‘‘(B) SHORT-TERM
CRISIS
RESIDENTIAL 
SERVICES.—A direct care service that assists 
with deescalating the severity of an individual’s 
level of distress or need for urgent care associ-
ated with a substance use or mental health dis-
order in a residential setting. 
‘‘(4) MENTAL
HEALTH
AND
SUBSTANCE
USE 
URGENT
CARE
FACILITIES.—Ambulatory services 
available 12–24 hours per day, 7 days a week, where 
individuals experiencing crisis can walk in without 
an appointment to receive crisis assessment, crisis 
intervention, medication, and connection to con-
tinuity of care. 
‘‘(5) 
ADDITIONAL
FACILITIES
AND
PRO-
VIDERS.—The Secretary shall specify additional fa-
cilities and health care providers as part of the crisis 
response continuum, as the Secretary determines ap-
propriate. 
‘‘(d) RELATIONSHIP TO STATE LAW.— 
‘‘(1) IN GENERAL.—Subject to paragraph (2), 
the standards established under this section are min-
imum standards and nothing in this section may be 
construed to preclude a State from establishing ad-
ditional standards, so long as such standards are not 
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inconsistent with the requirements of this section or 
other applicable law. 
‘‘(2) WAIVER
OR
MODIFICATION.—The Sec-
retary shall establish a process under which a State 
may request a waiver or modification of a standard 
established under this section.’’. 
SEC. 302. COVERAGE OF CRISIS RESPONSE SERVICES. 
(a) COVERAGE UNDER THE MEDICARE PROGRAM.— 
(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)) is 
amended— 
(A) in subparagraph (GG), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (HH), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(II) crisis response services as defined in 
subsection (lll);’’. 
(2) CRISIS
RESPONSE
SERVICES
DEFINED.— 
Section 1861 of the Social Security Act (42 U.S.C. 
1395x) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(lll) CRISIS RESPONSE SERVICES.— 
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‘‘(1) IN GENERAL.—The term ‘crisis response 
services’ means mental health or substance use serv-
ices that are furnished by a mobile crisis response 
team, a crisis receiving and stabilization facility, 
mental health or substance use urgent care facility, 
or other appropriate provider, as determined by the 
Secretary, to an individual, including children and 
adolescents, experiencing a mental health or sub-
stance use crisis. Such term includes services identi-
fied by the Secretary as part of the crisis response 
continuum of care under section 302 of the Behav-
ioral Health Crisis Services Expansion Act. 
‘‘(2) DEFINITIONS.—In this subsection, the 
terms ‘mobile crisis response team’, ‘crisis receiving 
and stabilization facility’, and ‘mental health and 
substance use urgent care facility’ have the meaning 
given those terms for purposes of such section 
302.’’. 
(3) PAYMENT.— 
(A) IN GENERAL.—Section 1833(a)(1) of 
the Social Security Act (42 U.S.C. 1395l(a)(1)) 
is amended— 
(i) by striking ‘‘and (DD)’’ and in-
serting ‘‘(DD)’’; and 
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(ii) by inserting before the semicolon 
at the end the following: ‘‘and (EE) with 
respect to crisis response services described 
in section 1861(s)(2)(II), the amounts paid 
shall be 80 percent of the lesser of the ac-
tual charge for the service or the amount 
determined under the payment basis estab-
lished under section 1834(z)’’. 
(B) 
ESTABLISHMENT
OF
PAYMENT 
BASIS.—Section 1834 of the Social Security Act 
(42 U.S.C. 1395m) is amended by adding at 
the end the following new subsection: 
‘‘(z) PAYMENT FOR CRISIS RESPONSE SERVICES.— 
The Secretary shall establish a payment basis determined 
appropriate by the Secretary with respect to crisis re-
sponse services (as defined in section 1861(lll)) furnished 
by a provider of services or supplier.’’. 
(4) AMBULANCE TRANSPORT OF INDIVIDUALS 
IN CRISIS.— 
(A) IN GENERAL.—Section 1834(l) of the 
Social Security Act (42 U.S.C. 1395m(l)) is 
amended by adding at the end the following 
new paragraph: 
‘‘(18) TRANSPORTATION
OF
INDIVIDUALS
IN 
CRISIS.—With respect to ambulance services fur-
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nished on or after the date that is 3 years after the 
date of the enactment of the Behavioral Health Cri-
sis Services Expansion Act, the regulations described 
in section 1861(s)(7) shall provide coverage under 
such section for ambulance and other qualified emer-
gency transport services to transport an individual 
experiencing a mental health or substance crisis to 
an appropriate facility, such as a community mental 
health center (as defined in section 1861(ff)(3)(B)) 
or other facility or provider identified by the Sec-
retary as part of the crisis response continuum of 
care under section 203 of the Behavioral Health Cri-
sis Services Expansion Act, as appropriate, for crisis 
response 
services 
described 
in 
section 
1861(s)(2)(II).’’. 
(B) CONFORMING
AMENDMENT.—Section 
1861(s)(7) of such Act (42 U.S.C. 1395x(s)(7)) 
is amended by striking ‘‘section 1834(l)(14)’’ 
and inserting ‘‘paragraphs (14) and (18) of sec-
tion 1834(l)’’. 
