, first responders, such as paramedics 

8 and law enforcement, and community partners 

9 (including National Suicide Prevention Lifeline 

10 or 9–8–8 call centers, 9–1–1 public service an11 swering points, and local mental health and 

12 substance use disorder treatment providers) op13 erating in a common region for the discussion 

14 of case management, best practices, and general 

15 performance improvement. 

16 ‘‘(3) SERVICE CAPACITY AND QUALITY STAND17 ARDS.—Such standards shall include definitions of— 

18 ‘‘(A) adequate volume of services to meet 

19 population need; 

20 ‘‘(B) appropriate timely response; and 

21 ‘‘(C) capacity to meet the needs of dif22 ferent patient populations who may experience 

23 a mental health or substance use crisis, includ24 ing children, families, and all age groups, cul25 tural and linguistic minorities, individuals with 


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1 co-occurring mental health and substance use 

2 disorders, individuals with cognitive disabilities, 

3 individuals with developmental delays, and indi4 viduals with chronic medical conditions and 

5 physical disabilities. 

6 ‘‘(4) OVERSIGHT AND ACCREDITATION.—The 

7 Secretary shall designate entities charged with the 

8 oversight and accreditation of entities within the cri9 sis response continuum. 

10 ‘‘(5) IMPLEMENTATION TIMEFRAME.—Not later 

11 than 1 year after the date of enactment of this title, 

12 the Secretary shall establish the standards under 

13 this section. 

14 ‘‘(6) DATA COLLECTION AND EVALUATIONS.— 

15 ‘‘(A) IN GENERAL.—The Secretary, di16 rectly or through grants, contracts, or inter17 agency agreements, shall collect data and con18 duct evaluations with respect to the provision of 

19 services and programs offered on the crisis re20 sponse continuum for purposes of assessing the 

21 extent to which the provision of such services 

22 and programs meet certain objectives and out23 comes measures as determined by the Sec24 retary. Such objectives shall include— 


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1 ‘‘(i) a reduction in reliance on law en2 forcement response to individuals in crisis 

3 who would be more appropriately served by 

4 a mobile crisis team capable of responding 

5 to mental health and substance related cri6 ses; 

7 ‘‘(ii) a reduction in boarding or ex8 tended holding of patients in emergency 

9 room facilities who require further psy10 chiatric care, including care for substance 

11 use disorders; 

12 ‘‘(iii) evidence of adequate access to 

13 crisis care centers and crisis bed services; 

14 and 

15 ‘‘(iv) evidence of adequate linkage to 

16 appropriate post-crisis care and longitu17 dinal treatment for mental health or sub18 stance use disorder when relevant. 

19 ‘‘(B) RULEMAKING.—The Secretary shall 

20 carry out this subsection through notice and 

21 comment rulemaking, following a request for in22 formation from stakeholders. 

23 ‘‘(c) COMPONENTS OF CRISIS RESPONSE CON24 TINUUM.—The crisis response continuum consists of at 

25 least the following components: 


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1 ‘‘(1) CRISIS CALL CENTERS.—Regional clini2 cally managed crisis call centers that provide tele3 phonic crisis intervention capabilities. Such centers 

4 should meet National Suicide Prevention Lifeline 

5 operational guidelines regarding suicide risk assess6 ment and engagement and offer air traffic control7 quality coordination of crisis care in real-time. 

8 ‘‘(2) MOBILE CRISIS RESPONSE TEAM.—Teams 

9 of providers that are available to reach any indi10 vidual in the service area in their home, workplace, 

11 school, physician’s office or outpatient treatment set12 ting, or any other community-based location of the 

13 individual in crisis in a timely manner. 

14 ‘‘(3) CRISIS RECEIVING AND STABILIZATION FA15 CILITIES.—Subacute inpatient facilities and other 

16 facilities specified by the Secretary that provide 

17 short-term observation and crisis stabilization serv18 ices to all referrals, including the following services: 

19 ‘‘(A) 23-HOUR CRISIS STABILIZATION

20 SERVICES.—A direct care service that provides 

21 individuals in severe distress with up to 23 con22 secutive hours of supervised care to assist with 

23 deescalating the severity of their crisis or need 

24 for urgent care in a subacute inpatient setting. 


