I 
114TH CONGRESS 
1ST SESSION H. R. 2646 
To make available needed psychiatric, psychological, and supportive services 
for individuals with mental illness and families in mental health crisis, 
and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JUNE 4, 2015 
Mr. MURPHY of Pennsylvania (for himself, Ms. EDDIE BERNICE JOHNSON of 
Texas, Mr. BUCHANAN, Mr. DIAZ-BALART, Mr. BILIRAKIS, Mr. DOLD, 
Mr. GUINTA, Mrs. MIMI WALTERS of California, Mr. BRENDAN F. 
BOYLE of Pennsylvania, Mrs. ELLMERS of North Carolina, Mr. DENHAM, 
Mr. VARGAS, Mrs. MILLER of Michigan, Mr. HASTINGS, Mr. CALVERT, 
Mr. NUNES, Mr. HUNTER, Mr. BLUMENAUER, and Ms. SINEMA) intro-
duced the following bill; which was referred to the Committee on Energy 
and Commerce, and in addition to the Committees on Ways and Means 
and Education and the Workforce, for a period to be subsequently deter-
mined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
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, 
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 2015’’. 
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(b) TABLE OF CONTENTS.—The table of contents for 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
Sec. 2. Definitions. 
TITLE I—ASSISTANT SECRETARY FOR MENTAL HEALTH AND 
SUBSTANCE USE DISORDERS 
Sec. 101. Assistant Secretary for Mental Health and Substance Use Disorders. 
Sec. 102. Transfer of SAMHSA authorities. 
Sec. 103. Reports. 
Sec. 104. Advisory Council on Graduate Medical Education. 
TITLE II—GRANT REFORM AND RESTRUCTURING 
Sec. 201. National mental health policy laboratory. 
Sec. 202. Innovation grants. 
Sec. 203. Demonstration grants. 
Sec. 204. Early childhood intervention and treatment. 
Sec. 205. Extension of assisted outpatient treatment grant program for individ-
uals with serious mental illness. 
Sec. 206. Block grants. 
Sec. 207. Workforce development. 
Sec. 208. Authorized grants and programs. 
TITLE III—INTERAGENCY SERIOUS MENTAL ILLNESS 
COORDINATING COMMITTEE 
Sec. 301. Interagency Serious Mental Illness Coordinating Committee. 
TITLE IV—HIPAA AND FERPA CAREGIVERS 
Sec. 401. Promoting appropriate treatment for mentally ill individuals by treat-
ing their caregivers as personal representatives for purposes of 
HIPAA privacy regulations. 
Sec. 402. Caregivers permitted access to certain education records under 
FERPA. 
Sec. 403. Confidentiality of records. 
TITLE V—MEDICARE AND MEDICAID REFORMS 
Sec. 501. Enhanced Medicaid coverage relating to certain mental health serv-
ices. 
Sec. 502. Access to mental health prescription drugs under Medicare and Med-
icaid. 
Sec. 503. Elimination of 190-day lifetime limit on coverage of inpatient psy-
chiatric hospital services under Medicare. 
Sec. 504. Modifications to Medicare discharge planning requirements. 
Sec. 505. Demonstration programs to improve community mental health serv-
ices. 
TITLE VI—RESEARCH BY NATIONAL INSTITUTE OF MENTAL 
HEALTH 
Sec. 601. Increase in funding for certain research. 
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TITLE VII—BEHAVIORAL HEALTH INFORMATION TECHNOLOGY 
Sec. 701. Extension of health information technology assistance for behavioral 
and mental health and substance abuse. 
Sec. 702. Extension of eligibility for Medicare and Medicaid health information 
technology implementation assistance. 
TITLE VIII—SAMHSA REAUTHORIZATION AND REFORMS 
Subtitle A—Organization and General Authorities 
Sec. 801. In general. 
Sec. 802. Advisory councils. 
Sec. 803. Peer review. 