(5) EFFECTIVE DATE.—The amendments made 
by this subsection shall apply to services furnished 
on or after the date that is 3 years after the date 
of the enactment of this Act. 
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(b) MANDATORY COVERAGE OF CRISIS RESPONSE 
SERVICES UNDER THE MEDICAID PROGRAM.—Title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.) is 
amended— 
(1) in section 1902(a)(10)(A), in the matter 
preceding clause (i), by striking ‘‘and (30)’’ and in-
serting ‘‘(30), and (31)’’; and 
(2) in section 1905— 
(A) in subsection (a)— 
(i) in paragraph (30), by striking ‘‘; 
and’’ and inserting a semicolon; 
(ii) by redesignating paragraph (31) 
as paragraph (32); and 
(iii) by inserting the following para-
graph after paragraph (30): 
‘‘(31) crisis response services (as defined in sec-
tion 1861(lll)); and’’. 
(3) PRESUMPTIVE
ELIGIBILITY
DETERMINA-
TION BY CRISIS RESPONSE SERVICE PROVIDERS.— 
Section 1902(a)(47)(B) of the Social Security Act 
(42 U.S.C. 1396a(a)(47)(B)) is amended by insert-
ing ‘‘or provider of crisis response services (as de-
fined in section 1861(lll))’’ after ‘‘any hospital’’. 
(4) EFFECTIVE DATE.— 
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(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, 
in the case of a State that has a 2-year legisla-
tive session, each year of such session shall be 
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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(lll) 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(lll) 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).’’. 
(e) TRICARE COVERAGE.— 
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(1) IN
GENERAL.—The Secretary of Defense 
shall provide coverage under the TRICARE program 
for crisis response services, as defined in section 
1861(lll) of the Social Security Act (42 U.S.C. 
1395x) (as amended by section 303). 
(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 (lll) of section 1861 of 
the Social Security Act (42 U.S.C. 1395x)),’’ after ‘‘serv-
ices’’. 
(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 (lll) of sec-
tion 1861 of the Social Security Act (42 U.S.C. 1395x).’’. 
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(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(lll)).’’. 
SEC. 303. BUILDING THE CRISIS CONTINUUM INFRASTRUC-
TURE. 
(a) ADDITIONAL AMOUNTS FOR MENTAL HEALTH 
BLOCK GRANT.—Section 1920 of the Public Health Serv-
ice Act (42 U.S.C. 300x–9) is amended by adding at the 
end the following: 
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‘‘(d) SUPPORT FOR CRISIS RESPONSE SERVICES IN-
FRASTRUCTURE.— 
‘‘(1) IN
GENERAL.—In addition to amounts 
made available under subsection (a), there are au-
thorized to be appropriated such sums as are nec-
essary for each of fiscal years 2022, 2023, and 
2024, for purposes of supporting the infrastructure 
needed to provide crisis response services (as defined 
in section 1861(lll) of the Social Security Act) in the 
States, which may include training and continuing 
education, and administrative expenses with respect 
to the provision of such services. 
‘‘(2) ALLOTMENTS.—Each fiscal year for which 
amounts are appropriated under paragraph (1), the 
Secretary shall allot to each State that receives a 
grant under section 1911 for the fiscal year an 
amount that bears the same relationship to the total 
amount appropriated under paragraph (1) for the 
fiscal year that the amount received by the State 
under section 1911(a) for the fiscal year bears to 
the total amount appropriated under subsection (a) 
for the fiscal year. 
‘‘(e) TECHNICAL ASSISTANCE.—The Secretary shall 
provide to States technical assistance regarding the provi-
sion of crisis response services, as defined in section 
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1861(lll) of the Social Security Act, including guidance on 
how States may blend Medicaid funds available to States 
under title XIX of the Social Security Act and funds avail-
able to States under the community mental health services 
block grant program under this subpart and the substance 
abuse prevention and treatment block grant program 
under subpart II to provide such services. 
‘‘(f) CLEARINGHOUSE
OF BEST PRACTICES.—The 
Secretary shall develop and maintain a publicly available 
clearinghouse of best practices for the successful operation 
of each segment of the system for providing crisis response 
services (as defined in section 1861(lll) of the Social Secu-
rity Act) and the integration of such best practices into 
the provision of such services. The clearinghouse shall be 
updated annually. 
‘‘(g) RULE
OF CONSTRUCTION.—With respect to 
funds allocated under the crisis care set-aside authorized 
under (a), the provisions contained in 1912(b)(1)(A)(vi) 
shall not apply.’’. 
SEC. 304. 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 
Attorney General, shall convene a panel for the purposes 
of making recommendations for training and protocol for 
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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, as described in section 
302, including 9–8–8 dispatchers; 
(5) individuals who have received services under 
such crisis response continuum, including individuals 
under the age of 18; 
(6) members of underserved communities in-
cluding ethnic and racial minority groups and sexual 
orientation and gender minority groups; 
(7) representatives from Tribes or Tribal orga-
nizations; and 
(8) other individuals, as the Secretary deter-
mines appropriate. 
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(c) RECOMMENDATIONS.— 
(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 (as defined in section 302(c)(3) of the 
9–8–8 National Suicide Prevention Lifeline Implementa-
tion Act of 2022) and the mental health and substance 
use urgent care facilities (as defined in section 302(c)(5) 
of such Act)’’. 
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