II 
114TH CONGRESS 
2D SESSION 
H. R. 2646 
IN THE SENATE OF THE UNITED STATES 
JULY 7, 2016 
Received 
AN ACT 
To make available needed psychiatric, psychological, and sup-
portive services for individuals with mental illness and 
families in mental health crisis, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
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SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 
(a) SHORT TITLE.—This Act may be cited as the 
‘‘Helping Families in Mental Health Crisis Act of 2016’’. 
(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
TITLE I—ASSISTANT SECRETARY FOR MENTAL HEALTH AND 
SUBSTANCE USE 
Sec. 101. Assistant Secretary for Mental Health and Substance Use. 
Sec. 102. Improving oversight of mental health and substance use programs. 
Sec. 103. National Mental Health and Substance Use Policy Laboratory. 
Sec. 104. Peer-support specialist programs. 
Sec. 105. Prohibition against lobbying using Federal funds by systems accept-
ing Federal funds to protect and advocate the rights of individ-
uals with mental illness. 
Sec. 106. Reporting for protection and advocacy organizations. 
Sec. 107. Grievance procedure. 
Sec. 108. Center for Behavioral Health Statistics and Quality. 
Sec. 109. Strategic plan. 
Sec. 110. Authorities of centers for mental health services and substance abuse 
treatment. 
Sec. 111. Advisory councils. 
Sec. 112. Peer review. 
TITLE II—MEDICAID MENTAL HEALTH COVERAGE 
Sec. 201. Rule of construction related to Medicaid coverage of mental health 
services and primary care services furnished on the same day. 
Sec. 202. Optional limited coverage of inpatient services furnished in institu-
tions for mental diseases. 
Sec. 203. Study and report related to Medicaid managed care regulation. 
Sec. 204. Guidance on opportunities for innovation. 
Sec. 205. Study and report on Medicaid emergency psychiatric demonstration 
project. 
Sec. 206. Providing EPSDT services to children in IMDs. 
Sec. 207. Electronic visit verification system required for personal care services 
and home health care services under Medicaid. 
TITLE III—INTERDEPARTMENTAL SERIOUS MENTAL ILLNESS 
COORDINATING COMMITTEE 
Sec. 301. Interdepartmental Serious Mental Illness Coordinating Committee. 
TITLE IV—COMPASSIONATE COMMUNICATION ON HIPAA 
Sec. 401. Sense of Congress. 
Sec. 402. Confidentiality of records. 
Sec. 403. Clarification of circumstances under which disclosure of protected 
health information is permitted. 
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Sec. 404. Development and dissemination of model training programs. 
TITLE V—INCREASING ACCESS TO TREATMENT FOR SERIOUS 
MENTAL ILLNESS 
Sec. 501. Assertive community treatment grant program for individuals with 
serious mental illness. 
Sec. 502. Strengthening community crisis response systems. 
Sec. 503. Increased and extended funding for assisted outpatient grant pro-
gram for individuals with serious mental illness. 
Sec. 504. Liability protections for health professional volunteers at community 
health centers. 
TITLE VI—SUPPORTING INNOVATIVE AND EVIDENCE-BASED 
PROGRAMS 
Subtitle A—Encouraging the Advancement, Incorporation, and Development 
of Evidence-Based Practices 
Sec. 601. Encouraging innovation and evidence-based programs. 
Sec. 602. Promoting access to information on evidence-based programs and 
practices. 
Sec. 603. Sense of Congress. 
Subtitle B—Supporting the State Response to Mental Health Needs 
Sec. 611. Community Mental Health Services Block Grant. 
Subtitle C—Strengthening Mental Health Care for Children and Adolescents 
Sec. 621. Tele-mental health care access grants. 
Sec. 622. Infant and early childhood mental health promotion, intervention, and 
treatment. 
Sec. 623. National Child Traumatic Stress Initiative. 
TITLE VII—GRANT PROGRAMS AND PROGRAM REAUTHORIZATION 
Subtitle A—Garrett Lee Smith Memorial Act Reauthorization 
Sec. 701. Youth interagency research, training, and technical assistance cen-
ters. 
Sec. 702. Youth suicide early intervention and prevention strategies. 
Sec. 703. Mental health and substance use disorder services on campus. 
Subtitle B—Other Provisions 
Sec. 711. National Suicide Prevention Lifeline Program. 
Sec. 712. Workforce development studies and reports. 
Sec. 713. Minority Fellowship Program. 
Sec. 714. Center and program repeals. 
Sec. 715. National violent death reporting system. 
Sec. 716. Sense of Congress on prioritizing Native American youth and suicide 
prevention programs. 
Sec. 717. Peer professional workforce development grant program. 
Sec. 718. National Health Service Corps. 
Sec. 719. Adult suicide prevention. 
Sec. 720. Crisis intervention grants for police officers and first responders. 
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Sec. 721. Demonstration grant program to train health service psychologists in 
community-based mental health. 
Sec. 722. Investment in tomorrow’s pediatric health care workforce. 
Sec. 723. CUTGO compliance. 
TITLE VIII—MENTAL HEALTH PARITY 
Sec. 801. Enhanced compliance with mental health and substance use disorder 
coverage requirements. 
Sec. 802. Action plan for enhanced enforcement of mental health and substance 
use disorder coverage. 
Sec. 803. Report on investigations regarding parity in mental health and sub-
stance use disorder benefits. 
Sec. 804. GAO study on parity in mental health and substance use disorder 
benefits. 
Sec. 805. Information and awareness on eating disorders. 
Sec. 806. Education and training on eating disorders. 
Sec. 807. GAO study on preventing discriminatory coverage limitations for indi-
viduals with serious mental illness and substance use disorders. 
Sec. 808. Clarification of existing parity rules. 
TITLE I—ASSISTANT SECRETARY 
FOR MENTAL HEALTH AND 
SUBSTANCE USE 
SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH 
AND SUBSTANCE USE. 
(a) ASSISTANT SECRETARY.—Section 501(c) of the 
Public Health Service Act (42 U.S.C. 290aa) is amended 
to read as follows: 
‘‘(c) ASSISTANT SECRETARY AND DEPUTY ASSIST-
ANT SECRETARY.— 
‘‘(1) ASSISTANT SECRETARY.— 
‘‘(A) APPOINTMENT.—The Administration 
shall be headed by an official to be known as 
the Assistant Secretary for Mental Health and 
Substance Use (hereinafter in this title referred 
to as the ‘Assistant Secretary’) who shall be ap-
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pointed by the President, by and with the ad-
vice and consent of the Senate. 
‘‘(B) QUALIFICATIONS.—In selecting the 
Assistant Secretary, the President shall give 
preference to individuals who have— 
‘‘(i) a doctoral degree in medicine, os-
teopathic medicine, or psychology; 
‘‘(ii) clinical and research experience 
regarding mental health and substance use 
disorders; and 
‘‘(iii) an understanding of biological, 
psychosocial, and pharmaceutical treat-
ments of mental illness and substance use 
disorders. 
‘‘(2) DEPUTY ASSISTANT SECRETARY.—The As-
sistant Secretary, with the approval of the Secretary, 
may appoint a Deputy Assistant Secretary and may 
employ and prescribe the functions of such officers 
and employees, including attorneys, as are necessary 
to administer the activities to be carried out through 
the Administration.’’. 
(b) TRANSFER OF AUTHORITIES.—The Secretary of 
Health and Human Services shall delegate to the Assist-
ant Secretary for Mental Health and Substance Use all 
duties and authorities that— 
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(1) as of the day before the date of enactment 
of this Act, were vested in the Administrator of the 
Substance Abuse and Mental Health Services Ad-
ministration; and 
(2) are not terminated by this Act. 
(c) EVALUATION.—Section 501(d) of the Public 
Health Service Act (42 U.S.C. 290aa(d)) is amended— 
(1) in paragraph (17), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (18), by striking the period at 
the end and inserting a semicolon; and 
(3) by adding at the end the following: 
‘‘(19) evaluate, in consultation with the Assist-
ant Secretary for Financial Resources, the informa-
tion used for oversight of grants under programs re-
lated to mental illness and substance use disorders, 
including co-occurring illness or disorders, adminis-
tered by the Center for Mental Health Services; 
‘‘(20) periodically review Federal programs and 
activities relating to the diagnosis or prevention of, 
or treatment or rehabilitation for, mental illness and 
substance use disorders to identify any such pro-
grams or activities that have proven to be effective 
or efficient in improving outcomes or increasing ac-
cess to evidence-based programs; 
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‘‘(21) establish standards for the appointment 
of peer-review panels to evaluate grant applications 
and recommend standards for mental health grant 
programs; and’’. 
(d) STANDARDS
FOR GRANT PROGRAMS.—Section 
501(d) of the Public Health Service Act (42 U.S.C. 
