I 

111TH CONGRESS 

1ST SESSION H. R. 3191 

To amend the Public Health Service Act to provide for integration of mental 

health services and mental health treatment outreach teams, and for 

other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JULY 13, 2009 

Mr. KENNEDY (for himself, Ms. ROS-LEHTINEN, and Mr. DAVIS of Illinois) 

introduced the following bill; which was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to provide for 

integration of mental health services and mental health 

treatment outreach teams, 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 This Act may be cited as the ‘‘Positive Aging Act of 

5 2009’’. 


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1 SEC. 2. DEMONSTRATION PROJECTS TO SUPPORT INTE2 GRATION OF MENTAL HEALTH SERVICES IN 

3 PRIMARY CARE SETTINGS. 

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

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

6 (1) in section 520(b)— 

7 (A) in paragraph (14), by striking ‘‘and’’ 

8 after the semicolon; 

9 (B) in paragraph (15), by striking the pe10 riod at the end and inserting ‘‘; and’’; and 

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

12 ‘‘(16) conduct the demonstration projects speci13 fied in section 520K.’’; and 

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

15 ‘‘SEC. 520K. PROJECTS TO DEMONSTRATE INTEGRATION OF 

16 MENTAL HEALTH SERVICES IN PRIMARY 

17 CARE SETTINGS. 

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

19 the Director of the Center for Mental Health Services, 

20 shall award grants to public and private nonprofit entities 

21 for projects to demonstrate ways of integrating mental 

22 health services for older adults into primary care settings, 

23 such as health centers receiving a grant under section 330 

24 (or determined by the Secretary to meet the requirements 

25 for receiving such a grant), other federally qualified health 

26 centers, primary care clinics, and private practice sites. 


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1 ‘‘(b) REQUIREMENTS.—In order to be eligible for a 

2 grant under this section, the project to be carried out by 

3 the entity shall provide for collaborative care within a pri4 mary care setting, provided by licensed mental health pro5 fessionals with appropriate training and experience in the 

6 treatment of older adults, in which screening, assessment, 

7 and intervention services are combined into an integrated 

8 service delivery model, including— 

9 ‘‘(1) screening services by a mental health pro10 fessional with at least a masters degree in an appro11 priate field of training; 

12 ‘‘(2) referrals for necessary prevention, inter13 vention, follow-up care, consultations, and care plan14 ning oversight for mental health and other service 

15 needs, as indicated; and 

16 ‘‘(3) adoption and implementation of evidence17 based intervention and treatment protocols (to the 

18 extent such protocols are available) for mental dis19 orders prevalent in older adults including, but not 

20 limited to, mood and anxiety disorders, dementias of 

21 all kinds (including the behavioral and psychological 

22 symptoms of dementia), psychotic disorders, and 

23 substance-related disorders. 


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1 ‘‘(c) CONSIDERATIONS IN AWARDING GRANTS.—In 

2 awarding grants under this section, the Secretary, to the 

3 extent feasible, shall ensure that— 

4 ‘‘(1) projects are funded in a variety of geo5 graphic areas, including urban and rural areas; and 

6 ‘‘(2) a variety of populations, including racial 

7 and ethnic minorities and low-income populations, 

8 are served by projects funded under this section. 

9 ‘‘(d) DURATION.—A project may receive funding pur10 suant to a grant under this section for a period of up to 

11 3 years, with an extension period of 2 additional years 

12 at the discretion of the Secretary. 

13 ‘‘(e) APPLICATION.—To be eligible to receive a grant 

14 under this section, a public or private nonprofit entity 

15 shall— 

16 ‘‘(1) submit an application to the Secretary (in 

17 such form, containing such information, and at such 

18 time as the Secretary may specify); and 

19 ‘‘(2) agree to report to the Secretary standard20 ized clinical and behavioral data and other perform21 ance data necessary to evaluate patient outcomes 

22 and to facilitate evaluations across participating 

23 projects. 

24 ‘‘(f) EVALUATION.—Not later than July 31 of the 

25 second calendar year after the date of enactment of this 


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1 section, and July 31 of every year thereafter, the Sec2 retary shall submit to Congress a report evaluating the 

3 projects receiving awards under this section for the year 

4 involved. 

5 ‘‘(g) SUPPLEMENT, NOT SUPPLANT.—Funds made 

6 available under this section shall supplement, and not sup7 plant, other Federal, State, or local funds available to an 

8 entity to carry out activities described in this section. 