Subtitle B—Protection and Advocacy for Individuals With Mental Illness 
Sec. 811. Prohibition against lobbying by systems accepting Federal funds to 
protect and advocate the rights of individuals with mental ill-
ness. 
Sec. 812. Ensuring that caregivers of individuals with serious mental illness 
have access to the protected health information of such individ-
uals. 
Sec. 813. Protection and advocacy activities to focus exclusively on safe-
guarding rights to be free from abuse and neglect. 
Sec. 814. Reporting. 
Sec. 815. Grievance procedure. 
Sec. 816. Evidence-based treatment for individuals with serious mental illness. 
TITLE IX—REPORTING 
Sec. 901. GAO study on preventing discriminatory coverage limitations for indi-
viduals with serious mental illness and substance use disorders. 
SEC. 2. DEFINITIONS. 
In this Act: 
(1) Except as inconsistent with the provisions 
of this Act, the term ‘‘Assistant Secretary’’ means 
the Assistant Secretary for Mental Health and Sub-
stance Use Disorders. 
(2) The term ‘‘evidence-based’’ means the con-
scientious, systematic, explicit, and judicious ap-
praisal and use of external, current, reliable, and 
valid research findings as the basis for making deci-
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sions about the effectiveness and efficacy of a pro-
gram, intervention, or treatment. 
TITLE I—ASSISTANT SECRETARY 
FOR MENTAL HEALTH AND 
SUBSTANCE USE DISORDERS 
SEC. 101. ASSISTANT SECRETARY FOR MENTAL HEALTH 
AND SUBSTANCE USE DISORDERS. 
(a) IN GENERAL.—There shall be in the Department 
of Health and Human Services an official to be known 
as the Assistant Secretary for Mental Health and Sub-
stance Use Disorders, who shall— 
(1) report directly to the Secretary; 
(2) be appointed by the Secretary of Health 
and Human Services, by and with the advice and 
consent of the Senate; and 
(3) be selected from among individuals who— 
(A)(i) have a doctoral degree in medicine 
or osteopathic medicine and clinical and re-
search experience in psychiatry; 
(ii) graduated from an Accreditation Coun-
cil for Graduate Medical Education-accredited 
psychiatric residency program; and 
(iii) have an understanding of biological, 
psychosocial, and pharmaceutical treatments of 
mental illness and substance use disorders; or 
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(B) have a doctoral degree in psychology 
with— 
(i) clinical and research experience re-
garding mental illness and substance use 
disorders; and 
(ii) an understanding of biological, 
psychosocial, and pharmaceutical treat-
ments of mental illness and substance use 
disorders. 
(b) DUTIES.—The Assistant Secretary shall— 
(1) promote, evaluate, organize, integrate, and 
coordinate research, treatment, and services across 
departments, agencies, organizations, and individ-
uals with respect to the problems of individuals suf-
fering from substance use disorders or mental ill-
ness; 
(2) carry out any functions within the Depart-
ment of Health and Human Services— 
(A) to improve the treatment of, and re-
lated services to, individuals with respect to 
substance use disorders or mental illness; 
(B) to improve secondary prevention or 
tertiary prevention services for such individuals; 
(C) to ensure access to effective, evidence- 
based treatment for individuals with mental ill-
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nesses and individuals with a substance use dis-
order; 
(D) to ensure that grant programs of the 
Department adhere to scientific standards with 
an emphasis on secondary prevention and ter-
tiary prevention for individuals with serious 
mental illness or substance use disorders; and 
(E) to develop and implement initiatives to 
encourage individuals to pursue careers (espe-
cially in underserved areas and populations) as 
psychiatrists, psychologists, psychiatric nurse 
practitioners, clinical social workers, and other 
licensed mental health professionals specializing 
in the diagnosis, evaluation, and treatment of 
individuals with severe mental illness, including 
individuals— 
(i) who are vulnerable to crises, psy-
chotic episodes, or suicidal rumination; 