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1 ‘‘(B) SHORT-TERM CRISIS RESIDENTIAL

2 SERVICES.—A direct care service that assists 

3 with deescalating the severity of an individual’s 

4 level of distress or need for urgent care associ5 ated with a substance use or mental health dis6 order in a residential setting. 

7 ‘‘(4) MENTAL HEALTH AND SUBSTANCE USE

8 URGENT CARE FACILITIES.—Ambulatory services 

9 available 12–24 hours per day, 7 days a week, where 

10 individuals experiencing crisis can walk in without 

11 an appointment to receive crisis assessment, crisis 

12 intervention, medication, and connection to con13 tinuity of care. 

14 ‘‘(5) ADDITIONAL FACILITIES AND PRO15 VIDERS.—The Secretary shall specify additional fa16 cilities and health care providers as part of the crisis 

17 response continuum, as the Secretary determines ap18 propriate. 

19 ‘‘(d) RELATIONSHIP TO STATE LAW.— 

20 ‘‘(1) IN GENERAL.—Subject to paragraph (2), 

21 the standards established under this section are min22 imum standards and nothing in this section may be 

23 construed to preclude a State from establishing ad24 ditional standards, so long as such standards are not 


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1 inconsistent with the requirements of this section or 

2 other applicable law. 

3 ‘‘(2) WAIVER OR MODIFICATION.—The Sec4 retary shall establish a process under which a State 

5 may request a waiver or modification of a standard 

6 established under this section.’’. 

7 SEC. 302. COVERAGE OF CRISIS RESPONSE SERVICES. 

8 (a) COVERAGE UNDER THE MEDICARE PROGRAM.— 

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

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

11 amended— 

12 (A) in subparagraph (GG), by striking 

13 ‘‘and’’ at the end; 

14 (B) in subparagraph (HH), by striking the 

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

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

17 subparagraph: 

18 ‘‘(II) crisis response services as defined in 

19 subsection (lll);’’. 

20 (2) CRISIS RESPONSE SERVICES DEFINED.— 

21 Section 1861 of the Social Security Act (42 U.S.C. 

22 1395x) is amended by adding at the end the fol23 lowing new subsection: 

24 ‘‘(lll) CRISIS RESPONSE SERVICES.— 


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1 ‘‘(1) IN GENERAL.—The term ‘crisis response 

2 services’ means mental health or substance use serv3 ices that are furnished by a mobile crisis response 

4 team, a crisis receiving and stabilization facility, 

5 mental health or substance use urgent care facility, 

6 or other appropriate provider, as determined by the 

7 Secretary, to an individual, including children and 

8 adolescents, experiencing a mental health or sub9 stance use crisis. Such term includes services identi10 fied by the Secretary as part of the crisis response 

11 continuum of care under section 302 of the Behav12 ioral Health Crisis Services Expansion Act. 

13 ‘‘(2) DEFINITIONS.—In this subsection, the 

14 terms ‘mobile crisis response team’, ‘crisis receiving 

15 and stabilization facility’, and ‘mental health and 

16 substance use urgent care facility’ have the meaning 

17 given those terms for purposes of such section 

18 302.’’. 

19 (3) PAYMENT.— 

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

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

22 is amended— 

23 (i) by striking ‘‘and (DD)’’ and in24 serting ‘‘(DD)’’; and 


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1 (ii) by inserting before the semicolon 

2 at the end the following: ‘‘and (EE) with 

3 respect to crisis response services described 

4 in section 1861(s)(2)(II), the amounts paid 

5 shall be 80 percent of the lesser of the ac6 tual charge for the service or the amount 

7 determined under the payment basis estab8 lished under section 1834(z)’’. 

