illness that can be diagnosed and treated in a given 
year; 
(2) mental illness costs our economy more than 
$80,000,000,000 annually, accounting for 15 per-
cent of the total economic burden of disease; 
(3) alcohol and drug abuse contributes to the 
death of more than 100,000 people and costs society 
upwards of half a trillion dollars a year; 
(4) individuals with serious mental illness die 
on average 25 years sooner than individuals in the 
general population; and 
(5) community mental and behavioral health or-
ganizations provide cost-efficient and evidence-based 
treatment and care for millions of Americans with 
mental illness and addiction disorders. 
SEC. 3. CO-LOCATING PRIMARY AND SPECIALTY CARE IN 
COMMUNITY-BASED MENTAL HEALTH SET-
TINGS. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 
adding at the end the following: 
‘‘SEC. 520K. GRANTS FOR CO-LOCATING PRIMARY AND SPE-
CIALTY CARE IN COMMUNITY-BASED MENTAL 
HEALTH SETTINGS. 
‘‘(a) DEFINITIONS.—In this section: 
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‘‘(1) ELIGIBLE ENTITY.—The term ‘eligible en-
tity’ means a qualified community mental health 
program defined under section 1913(b)(1). 
‘‘(2) SPECIAL POPULATIONS.—The term ‘spe-
cial populations’ refers to the following 3 groups: 
‘‘(A) Children and adolescents with mental 
and emotional disturbances who have co-occur-
ring primary care conditions and chronic dis-
eases. 
‘‘(B) Adults with mental illnesses who have 
co-occurring primary care conditions and chron-
ic diseases. 
‘‘(C) Older adults with mental illnesses 
who have co-occurring primary care conditions 
and chronic diseases. 
‘‘(b) PROGRAM AUTHORIZED.—The Secretary, acting 
through the Administrator of the Substance Abuse and 
Mental Health Services Administration and in coordina-
tion with the Director of the Health Resources and Serv-
ices Administration, shall award grants to eligible entities 
to establish demonstration projects for the provision of co-
ordinated and integrated services to special populations 
through the co-location of primary and specialty care serv-
ices in community-based mental and behavioral health set-
tings. 
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‘‘(c) APPLICATION.—To be eligible to receive a grant 
under this section, an eligible entity shall submit an appli-
cation to the Administrator at such time, in such manner, 
and accompanied by such information as the Adminis-
trator may require. Each such application shall include— 
‘‘(1) an assessment of the primary care needs 
of the patients served by the eligible entity and a de-
scription of how the eligible entity will address such 
needs; and 
‘‘(2) a description of partnerships, cooperative 
agreements, or other arrangements with local pri-
mary care providers, including community health 
centers, to provide services to special populations. 
‘‘(d) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—For the benefit of special 
populations, an eligible entity shall use funds award-
ed under this section for— 
‘‘(A) the provision, by qualified primary 
care professionals on a reasonable cost basis, 
of— 
‘‘(i) primary care services on site at 
the eligible entity; 
‘‘(ii) diagnostic and laboratory serv-
ices; or 
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‘‘(iii) adult and pediatric eye, ear, and 
dental screenings; 
‘‘(B) reasonable costs associated with 
medically necessary referrals to qualified spe-
cialty care professionals as well as to other co-
ordinators of care or, if permitted by the terms 
of the grant, for the provision, by qualified spe-
cialty care professionals on a reasonable cost 
basis on site at the eligible entity, of— 
‘‘(i) endocrinology services; 
‘‘(ii) oncology services; 
‘‘(iii) pulmonary/respiratory services; 
or 
‘‘(iv) cardiovascular services; 
‘‘(C) information technology required to 
accommodate the clinical needs of primary and 
specialty care professionals; or 
‘‘(D) facility improvements or modifica-
tions needed to bring primary and specialty 
care professionals on site at the eligible entity. 
‘‘(2) LIMITATION.—Not to exceed 15 percent of 
grant funds may be used for activities described in 
subparagraphs (C) and (D) of paragraph (1). 
‘‘(e) GEOGRAPHIC DISTRIBUTION.—The Secretary 
shall ensure that grants awarded under this section are 
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equitably distributed among the geographical regions of 
the United States and between urban and rural popu-
lations. 