(ii) whose deterioration can be rapid; 
or 
(iii) who require more frequent con-
tact or integration of a variety of services 
by the treating mental health professional; 
(3) carry out the administrative and financial 
management, policy development and planning, eval-
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uation, knowledge dissemination, and public infor-
mation functions that are required for the implemen-
tation of mental health programs, including block 
grants, treatments, and data collection; 
(4) conduct and coordinate demonstration 
projects, evaluations, and service system assessments 
and other activities necessary to improve the avail-
ability and quality of treatment, prevention, and re-
lated services related to substance use disorders and 
mental illness; 
(5) within the Department of Health and 
Human Services, oversee and coordinate all pro-
grams and activities relating to— 
(A) the prevention of, or treatment or re-
habilitation for, mental health or substance use 
disorders; 
(B) parity in health insurance benefits and 
conditions relating to mental health and sub-
stance use disorder; or 
(C) the reduction of homelessness among 
individuals with mental illness; 
(6) across the Federal Government, in conjunc-
tion with the Interagency Serious Mental Illness Co-
ordinating Committee under section 501A— 
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(A) review all programs and activities re-
lating to the prevention of, or treatment or re-
habilitation for, mental illness or substance use 
disorders; 
(B) identify any such programs and activi-
ties that are duplicative; 
(C) identify any such programs and activi-
ties that are not evidence-based, effective, or ef-
ficient; and 
(D) formulate recommendations for ex-
panding, coordinating, eliminating, and improv-
ing programs and activities identified pursuant 
to subparagraph (B) or (C) and merging such 
programs and activities into other, successful 
programs and activities; 
(7) identify evidence-based best practices across 
the Federal Government for treatment and services 
for those with mental health and substance use dis-
orders by reviewing practices for efficiency, effective-
ness, quality, coordination, and cost effectiveness; 
(8) be the head of and supervise the National 
Mental Health Policy Laboratory; and 
(9) not later than one year after the date of en-
actment of the Helping Families in Mental Health 
Crisis Act of 2015, submit to the Congress a report 
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containing a nationwide strategy to increase the psy-
chiatric workforce and recruit medical professionals 
for the treatment of individuals with serious mental 
illness and substance use disorders. 
(c) NATIONWIDE STRATEGY.—The Assistant Sec-
retary shall ensure that the nationwide strategy in the re-
port under subsection (b)(9) is designed— 
(1) to encourage and incentivize students en-
rolled in an accredited medical or osteopathic med-
ical school to enter the specialty of psychiatry; 
(2) to promote greater research-oriented psy-
chiatrist residency training on evidence-based service 
delivery models for individuals with serious mental 
illness or substance use disorders; 
(3) to promote appropriate Federal administra-
tive and fiscal mechanisms that support— 
(A) evidence-based collaborative care mod-
els; and 
(B) the necessary psychiatric workforce ca-
pacity for these models, including psychiatrists 
(including child and adolescent psychiatrists), 
psychologists, psychiatric nurse practitioners, 
clinical social workers, and mental health, peer- 
support specialists; 
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(4) to increase access to child and adolescent 
psychiatric services in order to promote early inter-
vention for prevention and mitigation of mental ill-
ness; and 
(5) to identify populations and locations that 
are the most underserved by mental health profes-
sionals and the most in need of psychiatrists (includ-
ing child and adolescent psychiatrists), psychologists, 
psychiatric nurse practitioners, clinical social work-
ers, and mental health, peer-support specialists. 