9 (B) ESTABLISHMENT OF PAYMENT

10 BASIS.—Section 1834 of the Social Security Act 

11 (42 U.S.C. 1395m) is amended by adding at 

12 the end the following new subsection: 

13 ‘‘(z) PAYMENT FOR CRISIS RESPONSE SERVICES.— 

14 The Secretary shall establish a payment basis determined 

15 appropriate by the Secretary with respect to crisis re16 sponse services (as defined in section 1861(lll)) furnished 

17 by a provider of services or supplier.’’. 

18 (4) AMBULANCE TRANSPORT OF INDIVIDUALS

19 IN CRISIS.— 

20 (A) IN GENERAL.—Section 1834(l) of the 

21 Social Security Act (42 U.S.C. 1395m(l)) is 

22 amended by adding at the end the following 

23 new paragraph: 

24 ‘‘(18) TRANSPORTATION OF INDIVIDUALS IN

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1 nished on or after the date that is 3 years after the 

2 date of the enactment of the Behavioral Health Cri3 sis Services Expansion Act, the regulations described 

4 in section 1861(s)(7) shall provide coverage under 

5 such section for ambulance and other qualified emer6 gency transport services to transport an individual 

7 experiencing a mental health or substance crisis to 

8 an appropriate facility, such as a community mental 

9 health center (as defined in section 1861(ff)(3)(B)) 

10 or other facility or provider identified by the Sec11 retary as part of the crisis response continuum of 

12 care under section 203 of the Behavioral Health Cri13 sis Services Expansion Act, as appropriate, for crisis 

14 response services described in section 

15 1861(s)(2)(II).’’. 

16 (B) CONFORMING AMENDMENT.—Section 

17 1861(s)(7) of such Act (42 U.S.C. 1395x(s)(7)) 

18 is amended by striking ‘‘section 1834(l)(14)’’ 

19 and inserting ‘‘paragraphs (14) and (18) of sec20 tion 1834(l)’’. 

21 (5) EFFECTIVE DATE.—The amendments made 

22 by this subsection shall apply to services furnished 

23 on or after the date that is 3 years after the date 

24 of the enactment of this Act. 


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1 (b) MANDATORY COVERAGE OF CRISIS RESPONSE

2 SERVICES UNDER THE MEDICAID PROGRAM.—Title XIX 

3 of the Social Security Act (42 U.S.C. 1396 et seq.) is 

4 amended— 

5 (1) in section 1902(a)(10)(A), in the matter 

6 preceding clause (i), by striking ‘‘and (30)’’ and in7 serting ‘‘(30), and (31)’’; and 

8 (2) in section 1905— 

9 (A) in subsection (a)— 

10 (i) in paragraph (30), by striking ‘‘; 

11 and’’ and inserting a semicolon; 

12 (ii) by redesignating paragraph (31) 

13 as paragraph (32); and 

14 (iii) by inserting the following para15 graph after paragraph (30): 

16 ‘‘(31) crisis response services (as defined in sec17 tion 1861(lll)); and’’. 

18 (3) PRESUMPTIVE ELIGIBILITY DETERMINA19 TION BY CRISIS RESPONSE SERVICE PROVIDERS.— 

20 Section 1902(a)(47)(B) of the Social Security Act 

21 (42 U.S.C. 1396a(a)(47)(B)) is amended by insert22 ing ‘‘or provider of crisis response services (as de23 fined in section 1861(lll))’’ after ‘‘any hospital’’. 

24 (4) EFFECTIVE DATE.— 


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1 (A) IN GENERAL.—Except as provided in 

2 subparagraph (B), the amendments made by 

3 this section shall take effect on the date that is 

4 3 years after the date of the enactment of this 

5 Act. 

6 (B) DELAY PERMITTED IF STATE LEGISLA7 TION REQUIRED.—In the case of a State plan 

8 under title XIX of the Social Security Act (42 

9 U.S.C. 1396 et seq.) which the Secretary of 

10 Health and Human Services determines re11 quires State legislation (other than legislation 

12 appropriating funds) in order for the plan to 

13 meet the additional requirements imposed by 

14 the amendments made by this section, the State 

15 plan shall not be regarded as failing to comply 

16 with the requirements of such title solely on the 

17 basis of the failure of the plan to meet such ad18 ditional requirements before the first day of the 