290aa(d)), as amended by subsection (c), is further 
amended by adding at the end the following: 
‘‘(22) in consultation with the National Mental 
Health and Substance Use Policy Laboratory, and 
after providing an opportunity for public input, set 
standards for grant programs under this title for 
mental health and substance use services, which may 
address— 
‘‘(A) the capacity of the grantee to imple-
ment the award; 
‘‘(B) requirements for the description of 
the program implementation approach; 
‘‘(C) the extent to which the grant plan 
submitted by the grantee as part of its applica-
tion must explain how the grantee will reach 
the population of focus and provide a statement 
of need, including to what extent the grantee 
will increase the number of clients served and 
the estimated percentage of clients receiving 
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services who report positive functioning after 6 
months or no past-month substance use, as ap-
plicable; 
‘‘(D) the extent to which the grantee must 
collect and report on required performance 
measures; and 
‘‘(E) the extent to which the grantee is 
proposing evidence-based practices and the ex-
tent to which— 
‘‘(i) those evidence-based practices 
must be used with respect to a population 
similar to the population for which the evi-
dence-based practices were shown to be ef-
fective; or 
‘‘(ii) if no evidence-based practice ex-
ists for a population of focus, the way in 
which the grantee will implement adapta-
tions of evidence-based practices, prom-
ising practices, or cultural practices.’’. 
(e) EMERGENCY RESPONSE.—Section 501(m) of the 
Public Health Service Act (42 U.S.C. 290aa(m)) is 
amended by adding at the end the following: 
‘‘(4) AVAILABILITY OF FUNDS THROUGH FOL-
LOWING FISCAL YEAR.—Amounts made available for 
carrying out this subsection shall remain available 
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through the end of the fiscal year following the fiscal 
year for which such amounts are appropriated.’’. 
(f) MEMBER OF COUNCIL ON GRADUATE MEDICAL 
EDUCATION.—Section 762 of the Public Health Service 
Act (42 U.S.C. 290o) is amended— 
(1) in subsection (b)— 
(A) by redesignating paragraphs (4), (5), 
and (6) as paragraphs (5), (6), and (7), respec-
tively; and 
(B) by inserting after paragraph (3) the 
following: 
‘‘(4) the Assistant Secretary for Mental Health 
and Substance Use;’’; and 
(2) in subsection (c), by striking ‘‘(4), (5), and 
(6)’’ each place it appears and inserting ‘‘(5), (6), 
and (7)’’. 
(g) CONFORMING AMENDMENTS.—Title V of the 
Public Health Service Act (42 U.S.C. 290aa et seq.), as 
amended by the previous provisions of this section, is fur-
ther amended— 
(1) by striking ‘‘Administrator of the Substance 
Abuse and Mental Health Services Administration’’ 
each place it appears and inserting ‘‘Assistant Sec-
retary for Mental Health and Substance Use’’; and 
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(2) by striking ‘‘Administrator’’ each place it 
appears (including in any headings) and inserting 
‘‘Assistant Secretary’’, except where the term ‘‘Ad-
ministrator’’ appears— 
(A) in each of subsections (e) and (f) of 
section 501 of such Act (42 U.S.C. 290aa), in-
cluding the headings of such subsections, within 
the term ‘‘Associate Administrator’’; 
(B) in section 507(b)(6) of such Act (42 
U.S.C. 290bb(b)(6)), within the term ‘‘Adminis-
trator of the Health Resources and Services Ad-
ministration’’; 
(C) in section 507(b)(6) of such Act (42 
U.S.C. 290bb(b)(6)), within the term ‘‘Adminis-
trator of the Centers for Medicare & Medicaid 
Services’’; 
(D) in section 519B(c)(1)(B) of such Act 
(42 U.S.C. 290bb–25b(c)(1)(B)), within the 
term ‘‘Administrator of the National Highway 
Traffic Safety Administration’’; or 
(E) in each of sections 519B(c)(1)(B), 
520C(a), and 520D(a) of such Act (42 U.S.C. 
290bb–25b(c)(1)(B), 
290bb–34(a), 
290bb– 
35(a)), within the term ‘‘Administrator of the 
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Office of Juvenile Justice and Delinquency Pre-
vention’’. 
(h) REFERENCES.—After executing subsections (a), 
(b), and (f), any reference in statute, regulation, or guid-
ance to the Administrator of the Substance Abuse and 
Mental Health Services Administration shall be construed 
to be a reference to the Assistant Secretary for Mental 
Health and Substance Use. 
SEC. 102. IMPROVING OVERSIGHT OF MENTAL HEALTH 
AND SUBSTANCE USE PROGRAMS. 
Title V of the Public Health Service Act is amended 
by inserting after section 501 of such Act (42 U.S.C. 
290aa) the following: 
‘‘SEC. 501A. IMPROVING OVERSIGHT OF MENTAL HEALTH 
AND SUBSTANCE USE PROGRAMS. 
‘‘(a) ACTIVITIES.—For the purpose of ensuring effi-
cient and effective planning and evaluation of mental ill-
ness and substance use disorder programs and related ac-
tivities, the Assistant Secretary for Planning and Evalua-
tion, in consultation with the Assistant Secretary for Men-
tal Health and Substance Use, shall— 
‘‘(1) collect and organize relevant data on 
homelessness, involvement with the criminal justice 
system, hospitalizations, mortality outcomes, and 
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other measures the Secretary deems appropriate 
from across Federal departments and agencies; 
‘‘(2) evaluate programs related to mental illness 
and substance use disorders, including co-occurring 
illness or disorders, across Federal departments and 
agencies, as appropriate, including programs related 
to— 
‘‘(A) prevention, intervention, treatment, 
and recovery support services, including such 
services for individuals with a serious mental ill-
ness or serious emotional disturbance; 
‘‘(B) the reduction of homelessness and in-
volvement with the criminal justice system 
among individuals with a mental illness or sub-
stance use disorder; and 
‘‘(C) public health and health services; and 
‘‘(3) consult, as appropriate, with the Assistant 
Secretary, the Behavioral Health Coordinating 
Council of the Department of Health and Human 
Services, other agencies within the Department of 
Health and Human Services, and other relevant 
Federal departments. 
‘‘(b) RECOMMENDATIONS.—The Assistant Secretary 
for Planning and Evaluation shall develop an evaluation 
strategy that identifies priority programs to be evaluated 
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by the Assistant Secretary and priority programs to be 
evaluated by other relevant agencies within the Depart-
ment of Health and Human Services. The Assistant Sec-
retary for Planning and Evaluation shall provide rec-
ommendations on improving programs and activities based 
on the evaluation described in subsection (a)(2) as needing 
improvement.’’. 
SEC. 103. NATIONAL MENTAL HEALTH AND SUBSTANCE 
USE POLICY LABORATORY. 
Title V of the Public Health Service Act (42 U.S.C. 
290aa et seq.) is amended by inserting after section 501A, 
as added by section 102 of this Act, the following: 
‘‘SEC. 501B. NATIONAL MENTAL HEALTH AND SUBSTANCE 
USE POLICY LABORATORY. 
‘‘(a) IN GENERAL.—There shall be established within 
the Administration a National Mental Health and Sub-
stance Use Policy Laboratory (referred to in this section 
as the ‘Laboratory’). 
‘‘(b) RESPONSIBILITIES.—The Laboratory shall— 
‘‘(1) continue to carry out the authorities and 
activities that were in effect for the Office of Policy, 
Planning, and Innovation as such Office existed 
prior to the date of enactment of the Helping Fami-
lies in Mental Health Crisis Act of 2016; 
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‘‘(2) identify, coordinate, and facilitate the im-
plementation of policy changes likely to have a sig-
nificant effect on mental health, mental illness, and 
the prevention and treatment of substance use dis-
order services; 
‘‘(3) collect, as appropriate, information from 
grantees under programs operated by the Adminis-
tration in order to evaluate and disseminate infor-
mation on evidence-based practices, including cul-
turally and linguistically appropriate services, as ap-
propriate, and service delivery models; 
‘‘(4) provide leadership in identifying and co-
ordinating policies and programs, including evidence- 
based programs, related to mental illness and sub-
stance use disorders; 
‘‘(5) recommend ways in which payers may im-
plement program and policy findings of the Adminis-
tration and the Laboratory to improve outcomes and 
reduce per capita program costs; 
‘‘(6) in consultation with the Assistant Sec-
retary for Planning and Evaluation, as appropriate, 
periodically review Federal programs and activities 
relating to the diagnosis or prevention of, or treat-
ment or rehabilitation for, mental illness and sub-
stance use disorders, including by— 
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‘‘(A) identifying any such programs or ac-
tivities that are duplicative; 
‘‘(B) identifying any such programs or ac-
tivities that are not evidence-based, effective, or 
efficient; and 
‘‘(C) formulating recommendations for co-
ordinating, eliminating, or improving programs 
or activities identified under subparagraph (A) 
or (B) and merging such programs or activities 
into other successful programs or activities; and 
‘‘(7) carry out other activities as deemed nec-
essary to continue to encourage innovation and dis-
seminate evidence-based programs and practices, in-
cluding programs and practices with scientific merit. 