(d) PRIORITIZATION OF INTEGRATION OF SERVICES, 
EARLY DIAGNOSIS, INTERVENTION, AND WORKFORCE 
DEVELOPMENT.—In carrying out the duties described in 
subsection (b), the Assistant Secretary shall prioritize— 
(1) the integration of mental health, substance 
use, and physical health services for the purpose of 
diagnosing, preventing, treating, or providing reha-
bilitation for mental illness or substance use dis-
orders, including any such services provided through 
the justice system (including departments of correc-
tion) or other entities other than the Department of 
Health and Human Services; 
(2) crisis intervention for, early diagnosis and 
intervention services for the prevention of, and treat-
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ment and rehabilitation for, serious mental illness or 
substance use disorders; and 
(3) workforce development for— 
(A) appropriate treatment of serious men-
tal illness or substance use disorders; and 
(B) research activities that advance sci-
entific and clinical understandings of these dis-
orders, including the development and imple-
mentation of a continuing nationwide strategy 
to increase the psychiatric workforce with psy-
chiatrists, child and adolescent psychiatrists, 
psychologists, psychiatric nurse practitioners, 
clinical social workers, and mental health peer 
support specialists. 
(e) REQUIREMENTS AND RESTRICTIONS ON AUTHOR-
ITY TO AWARD GRANTS.—In awarding any grant or fi-
nancial assistance, the Assistant Secretary, and any agen-
cy or official within the Office of the Assistant Secretary, 
shall comply with the following: 
(1) The grant or financial assistance shall be 
for activities consisting of, or based upon, applied 
scientific research. 
(2) Any program to be funded shall be dem-
onstrated— 
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(A) in the case of an ongoing program, to 
be effective; and 
(B) in the case of a new program, to have 
the prospect of being effective. 
(3) The programs and activities to be funded 
shall use evidence-based best practices or emerging 
evidence-based best practices that are translational 
and can be expanded or replicated to other States, 
local communities, agencies, or through the Medicaid 
program under title XIX of the Social Security Act. 
(4) An application for the grant or financial as-
sistance shall include, as applicable, a scientific jus-
tification based on previously demonstrated models, 
the number of individuals to be served, the popu-
lation to be targeted, what objective outcomes meas-
ures will be used, and details on how the program 
or activity to be funded can be replicated and by 
whom. 
(5) Applicants shall be evaluated and selected 
through a blind, peer-review process by expert men-
tal health care providers with professional experience 
in mental health research or treatment and where 
appropriate or necessary professional experience re-
lated to substance abuse and other areas of expertise 
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appropriate to the grant or other financial assist-
ance. 
(6) No member of a peer-review group con-
ducting a blind, peer-review process, as required by 
paragraph (5), may be related to anyone who may 
be applying for the type of award being reviewed, 
may be a current grant applicant, or may have a fi-
nancial or employment interested in selecting whom 
to receive the award. 
(7) Award recipients may be periodically re-
viewed and audited at the discretion of the Inspector 
General of the Department of Health and Human 
Services or the Comptroller General of the United 
States to ensure that— 
(A) the best scientific method for both 
services and data collection is being followed; 
and 
(B) Federal funds are being used as re-
quired by the conditions of the award and by 
applicable guidelines of the NMHPL. 
(8) Award recipients that fail an audit or fail 
to provide information pursuant to an audit shall 
have their awards terminated. 
(f) DEFINITIONS.—In this section: 
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(1) The term ‘‘secondary prevention’’ means 
prevention that is designed to prevent a disease or 
condition from occurring among individuals or a 
subpopulation determined to be at risk for the dis-
ease or condition. 
(2) The term ‘‘tertiary prevention’’ means pre-
vention that is designed to reduce or minimize the 
consequences of a disease or condition among indi-
viduals showing symptoms of the disease or condi-
tion. 
SEC. 102. TRANSFER OF SAMHSA AUTHORITIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall delegate to the Assistant Secretary 
all duties and authorities that— 
(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. 
(b) TRANSITION.—This section and the amendments 
made by this section apply beginning on the day that is 
6 months after the date of enactment of this Act. As of 
such day, the Secretary of Health and Human Services 
shall provide for the transfer of the personnel, assets, and 
obligations of the Substance Abuse and Mental Health 
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Services Administration to the Office of the Assistant Sec-
retary. 