19 first calendar quarter beginning after the close 

20 of the first regular session of the State legisla21 ture that begins after the date of enactment of 

22 this Act. For purposes of the previous sentence, 

23 in the case of a State that has a 2-year legisla24 tive session, each year of such session shall be 


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1 deemed to be a separate regular session of the 

2 State legislature. 

3 (c) ESSENTIAL HEALTH BENEFITS.—Section 

4 1302(b)(1)(E) of the Patient Protection and Affordable 

5 Care Act (42 U.S.C. 18022(b)(1)(E)) is amended by in6 serting ‘‘and crisis response services (as defined in section 

7 1861(lll) of the Social Security Act)’’ before the period. 

8 (d) GROUP HEALTH PLANS AND HEALTH INSUR9 ANCE ISSUERS.— 

10 (1) IN GENERAL.—Section 2707 of the Public 

11 Health Service Act (42 U.S.C. 300gg–6) is amended 

12 by adding at the end the following: 

13 ‘‘(e) CRISIS RESPONSE SERVICES.—A group health 

14 plan or a health insurance issuer offering group or indi15 vidual health insurance coverage shall ensure that such 

16 coverage includes crisis response services (as defined in 

17 section 1861(lll) of the Social Security Act).’’. 

18 (2) APPLICATION TO GRANDFATHERED

19 PLANS.—Section 1251(a)(4)(A) of the Public Health 

20 Service Act (42 U.S.C. 18011(a)(4)(A)) is amended 

21 by adding at the end the following new clause: 

22 ‘‘(v) Section 2707(e) (relating to cov23 erage of crisis response services).’’. 

24 (e) TRICARE COVERAGE.— 


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1 (1) IN GENERAL.—The Secretary of Defense 

2 shall provide coverage under the TRICARE program 

3 for crisis response services, as defined in section 

4 1861(lll) of the Social Security Act (42 U.S.C. 

5 1395x) (as amended by section 303). 

6 (2) TRICARE PROGRAM DEFINED.—In this sec7 tion, the term ‘‘TRICARE program’’ has the mean8 ing given the term in section 1072 of title 10, 

9 United States Code. 

10 (f) REIMBURSEMENT FOR CRISIS RESPONSE SERV11 ICES FOR VETERANS.—Section 1725(f)(1) of title 38, 

12 United States Code, is amended, in the matter preceding 

13 subparagraph (A), by inserting ‘‘, including crisis response 

14 services (as defined in subsection (lll) of section 1861 of 

15 the Social Security Act (42 U.S.C. 1395x)),’’ after ‘‘serv16 ices’’. 

17 (g) COVERAGE UNDER FEHB.— 

18 (1) IN GENERAL.—Section 8902 of title 5, 

19 United States Code, is amended by adding at the 

20 end the following: 

21 ‘‘(p) Each contract for a plan under this chapter shall 

22 require the carrier to provide coverage for crisis response 

23 services, as that term is defined in subsection (lll) of sec24 tion 1861 of the Social Security Act (42 U.S.C. 1395x).’’. 


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1 (2) EFFECTIVE DATE.—The amendment made 

2 by paragraph (1) shall apply beginning with respect 

3 to the third contract year for chapter 89 of title 5, 

4 United States Code, that begins on or after the date 

5 that is 3 years after the date of enactment of this 

6 Act. 

7 (h) COVERAGE UNDER CHIP.—Section 2103(c)(5) 

8 of the Social Security Act (42 U.S.C. 1397cc(c)(5)) is 

9 amended— 

10 (1) in subparagraph (A), by striking ‘‘and’’ at 

11 the end; 

12 (2) in subparagraph (B), by striking the period 

13 and inserting ‘‘; and’’; and 

14 (3) by adding at the end the following new sub15 paragraph: 

16 ‘‘(C) beginning on the date that is 3 years 

17 after the date of the enactment of this subpara18 graph, crisis response services (as defined in 

19 section 1861(lll)).’’. 