‘‘(c) EVIDENCE-BASED PRACTICES
AND SERVICE 
DELIVERY MODELS.— 
‘‘(1) IN GENERAL.—In selecting evidence-based 
best practices and service delivery models for evalua-
tion and dissemination, the Laboratory— 
‘‘(A) shall give preference to models that 
improve— 
‘‘(i) the coordination between mental 
health and physical health providers; 
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‘‘(ii) the coordination among such pro-
viders and the justice and corrections sys-
tem; and 
‘‘(iii) the cost effectiveness, quality, 
effectiveness, and efficiency of health care 
services furnished to individuals with seri-
ous mental illness or serious emotional dis-
turbance, in mental health crisis, or at risk 
to themselves, their families, and the gen-
eral public; and 
‘‘(B) may include clinical protocols and 
practices used in the Recovery After Initial 
Schizophrenia Episode (RAISE) project and the 
North American Prodrome Longitudinal Study 
(NAPLS) of the National Institute of Mental 
Health. 
‘‘(2) DEADLINE FOR BEGINNING IMPLEMENTA-
TION.—The Laboratory shall begin implementation 
of the duties described in this section not later than 
January 1, 2018. 
‘‘(3) CONSULTATION.—In carrying out the du-
ties under this section, the Laboratory shall consult 
with— 
‘‘(A) representatives of the National Insti-
tute of Mental Health, the National Institute 
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on Drug Abuse, and the National Institute on 
Alcohol Abuse and Alcoholism, on an ongoing 
basis; 
‘‘(B) other appropriate Federal agencies; 
‘‘(C) clinical and analytical experts with 
expertise in psychiatric medical care and clinical 
psychological care, health care management, 
education, corrections health care, and mental 
health court systems, as appropriate; and 
‘‘(D) other individuals and agencies as de-
termined appropriate by the Assistant Sec-
retary.’’. 
SEC. 104. PEER-SUPPORT SPECIALIST PROGRAMS. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Comptroller General 
of the United States shall conduct a study on peer-support 
specialist programs in up to 10 States (to be selected by 
the Comptroller General) that receive funding from the 
Substance Abuse and Mental Health Services Administra-
tion and submit to the Committee on Health, Education, 
Labor, and Pensions of the Senate and the Committee on 
Energy and Commerce of the House of Representatives 
a report containing the results of such study. 
(b) CONTENTS OF STUDY.—In conducting the study 
under subsection (a), the Comptroller General of the 
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United States shall examine and identify best practices in 
the selected States related to training and credential re-
quirements for peer-support specialist programs, such 
as— 
(1) hours of formal work or volunteer experi-
ence related to mental illness and substance use dis-
orders conducted through such programs; 
(2) types of peer-support specialist exams re-
quired for such programs in the States; 
(3) codes of ethics used by such programs in 
the States; 
(4) required or recommended skill sets of such 
programs in the State; and 
(5) requirements for continuing education. 
SEC. 105. PROHIBITION AGAINST LOBBYING USING FED-
ERAL FUNDS BY SYSTEMS ACCEPTING FED-
ERAL FUNDS TO PROTECT AND ADVOCATE 
THE RIGHTS OF INDIVIDUALS WITH MENTAL 
ILLNESS. 
Section 105(a) of the Protection and Advocacy for 
Individuals with Mental Illness Act (42 U.S.C. 10805(a)) 
is amended— 
(1) in paragraph (9), by striking ‘‘and’’ at the 
end; 
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(2) in paragraph (10), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(11) agree to refrain, during any period for 
which funding is provided to the system under this 
part, from using Federal funds to pay the salary or 
expenses of any grant or contract recipient, or agent 
acting for such recipient, related to any activity de-
signed to influence the enactment of legislation, ap-
propriations, regulation, administrative action, or 
Executive order proposed or pending before the Con-
gress or any State or local government, including 
any legislative body, other than for normal and rec-
ognized executive-legislative relationships or partici-
pation by an agency or officer of a State, local, or 
tribal government in policymaking and administra-
tive processes within the executive branch of that 
government.’’. 
SEC. 106. REPORTING FOR PROTECTION AND ADVOCACY 
ORGANIZATIONS. 
(a) PUBLIC AVAILABILITY
OF REPORTS.—Section 
105(a)(7) of the Protection and Advocacy for Individuals 
with Mental Illness Act (42 U.S.C. 10805(a)(7)) is 
amended by striking ‘‘is located a report’’ and inserting 
‘‘is located, and make publicly available, a report’’. 
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(b) DETAILED ACCOUNTING.—Section 114(a) of the 
Protection and Advocacy for Individuals with Mental Ill-
ness Act (42 U.S.C. 10824(a)) is amended— 
(1) in paragraph (3), by striking ‘‘and’’ at the 
end; 
(2) in paragraph (4), by striking the period at 
the end and inserting ‘‘; and’’; and 
(3) by adding at the end the following: 
‘‘(5) using data from the existing required an-
nual program progress reports submitted by each 
system funded under this title, a detailed accounting 
for each such system of how funds are spent, 
disaggregated according to whether the funds were 
received from the Federal Government, the State 
government, a local government, or a private enti-
ty.’’. 
SEC. 107. GRIEVANCE PROCEDURE. 
Section 105 of the Protection and Advocacy for Indi-
viduals with Mental Illness Act (42 U.S.C. 10805), as 
amended, is further amended by adding at the end the 
following: 
‘‘(d) GRIEVANCE PROCEDURE.—The Secretary shall 
establish an independent grievance procedure for persons 
described in subsection (a)(9).’’. 
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SEC. 108. CENTER FOR BEHAVIORAL HEALTH STATISTICS 
AND QUALITY. 
Title V of the Public Health Service Act (42 U.S.C. 
290aa et seq.) is amended— 
(1) in section 501(b) (42 U.S.C. 290aa(b)), by 
adding at the end the following: 
‘‘(4) The Center for Behavioral Health Statis-
tics and Quality.’’; 
(2) in section 502(a)(1) (42 U.S.C. 290aa– 
1(a)(1))— 
(A) in subparagraph (C), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (D), by striking the 
period at the end and inserting ‘‘; and’’; and 
(C) by inserting after subparagraph (D) 
the following: 
‘‘(E) the Center for Behavioral Health 
Statistics and Quality.’’; and 
(3) in part B (42 U.S.C. 290bb et seq.) by add-
ing at the end the following new subpart: 
‘‘Subpart 4—Center for Behavioral Health Statistics 
and Quality 
‘‘SEC. 520L. CENTER FOR BEHAVIORAL HEALTH STATISTICS 
AND QUALITY. 
‘‘(a) ESTABLISHMENT.—There is established in the 
Administration a Center for Behavioral Health Statistics 
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and Quality (in this section referred to as the ‘Center’). 
The Center shall be headed by a Director (in this section 
referred to as the ‘Director’) appointed by the Secretary 
from among individuals with extensive experience and aca-
demic qualifications in research and analysis in behavioral 
health care or related fields. 
‘‘(b) DUTIES.—The Director of the Center shall— 
‘‘(1) coordinate the Administration’s integrated 
data strategy by coordinating— 
‘‘(A) surveillance and data collection (in-
cluding that authorized by section 505); 
‘‘(B) evaluation; 
‘‘(C) statistical and analytic support; 
‘‘(D) service systems research; and 
‘‘(E) performance and quality information 
systems; 
‘‘(2) recommend a core set of measurement 
standards for grant programs administered by the 
Administration; and 
‘‘(3) coordinate evaluation efforts for the grant 
programs, contracts, and collaborative agreements of 
the Administration. 
‘‘(c) BIANNUAL REPORT TO CONGRESS.—Not later 
than 2 years after the date of enactment of this section, 
and every 2 years thereafter, the Director of the Center 
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shall submit to Congress a report on the quality of services 
furnished through grant programs of the Administration, 
including applicable measures of outcomes for individuals 
and public outcomes such as— 
‘‘(1) the number of patients screened positive 
for unhealthy alcohol use who receive brief coun-
seling as appropriate; the number of patients 
screened positive for tobacco use and receiving 
smoking cessation interventions; the number of pa-
tients with a new diagnosis of major depressive epi-
sode who are assessed for suicide risk; the number 
of patients screened positive for clinical depression 
with a documented followup plan; and the number of 
patients with a documented pain assessment that 
have a followup treatment plan when pain is present; 
and satisfaction with care; 
‘‘(2) the incidence and prevalence of mental ill-
ness and substance use disorders; the number of sui-
cide attempts and suicide completions; overdoses 
seen in emergency rooms resulting from alcohol and 
drug use; emergency room boarding; overdose 
deaths; emergency psychiatric hospitalizations; new 
criminal justice involvement while in treatment; sta-
ble housing; and rates of involvement in employ-
ment, education, and training; and 
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‘‘(3) such other measures for outcomes of serv-
ices as the Director may determine. 