(c) CONFORMING AMENDMENTS.—Title V of the 
Public Health Service Act (42 U.S.C. 290aa et seq.) is 
amended— 
(1) in the title heading, by striking ‘‘SUB-
STANCE ABUSE AND MENTAL HEALTH 
SERVICES ADMINISTRATION’’ and insert-
ing ‘‘MENTAL HEALTH AND SUBSTANCE 
USE DISORDERS’’; 
(2) by amending section 501(a) to read as fol-
lows: 
‘‘(a) ASSISTANT SECRETARY.—The Assistant Sec-
retary for Mental Health and Substance Use Disorders 
shall have the duties and authorities vested in the Assist-
ant Secretary by this title in addition to the duties and 
authorities vested in the Assistant Secretary by section 
501 of the Helping Families in Mental Health Crisis Act 
of 2015 and other provisions of law.’’; 
(3) by amending section 501(c) to read as fol-
lows: 
‘‘(c) DEPUTY ASSISTANT SECRETARY.—The Assist-
ant Secretary, with the approval of the Secretary, may ap-
point a Deputy Assistant Secretary and may employ and 
prescribe the functions of such officers and employees, in-
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cluding attorneys, as are necessary to administer the ac-
tivities to be carried out under this title.’’; 
(4) by striking subsection (o) (relating to au-
thorization of appropriations); 
(5) 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 Dis-
orders’’; 
(6) by striking ‘‘Administrator’’ each place it 
appears and inserting ‘‘Assistant Secretary’’, except 
where the term ‘‘Administrator’’ appears within the 
term— 
(A) Associate Administrator; 
(B) Administrator of the Health Resources 
and Services Administration; 
(C) Administrator of the Centers for Medi-
care & Medicaid Services; or 
(D) Administrator of the Office of Juvenile 
Justice and Delinquency Prevention; 
(7) by striking ‘‘Substance Abuse and Mental 
Health Services Administration’’ each place it ap-
pears and inserting ‘‘Office of the Assistant Sec-
retary’’; 
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(8) in section 502, by striking ‘‘Administration 
or Center’’ each place it appears and inserting ‘‘Of-
fice or Center’’; 
(9) in section 502, by striking ‘‘Administra-
tion’s’’ and inserting ‘‘Office of the Assistant Sec-
retary’s’’; and 
(10) by striking the term ‘‘Administration’’ 
each place it appears and inserting ‘‘Office of the 
Assistant Secretary’’, except in the heading of sec-
tion 520G(b) and where the term ‘‘Administration’’ 
appears with the term— 
(A) Health Resources and Services Admin-
istration; or 
(B) National Highway Traffic Safety Ad-
ministration. 
(d) REFERENCES.—After executing subsection (a), 
subsection (b), and the amendments made by subsection 
(c)— 
(1) 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 Sec-
retary for Mental Health and Substance Use Dis-
orders; and 
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(2) any reference in statute, regulation, or guid-
ance to the Substance Abuse and Mental Health 
Services Administration shall be construed to be a 
reference to the Office of the Assistant Secretary. 
SEC. 103. REPORTS. 
(a) REPORT ON INVESTIGATIONS REGARDING PAR-
ITY
IN MENTAL HEALTH
AND SUBSTANCE USE DIS-
ORDER BENEFITS.— 
(1) IN
GENERAL.—Not later than 180 days 
after the enactment of this Act, and annually there-
after, the Administrator of the Centers for Medicare 
& Medicaid Services, in collaboration with the As-
sistant Secretary of Labor of the Employee Benefits 
Security Administration and the Secretary of the 
Treasury, and in consultation with the Assistant 
Secretary for Mental Health and Substance Use 
Disorders, shall submit to the Congress a report— 
(A) identifying Federal investigations con-
ducted or completed during the preceding 12- 
month period regarding compliance with parity 
in mental health and substance use disorder 
benefits, including benefits provided to persons 
with serious mental illness and substance use 
disorders, under the Paul Wellstone and Pete 
Domenici Mental Health Parity and Addiction 
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Equity Act of 2008 (subtitle B of title V of di-
vision C of Public Law 110–343); and 
(B) summarizing the results of such inves-
tigations. 
