ing ‘‘or provider of crisis response services (as de-
fined in section 1861(nnn))’’ after ‘‘any hospital’’. 
(4) EFFECTIVE DATE.— 
(A) IN GENERAL.—Except as provided in 
subparagraph (B), the amendments made by 
this section shall take effect on the date that is 
3 years after the date of the enactment of this 
Act. 
(B) DELAY PERMITTED IF STATE LEGISLA-
TION REQUIRED.—In the case of a State plan 
under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) which the Secretary of 
Health and Human Services determines re-
quires State legislation (other than legislation 
appropriating funds) in order for the plan to 
meet the additional requirements imposed by 
the amendments made by this section, the State 
plan shall not be regarded as failing to comply 
with the requirements of such title solely on the 
basis of the failure of the plan to meet such ad-
ditional requirements before the first day of the 
first calendar quarter beginning after the close 
of the first regular session of the State legisla-
ture that begins after the date of enactment of 
this Act. For purposes of the previous sentence, 
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in the case of a State that has a 2-year legisla-
tive session, each year of such session shall be 
deemed to be a separate regular session of the 
State legislature. 
(c) 
ESSENTIAL
HEALTH
BENEFITS.—Section 
1302(b)(1)(E) of the Patient Protection and Affordable 
Care Act (42 U.S.C. 18022(b)(1)(E)) is amended by in-
serting ‘‘and crisis response services (as defined in section 
1861(nnn) of the Social Security Act)’’ before the period. 
(d) GROUP HEALTH PLANS AND HEALTH INSUR-
ANCE ISSUERS.— 
(1) IN GENERAL.—Section 2707 of the Public 
Health Service Act (42 U.S.C. 300gg–6) is amended 
by adding at the end the following: 
‘‘(e) CRISIS RESPONSE SERVICES.—A group health 
plan or a health insurance issuer offering group or indi-
vidual health insurance coverage shall ensure that such 
coverage includes crisis response services (as defined in 
section 1861(nnn) of the Social Security Act).’’. 
(2) 
APPLICATION
TO
GRANDFATHERED 
PLANS.—Section 1251(a)(4)(A) of the Public Health 
Service Act (42 U.S.C. 18011(a)(4)(A)) is amended 
by adding at the end the following new clause: 
‘‘(v) Section 2707(e) (relating to cov-
erage of crisis response services).’’. 
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(e) TRICARE COVERAGE.— 
(1) IN
GENERAL.—The Secretary of Defense 
shall provide coverage under the TRICARE program 
for crisis response services, as defined in section 
1861(nnn) of the Social Security Act (42 U.S.C. 
1395x). 
(2) TRICARE PROGRAM DEFINED.—In this sec-
tion, the term ‘‘TRICARE program’’ has the mean-
ing given the term in section 1072 of title 10, 
United States Code. 
(f) REIMBURSEMENT FOR CRISIS RESPONSE SERV-
ICES
FOR VETERANS.—Section 1725(f)(1) of title 38, 
United States Code, is amended, in the matter preceding 
subparagraph (A), by inserting ‘‘, including crisis response 
services (as defined in subsection (nnn) of section 1861 
of the Social Security Act (42 U.S.C. 1395x)),’’ after 
‘‘services’’. 
(g) COVERAGE UNDER FEHB.— 
(1) IN
GENERAL.—Section 8902 of title 5, 
United States Code, is amended by adding at the 
end the following: 
‘‘(p) Each contract for a plan under this chapter shall 
require the carrier to provide coverage for crisis response 
services, as that term is defined in subsection (nnn) of 
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section 1861 of the Social Security Act (42 U.S.C. 
1395x).’’. 
(2) EFFECTIVE DATE.—The amendment made 
by paragraph (1) shall apply beginning with respect 
to the third contract year for chapter 89 of title 5, 
United States Code, that begins on or after the date 
that is 3 years after the date of enactment of this 
Act. 
(h) COVERAGE UNDER CHIP.—Section 2103(c)(5) 
of the Social Security Act (42 U.S.C. 1397cc(c)(5)) is 
amended— 
(1) in subparagraph (A), by striking ‘‘and’’ at 
the end; 
(2) in subparagraph (B), by striking the period 
and inserting ‘‘; and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(C) beginning on the date that is 3 years 
after the date of the enactment of this subpara-
graph, crisis response services (as defined in 
section 1861(nnn)).’’. 
SEC. 302. INCIDENT REPORTING. 
(a) ESTABLISHMENT
OF PROTOCOL PANEL.—The 
Secretary of Health and Human Services (referred to in 
this section as the ‘‘Secretary’’), in consultation with the 
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Attorney General, shall convene a panel for the purposes 
of making recommendations for training and protocol for 
9–1–1 dispatchers to respond appropriately to individuals 
experiencing a behavioral health crisis based on the char-
acteristics of the incident and the needs of the caller. 
(b) PANELISTS.—The Secretary shall appoint individ-
uals to serve staggered 10-year terms on the panel estab-
lished under subsection (a). Such individuals shall in-
clude— 
(1) psychiatrists; 
(2) paramedics and other emergency medical 
services personnel; 
(3) law enforcement officers and 9–1–1 dis-
patchers; 
(4) representatives from each segment of the 
crisis response continuum, including 9–8–8 dis-
patchers; 
(5) members of underserved communities in-
cluding ethnic and racial minority groups and sexual 
orientation and gender minority groups; 
(6) representatives from Tribes or Tribal orga-
nizations; and 
(7) other individuals, as the Secretary deter-
mines appropriate. 