‘‘(d) STAFFING COMPOSITION.—The staff of the Cen-
ter may include individuals with advanced degrees and 
field expertise as well as clinical and research experience 
in mental illness and substance use disorders such as— 
‘‘(1) professionals with clinical and research ex-
pertise in the prevention and treatment of, and re-
covery from, mental illness and substance use dis-
orders; 
‘‘(2) professionals with training and expertise in 
statistics or research and survey design and meth-
odologies; and 
‘‘(3) other related fields in the social and behav-
ioral sciences, as specified by relevant position de-
scriptions. 
‘‘(e) GRANTS AND CONTRACTS.—In carrying out the 
duties established in subsection (b), the Director may 
make grants to, and enter into contracts and cooperative 
agreements with, public and nonprofit private entities. 
‘‘(f) DEFINITION.—In this section, the term ‘emer-
gency room boarding’ means the practice of admitting pa-
tients to an emergency department and holding such pa-
tients in the department until inpatient psychiatric beds 
become available.’’. 
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SEC. 109. STRATEGIC PLAN. 
Section 501 of the Public Health Service Act (42 
U.S.C. 290aa) is further amended— 
(1) by redesignating subsections (l) through (o) 
as subsections (m) through (p), respectively; and 
(2) by inserting after subsection (k) the fol-
lowing: 
‘‘(l) STRATEGIC PLAN.— 
‘‘(1) IN GENERAL.—Not later than December 1, 
2017, and every 5 years thereafter, the Assistant 
Secretary shall develop and carry out a strategic 
plan in accordance with this subsection for the plan-
ning and operation of evidence-based programs and 
grants carried out by the Administration. 
‘‘(2) COORDINATION.—In developing and car-
rying out the strategic plan under this section, the 
Assistant Secretary shall take into consideration the 
report of the Interdepartmental Serious Mental Ill-
ness Coordinating Committee under section 301 of 
the Helping Families in Mental Health Crisis Act of 
2016. 
‘‘(3) PUBLICATION OF PLAN.—Not later than 
December 1, 2017, and every 5 years thereafter, the 
Assistant Secretary shall— 
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‘‘(A) submit the strategic plan developed 
under paragraph (1) to the appropriate commit-
tees of Congress; and 
‘‘(B) post such plan on the Internet 
website of the Administration. 
‘‘(4) CONTENTS.—The strategic plan developed 
under paragraph (1) shall— 
‘‘(A) identify strategic priorities, goals, and 
measurable objectives for mental illness and 
substance use disorder activities and programs 
operated and supported by the Administration, 
including priorities to prevent or eliminate the 
burden of mental illness and substance use dis-
orders; 
‘‘(B) identify ways to improve services for 
individuals with a mental illness or substance 
use disorder, including services related to the 
prevention of, diagnosis of, intervention in, 
treatment of, and recovery from, mental illness 
or substance use disorders, including serious 
mental illness or serious emotional disturbance, 
and access to services and supports for individ-
uals with a serious mental illness or serious 
emotional disturbance; 
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‘‘(C) ensure that programs provide, as ap-
propriate, access to effective and evidence-based 
prevention, diagnosis, intervention, treatment, 
and recovery services, including culturally and 
linguistically appropriate services, as appro-
priate, for individuals with a mental illness or 
substance use disorder; 
‘‘(D) identify opportunities to collaborate 
with the Health Resources and Services Admin-
istration to develop or improve— 
‘‘(i) initiatives to encourage individ-
uals to pursue careers (especially in rural 
and underserved areas and populations) as 
psychiatrists, 
psychologists, 
psychiatric 
nurse practitioners, physician assistants, 
occupational 
therapists, 
clinical 
social 
workers, certified peer-support specialists, 
licensed professional counselors, or other 
licensed or certified mental health profes-
sionals, including such professionals spe-
cializing in the diagnosis, evaluation, or 
treatment of individuals with a serious 
mental illness or serious emotional disturb-
ance; and 
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‘‘(ii) a strategy to improve the recruit-
ment, training, and retention of a work-
force for the treatment of individuals with 
mental illness or substance use disorders, 
or co-occurring illness or disorders; 
‘‘(E) identify opportunities to improve col-
laboration with States, local governments, com-
munities, and Indian tribes and tribal organiza-
tions (as such terms are defined in section 4 of 
the Indian Self-Determination and Education 
Assistance Act (25 U.S.C. 450b)); and 
‘‘(F) specify a strategy to disseminate evi-
denced-based and promising best practices re-
lated to prevention, diagnosis, early interven-
tion, treatment, and recovery services related to 
mental illness, particularly for individuals with 
a serious mental illness and children and ado-
lescents with a serious emotional disturbance, 
and substance use disorders.’’. 
SEC. 110. AUTHORITIES OF CENTERS FOR MENTAL HEALTH 
SERVICES AND SUBSTANCE ABUSE TREAT-
MENT. 
(a) CENTER FOR MENTAL HEALTH SERVICES.—Sec-
tion 520(b) of the Public Health Service Act (42 U.S.C. 
290bb–31(b)) is amended— 
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(1) by redesignating paragraphs (3) through 
(15) as paragraphs (4) through (16), respectively; 
(2) by inserting after paragraph (2) the fol-
lowing: 
‘‘(3) collaborate with the Director of the Na-
tional Institute of Mental Health to ensure that, as 
appropriate, programs related to the prevention and 
treatment of mental illness and the promotion of 
mental health are carried out in a manner that re-
flects the best available science and evidence-based 
practices, including culturally and linguistically ap-
propriate services;’’; 
(3) in paragraph (5), as so redesignated, by in-
serting ‘‘through policies and programs that reduce 
risk and promote resiliency’’ before the semicolon; 
(4) in paragraph (6), as so redesignated, by in-
serting ‘‘in collaboration with the Director of the 
National Institute of Mental Health,’’ before ‘‘de-
velop’’; 
(5) in paragraph (8), as so redesignated, by in-
serting ‘‘, increase meaningful participation of indi-
viduals with mental illness in programs and activi-
ties of the Administration,’’ before ‘‘and protect the 
legal’’; 
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(6) in paragraph (10), as so redesignated, by 
striking ‘‘professional and paraprofessional per-
sonnel pursuant to section 303’’ and inserting 
‘‘paraprofessional personnel and health profes-
sionals’’; 
(7) in paragraph (11), as so redesignated, by 
inserting ‘‘and telemental health,’’ after ‘‘rural men-
tal health,’’; 
(8) in paragraph (12), as so redesignated, by 
striking ‘‘establish a clearinghouse for mental health 
information to assure the widespread dissemination 
of such information’’ and inserting ‘‘disseminate 
mental health information, including evidenced-based 
practices,’’; 
(9) in paragraph (15), as so redesignated, by 
striking ‘‘and’’ at the end; 
(10) in paragraph (16), as so redesignated, by 
striking the period and inserting ‘‘; and’’; and 
(11) by adding at the end the following: 
‘‘(17) consult with other agencies and offices of 
the Department of Health and Human Services to 
ensure, with respect to each grant awarded by the 
Center for Mental Health Services, the consistent 
documentation of the application of criteria when 
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awarding grants and the ongoing oversight of grant-
ees after such grants are awarded.’’. 
(b) DIRECTOR OF THE CENTER FOR SUBSTANCE 
ABUSE TREATMENT.—Section 507 of the Public Health 
Service Act (42 U.S.C. 290bb) is amended— 
(1) in subsection (a)— 
(A) by striking ‘‘treatment of substance 
abuse’’ and inserting ‘‘treatment of substance 
use disorders’’; and 
(B) by striking ‘‘abuse treatment systems’’ 
and inserting ‘‘use disorder treatment systems’’; 
and 
(2) in subsection (b)— 
(A) in paragraph (3), by striking ‘‘abuse’’ 
and inserting ‘‘use disorder’’; 
(B) in paragraph (4), by striking ‘‘individ-
uals who abuse drugs’’ and inserting ‘‘individ-
uals who use drugs’’; 
(C) in paragraph (9), by striking ‘‘carried 
out by the Director’’; 
(D) by striking paragraph (10); 
(E) by redesignating paragraphs (11) 
through (14) as paragraphs (10) through (13), 
respectively; 
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(F) in paragraph (12), as so redesignated, 
by striking ‘‘; and’’ and inserting a semicolon; 
and 
(G) by striking paragraph (13), as so re-
designated, and inserting the following: 
‘‘(13) ensure the consistent documentation of 
the application of criteria when awarding grants and 
the ongoing oversight of grantees after such grants 
are awarded; and 
‘‘(14) work with States, providers, and individ-
uals in recovery, and their families, to promote the 
expansion of recovery support services and systems 
of care oriented towards recovery.’’. 