20 SEC. 303. BUILDING THE CRISIS CONTINUUM INFRASTRUC21 TURE. 

22 (a) ADDITIONAL AMOUNTS FOR MENTAL HEALTH

23 BLOCK GRANT.—Section 1920 of the Public Health Serv24 ice Act (42 U.S.C. 300x–9) is amended by adding at the 

25 end the following: 


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1 ‘‘(d) SUPPORT FOR CRISIS RESPONSE SERVICES IN2 FRASTRUCTURE.— 

3 ‘‘(1) IN GENERAL.—In addition to amounts 

4 made available under subsection (a), there are au5 thorized to be appropriated such sums as are nec6 essary for each of fiscal years 2022, 2023, and 

7 2024, for purposes of supporting the infrastructure 

8 needed to provide crisis response services (as defined 

9 in section 1861(lll) of the Social Security Act) in the 

10 States, which may include training and continuing 

11 education, and administrative expenses with respect 

12 to the provision of such services. 

13 ‘‘(2) ALLOTMENTS.—Each fiscal year for which 

14 amounts are appropriated under paragraph (1), the 

15 Secretary shall allot to each State that receives a 

16 grant under section 1911 for the fiscal year an 

17 amount that bears the same relationship to the total 

18 amount appropriated under paragraph (1) for the 

19 fiscal year that the amount received by the State 

20 under section 1911(a) for the fiscal year bears to 

21 the total amount appropriated under subsection (a) 

22 for the fiscal year. 

23 ‘‘(e) TECHNICAL ASSISTANCE.—The Secretary shall 

24 provide to States technical assistance regarding the provi25 sion of crisis response services, as defined in section 


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1 1861(lll) of the Social Security Act, including guidance on 

2 how States may blend Medicaid funds available to States 

3 under title XIX of the Social Security Act and funds avail4 able to States under the community mental health services 

5 block grant program under this subpart and the substance 

6 abuse prevention and treatment block grant program 

7 under subpart II to provide such services. 

8 ‘‘(f) CLEARINGHOUSE OF BEST PRACTICES.—The 

9 Secretary shall develop and maintain a publicly available 

10 clearinghouse of best practices for the successful operation 

11 of each segment of the system for providing crisis response 

12 services (as defined in section 1861(lll) of the Social Secu13 rity Act) and the integration of such best practices into 

14 the provision of such services. The clearinghouse shall be 

15 updated annually. 

16 ‘‘(g) RULE OF CONSTRUCTION.—With respect to 

17 funds allocated under the crisis care set-aside authorized 

18 under (a), the provisions contained in 1912(b)(1)(A)(vi) 

19 shall not apply.’’. 

20 SEC. 304. INCIDENT REPORTING. 

21 (a) ESTABLISHMENT OF PROTOCOL PANEL.—The 

22 Secretary of Health and Human Services (referred to in 

23 this section as the ‘‘Secretary’’), in consultation with the 

24 Attorney General, shall convene a panel for the purposes 

25 of making recommendations for training and protocol for 


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1 9–1–1 dispatchers to respond appropriately to individuals 

2 experiencing a behavioral health crisis based on the char3 acteristics of the incident and the needs of the caller. 

4 (b) PANELISTS.—The Secretary shall appoint individ5 uals to serve staggered 10-year terms on the panel estab6 lished under subsection (a). Such individuals shall in7 clude— 

8 (1) psychiatrists; 

9 (2) paramedics and other emergency medical 

10 services personnel; 

11 (3) law enforcement officers and 9–1–1 dis12 patchers; 

13 (4) representatives from each segment of the 

14 crisis response continuum, as described in section 

15 302, including 9–8–8 dispatchers; 

16 (5) individuals who have received services under 

17 such crisis response continuum, including individuals 

18 under the age of 18; 

19 (6) members of underserved communities in20 cluding ethnic and racial minority groups and sexual 

21 orientation and gender minority groups; 

22 (7) representatives from Tribes or Tribal orga23 nizations; and 

24 (8) other individuals, as the Secretary deter25 mines appropriate. 