‘‘(f) EVALUATION.—Not later than 3 months after a 
grant or cooperative agreement awarded under this section 
expires, an eligible entity shall submit to the Secretary the 
results of an evaluation to be conducted by the entity con-
cerning the effectiveness of the activities carried out under 
the grant or agreement. 
‘‘(g) REPORT.—Not later than 5 years after the date 
of enactment of this section, the Secretary shall prepare 
and submit to the appropriate committees of Congress a 
report that shall evaluate the activities funded under this 
section. The report shall include an evaluation of the im-
pact of co-locating primary and specialty care in commu-
nity mental and behavioral health settings on overall pa-
tient health status and recommendations on whether or 
not the demonstration program under this section should 
be made permanent. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$50,000,0000 for fiscal year 2009 and such sums as may 
be necessary for each of fiscal years 2010 through 2013.’’. 
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SEC. 4. INTEGRATING TREATMENT FOR MENTAL HEALTH 
AND SUBSTANCE ABUSE CO-OCCURRING DIS-
ORDERS. 
Section 520I of the Public Health Service Act (42 
U.S.C. 290bb–40) is amended— 
(1) by striking subsection (i) and inserting the 
following: 
‘‘(j) FUNDING.—The Secretary shall make available 
to carry out this section, $14,000,000 for fiscal year 2009, 
$20,000,000 for fiscal year 2010, and such sums as may 
be necessary for each of fiscal years 2011 through 2013. 
Such sums shall be made available in equal amount from 
amounts appropriated under sections 509 and 520A.’’; 
and 
(2) by inserting before subsection (j), the fol-
lowing: 
‘‘(i) COMMUNITY MENTAL HEALTH PROGRAM.—For 
purposes of eligibility under this section, the term ‘private 
nonprofit organization’ includes a qualified community 
mental health program as defined under section 
1913(b)(1).’’. 
SEC. 5. IMPROVING THE MENTAL HEALTH WORKFORCE. 
(a) NATIONAL HEALTH SERVICE CORPS.—Para-
graph (1) of section 332(a) of the Public Health Service 
Act (42 U.S.C. 254e(a)) is amended by inserting ‘‘and 
community mental health centers meeting the criteria 
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specified in section 1913(c)’’ after ‘‘Social Security Act 
(42 U.S.C. 1395x(aa)),’’. 
(b) RECRUITMENT
AND RETENTION
OF MENTAL 
HEALTH PROFESSIONALS.—Subpart X of part D of title 
III of the Public Health Service Act (42 U.S.C. 256f et 
seq.) is amended by adding at the end the following: 
‘‘SEC. 340H. GRANTS FOR RECRUITMENT AND RETENTION 
OF MENTAL HEALTH PROFESSIONALS. 
‘‘(a) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Administrator of the Health Resources and 
Services Administration, shall award grants to States, ter-
ritories, and Indian tribes or tribal organizations for inno-
vative programs to address the behavioral and mental 
health workforce needs of designated mental health profes-
sional shortage areas. 
‘‘(b) USE OF FUNDS.—An eligible entity shall use 
grant funds awarded under this section for— 
‘‘(1) loan forgiveness and repayment programs 
(to be carried out in a manner similar to the loan 
repayment programs carried out under subpart III 
of part D) for behavioral and mental health profes-
sionals who— 
‘‘(A) agree to practice in designated men-
tal health professional shortage areas; 
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‘‘(B) are graduates of programs in behav-
ioral or mental health; 
‘‘(C) agree to serve in community-based 
non-profit entities, or as public mental health 
professionals for the Federal, State or local gov-
ernment; and 
‘‘(D) agree to— 
‘‘(i) provide services to patients re-
gardless of such patients’ ability to pay; 
and 
‘‘(ii) use a sliding payment scale for 
patients who are unable to pay the total 
cost of services; 
‘‘(2) behavioral and mental health professional 
recruitment and retention efforts, with a particular 
emphasis on candidates from racial and ethnic mi-
nority and medically-underserved communities; 
‘‘(3) grants or low-interest or no-interest loans 
for behavioral and mental health professionals who 
participate in the Medicaid program under title XIX 
of the Social Security Act to establish or expand 
practices in designated mental health professional 
shortage areas, or to serve in qualified community 
mental health programs as defined in section 
1913(b)(1); 
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‘‘(4) placement and support for behavioral and 
mental health students, residents, trainees, and fel-
lows or interns; or 
‘‘(5) continuing behavioral and mental health 
education, including distance-based education. 