SEC. 111. ADVISORY COUNCILS. 
Section 502(b) of the Public Health Service Act (42 
U.S.C. 290aa–1(b)) is amended— 
(1) in paragraph (2)— 
(A) in subparagraph (E), by striking 
‘‘and’’ after the semicolon; 
(B) by redesignating subparagraph (F) as 
subparagraph (I); and 
(C) by inserting after subparagraph (E), 
the following: 
‘‘(F) for the advisory councils appointed 
under subsections (a)(1)(A) and (a)(1)(D), the 
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Director of the National Institute of Mental 
Health; 
‘‘(G) for the advisory councils appointed 
under subsections (a)(1)(A), (a)(1)(B), and 
(a)(1)(C), the Director of the National Institute 
on Drug Abuse; 
‘‘(H) for the advisory councils appointed 
under subsections (a)(1)(A), (a)(1)(B), and 
(a)(1)(C), the Director of the National Institute 
on Alcohol Abuse and Alcoholism; and’’; and 
(2) in paragraph (3), by adding at the end the 
following: 
‘‘(C) Not less than half of the members of 
the advisory council appointed under subsection 
(a)(1)(D)— 
‘‘(i) shall have— 
‘‘(I) a medical degree; 
‘‘(II) a doctoral degree in psy-
chology; or 
‘‘(III) an advanced degree in 
nursing or social work from an ac-
credited graduate school or be a cer-
tified physician assistant; and 
‘‘(ii) shall specialize in the mental 
health field.’’. 
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SEC. 112. PEER REVIEW. 
Section 504(b) of the Public Health Service Act (42 
U.S.C. 290aa–3(b)) is amended by adding at the end the 
following: ‘‘In the case of any such peer review group that 
is reviewing a grant, cooperative agreement, or contract 
related to mental illness treatment, not less than half of 
the members of such peer review group shall be licensed 
and experienced professionals in the prevention, diagnosis, 
or treatment of, or recovery from, mental illness or sub-
stance use disorders and have a medical degree, a doctoral 
degree in psychology, or an advanced degree in nursing 
or social work from an accredited program.’’. 
TITLE II—MEDICAID MENTAL 
HEALTH COVERAGE 
SEC. 201. RULE OF CONSTRUCTION RELATED TO MEDICAID 
COVERAGE OF MENTAL HEALTH SERVICES 
AND PRIMARY CARE SERVICES FURNISHED 
ON THE SAME DAY. 
Nothing in title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) shall be construed as prohibiting sep-
arate payment under the State plan under such title (or 
under a waiver of the plan) for the provision of a mental 
health service or primary care service under such plan, 
with respect to an individual, because such service is— 
(1) a primary care service furnished to the indi-
vidual by a provider at a facility on the same day 
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a mental health service is furnished to such indi-
vidual by such provider (or another provider) at the 
facility; or 
(2) a mental health service furnished to the in-
dividual by a provider at a facility on the same day 
a primary care service is furnished to such individual 
by such provider (or another provider) at the facil-
ity. 
SEC. 202. OPTIONAL LIMITED COVERAGE OF INPATIENT 
SERVICES FURNISHED IN INSTITUTIONS FOR 
MENTAL DISEASES. 
(a) IN GENERAL.—Section 1903(m)(2) of the Social 
Security Act (42 U.S.C. 1396b(m)(2)) is amended by add-
ing at the end the following new subparagraph: 
‘‘(I)(i) Notwithstanding the limitation specified in the 
subdivision (B) following paragraph (29) of section 
1905(a) and subject to clause (ii), a State may, under a 
risk contract entered into by the State under this title (or 
under section 1115) with a medicaid managed care organi-
zation or a prepaid inpatient health plan (as defined in 
section 438.2 of title 42, Code of Federal Regulations (or 
any successor regulation)), make a monthly capitation 
payment to such organization or plan for enrollees with 
the organization or plan who are over 21 years of age and 
under 65 years of age and are receiving inpatient treat-
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ment in an institution for mental diseases (as defined in 
section 1905(i)), so long as each of the following condi-
tions is met: 
‘‘(I) The institution is a hospital providing in-
patient psychiatric or substance use disorder services 
or a sub-acute facility providing psychiatric or sub-
stance use disorder crisis residential services. 
‘‘(II) The length of stay in such an institution 
for such treatment is for a short-term stay of no 
more than 15 days during the period of the monthly 
capitation payment. 
‘‘(III) The provision of such treatment meets 
the following criteria for consideration as services or 
settings that are provided in lieu of services or set-
tings covered under the State plan: 
‘‘(aa) The State determines that the alter-
native service or setting is a medically appro-
priate and cost-effective substitute for the serv-
ice or setting covered under the State plan. 
‘‘(bb) The enrollee is not required by the 
managed care organization or prepaid inpatient 
health plan to use the alternative service or set-
ting. 
‘‘(cc) Such treatment is authorized and 
identified in such contract, and will be offered 
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to such enrollees at the option of the managed 
care organization or prepaid inpatient health 
plan. 
‘‘(ii) For purposes of setting the amount of such a 
monthly capitation payment, a State may use the utiliza-
tion of services provided to an individual under this sub-
paragraph when developing the inpatient psychiatric or 
substance use disorder component of such payment, but 
the amount of such payment for such services may not 
exceed the cost of the same services furnished through 
providers included under the State plan.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply beginning on July 5, 2016, or 
the date of the enactment of this Act, whichever is later. 
SEC. 203. STUDY AND REPORT RELATED TO MEDICAID 
MANAGED CARE REGULATION. 
(a) STUDY.—The Secretary of Health and Human 
Services, acting through the Administrator of the Centers 
for Medicare & Medicaid Services, shall conduct a study 
on coverage under the Medicaid program under title XIX 
of the Social Security Act (42 U.S.C. 1396 et seq.) of serv-
ices provided through a medicaid managed care organiza-
tion (as defined in section 1903(m) of such Act (42 U.S.C. 
1396b(m)) or a prepaid inpatient health plan (as defined 
in section 438.2 of title 42, Code of Federal Regulations 
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(or any successor regulation)) with respect to individuals 
over the age of 21 and under the age of 65 for the treat-
ment of a mental health disorder in institutions for mental 
diseases (as defined in section 1905(i) of such Act (42 
U.S.C. 1396d(i))). Such study shall include information 
on the following: 
(1) The extent to which States, including the 
District of Columbia and each territory or possession 
of the United States, are providing capitated pay-
ments to such organizations or plans for enrollees 
who are receiving services in institutions for mental 
diseases. 
(2) The number of individuals receiving medical 
assistance under a State plan under such title XIX, 
or a waiver of such plan, who receive services in in-
stitutions for mental diseases through such organiza-
tions and plans. 
(3) The range of and average number of 
months, and the length of stay during such months, 
that such individuals are receiving such services in 
such institutions. 
(4) How such organizations or plans determine 
when to provide for the furnishing of such services 
through an institution for mental diseases in lieu of 
other benefits (including the full range of commu-
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nity-based services) under their contract with the 
State agency administering the State plan under 
such title XIX, or a waiver of such plan, to address 
psychiatric or substance use disorder treatment. 
(5) The extent to which the provision of serv-
ices within such institutions has affected the 
capitated payments for such organizations or plans. 
(b) REPORT.—Not later than 3 years after the date 
of the enactment of this Act, the Secretary shall submit 
to Congress a report on the study conducted under sub-
section (a). 
SEC. 204. GUIDANCE ON OPPORTUNITIES FOR INNOVATION. 
Not later than 1 year after the date of the enactment 
of this Act, the Administrator of the Centers for Medicare 
& Medicaid Services shall issue a State Medicaid Director 
letter regarding opportunities to design innovative service 
delivery systems, including systems for providing commu-
nity-based services, for individuals with serious mental ill-
ness or serious emotional disturbance who are receiving 
medical assistance under title XIX of the Social Security 
Act (42 U.S.C. 1396 et seq.). The letter shall include op-
portunities for demonstration projects under section 1115 
of such Act (42 U.S.C. 1315), to improve care for such 
individuals. 
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SEC. 205. STUDY AND REPORT ON MEDICAID EMERGENCY 
PSYCHIATRIC DEMONSTRATION PROJECT. 
