540 
in communities will help to increase utilization of 
mental health services for people who have trouble 
functioning because of mental health challenges. 
(12) There is a link between mental health di-
agnosis and the likelihood of an individual commit-
ting suicide. 
(13) A comprehensive public health approach to 
behavioral health fosters protective factors in racial 
and ethnic communities that support mental health. 
(14) Approaches to mental health and address-
ing trauma must keep in mind the historical and 
cultural trauma that has impacted many commu-
nities of color. 
(15) Treatment modalities must keep individual 
communities’ approaches to mental health in mind, 
for example— 
(A) cultural healing practices; and 
(B) the mental health professionals needed 
to provide those services such as peer support 
specialists. 
(16) Approaches to mental health and address-
ing trauma must keep in mind the concept of 
intersectionality of individuals; that individuals may 
have many inequities that shape the way they proc-
ess and experience everyday life. 
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SEC. 602. COVERAGE OF MARRIAGE AND FAMILY THERA-
PIST 
SERVICES, 
MENTAL 
HEALTH 
COUN-
SELOR SERVICES, AND SUBSTANCE ABUSE 
COUNSELOR SERVICES UNDER PART B OF 
THE MEDICARE PROGRAM. 
(a) COVERAGE OF SERVICES.— 
(1) IN
GENERAL.—Section 1861(s)(2) of the 
Social Security Act (42 U.S.C. 1395x(s)(2)), as 
amended by section 431(c), is amended— 
(A) in subparagraph (GG), by striking 
‘‘and’’ at the end; 
(B) in subparagraph (HH), by inserting 
‘‘and’’ at the end; and 
(C) by adding at the end the following new 
subparagraph: 
‘‘(II) marriage and family therapist services (as 
defined in subsection (lll)(1)) and mental health 
counselor services (as defined in subsection (lll)(3)) 
and substance abuse counselor services (as defined 
in subsection (lll)(5));’’. 
(2) DEFINITIONS.—Section 1861 of the Social 
Security Act (42 U.S.C. 1395x), as amended by sec-
tions 205(b)(a), 413(a), and 431(c), is amended by 
adding at the end the following new subsection: 
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‘‘Marriage and Family Therapist Services; Marriage and 
Family Therapist; Mental Health Counselor Serv-
ices; Mental Health Counselor; Substance Abuse 
Counselor Services; Substance Abuse Counselor; 
Peer Support Specialist 
‘‘(lll)(1) The term ‘marriage and family therapist 
services’ means services performed by a marriage and 
family therapist (as defined in paragraph (2)) for the diag-
nosis and treatment of mental illnesses, which the mar-
riage and family therapist is legally authorized to perform 
under State law (or the State regulatory mechanism pro-
vided by State law) of the State in which such services 
are performed, as would otherwise be covered if furnished 
by a physician or as an incident to a physician’s profes-
sional service, but only if no facility or other provider 
charges or is paid any amounts with respect to the fur-
nishing of such services. 
‘‘(2) The term ‘marriage and family therapist’ means 
an individual who— 
‘‘(A) possesses a master’s or doctoral degree 
that qualifies for licensure or certification as a mar-
riage and family therapist pursuant to State law, in-
cluding but not limited to, clinical social workers and 
occupational therapists; 
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‘‘(B) after obtaining such degree has performed 
at least 2 years of clinical supervised experience in 
marriage and family therapy; and 
‘‘(C) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of marriage and family therapists, is li-
censed or certified as a marriage and family thera-
pist in such State. 
‘‘(3) The term ‘mental health counselor services’ 
means services performed by a mental health counselor (as 
defined in paragraph (4)) for the diagnosis and treatment 
of mental illnesses that the mental health counselor is le-
gally authorized to perform under State law (or the State 
regulatory mechanism provided by the State law) of the 
State in which such services are performed, as would oth-
erwise be covered if furnished by a physician or as incident 
to a physician’s professional service, but only if no facility 
or other provider charges or is paid any amounts with re-
spect to the furnishing of such services. 
‘‘(4) The term ‘mental health counselor’ means an 
individual who— 
‘‘(A) possesses a master’s or doctor’s degree in 
mental health counseling or a related field, including 
clinical social workers and occupational therapists; 
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‘‘(B) after obtaining such a degree has per-
formed at least 2 years of supervised mental health 
counselor practice; and 
‘‘(C) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of mental health counselors or professional 
counselors, is licensed or certified as a mental health 
counselor or professional counselor in such State. 
‘‘(5) The term ‘substance abuse counselor services’ 
means services performed by a substance abuse counselor 
(as defined in paragraph (6)) for the diagnosis and treat-
ment of substance abuse and addiction that the substance 
abuse counselor is legally authorized to perform under 
State law (or the State regulatory mechanism provided by 
the State law) of the State in which such services are per-
formed, as would otherwise be covered if furnished by a 
physician or as incident to a physician’s professional serv-
ice, but only if no facility or other provider charges or is 
paid any amounts with respect to the furnishing of such 
services. 