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

10 are authorized to be appropriated such sums as may be 

11 necessary to carry out this section for fiscal year 2010 

12 and each fiscal year thereafter.’’. 

13 SEC. 3. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH 

14 TREATMENT OUTREACH TEAMS. 

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 2, is further amended by adding at the end the 

18 following: 

19 ‘‘SEC. 520L. GRANTS FOR COMMUNITY-BASED MENTAL 

20 HEALTH TREATMENT OUTREACH TEAMS. 

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

22 the Director of the Center for Mental Health Services, 

23 shall award grants to public or private nonprofit entities 

24 that are community-based providers of geriatric mental 

25 health services, to support the establishment and mainteVerDate Nov 24 2008 02:14 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H3191.IH H3191

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1 nance by such entities of interdisciplinary geriatric mental 

2 health outreach teams in community settings where older 

3 adults reside or receive social services. Entities eligible for 

4 such grants include— 

5 ‘‘(1) mental health service providers of a State 

6 or local government; 

7 ‘‘(2) outpatient programs of private, nonprofit 

8 hospitals; 

9 ‘‘(3) community mental health centers meeting 

10 the criteria specified in section 1913(c); and 

11 ‘‘(4) other community-based providers of mental 

12 health services. 

13 ‘‘(b) REQUIREMENTS.—To be eligible to receive a 

14 grant under this section, an entity shall— 

15 ‘‘(1) adopt and implement, for use by its mental 

16 health outreach team, evidence-based intervention 

17 and treatment protocols (to the extent such proto18 cols are available) for mental disorders prevalent in 

19 older adults including, but not limited to, mood and 

20 anxiety disorders, dementias of all kinds (including 

21 the behavioral and psychological symptoms of de22 mentia), psychotic disorders, and substance-related 

23 disorders, relying to the greatest extent feasible on 

24 protocols that have been developed— 


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1 ‘‘(A) by or under the auspices of the Sec2 retary; or 

3 ‘‘(B) by academicians; 

4 ‘‘(2) provide screening for mental disorders, di5 agnostic services, referrals for treatment, and case 

6 management and coordination through such teams; 

7 and 

8 ‘‘(3) coordinate and integrate the services pro9 vided by such team with the services of social serv10 ice, mental health, and medical providers at the site 

11 or sites where the team is based in order to— 

12 ‘‘(A) improve patient outcomes; and 

13 ‘‘(B) to assure, to the maximum extent 

14 feasible, the continuing independence of older 

15 adults who are residing in the community. 

16 ‘‘(c) COOPERATIVE ARRANGEMENTS WITH SITES

17 SERVING AS BASES FOR OUTREACH.—An entity receiving 

18 a grant under this section may enter into an agreement 

19 with a person operating a site at which a geriatric mental 

20 health outreach team of the entity is based, including— 

21 ‘‘(1) senior centers; 

22 ‘‘(2) adult day care programs; 

23 ‘‘(3) assisted living facilities; and 

24 ‘‘(4) recipients of grants to provide services to 

25 older adults under the Older Americans Act of 1965, 


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1 under which such person provides (and is reim2 bursed by the entity, out of funds received under the 

3 grant, for) any supportive services, such as transpor4 tation and administrative support, that such person 

5 provides to an outreach team of such entity. 

6 ‘‘(d) CONSIDERATIONS IN AWARDING GRANTS.—In 

7 awarding grants under this section, the Secretary, to the 

8 extent feasible, shall ensure that— 

9 ‘‘(1) projects are funded in a variety of geo10 graphic areas, including urban and rural areas; and 

11 ‘‘(2) a variety of populations, including racial 

12 and ethnic minorities and low-income populations, 

13 are served by projects funded under this section. 

14 ‘‘(e) APPLICATION.—To be eligible to receive a grant 

15 under this section, an entity shall— 

16 ‘‘(1) submit an application to the Secretary (in 

17 such form, containing such information, at such 

18 time as the Secretary may specify); and 

19 ‘‘(2) agree to report to the Secretary standard20 ized clinical and behavioral data and other perform21 ance data necessary to evaluate patient outcomes 

22 and to facilitate evaluations across participating 

23 projects. 