(a) COLLECTION OF INFORMATION.—The Secretary 
of Health and Human Services, acting through the Ad-
ministrator of the Centers for Medicare & Medicaid Serv-
ices, shall, with respect to each State that has participated 
in the demonstration project established under section 
2707 of the Patient Protection and Affordable Care Act 
(42 U.S.C. 1396a note), collect from each such State in-
formation on the following: 
(1) The number of institutions for mental dis-
eases (as defined in section 1905(i) of the Social Se-
curity Act (42 U.S.C. 1396d(i))) and beds in such 
institutions that received payment for the provision 
of services to individuals who receive medical assist-
ance under a State plan under the Medicaid pro-
gram under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) (or under a waiver of such 
plan) through the demonstration project in each 
such State as compared to the total number of insti-
tutions for mental diseases and beds in the State. 
(2) The extent to which there is a reduction in 
expenditures under the Medicaid program under title 
XIX of the Social Security Act (42 U.S.C. 1396 et 
seq.) or other spending on the full continuum of 
physical or mental health care for individuals who 
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receive treatment in an institution for mental dis-
eases under the demonstration project, including 
outpatient, inpatient, emergency, and ambulatory 
care, that is attributable to such individuals receiv-
ing treatment in institutions for mental diseases 
under the demonstration project. 
(3) The number of forensic psychiatric hos-
pitals, the number of beds in such hospitals, and the 
number of forensic psychiatric beds in other hos-
pitals in such State, based on the most recent data 
available, to the extent practical, as determined by 
such Administrator. 
(4) The amount of any disproportionate share 
hospital payments under section 1923 of the Social 
Security Act (42 U.S.C. 1396r–4) that institutions 
for mental diseases in the State received during the 
period beginning on July 1, 2012, and ending on 
June 30, 2015, and the extent to which the dem-
onstration project reduced the amount of such pay-
ments. 
(5) The most recent data regarding all facilities 
or sites in the State in which any individuals with 
serious mental illness who are receiving medical as-
sistance under a State plan under the Medicaid pro-
gram under title XIX of the Social Security Act (42 
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U.S.C. 1396 et seq.) (or under a waiver of such 
plan) are treated during the period referred to in 
paragraph (4), to the extent practical, as determined 
by the Administrator, including— 
(A) the types of such facilities or sites 
(such as an institution for mental diseases, a 
hospital emergency department, or other inpa-
tient hospital); 
(B) the average length of stay in such a 
facility 
or 
site 
by 
such 
an 
individual, 
disaggregated by facility type; and 
(C) the payment rate under the State plan 
(or a waivers of such plan) for services fur-
nished to such an individual for that treatment, 
disaggregated by facility type, during the period 
in which the demonstration project is in oper-
ation. 
(6) The extent to which the utilization of hos-
pital emergency departments during the period in 
which the demonstration project was is in operation 
differed, with respect to individuals who are receiv-
ing medical assistance under a State plan under the 
Medicaid program under title XIX of the Social Se-
curity Act (42 U.S.C. 1396 et seq.) (or under a 
waiver of such plan), between— 
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(A) those individuals who received treat-
ment in an institution for mental diseases 
under the demonstration project; 
(B) those individuals who met the eligi-
bility requirements 
for 
the 
demonstration 
project but who did not receive treatment in an 
institution for mental diseases under the dem-
onstration project; and 
(C) those individuals with serious mental 
illness who did not meet such eligibility require-
ments and did not receive treatment for such 
illness in an institution for mental diseases. 
(b) REPORT.—Not later than 2 years after the date 
of the enactment of this Act, the Secretary of Health and 
Human Services shall submit to Congress a report that 
summarizes and analyzes the information collected under 
subsection (a). Such report may be submitted as part of 
the report required under section 2707(f) of the Patient 
Protection and Affordable Care Act (42 U.S.C. 1396a 
note) or separately. 
SEC. 206. PROVIDING EPSDT SERVICES TO CHILDREN IN 
IMDS. 
(a) IN GENERAL.—Section 1905(a)(16) of the Social 
Security Act (42 U.S.C. 1396d(a)(16)) is amended— 
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(1) by striking ‘‘effective January 1, 1973’’ and 
inserting ‘‘(A) effective January 1, 1973’’; and 
(2) by inserting before the semicolon at the end 
the following: ‘‘, and, (B) for individuals receiving 
services described in subparagraph (A), early and 
periodic screening, diagnostic, and treatment serv-
ices (as defined in subsection (r)), whether or not 
such screening, diagnostic, and treatment services 
are furnished by the provider of the services de-
scribed in such subparagraph’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply with respect to items and serv-
ices furnished in calendar quarters beginning on or after 
January 1, 2019. 
SEC. 207. ELECTRONIC VISIT VERIFICATION SYSTEM RE-
QUIRED FOR PERSONAL CARE SERVICES AND 
HOME HEALTH CARE SERVICES UNDER MED-
ICAID. 
(a) IN GENERAL.—Section 1903 of the Social Secu-
rity Act (42 U.S.C. 1396b) is amended by inserting after 
subsection (k) the following new subsection: 
‘‘(l)(1) Subject to paragraphs (3) and (4), with re-
spect to any amount expended for personal care services 
or home health care services requiring an in-home visit 
by a provider that are provided under a State plan under 
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this title (or under a waiver of the plan) and furnished 
in a calendar quarter beginning on or after January 1, 
2019 (or, in the case of home health care services, on or 
after January 1, 2023), unless a State requires the use 
of an electronic visit verification system for such services 
furnished in such quarter under the plan or such waiver, 
the Federal medical assistance percentage shall be re-
duced— 
‘‘(A) in the case of personal care services— 
‘‘(i) for calendar quarters in 2019 and 
2020, by .25 percentage points; 
‘‘(ii) for calendar quarters in 2021, by .5 
percentage points; 
‘‘(iii) for calendar quarters in 2022, by .75 
percentage points; and 
‘‘(iv) for calendar quarters in 2023 and 
each year thereafter, by 1 percentage point; and 
‘‘(B) in the case of home health care services— 
‘‘(i) for calendar quarters in 2023 and 
2024, by .25 percentage points; 
‘‘(ii) for calendar quarters in 2025, by .5 
percentage points; 
‘‘(iii) for calendar quarters in 2026, by .75 
percentage points; and 
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‘‘(iv) for calendar quarters in 2027 and 
each year thereafter, by 1 percentage point. 
‘‘(2) Subject to paragraphs (3) and (4), in imple-
menting the requirement for the use of an electronic visit 
verification system under paragraph (1), a State shall— 
‘‘(A) consult with agencies and entities that 
provide personal care services, home health care 
services, or both under the State plan (or under a 
waiver of the plan) to ensure that such system— 
‘‘(i) is minimally burdensome; 
‘‘(ii) takes into account existing best prac-
tices and electronic visit verification systems in 
use in the State; and 
‘‘(iii) is conducted in accordance with the 
requirements of HIPAA privacy and security 
law (as defined in section 3009 of the Public 
Health Service Act); 
‘‘(B) take into account a stakeholder process 
that includes input from beneficiaries, family care-
givers, individuals who furnish personal care services 
or home health care services, and other stakeholders, 
as determined by the State in accordance with guid-
ance from the Secretary; and 
‘‘(C) ensure that individuals who furnish per-
sonal care services, home health care services, or 
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both under the State plan (or under a waiver of the 
plan) are provided the opportunity for training on 
the use of such system. 
‘‘(3) Paragraphs (1) and (2) shall not apply in the 
case of a State that, as of the date of the enactment of 
this subsection, requires the use of any system for the elec-
tronic verification of visits conducted as part of both per-
sonal care services and home health care services, so long 
as the State continues to require the use of such system 
with respect to the electronic verification of such visits. 
‘‘(4)(A) In the case of a State described in subpara-
graph (B), the reduction under paragraph (1) shall not 
apply— 
‘‘(i) in the case of personal care services, for 
calendar quarters in 2019; and 
‘‘(ii) in the case of home health care services, 
for calendar quarters in 2023. 
‘‘(B) For purposes of subparagraph (A), a State de-
scribed in this subparagraph is a State that demonstrates 
to the Secretary that the State— 
‘‘(i) has made a good faith effort to comply 
with the requirements of paragraphs (1) and (2) (in-
cluding by taking steps to adopt the technology used 
for an electronic visit verification system); or 
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‘‘(ii) in implementing such a system, has en-
countered unavoidable system delays. 
‘‘(5) In this subsection: 
‘‘(A) The term ‘electronic visit verification sys-
tem’ means, with respect to personal care services or 
home health care services, a system under which vis-
its conducted as part of such services are electroni-
cally verified with respect to— 
‘‘(i) the type of service performed; 
‘‘(ii) the individual receiving the service; 
‘‘(iii) the date of the service; 
‘‘(iv) the location of service delivery; 
‘‘(v) the individual providing the service; 
and 
‘‘(vi) the time the service begins and ends. 
‘‘(B) The term ‘home health care services’ 
means services described in section 1905(a)(7) pro-
vided under a State plan under this title (or under 
a waiver of the plan). 