‘‘(c) APPLICATION.— 
‘‘(1) IN GENERAL.—Each eligible entity desir-
ing a grant under this section shall submit an appli-
cation to the Secretary at such time, in such man-
ner, and containing such information as the Sec-
retary may reasonably require. 
‘‘(2) ASSURANCES.—The application shall in-
clude assurances that the applicant will meet the re-
quirements of this subsection and that the applicant 
possesses sufficient infrastructure to manage the ac-
tivities to be funded through the grant and to evalu-
ate and report on the outcomes resulting from such 
activities. 
‘‘(d) MATCHING REQUIREMENT.—The Secretary may 
not make a grant to an eligible entity under this section 
unless that entity agrees that, with respect to the costs 
to be incurred by the entity in carrying out the activities 
for which the grant was awarded, the entity will provide 
non-Federal contributions in an amount equal to not less 
than 35 percent of Federal funds provided under the 
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grant. The entity may provide the contributions in cash 
or in kind, fairly evaluated, including plant, equipment, 
and services, and may provide the contributions from 
State, local, or private sources. 
‘‘(e) SUPPLEMENT NOT SUPPLANT.—A grant award-
ed under this section shall be expended to supplement, and 
not supplant, the expenditures of the eligible entity and 
the value of in-kind contributions for carrying out the ac-
tivities for which the grant was awarded. 
‘‘(f) GEOGRAPHIC DISTRIBUTION.—The Secretary 
shall ensure that grants awarded under this section are 
equitably distributed among the geographical regions of 
the United States and between urban and rural popu-
lations. 
‘‘(g) EVALUATION.—Not later than 3 months after 
a grant awarded under this section expires, an eligible en-
tity shall submit to the Secretary the results of an evalua-
tion to be conducted by the entity concerning the effective-
ness of the activities carried out under the grant. 
‘‘(h) REPORT.—Not later than 5 years after the date 
of enactment of this section, the Secretary shall prepare 
and submit to the appropriate committees of Congress a 
report containing data relating to whether grants provided 
under this section have increased access to behavioral and 
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mental health services in designated mental health profes-
sional shortage areas. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$10,000,000 for fiscal year 2009, and such sums as may 
be necessary for each of fiscal years 2010 through 2013.’’. 
(c) BEHAVIORAL AND MENTAL HEALTH EDUCATION 
AND TRAINING PROGRAMS.—Part A of title V of the Pub-
lic Health Service Act (42 U.S.C. 290aa et seq.) is amend-
ed by adding at the end the following: 
‘‘SEC. 506C. GRANTS FOR BEHAVIORAL AND MENTAL 
HEALTH EDUCATION AND TRAINING PRO-
GRAMS. 
‘‘(a) DEFINITION.—For the purposes of this section, 
the term ‘related mental health personnel’ means an indi-
vidual who— 
‘‘(1) facilitates access to a medical, social, edu-
cational, or other service; and 
‘‘(2) is not a mental health professional, but 
who is the first point of contact with persons who 
are seeking mental health services. 
‘‘(b) 
ESTABLISHMENT.—The 
Secretary, 
acting 
through the Administrator of the Substance Abuse and 
Mental Health Services Administration, shall establish a 
program to increase the number of trained behavioral and 
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mental health professionals and related mental health per-
sonnel by awarding grants on a competitive basis to men-
tal and behavioral health nonprofit organizations or ac-
credited institutions of higher education to enable such en-
tities to establish or expand accredited mental and behav-
ioral health education programs. 
‘‘(c) APPLICATION.— 
‘‘(1) IN GENERAL.—Each eligible entity desir-
ing a grant under this section shall submit an appli-
cation to the Secretary at such time, in such man-
ner, and containing such information as the Sec-
retary may reasonably require. 
‘‘(2) ASSURANCES.—The application shall in-
clude assurances that the applicant will meet the re-
quirements of this subsection and that the applicant 
possesses sufficient infrastructure to manage the ac-
tivities to be funded through the grant and to evalu-
ate and report on the outcomes resulting from such 
activities. 