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1 (c) RECOMMENDATIONS.— 

2 (1) TOPICS.—In issuing recommendations 

3 under this section, the panel shall consider— 

4 (A) connecting 9–1–1 callers to crisis care 

5 services instead of responding with law enforce6 ment officers; 

7 (B) integrating the 9–8–8 system into the 

8 9–1–1 system, or transferring calls from the 9– 

9 1–1 system to the 9–8–8 system as appropriate; 

10 and 

11 (C) a process for identifying 9–1–1 callers 

12 who may be experiencing psychiatric symptoms 

13 or a mental health crisis, substance use crisis, 

14 or co-occurring crisis and evaluating the level of 

15 need of such callers, as defined by relevant, 

16 standardized assessment tools such as the Level 

17 of Care Utilization System (LOCUS), the Child 

18 and Adolescent Level of Care Utilization Sys19 tem (CALOCUS), and the American Society of 

20 Addiction Medicine (ASAM) Criteria. 

21 (2) UPDATES.—The panel shall update rec22 ommendations issued under this section not less fre23 quently than every 5 years. 


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1 TITLE IV—MEDICAID 

2 AMENDMENTS 

3 SEC. 401. REVISIONS TO THE STATE OPTION TO PROVIDE 

4 QUALIFYING COMMUNITY-BASED MOBILE 

5 CRISIS INTERVENTION SERVICES AND OTHER 

6 SERVICES UNDER STATE PLANS UNDER THE 

7 MEDICAID PROGRAM. 

8 (a) IN GENERAL.—Section 1947 of the Social Secu9 rity Act (42 U.S.C. 1396w–6) is amended— 

10 (1) in subsection (a)— 

11 (A) by striking ‘‘for qualifying community12 based mobile crisis intervention services’’ and 

13 inserting ‘‘for— 

14 ‘‘(1) qualifying community-based mobile crisis 

15 intervention services; 

16 ‘‘(2) regional and local lifeline call center oper17 ations; and 

18 ‘‘(3) programs for the purpose receiving and 

19 stabilization individuals (including beds in homes 

20 and facilities for such purpose).’’; and 

21 (B) by striking ‘‘during the 5-year period’’; 

22 (2) in subsection (c)— 

23 (A) by striking ‘‘85 percent.’’ and inserting 

24 the following: ‘‘85 percent, and for medical as25 sistance for items described in paragraphs (2) 


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1 and (3) of subsection (a) furnished during such 

2 quarter shall be equal to 85 percent.’’; and 

3 (B) by striking ‘‘occurring during the pe4 riod described in subsection (a) that a State’’ 

5 and inserting ‘‘in which a State provides med6 ical assistance for qualifying community-based 

7 mobile crisis intervention services under this 

8 section and’’; 

9 (3) in subsection (e), by adding at the end at 

10 the following new sentence: ‘‘There is appropriated, 

11 out of any funds in the Treasury not otherwise ap12 propriated, $5,000,000 to the Secretary for the pur13 poses described in the preceding sentence to remain 

14 available until expended.’’; and 

15 (4) in subsection (d)(2)— 

16 (A) in subparagraph (A), by striking ‘‘for 

17 the fiscal year preceding the first fiscal quarter 

18 occurring during the period described in sub19 section (a)’’ and inserting ‘‘for the fiscal year 

20 preceding the first fiscal quarter in which the 

21 State provides medical assistance for qualifying 

22 community-based mobile crisis intervention 

23 services under this section’’; and 

24 (B) in subparagraph (B), by striking ‘‘oc25 curring during the period described in subVerDate Sep 11 2014 17:03 Mar 23, 2022 Jkt 029200 PO 00000 Frm 00047 Fmt 6652 Sfmt 6201 E:\BILLS\H7116.IH H7116

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1 section (a)’’ and inserting ‘‘occurring during a 

2 fiscal quarter’’. 