(2) CONTENTS.—Subject to paragraph (3), 
each report under paragraph (1) shall include the 
following information: 
(A) The number of investigations opened 
and closed during the covered reporting period. 
(B) The benefit classification or classifica-
tions examined by each investigation. 
(C) The subject matter or subject matters 
of each investigation, including quantitative and 
nonquantitative treatment limitations. 
(D) A summary of the basis of the final 
decision rendered for each investigation. 
(3) LIMITATION.—Individually identifiable in-
formation shall be excluded from reports under 
paragraph (1) consistent with Federal privacy pro-
tections. 
(b) REPORT ON BEST PRACTICES FOR PEER-SUP-
PORT SPECIALIST PROGRAMS, TRAINING, AND CERTIFI-
CATION.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, and biannually 
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thereafter, the Assistant Secretary shall submit to 
the Congress and make publicly available a report on 
best practices and professional standards in States 
for— 
(A) establishing and operating health care 
programs using peer-support specialists; and 
(B) training and certifying peer-support 
specialists. 
(2) PEER-SUPPORT SPECIALIST DEFINED.—In 
this subsection, the term ‘‘peer-support specialist’’ 
means an individual who— 
(A) uses his or her lived experience of re-
covery from mental illness or substance abuse, 
plus skills learned in formal training, to facili-
tate support groups, and to work on a one-on- 
one basis, with individuals with a serious men-
tal illness or a substance use disorder, in con-
sultation with and under the supervision of a li-
censed mental health or substance use treat-
ment professional; 
(B) has been an active participant in men-
tal health or substance use treatment for at 
least the preceding 2 years; 
(C) does not provide direct medical serv-
ices; and 
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(D) does not perform services outside of 
his or her area of training, expertise, com-
petence, or scope of practice. 
(3) CONTENTS.—Each report under this sub-
section shall include information on best practices 
and standards with regard to the following: 
(A) Hours of formal work or volunteer ex-
perience related to mental health and substance 
use issues. 
(B) Types of peer specialist exams re-
quired. 
(C) Code of ethics. 
(D) Additional training required prior to 
certification, including in areas such as— 
(i) psychopharmacology; 
(ii) integrating physical medicine and 
mental health supportive services; 
(iii) ethics; 
(iv) scope of practice; 
(v) crisis intervention; 
(vi) identification and treatment of 
mental health disorders; 
(vii) State confidentiality laws; 
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(viii) Federal privacy protections, in-
cluding under the Health Insurance Port-
ability and Accountability Act of 1996; and 
(ix) other areas as determined by the 
Assistant Secretary. 
(E) Requirements to explain what, where, 
when, and how to accurately complete all re-
quired documentation activities. 
(F) Required or recommended skill sets, 
including— 
(i) identifying consumer risk indica-
tors, including individual stressors, trig-
gers, and indicators of escalating symp-
toms; 
(ii) 
explaining 
basic 
de-escalation 
techniques; 
(iii) explaining basic suicide preven-
tion concepts and techniques; 
(iv) identifying indicators that the 
consumer may be experiencing abuse or ne-
glect; 
(v) identifying and responding appro-
priately to personal stressors, triggers, and 
indicators; 
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(vi) identifying the consumer’s current 
stage of change or recovery; 
(vii) explaining the typical process 
that should be followed to access or partici-
pate in community mental health and re-
lated services; and 
(viii) identifying circumstances when 
it is appropriate to request assistance from 
other professionals to help meet the con-
sumer’s recovery goals. 
(G) Requirements for continuing education 
credits annually. 