‘‘(d) PRIORITY.—In awarding grants under this sec-
tion, the Secretary shall give priority to applicants that— 
‘‘(1) demonstrate a familiarity with the use of 
evidenced-based methods in behavioral and mental 
health services; 
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‘‘(2) provide interdisciplinary training experi-
ences; and 
‘‘(3) demonstrate a commitment to training 
methods and practices that emphasize the integrated 
treatment of mental health and substance abuse dis-
orders. 
‘‘(e) USE OF FUNDS.—Funds awarded under this 
section shall be used to— 
‘‘(1) establish or expand accredited behavioral 
and mental health education programs, including im-
proving the coursework, related field placements, or 
faculty of such programs; or 
‘‘(2) establish or expand accredited mental and 
behavioral health training programs for related men-
tal health personnel. 
‘‘(f) REQUIREMENTS.—The Secretary may award a 
grant to an eligible entity only if such entity agrees that— 
‘‘(1) any behavioral or mental health program 
assisted under the grant will prioritize cultural com-
petency and the recruitment of trainees from racial 
and ethnic minority and medically-underserved com-
munities; and 
‘‘(2) with respect to any violation of the agree-
ment between the Secretary and the entity, the enti-
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ty will pay such liquidated damages as prescribed by 
the Secretary. 
‘‘(g) GEOGRAPHIC DISTRIBUTION.—The Secretary 
shall ensure that grants awarded under this section are 
equitably distributed among the geographical regions of 
the United States and between urban and rural popu-
lations. 
‘‘(h) EVALUATION.—Not later than 3 months after 
a grant awarded under this section expires, an eligible en-
tity shall submit to the Secretary the results of an evalua-
tion to be conducted by the entity concerning the effective-
ness of the activities carried out under the grant. 
‘‘(i) REPORT.—Not later than 5 years after the date 
of enactment of this section, the Secretary shall prepare 
and submit to the appropriate committees of Congress a 
report containing data relating to whether grants provided 
under this section have increased access to behavioral and 
mental health services in designated mental health profes-
sional shortage areas. 
‘‘(j) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated to carry out this section 
$4,000,0000 for fiscal year 2009, and such sums as may 
be necessary for each of fiscal years 2010 through 2013.’’. 
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SEC. 6. IMPROVING ACCESS TO MENTAL HEALTH SERVICES 
IN MEDICALLY-UNDERSERVED AREAS. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.) is amended by 
inserting after section 520A the following: 
‘‘SEC. 520B. GRANTS FOR TELE-MENTAL HEALTH IN MEDI-
CALLY-UNDERSERVED AREAS. 
‘‘(a) PROGRAM AUTHORIZED.—The Secretary, acting 
through the Administrator of the Substance Abuse and 
Mental Health Services Administration, shall award 
grants to eligible entities to provide tele-mental health in 
medically-underserved areas. 
‘‘(b) ELIGIBLE ENTITY.—To be eligible for assist-
ance under the program under subsection (a), an entity 
shall be a qualified community mental health program (as 
defined in section 1913(b)(1)). 
‘‘(c) APPLICATION.— 
‘‘(1) IN GENERAL.—Each eligible entity desir-
ing a grant under this section shall submit an appli-
cation to the Secretary at such time, in such man-
ner, and containing such information as the Sec-
retary may reasonably require. 
‘‘(2) ASSURANCES.—The application shall in-
clude assurances that the applicant will meet the re-
quirements of this subsection and that the applicant 
possesses sufficient infrastructure to manage the ac-
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tivities to be funded through the grant and to evalu-
ate and report on the outcomes resulting from such 
activities. 
‘‘(d) USE OF FUNDS.—An eligible entity shall use 
funds received under a grant under this section for— 
‘‘(1) the provision of tele-mental health services; 
or 
‘‘(2) infrastructure improvements for the provi-
sion of tele-mental health services. 
‘‘(e) GEOGRAPHIC DISTRIBUTION.—The Secretary 
shall ensure that grants awarded under this section are 
equitably distributed among the geographical regions of 
the United States and between urban and rural popu-
lations. 