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

4 subsection (a) shall take effect as if included in the enact5 ment of the American Rescue Plan Act of 2021 (Public 

6 Law 117–2). 

7 SEC. 402. REVISIONS TO THE IMD EXCLUSION UNDER MED8 ICAID. 

9 (a) SHRINKING OF THE IMD EXCLUSION UNDER

10 MEDICAID.—Section 1905(a)(1) of the Social Security Act 

11 (42 U.S.C. 1396d(a)(1)) is amended by inserting ‘‘, except 

12 for, services that, beginning the day after the date of the 

13 enactment of the 9–8–8 National Suicide Prevention Life14 line Implementation Act of 2022, are furnished in psy15 chiatric acute care crisis beds administered by community 

16 behavioral health organizations certified under section 223 

17 of the Protecting Access to Medicare Act of 2014, mental 

18 health centers that meet the criteria of section 1913(c) 

19 of the Public Health Service Act, crisis receiving and sta20 bilization facilities (as defined in section 302(c)(3) of the 

21 9–8–8 National Suicide Prevention Lifeline Implementa22 tion Act of 2022) and the mental health and substance 

23 use urgent care facilities (as defined in section 302(c)(5) 

24 of such Act)’’. 


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1 (b) GUIDANCE RELATING TO IMD EXCLUSION.—Not 

2 later than 180 days after the date of the enactment of 

3 this Act, the Secretary of Health and Human Services 

4 shall issue guidance that crisis stabilization units (as de5 scribed in section 1905(a)(1) of the Social Security Act 

6 (42 U.S.C. 1396d(a)(1)) are excluded from the prohibition 

7 specified in the parenthetical of paragraph (1) of section 

8 1905(a) (relating to services in an institution for mental 

9 diseases), including the following facilities and services: 

10 (1) Subacute crisis receiving in inpatient or 

11 other facilities specified by the Secretary that pro12 vide short-term observation for all referrals to indi13 viduals in severe distress, as further defined by the 

14 Secretary, with up to 23 consecutive hours of super15 vised care to assist with deescalating the severity of 

16 a mental health or substance use crisis or need for 

17 urgent care in a sub-acute inpatient setting. 

18 (2) Short term crisis stabilization services as19 sisting with deescalating the severity of individuals 

20 in severe distress, as defined by the Secretary, or 

21 need for urgent care associated with a substance use 

22 or mental health disorder in an inpatient or residen23 tial setting with reimbursement limited to 72 hours. 

24 (c) REPORTS ON CRISIS STABILIZATION UTILIZA25 TION.—Not later than 1 year after the date of the enactVerDate Sep 11 2014 17:03 Mar 23, 2022 Jkt 029200 PO 00000 Frm 00049 Fmt 6652 Sfmt 6201 E:\BILLS\H7116.IH H7116

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1 ment of this Act, the Secretary shall submit to the appro2 priate congressional committees of jurisdiction a report 

3 addressing the utilization of facility-based crisis services, 

4 including the number of patients served, type and duration 

5 of facility-based services, linkage to community-based re6 sources, and information on the total number of law en7 forcement drop-offs and other data relevant for diverting 

8 mental health and substance use disorder emergencies 

9 from law enforcement response. 

10 SEC. 403. EXCELLENCE IN MENTAL HEALTH AND ADDIC11 TION TREATMENT. 

12 (a) EXPANSION OF COMMUNITY MENTAL HEALTH

13 SERVICES DEMONSTRATION PROGRAM.—Section 223 of 

14 the Protecting Access to Medicare Act of 2014 (42 U.S.C. 