‘‘(6) The term ‘substance abuse counselor’ means an 
individual who— 
‘‘(A) has performed at least 2 years of super-
vised substance abuse counselor practice; 
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‘‘(B) in the case of an individual performing 
services in a State that provides for licensure or cer-
tification of substance abuse counselors or profes-
sional counselors, is licensed or certified as a sub-
stance abuse counselor or professional counselor in 
such State; or 
‘‘(C) is a drug and alcohol counselor as defined 
in section 40.281 of title 49, Code of Federal Regu-
lations. 
‘‘(7) The term ‘peer support specialist’ means an in-
dividual who— 
‘‘(A) is an individual living in recovery with 
mental illness, addiction, or systems involvement; 
‘‘(B) has skills learned in formal training; and 
‘‘(C) delivers services in behavioral health set-
tings to promote mind-body recovery and resil-
iency.’’. 
(3) PROVISION
FOR
PAYMENT
UNDER
PART 
B.—Section 1832(a)(2)(B) of the Social Security 
Act (42 U.S.C. 1395k(a)(2)(B)) is amended— 
(A) by striking ‘‘and’’ at the end of clause 
(iv); and 
(B) by adding at the end the following new 
clause: 
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‘‘(v) marriage and family therapist 
services, mental health counselor services, 
and substance abuse counselor services; 
and’’. 
(4) AMOUNT OF PAYMENT.—Section 1833(a)(1) 
of the Social Security Act (42 U.S.C. 1395l(a)(1)), 
as amended by section 431(c)(3), is amended— 
(A) by striking ‘‘and’’ before ‘‘(DD)’’; and 
(B) by inserting before the semicolon at 
the end the following: ‘‘, and (EE) with respect 
to marriage and family therapist services, men-
tal health counselor services, and substance 
abuse 
counselor 
services 
under 
section 
1861(s)(2)(II), the amounts paid shall be 80 
percent of the lesser of the actual charge for 
the services or 75 percent of the amount deter-
mined for payment of a psychologist under sub-
paragraph (L)’’. 
(5) EXCLUSION
OF
MARRIAGE
AND
FAMILY 
THERAPIST SERVICES, MENTAL HEALTH COUNSELOR 
SERVICES, AND PEER SUPPORT SPECIALIST SERV-
ICES FROM SKILLED NURSING FACILITY PROSPEC-
TIVE PAYMENT SYSTEM.—Section 1888(e)(2)(A)(ii) 
of 
the 
Social 
Security 
Act 
(42 
U.S.C. 
1395yy(e)(2)(A)(ii)) is amended by inserting ‘‘mar-
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547 
riage and family therapist services (as defined in 
section 1861(lll)(1)), mental health counselor serv-
ices (as defined in section 1861(lll)(3)),’’ after 
‘‘qualified psychologist services,’’. 
(6) INCLUSION
OF
MARRIAGE
AND
FAMILY 
THERAPISTS, MENTAL HEALTH COUNSELORS, AND 
SUBSTANCE ABUSE COUNSELORS AS PRACTITIONERS 
FOR
ASSIGNMENT
OF
CLAIMS.—Section 
1842(b)(18)(C) of the Social Security Act (42 
U.S.C. 1395u(b)(18)(C)) is amended by adding at 
the end the following new clauses: 
‘‘(vii) A marriage and family therapist (as de-
fined in section 1861(lll)(2)). 
‘‘(viii) A mental health counselor (as defined in 
section 1861(lll)(4)). 
‘‘(ix) A substance abuse counselor (as defined 
in section 1861(lll)(6)). 
‘‘(x) A peer support specialist (as defined in 
section 1861(III)(7)).’’. 
(b) COVERAGE OF CERTAIN MENTAL HEALTH SERV-
ICES PROVIDED IN CERTAIN SETTINGS.— 
(1) RURAL HEALTH CLINICS AND FEDERALLY 
QUALIFIED
HEALTH
CENTERS.—Section 
1861(aa)(1)(B) of the Social Security Act (42 
U.S.C. 1395x(aa)(1)(B)) is amended by striking ‘‘or 
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548 
by a clinical social worker (as defined in subsection 
(hh)(1)),’’ and inserting ‘‘, by a clinical social worker 
(as defined in subsection (hh)(1)), by a marriage 
and family therapist (as defined in subsection 
(lll)(2)), or by a mental health counselor (as defined 
in subsection (lll)(4)), or by a substance abuse coun-
selor (as defined in section 1861 (lll)(6)).’’. 