‘‘(C) The term ‘personal care services’ means 
personal care services provided under a State plan 
under this title (or under a waiver of the plan), in-
cluding services provided under section 1905(a)(24), 
1915(c), 1915(i), 1915(j), or 1915(k) or under a 
wavier under section 1115. 
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‘‘(6)(A) In the case in which a State requires personal 
care service and home health care service providers to uti-
lize an electronic visit verification system operated by the 
State or a contractor on behalf of the State, the Secretary 
shall pay to the State, for each quarter, an amount equal 
to 90 per centum of so much of the sums expended during 
such quarter as are attributable to the design, develop-
ment, or installation of such system, and 75 per centum 
of so much of the sums for the operation and maintenance 
of such system. 
‘‘(B) Subparagraph (A) shall not apply in the case 
in which a State requires personal care service and home 
health care service providers to utilize an electronic visit 
verification system that is not operated by the State or 
a contractor on behalf of the State.’’. 
(b) COLLECTION
AND DISSEMINATION
OF BEST 
PRACTICES.—Not later than January 1, 2018, the Sec-
retary of Health and Human Services shall, with respect 
to electronic visit verification systems (as defined in sub-
section (l)(5) of section 1903 of the Social Security Act 
(42 U.S.C. 1396b), as inserted by subsection (a)), collect 
and disseminate best practices to State Medicaid Directors 
with respect to— 
(1) training individuals who furnish personal 
care services, home health care services, or both 
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under the State plan under title XIX of such Act (or 
under a waiver of the plan) on such systems and the 
operation of such systems and the prevention of 
fraud with respect to the provision of personal care 
services or home health care services (as defined in 
such subsection (l)(5)); and 
(2) the provision of notice and educational ma-
terials to family caregivers and beneficiaries with re-
spect to the use of such electronic visit verification 
systems and other means to prevent such fraud. 
(c) RULES OF CONSTRUCTION.— 
(1) NO
EMPLOYER-EMPLOYEE
RELATIONSHIP 
ESTABLISHED.—Nothing in the amendment made by 
this section may be construed as establishing an em-
ployer-employee relationship between the agency or 
entity that provides for personal care services or 
home health care services and the individuals who, 
under a contract with such an agency or entity, fur-
nish such services for purposes of part 552 of title 
29, Code of Federal Regulations (or any successor 
regulations). 
(2) NO PARTICULAR OR UNIFORM ELECTRONIC 
VISIT
VERIFICATION
SYSTEM
REQUIRED.—Nothing 
in the amendment made by this section shall be con-
strued to require the use of a particular or uniform 
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electronic visit verification system (as defined in sub-
section (l)(5) of section 1903 of the Social Security 
Act (42 U.S.C. 1396b), as inserted by subsection 
(a)) by all agencies or entities that provide personal 
care services or home health care under a State plan 
under title XIX of the Social Security Act (or under 
a waiver of the plan) (42 U.S.C. 1396 et seq.). 
(3) NO LIMITS ON PROVISION OF CARE.—Noth-
ing in the amendment made by this section may be 
construed to limit, with respect to personal care 
services or home health care services provided under 
a State plan under title XIX of the Social Security 
Act (or under a waiver of the plan) (42 U.S.C. 1396 
et seq.), provider selection, constrain beneficiaries’ 
selection of a caregiver, or impede the manner in 
which care is delivered. 
(4) NO PROHIBITION ON STATE QUALITY MEAS-
URES REQUIREMENTS.—Nothing in the amendment 
made by this section shall be construed as prohib-
iting a State, in implementing an electronic visit 
verification system (as defined in subsection (l)(5) of 
section 1903 of the Social Security Act (42 U.S.C. 
1396b), as inserted by subsection (a)), from estab-
lishing requirements related to quality measures for 
such system. 
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TITLE 
III—INTERDEPART-
MENTAL 
SERIOUS 
MENTAL 
ILLNESS 
COORDINATING 
COMMITTEE 
SEC. 301. INTERDEPARTMENTAL SERIOUS MENTAL ILL-
NESS COORDINATING COMMITTEE. 
(a) ESTABLISHMENT.— 
(1) IN
GENERAL.—Not later than 3 months 
after the date of enactment of this Act, the Sec-
retary of Health and Human Services, or the des-
ignee of the Secretary, shall establish a committee to 
be known as the ‘‘Interdepartmental Serious Mental 
Illness Coordinating Committee’’ (in this section re-
ferred to as the ‘‘Committee’’). 
(2) FEDERAL ADVISORY COMMITTEE ACT.—Ex-
cept as provided in this section, the provisions of the 
Federal Advisory Committee Act (5 U.S.C. App.) 
shall apply to the Committee. 
(b) MEETINGS.—The Committee shall meet not fewer 
than two times each year. 
(c) RESPONSIBILITIES.—Not later than 1 year after 
the date of enactment of this Act, and 5 years after such 
date of enactment, the Committee shall submit to Con-
gress a report including— 
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(1) a summary of advances in serious mental 
illness and serious emotional disturbance research 
related to the prevention of, diagnosis of, interven-
tion in, and treatment and recovery of, serious men-
tal illnesses, serious emotional disturbances, and ad-
vances in access to services and support for individ-
uals with a serious mental illness or serious emo-
tional disturbance; 
(2) an evaluation of the effect on public health 
of Federal programs related to serious mental illness 
or serious emotional disturbance, including measure-
ments of public health outcomes such as— 
(A) rates of suicide, suicide attempts, prev-
alence of serious mental illness, serious emo-
tional disturbances, and substance use dis-
orders, overdose, overdose deaths, emergency 
hospitalizations, emergency room boarding, pre-
ventable emergency room visits, involvement 
with the criminal justice system, crime, home-
lessness, and unemployment; 
(B) increased rates of employment and en-
rollment in educational and vocational pro-
grams; 
(C) quality of mental illness and substance 
use disorder treatment services; and 
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(D) any other criteria as may be deter-
mined by the Secretary; 
(3) a plan to improve outcomes for individuals 
with serious mental illness or serious emotional dis-
turbances, including reducing incarceration for such 
individuals, reducing homelessness, and increasing 
employment; and 
(4) specific recommendations for actions that 
agencies can take to better coordinate the adminis-
tration of mental health services for people with seri-
ous mental illness or serious emotional disturbances. 
(d) COMMITTEE EXTENSION.—Upon the submission 
of the second report under subsection (c), the Secretary 
shall submit a recommendation to Congress on whether 
to extend the operation of the Committee. 
(e) MEMBERSHIP.— 
(1) FEDERAL MEMBERS.—The Committee shall 
be composed of the following Federal representa-
tives, or their designees: 
(A) The Secretary of Health and Human 
Services, who shall serve as the Chair of the 
Committee. 
(B) The Director of the National Institutes 
of Health. 
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(C) The Assistant Secretary for Health of 
the Department of Health and Human Services. 
(D) The Assistant Secretary for Mental 
Health and Substance Use. 
(E) The Attorney General of the United 
States. 
(F) The Secretary of Veterans Affairs. 
(G) The Secretary of Defense. 
(H) The Secretary of Housing and Urban 
Development. 
(I) The Secretary of Education. 
(J) The Secretary of Labor. 
(K) The Commissioner of Social Security. 
(L) The Administrator of the Centers for 
Medicare & Medicaid Services. 
(2) NON-FEDERAL MEMBERS.—The Committee 
shall also include not less than 14 non-Federal pub-
lic members appointed by the Secretary of Health 
and Human Services, of which— 
(A) at least two members shall be individ-
uals with lived experience with serious mental 
illness or serious emotional disturbance; 
(B) at least one member shall be a parent 
or legal guardian of an individual with a history 
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of a serious mental illness or serious emotional 
disturbance; 
(C) at least one member shall be a rep-
resentative of a leading research, advocacy, or 
service organization for individuals with serious 
mental illness or serious emotional disturbance; 
(D) at least two members shall be— 
(i) a licensed psychiatrist with experi-
ence treating serious mental illnesses or se-
rious emotional disturbances; 
(ii) a licensed psychologist with expe-
rience treating serious mental illnesses or 
serious emotional disturbances; 
(iii) a licensed clinical social worker 
with experience treating serious mental ill-
ness or serious emotional disturbances; or 
(iv) a licensed psychiatric nurse, nurse 
practitioner, or physician assistant with ex-
perience treating serious mental illnesses 
or serious emotional disturbances; 
(E) at least one member shall be a licensed 
mental health professional with a specialty in 
treating children and adolescents with serious 
emotional disturbances; 
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(F) at least one member shall be a mental 
health professional who has research or clinical 
mental health experience working with minori-
ties; 
(G) at least one member shall be a mental 
health professional who has research or clinical 
mental health experience working with medi-
cally underserved populations; 
(H) at least one member shall be a State 
certified mental health peer-support specialist; 
(I) at least one member shall be a judge 
with experience adjudicating cases within a 
mental health court; 
(J) at least one member shall be a law en-
forcement officer or corrections officer with ex-
tensive experience in interfacing with individ-
uals with a serious mental illness or serious 
emotional disturbance, or in a mental health 
crisis; and 
(K) at least one member shall be a home-
less services provider with experience working 
with individuals with serious mental illness, 
with serious emotional disturbance, or having 
mental health crisis. 