(c) RECOMMENDATIONS.— 
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(1) 
TOPICS.—In 
issuing 
recommendations 
under this section, the panel shall consider— 
(A) connecting 9–1–1 callers to crisis care 
services instead of responding with law enforce-
ment officers; 
(B) integrating the 9–8–8 system into the 
9–1–1 system, or transferring calls from the 9– 
1–1 system to the 9–8–8 system as appropriate; 
and 
(C) a process for identifying 9–1–1 callers 
who may be experiencing psychiatric symptoms 
or a mental health crisis, substance use crisis, 
or co-occurring crisis and evaluating the level of 
need of such callers, as defined by relevant, 
standardized assessment tools such as the Level 
of Care Utilization System (LOCUS), the Child 
and Adolescent Level of Care Utilization Sys-
tem (CALOCUS), and the American Society of 
Addiction Medicine (ASAM) Criteria. 
(2) UPDATES.—The panel shall update rec-
ommendations issued under this section not less fre-
quently than every 5 years. 
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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. 
(a) IN GENERAL.—Section 1947 of the Social Secu-
rity Act (42 U.S.C. 1396w–6) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘for qualifying community- 
based mobile crisis intervention services’’ and 
inserting ‘‘for— 
‘‘(1) qualifying community-based mobile crisis 
intervention services; 
‘‘(2) regional and local lifeline call center oper-
ations; and 
‘‘(3) programs for the purpose receiving and 
stabilization individuals (including beds in homes 
and facilities for such purpose).’’; and 
(B) by striking ‘‘during the 5-year period’’; 
(2) in subsection (c)— 
(A) by striking ‘‘85 percent.’’ and inserting 
the following: ‘‘85 percent, and for medical as-
sistance for items described in paragraphs (2) 
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and (3) of subsection (a) furnished during such 
quarter shall be equal to 85 percent.’’; and 
(B) by striking ‘‘occurring during the pe-
riod described in subsection (a) that a State’’ 
and inserting ‘‘in which a State provides med-
ical assistance for qualifying community-based 
mobile crisis intervention services under this 
section and’’; 
(3) in subsection (e), by adding at the end at 
the following new sentence: ‘‘There is appropriated, 
out of any funds in the Treasury not otherwise ap-
propriated, $5,000,000 to the Secretary for the pur-
poses described in the preceding sentence to remain 
available until expended.’’; and 
(4) in subsection (d)(2)— 
(A) in subparagraph (A), by striking ‘‘for 
the fiscal year preceding the first fiscal quarter 
occurring during the period described in sub-
section (a)’’ and inserting ‘‘for the fiscal year 
preceding the first fiscal quarter in which the 
State provides medical assistance for qualifying 
community-based 
mobile 
crisis 
intervention 
services under this section’’; and 
(B) in subparagraph (B), by striking ‘‘oc-
curring during the period described in sub-
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section (a)’’ and inserting ‘‘occurring during a 
fiscal quarter’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect as if included in the enact-
ment of the American Rescue Plan Act of 2021 (Public 
Law 117–2). 
SEC. 402. REVISIONS TO THE IMD EXCLUSION UNDER MED-
ICAID. 
(a) SHRINKING OF THE IMD EXCLUSION UNDER 
MEDICAID.—Section 1905(a)(1) of the Social Security Act 
(42 U.S.C. 1396d(a)(1)) is amended by inserting ‘‘, except 
for, services that, beginning the day after the date of the 
enactment of the 9–8–8 National Suicide Prevention Life-
line Implementation Act of 2022, are furnished in psy-
chiatric acute care crisis beds administered by community 
behavioral health organizations certified under section 223 
of the Protecting Access to Medicare Act of 2014, mental 
health centers that meet the criteria of section 1913(c) 
of the Public Health Service Act, crisis receiving and sta-
bilization facilities, and the mental health and substance 
use urgent care facilities’’. 
(b) GUIDANCE RELATING TO IMD EXCLUSION.—Not 
later than 180 days after the date of the enactment of 
this Act, the Secretary of Health and Human Services 
shall issue guidance that crisis stabilization units (as de-
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scribed in section 1905(a)(1) of the Social Security Act 
(42 U.S.C. 1396d(a)(1)) are excluded from the prohibition 
specified in the parenthetical of paragraph (1) of section 
1905(a) (relating to services in an institution for mental 
diseases), including the following facilities and services: 
(1) Subacute crisis receiving in inpatient or 
other facilities specified by the Secretary that pro-
vide short-term observation for all referrals to indi-
viduals in severe distress, as further defined by the 
Secretary, with up to 23 consecutive hours of super-
vised care to assist with deescalating the severity of 
a mental health or substance use crisis or need for 
urgent care in a sub-acute inpatient setting. 
(2) Short term crisis stabilization services as-
sisting with deescalating the severity of individuals 
in severe distress, as defined by the Secretary, or 
need for urgent care associated with a substance use 
or mental health disorder in an inpatient or residen-
tial setting with reimbursement limited to 72 hours. 
(c) REPORTS ON CRISIS STABILIZATION UTILIZA-
TION.—Not later than 1 year after the date of the enact-
ment of this Act, the Secretary shall submit to the appro-
priate congressional committees of jurisdiction a report 
addressing the utilization of facility-based crisis services, 
including the number of patients served, type and duration 
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of facility-based services, linkage to community-based re-
sources, and information on the total number of law en-
forcement drop-offs and other data relevant for diverting 
mental health and substance use disorder emergencies 
from law enforcement response. 
Æ 
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