(2) 
HOSPICE
PROGRAMS.—Section 
1861(dd)(2)(B)(i)(III) of the Social Security Act (42 
U.S.C. 1395x(dd)(2)(B)(i)(III)) is amended by in-
serting ‘‘or one marriage and family therapist (as 
defined in subsection (lll)(2))’’ after ‘‘social worker’’. 
(c) AUTHORIZATION
OF MARRIAGE
AND FAMILY 
THERAPISTS
TO
DEVELOP
DISCHARGE
PLANS
FOR 
POSTHOSPITAL SERVICES.—Section 1861(ee)(2)(G) of 
the Social Security Act (42 U.S.C. 1395x(ee)(2)(G)) is 
amended by inserting ‘‘marriage and family therapist (as 
defined in subsection (lll)(2)),’’ after ‘‘social worker,’’. 
(d) EFFECTIVE DATE.—The amendments made by 
this section shall apply with respect to services furnished 
on or after January 1, 2021. 
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549 
SEC. 603. INTEGRATED HEALTH CARE DEMONSTRATION 
PROGRAM. 
Part D of title V of the Public Health Service Act 
(42 U.S.C. 290dd et seq.) is amended by adding at the 
end the following: 
‘‘SEC. 553. INTERPROFESSIONAL HEALTH CARE TEAMS FOR 
PROVISION OF BEHAVIORAL HEALTH CARE 
IN PRIMARY CARE SETTINGS. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Assistant Secretary for Mental Health and Substance 
Abuse, shall award grants to eligible entities for the pur-
pose of establishing interprofessional health care teams 
that provide behavioral health care. 
‘‘(b) ELIGIBLE ENTITIES.—To be eligible to receive 
a grant under this section, an entity shall be a Federally 
qualified health center (as defined in section 1861(aa) of 
the Social Security Act), rural health clinic, or women’s 
health clinics behavioral health program (including any 
such program operated by a community-based organiza-
tion) serving a high proportion of individuals from racial 
and ethnic minority groups (as defined in section 
1707(g)). 
‘‘(c) LOAN FORGIVENESS.—To encourage qualified 
allied health professionals to enter the mental health field, 
an eligible entity receiving a grant under this section shall 
agree to use at least $10,000 of the grant on a loan for-
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550 
giveness program for practitioners who commit to working 
in the mental health field for a period of two years. 
‘‘(d) SCIENTIFICALLY AND CULTURALLY BASED.— 
Integrated health care funded through this section shall 
be scientifically and culturally based, taking into consider-
ation the results of the most recent peer-reviewed research 
available. 
‘‘(e) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there is authorized to be appro-
priated $20,000,000 for each of fiscal years 2021 through 
2025.’’. 
SEC. 604. ADDRESSING RACIAL AND ETHNIC MENTAL 
HEALTH DISPARITIES RESEARCH GAPS. 
(a) IN GENERAL.—Not later than 6 months after the 
date of the enactment of this Act, the Director of the Na-
tional Institute on Minority Health and Health Disparities 
shall enter into an arrangement with the National Acad-
emy of Sciences to carry out the activities under sub-
section (b), or, if the National Academy of Sciences de-
clines to enter into such an arrangement, the Director of 
the National Institute on Minority Health and Health Dis-
parities, in cooperation with the Agency for Healthcare 
Research and Quality, shall carry out the activities under 
subsection (b). 
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551 
(b) ACTIVITIES.—The applicable entity under sub-
section (a) shall— 
(1) conduct a study with respect to mental 
health disparities in racial and ethnic minority 
groups (as defined in section 1707(g) of the Public 
Health Service Act (42 U.S.C. 300u–6(g))); and 
(2) submit to Congress a report on the results 
of such study, including— 
(A) a compilation of information on the dy-
namics of mental health outcomes in such racial 
and ethnic minority groups; and 
(B) the degree of the co-occurrence of 
mental conditions with other disabilities in such 
racial and ethnic groups, including physical dis-
abilities, mental disabilities, and mental dis-
orders or mental health conditions which co- 
occur with one another; 
(C) a compilation of information on the 
impact of exposure to community violence, com-
munity trauma, adverse childhood experiences, 
weather extremes worsened by climate change 
(such as heat waves, hurricanes, and wildfires), 
substance use, and other psychological traumas, 
on mental disorders in such racial and minority 
groups, stratified by household income level; 
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552 
(D) a compilation of information on the 
impact of the intersectionality of transgender 
men in racial and ethnic minority groups; and 
(E) a description of how protective factors 
contrast and compare among different commu-
nities of color, identifying cultural strengths. 