24 ‘‘(f) COORDINATION.—The Secretary shall provide 

25 for appropriate coordination of programs and activities reVerDate Nov 24 2008 02:14 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H3191.IH H3191

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1 ceiving funds pursuant to a grant under this section with 

2 programs and activities receiving funds pursuant to grants 

3 under section 520K and sections 381, 422, and 423 of 

4 the Older Americans Act of 1965. 

5 ‘‘(g) EVALUATION.—Not later than July 31 of the 

6 second calendar year after the date of enactment of this 

7 section, and July 31 of every year thereafter, the Sec8 retary shall submit to Congress a report evaluating the 

9 projects receiving awards under this section for such year. 

10 ‘‘(h) SUPPLEMENT, NOT SUPPLANT.—Funds made 

11 available under this section shall supplement, and not sup12 plant, other Federal, State, or local funds available to an 

13 entity to carry out activities described in this section. 

14 ‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 

15 are authorized to be appropriated such sums as may be 

16 necessary to carry out this section for fiscal year 2010 

17 and each fiscal year thereafter.’’. 

18 SEC. 4. DESIGNATION OF DEPUTY DIRECTOR FOR OLDER 

19 ADULT MENTAL HEALTH SERVICES IN CEN20 TER FOR MENTAL HEALTH SERVICES. 

21 Section 520 of the Public Health Service Act (42 

22 U.S.C. 290bb–31) is amended— 

23 (1) by redesignating subsection (c) as sub24 section (d); and 


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1 (2) by inserting after subsection (b) the fol2 lowing: 

3 ‘‘(c) DEPUTY DIRECTOR FOR OLDER ADULT MEN4 TAL HEALTH SERVICES IN CENTER FOR MENTAL

5 HEALTH SERVICES.—The Director, after consultation 

6 with the Administrator, shall designate a Deputy Director 

7 for Older Adult Mental Health Services, who shall be re8 sponsible for the development and implementation of ini9 tiatives of the Center to address the mental health needs 

10 of older adults. Such initiatives shall include— 

11 ‘‘(1) research on prevention and identification 

12 of mental disorders in the older adult population; 

13 ‘‘(2) innovative demonstration projects for the 

14 delivery of community-based mental health services 

15 for older adults; 

16 ‘‘(3) support for the development and dissemi17 nation of evidence-based practice models, including 

18 models to address substance-related disorders in 

19 older adults; and 

20 ‘‘(4) development of model training programs 

21 for mental health professionals and caregivers serv22 ing older adults.’’. 


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1 SEC. 5. MEMBERSHIP OF ADVISORY COUNCIL FOR THE 

2 CENTER FOR MENTAL HEALTH SERVICES. 

3 Section 502(b)(3) of the Public Health Service Act 

4 (42 U.S.C. 290aa–1(b)(3)) is amended by adding at the 

5 end the following: 

6 ‘‘(C) In the case of the advisory council for 

7 the Center for Mental Health Services, the 

8 members appointed pursuant to subparagraphs 

9 (A) and (B) shall include representatives of 

10 older adults or their families, and professionals 

11 with an expertise in geriatric mental health.’’. 

12 SEC. 6. PROJECTS OF NATIONAL SIGNIFICANCE TAR13 GETING SUBSTANCE ABUSE IN OLDER 

14 ADULTS. 

15 Section 509(b)(2) of the Public Health Service Act 

16 (42 U.S.C. 290bb–2(b)(2)) is amended by inserting before 

17 the period the following: ‘‘, and to providing treatment for 

18 older adults with substance-related disorders’’. 

19 SEC. 7. CRITERIA FOR STATE PLANS UNDER COMMUNITY 

20 MENTAL HEALTH SERVICES BLOCK GRANTS. 

21 (a) IN GENERAL.—Section 1912(b)(4) of the Public 

22 Health Service Act (42 U.S.C. 300x–2(b)(4)) is amended 

23 to read as follows: 

24 ‘‘(4) TARGETED SERVICES TO OLDER INDIVID25 UALS, INDIVIDUALS WHO ARE HOMELESS, AND INDI26 VIDUALS LIVING IN RURAL AREAS.—The plan deVerDate Nov 24 2008 02:14 Jul 14, 2009 Jkt 079200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H3191.IH H3191

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1 scribes the State’s outreach to and services for older 

2 individuals, individuals who are homeless, and indi3 viduals living in rural areas, and how community4 based services will be provided to these individuals.’’. 

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

6 subsection (a) shall apply to State plans submitted on or 

7 after the date that is 180 days after the date of enactment 

8 of this Act. 

Æ 


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