15 1396a note) is amended— 

16 (1) in subsection (c), by adding at the end the 

17 following new paragraph: 

18 ‘‘(3) PLANNING GRANTS FOR ADDITIONAL

19 STATES.—In addition to the planning grants award20 ed under paragraph (1), the Secretary shall award 

21 planning grants to States (other than States selected 

22 to conduct demonstration programs under para23 graphs (1) or (8) of subsection (d)) for the purpose 

24 of developing proposals to participate in time-limited 


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1 demonstration programs described in subsection 

2 (d).’’; 

3 (2) in subsection (d)— 

4 (A) in paragraph (3), by striking ‘‘Subject 

5 to paragraph (8)’’ and inserting ‘‘Subject to 

6 paragraphs (8) and (9)’’; 

7 (B) in paragraph (5)(C)(iii)(II), by insert8 ing ‘‘or paragraph (9)’’ after ‘‘paragraph (8)’’; 

9 (C) in paragraph (7)— 

10 (i) in subparagraph (A), by inserting 

11 ‘‘through the year in which the last dem12 onstration under this section ends’’ after 

13 ‘‘annually thereafter’’; 

14 (ii) in subparagraph (B)— 

15 (I) by striking ‘‘December 31, 

16 2021’’ and inserting ‘‘September 30, 

17 2023’’; and 

18 (II) by adding at the end the fol19 lowing new sentence: ‘‘Such rec20 ommendations shall include data col21 lected after 2019.’’; and 

22 (iii) by adding at the end the fol23 lowing new subparagraph: 

24 ‘‘(C) FINAL EVALUATION.—Not later than 

25 18 months after all demonstration programs 


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1 under this section have ended, the Secretary 

2 shall submit to Congress a final evaluation of 

3 such programs.’’; and 

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

5 paragraph: 

6 ‘‘(9) FURTHER ADDITIONAL PROGRAMS.—In 

7 addition to the States selected under paragraphs (1) 

8 and (8), the Secretary shall select any State that 

9 submits an application that includes such informa10 tion as the Secretary shall require to conduct a dem11 onstration program that meets the requirements of 

12 paragraph (2) and paragraphs (4) through (7) for 2 

13 years or through September 30, 2023, whichever is 

14 longer.’’; and 

15 (3) in subsection (f)(1)(B), by inserting ‘‘, and 

16 $40,000,000 for fiscal year 2022’’ before the period. 

17 (b) CERTIFIED COMMUNITY BEHAVIORAL HEALTH

18 CLINIC EXPANSION GRANTS.—Part D of title V of the 

19 Public Health Service Act (42 U.S.C. 290dd et seq.) is 

20 amended by adding at the end the following: 

21 ‘‘SEC. 553. CERTIFIED COMMUNITY BEHAVIORAL HEALTH 

22 CLINIC EXPANSION GRANTS. 

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

24 award grants to communities and community organiza25 tions that meet the criteria for certified community behavVerDate Sep 11 2014 17:03 Mar 23, 2022 Jkt 029200 PO 00000 Frm 00052 Fmt 6652 Sfmt 6201 E:\BILLS\H7116.IH H7116

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1 ioral health clinics under section 223(a) of the Protecting 

2 Access to Medicare Act A of 2014. Grants awarded under 

3 this subsection shall be for a period of not more than 5 

4 years. 

5 ‘‘(b) TECHNICAL ASSISTANCE.—The Assistant Sec6 retary may provide appropriate information, training, and 

7 technical assistance through appropriate contract proce8 dures to entities receiving grants under subsection (a), or 

9 to health or social service providers pursuing certified 

10 community behavioral health clinics status or partnering 

11 with certified community behavioral health clinics, State 

12 policymakers considering certified community behavioral 

13 health clinics implementation under the Medicaid pro14 gram, and other stakeholders to facilitate successful imple15 mentation of the certification model. 

16 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.— 

17 ‘‘(1) GRANT PROGRAM.—For purposes of 

18 awarding grants under subsection (a), there is au19 thorized to be appropriated $500,000,000 for the pe20 riod of fiscal years 2022 through 2024. 

21 ‘‘(2) TECHNICAL ASSISTANCE.—For purposes 

22 of carrying out the technical assistance program 

23 under subsection (b), there are authorized to be apVerDate Sep 11 2014 17:03 Mar 23, 2022 Jkt 029200 PO 00000 Frm 00053 Fmt 6652 Sfmt 6201 E:\BILLS\H7116.IH H7116

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1 propriated $5,000,000 for each of fiscal years 2022 

2 through 2026.’’. 

Æ 


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