SEC. 605. HEALTH PROFESSIONS COMPETENCIES TO AD-
DRESS RACIAL AND ETHNIC MENTAL HEALTH 
DISPARITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Assistant Secretary 
for Mental Health and Substance Use, shall award grants 
to qualified national organizations for the purposes of— 
(1) developing, and disseminating to health pro-
fessional educational programs curricula or core 
competencies addressing mental health inequities 
among racial and ethnic minority groups for use in 
the training of students in the professions of social 
work, psychology, psychiatry, marriage and family 
therapy, mental health counseling, peer support, and 
substance abuse counseling; and 
(2) certifying community health workers and 
peer wellness specialists with respect to such cur-
ricula and core competencies and integrating and ex-
panding the use of such workers and specialists into 
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553 
health care and community-based settings to address 
mental health disparities among racial and ethnic 
minority groups. 
(b) CURRICULA; CORE COMPETENCIES.—Organiza-
tions receiving funds under subsection (a) may use the 
funds to engage in the following activities related to the 
development and dissemination of curricula or core com-
petencies described in subsection (a)(1): 
(1) Formation of committees or working groups 
comprised of experts from accredited health profes-
sions schools to identify core competencies relating 
to mental health disparities among racial and ethnic 
minority groups. 
(2) Planning of workshops in national fora to 
allow for public input, including input from commu-
nities of color with lived experience, into the edu-
cational needs associated with mental health dispari-
ties among racial and ethnic minority groups. 
(3) Dissemination and promotion of the use of 
curricula or core competencies in undergraduate and 
graduate health professions training programs na-
tionwide. 
(4) Establishing external stakeholder advisory 
boards to provide meaningful input into policy and 
program development and best practices to reduce 
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554 
mental health inequities among racial and ethnic 
groups, including participation from communities of 
color with lived experience of the impacts of mental 
health disparities. 
(c) DEFINITIONS.—In this section: 
(1) QUALIFIED NATIONAL ORGANIZATION.—The 
term ‘‘qualified national organization’’ means a na-
tional organization that focuses on the education of 
students in programs of social work, occupational 
therapy, psychology, psychiatry, and marriage and 
family therapy. 
(2) RACIAL AND ETHNIC MINORITY GROUP.— 
The term ‘‘racial and ethnic minority group’’ has the 
meaning given to such term in section 1707(g) of 
the Public Health Service Act (42 U.S.C. 300u– 
6(g)). 
(d) AUTHORIZATION
OF APPROPRIATIONS.—There 
are authorized to be appropriated to carry out this section 
such sums as may be necessary for each of fiscal years 
2021 through 2025. 
SEC. 606. GEOACCESS STUDY. 
The Assistant Secretary for Mental Health and Sub-
stance Use shall— 
(1) conduct a study to— 
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555 
(A) determine which geographic areas of 
the United States have shortages of specialty 
mental health providers; and 
(B) assess the preparedness of speciality 
mental health providers to deliver culturally and 
linguistically appropriate, affordable, and acces-
sible services; and 
(2) submit a report to Congress on the results 
of such study. 
SEC. 607. ASIAN AMERICAN, NATIVE HAWAIIAN, PACIFIC IS-
LANDER, AND HISPANIC AND LATINO BEHAV-
IORAL AND MENTAL HEALTH OUTREACH AND 
EDUCATION STRATEGIES. 
Part D of title V of the Public Health Service Act 
(42 U.S.C. 290dd et seq.), as amended by section 603, 
is further amended by adding at the end the following new 
section: 
‘‘SEC. 554. BEHAVIORAL AND MENTAL HEALTH OUTREACH 
AND EDUCATION STRATEGIES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Assistant Secretary for Mental Health and Substance 
Use, shall, in coordination with advocacy and behavioral 
and mental health organizations serving populations of 
Asian American, Native Hawaiian, Pacific Islander, and 
Hispanic and Latino individuals or communities, develop 
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and implement an outreach and education strategy to pro-
mote behavioral and mental health, clarify that behavioral 
and mental health conditions are treatable and that rea-
sonable accommodations are required under section 504 
of the Rehabilitation Act of 1973 (29 U.S.C. 794) and 
titles II and III of the Americans with Disabilities Act 
of 1990 (42 U.S.C. 12131 et seq.), and reduce stigma as-
sociated with mental health conditions and substance 
abuse among the Asian American, Native Hawaiian, and 
Pacific Islander and Hispanic and Latino populations. 
Such strategy shall— 
‘‘(1) be designed to— 
‘‘(A) meet the diverse cultural and lan-
guage needs of the various Asian American, 
Native Hawaiian, Pacific Islander, and His-
panic and Latino populations; and 
‘‘(B) ensure such strategies are develop-
mentally (with respect to the beneficiary’s rel-
ative age and experience) and age appropriate, 
as well as cognitively accessible to persons with 
cognitive disabilities; 
‘‘(2) increase awareness of symptoms of mental 
illnesses common among such populations, taking 
into account differences within subgroups (such as 
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