‘‘(f) EVALUATION.—Not later than 3 months after a 
grant awarded under this section expires, an eligible entity 
shall submit to the Secretary the results of an evaluation 
to be conducted by the entity concerning the effectiveness 
of the activities carried out under the grant. 
‘‘(g) REPORT.—Not later than 5 years after the date 
of enactment of this section, the Secretary shall prepare 
and submit to the appropriate committees of Congress a 
report that shall evaluate the activities funded under this 
section. 
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‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$20,000,000 for fiscal year 2009, and such sums as may 
be necessary for each of fiscal years 2010 through 2013.’’. 
SEC. 7. IMPROVING HEALTH INFORMATION TECHNOLOGY 
FOR MENTAL HEALTH PROVIDERS. 
Part A of title V of the Public Health Service Act 
(42 U.S.C. 290aa et seq.), as amended by section 5(c), 
is further amended by adding at the end the following: 
‘‘SEC. 506D. IMPROVING HEALTH INFORMATION TECH-
NOLOGY FOR MENTAL HEALTH PROVIDERS. 
‘‘(a) IN GENERAL.—The Secretary, in consultation 
with the Secretary of Veterans Affairs, shall collaborate 
with the Administrator of the Substance Abuse and Men-
tal Health Services Administration and the National Coor-
dinator for Health Information Technology to— 
‘‘(1) develop and implement a plan for ensuring 
that various components of the National Health In-
formation Infrastructure, including data and privacy 
standards, electronic health records, and community 
and regional health networks, address the needs of 
mental health and substance abuse treatment pro-
viders; and 
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‘‘(2) finance related infrastructure improve-
ments, technical support, personnel training, and on-
going quality improvements. 
‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$10,000,000 for fiscal year 2009, and such sums as may 
be necessary for each of fiscal years 2010 through 2013.’’. 
SEC. 8. PAPERWORK REDUCTION STUDY. 
(a) IN GENERAL.—Not later than 12 months after 
the date of enactment of this Act, the Institute of Medi-
cine shall submit to the appropriate committees of Con-
gress a report that evaluates the combined paperwork bur-
den of qualified community mental health programs as de-
fined in section 1913(b)(1) of the Public Health Service 
Act. 
(b) SCOPE.—In preparing the report under sub-
section (a), the Institute of Medicine shall examine licens-
ing, certification, service definitions, claims payment, bill-
ing codes, and financial auditing requirements utilized by 
the Office of Management and Budget, the Centers for 
Medicare & Medicaid Services, the Health Resources and 
Services Administration, the Substance Abuse and Mental 
Health Services Administration, the Office of the Inspec-
tor General, State Medicaid agencies, State departments 
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of health, State departments of education, and State and 
local juvenile justice and social service agencies to— 
(1) establish an estimate of the combined na-
tionwide cost of complying with the requirements de-
scribed in this paragraph, in terms of both adminis-
trative funding and staff time; 
(2) establish an estimate of the per capita cost 
to each qualified community mental health program 
defined in section 1913(b)(1) of the Public Health 
Service Act to comply with the requirements of this 
paragraph, in terms of both administrative funding 
and staff time; and 
(3) make administrative and statutory rec-
ommendations to Congress, which may include a 
uniform methodology, to reduce the paperwork bur-
den experienced by qualified community mental 
health programs defined in section 1913(b)(1) of the 
Public Health Service Act. 
(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
$550,000 for each of fiscal years 2009 and 2010. 
SEC. 9. WAGE STUDY. 
(a) IN GENERAL.—Not later than 12 months after 
the date of enactment of this Act, the Institute of Medi-
cine shall conduct a nationwide analysis, and submit a re-
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port to the appropriate committees of Congress, con-
cerning the compensation structure of professional and 
paraprofessional personnel employed by qualified commu-
nity mental health programs as defined under section 
1913(b)(1) of the Public Health Service Act, as compared 
with the compensation structure of comparable health 
safety net providers and relevant private sector health care 
employers. 
(b) SCOPE.—In preparing the report under sub-
section (a), the Institute of Medicine shall examine com-
pensation disparities, if such disparities are determined to 
exist, by type of personnel, type of provider or private sec-
tor employer, and geographic region. 
(c) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section, 
$550,000 for each of fiscal years 2009 and 20l0. 
Æ 
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