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(3) TERMS.—A member of the Committee ap-
pointed under paragraph (2) shall serve for a term 
of 3 years, and may be reappointed for one or more 
additional 3-year terms. Any member appointed to 
fill a vacancy for an unexpired term shall be ap-
pointed for the remainder of such term. A member 
may serve after the expiration of the member’s term 
until a successor has been appointed. 
(f) WORKING GROUPS.—In carrying out its func-
tions, the Committee may establish working groups. Such 
working groups shall be composed of Committee members, 
or their designees, and may hold such meetings as are nec-
essary. 
(g) SUNSET.—The Committee shall terminate on the 
date that is 6 years after the date on which the Committee 
is established under subsection (a)(1). 
TITLE IV—COMPASSIONATE 
COMMUNICATION ON HIPAA 
SEC. 401. SENSE OF CONGRESS. 
(a) FINDINGS.—Congress finds the following: 
(1) The vast majority of individuals with mental 
illness are capable of understanding their illness and 
caring for themselves. 
(2) Persons with serious mental illness (in this 
section referred to as ‘‘SMI’’), including schizo-
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phrenia spectrum, bipolar disorders, and major de-
pressive disorder, may be significantly impaired in 
their ability to understand or make sound decisions 
for their care and needs. By nature of their illness, 
cognitive impairments in reasoning and judgment, as 
well as the presence of hallucinations, delusions, and 
severe emotional distortions, they may lack the 
awareness they even have a mental illness (a condi-
tion known as anosognosia), and thus may be unable 
to make sound decisions regarding their care, nor 
follow through consistently and effectively on their 
care needs. 
(3) Persons with mental illness or SMI may re-
quire and benefit from mental health treatment in 
order to recover to the fullest extent of their ability; 
these beneficial interventions may include psychiatric 
care, psychological care, medication, peer support, 
educational support, employment support, and hous-
ing support. 
(4) Persons with SMI who are provided with 
professional and supportive services may still experi-
ence times when their symptoms may greatly impair 
their abilities to make sound decisions for their per-
sonal care or may discontinue their care as a result 
of this impaired decisionmaking resulting in a fur-
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ther deterioration of their condition. They may expe-
rience a temporary or prolonged impairment as a re-
sult of their diminished capacity to care for them-
selves. 
(5) Episodes of psychiatric crises among those 
with SMI can result in neurological harm to the in-
dividual’s brain. 
(6) Persons with SMI— 
(A) are at high risk for other chronic phys-
ical illnesses, with approximately 50 percent 
having two or more co-occurring chronic phys-
ical illnesses such as cardiac, pulmonary, can-
cer, and endocrine disorders; and 
(B) have three times the odds of having 
chronic bronchitis, five times the odds of having 
emphysema, and four times the odds of having 
COPD, are more than four times as likely to 
have fluid and electrolyte disorders, and are 
nearly three times as likely to be nicotine de-
pendent. 
(7) Some psychotropic medications, such as sec-
ond generation antipsychotics, significantly increase 
risk for chronic illnesses such as diabetes and car-
diovascular disease. 
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(8) When the individual fails to seek or main-
tain treatment for these physical conditions over a 
long term, it can result in the individual becoming 
gravely disabled, or developing life-threatening ill-
nesses. Early and consistent treatment can amelio-
rate or reduce symptoms or cure the disease. 
(9) Persons with SMI die 7 to 24 years earlier 
than their age cohorts primarily because of com-
plications from their chronic physical illness and fail-
ure to seek or maintain treatment resulting from 
emotional and cognitive impairments from their 
SMI. 
(10) It is beneficial to the person with SMI and 
chronic illness to seek and maintain continuity of 
medical care and treatment for their mental illness 
to prevent further deterioration and harm to their 
own safety. 
(11) When the individual with SMI is signifi-
cantly diminished in their capacity to care for them-
selves long term or acutely, other supportive inter-
ventions to assist their care may be necessary to 
protect their health and safety. 
(12) Prognosis for the physical and psychiatric 
health of those with SMI may improve when respon-
sible caregivers facilitate and participate in care. 
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(13) When an individual with SMI is chron-
ically incapacitated in their ability to care for them-
selves, caregivers can pursue legal guardianship to 
facilitate care in appropriate areas while being mind-
ful to allow the individual to make decisions for 
themselves in areas where they are capable. 
(14) Individuals with SMI who have prolonged 
periods of being significantly functional can, during 
such periods, design and sign an advanced directive 
to predefine and choose medications, providers, 
treatment plans, and hospitals, and provide care-
givers with guardianship the ability to help in those 
times when a patient’s psychiatric symptoms worsen 
to the point of making them incapacitated or leaving 
them with a severely diminished capacity to make in-
formed decisions about their care which may result 
in harm to their physical and mental health. 
(15) All professional and support efforts should 
be made to help the individual with SMI and acute 
or chronic physical illnesses to understand and fol-
low through on treatment. 
(16) When individuals with SMI, even after ef-
forts to help them understand, have failed to care 
for themselves, there exists confusion in the health 
care community around what is currently permis-
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sible under HIPAA rules. This confusion may hinder 
communication with responsible caregivers who may 
be able to facilitate care for the patient with SMI in 
instances when the individual does not give permis-
sion for disclosure. 
(b) SENSE OF CONGRESS.—It is the sense of the 
Congress that, for the sake of the health and safety of 
persons with serious mental illness, more clarity is needed 
surrounding the existing HIPAA privacy rule promulgated 
pursuant to section 264(c) of the Health Insurance Port-
ability and Accountability Act (42 U.S.C. 1320d–2 note) 
to permit health care professionals to communicate, when 
necessary, with responsible known caregivers of such per-
sons, the limited, appropriate protected health information 
of such persons in order to facilitate treatment, but not 
including psychotherapy notes. 
SEC. 402. CONFIDENTIALITY OF RECORDS. 
Not later than 1 year after the date on which the 
Secretary of Health and Human Services first finalizes 
regulations updating part 2 of title 42, Code of Federal 
Regulations (relating to confidentiality of alcohol and drug 
abuse patient records) after the date of enactment of this 
Act, the Secretary shall convene relevant stakeholders to 
determine the effect of such regulations on patient care, 
health outcomes, and patient privacy. The Secretary shall 
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submit to the Committee on Energy and Commerce of the 
House of Representatives and the Committee on Health, 
Education, Labor, and Pensions of the Senate, and make 
publicly available, a report on the findings of such stake-
holders. 
SEC. 403. CLARIFICATION OF CIRCUMSTANCES UNDER 
WHICH DISCLOSURE OF PROTECTED HEALTH 
INFORMATION IS PERMITTED. 
(a) IN GENERAL.—Not later than 1 year after the 
date of enactment of this section, the Secretary of Health 
and Human Services shall promulgate final regulations 
clarifying the circumstances under which, consistent with 
the provisions of subpart C of title XI of the Social Secu-
rity Act (42 U.S.C. 1320d et seq.) and regulations pro-
mulgated pursuant to section 264(c) of the Health Insur-
ance Portability and Accountability Act of 1996 (42 
U.S.C. 1320d–2 note), a health care provider or covered 
entity may disclose the protected health information of a 
patient with a mental illness, including for purposes of— 
(1) communicating (including with respect to 
treatment, side effects, risk factors, and the avail-
ability of community resources) with a family mem-
ber of such patient, caregiver of such patient, or 
other individual to the extent that such family mem-
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ber, caregiver, or individual is involved in the care 
of the patient; 
(2) communicating with a family member of the 
patient, caregiver of such patient, or other individual 
involved in the care of the patient in the case that 
the patient is an adult; 
(3) communicating with the parent or caregiver 
of a patient in the case that the patient is a minor; 
(4) considering the patient’s capacity to agree 
or object to the sharing of the protected health in-
formation of the patient; 
(5) communicating and sharing information 
with the family or caregivers of the patient when— 
(A) the patient consents; 
(B) the patient does not consent, but the 
patient lacks the capacity to agree or object and 
the communication or sharing of information is 
in the patient’s best interest; 
(C) the patient does not consent and the 
patient is not incapacitated or in an emergency 
circumstance, but the ability of the patient to 
make rational health care decisions is signifi-
cantly diminished by reason of the physical or 
mental health condition of the patient; and 
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