(c) REPORT ON THE STATE OF THE STATES IN MEN-
TAL HEALTH AND SUBSTANCE USE TREATMENT.— 
(1) IN GENERAL.—Not later than 1 year after 
the date of enactment of this Act, and not less than 
every 2 years thereafter, the Assistant Secretary 
shall submit to the Congress and make available to 
the public a report on the state of the States in 
mental health and substance use treatment, includ-
ing the following: 
(A) A detailed report on how Federal men-
tal health and substance use treatment funds 
are used in each State including: 
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(i) The numbers of individuals with 
serious mental illness or substance use dis-
orders who are served with Federal funds. 
(ii) The types of programs made avail-
able to individuals with serious mental ill-
ness or substance use disorders. 
(B) A summary of best practice models in 
the States highlighting programs that are cost 
effective, provide evidence-based care, increase 
access to care, integrate physical, psychiatric, 
psychological, and behavioral medicine, and im-
prove outcomes for individuals with mental ill-
ness or substance use disorders. 
(C) A statistical report of outcome meas-
ures in each State, including— 
(i) rates of suicide, suicide attempts, 
substance 
abuse, 
overdose, 
overdose 
deaths, emergency psychiatric hospitaliza-
tions, and emergency room boarding; and 
(ii) for those with mental illness, ar-
rests, incarcerations, victimization, home-
lessness, joblessness, employment, and en-
rollment in educational or vocational pro-
grams. 
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(D) Outcome measures on State-assisted 
outpatient treatment programs, including— 
(i) rates of keeping treatment ap-
pointments and compliance with prescribed 
medications; 
(ii) participants’ perceived effective-
ness of the program; 
(iii) rates of the programs helping 
those with serious mental illness gain con-
trol over their lives; 
(iv) alcohol and drug abuse rates; 
(v) incarceration and arrest rates; 
(vi) violence against persons or prop-
erty; 
(vii) homelessness; and 
(viii) total treatment costs for compli-
ance with the program. 
(E) STATE AND COUNTIES WITH ASSISTED 
OUTPATIENT
TREATMENT
PROGRAMS.—For 
States and counties with assisted outpatient 
treatment programs, the information reported 
under this subsection shall include a compari-
son of the outcomes of individuals with serious 
mental illness who participated in the programs 
versus the outcomes of individuals who did not 
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participate but were eligible to do so by nature 
of their history. 
(F) STATES AND COUNTIES WITHOUT AOT 
PROGRAMS.—For States and counties without 
assisted outpatient treatment programs, the in-
formation reported under this subsection shall 
include data on individuals with mental illness 
who— 
(i) have a history of violence, incarcer-
ation, and arrests; 
(ii) have a history of emergency psy-
chiatric hospitalizations; 
(iii) are substantially unlikely to par-
ticipate in treatment on their own; 
(iv) may be unable for reasons other 
than indigence, to provide for any of their 
basic needs such as food, clothing, shelter, 
health or safety; 
(v) have a history of mental illness or 
condition that is likely to substantially de-
teriorate if the individual is not provided 
with timely treatment; and 
(vi) due to their mental illness, have a 
lack of capacity to fully understand or lack 
judgment, or diminished capacity to make 
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informed decisions, regarding their need 
for treatment, care, or supervision. 
(2) DEFINITION.—In this subsection, the term 
‘‘emergency room boarding’’ means the practice of 
admitting patients to an emergency department and 
holding them in the department until inpatient psy-
chiatric beds become available. 
(d) REPORTING COMPLIANCE STUDY.— 
(1) IN GENERAL.—The Assistant Secretary for 
Mental Health and Substance Use Disorders shall 
enter into an arrangement with the Institute of 
Medicine of the National Academies (or, if the Insti-
tute declines, another appropriate entity) under 
which, not later than 12 months after the date of 
enactment of this Act, the Institute will submit to 
the appropriate committees of Congress a report 
that evaluates the combined paperwork burden of— 
(A) community mental health centers 
meeting the criteria specified in section 1913(c) 
of the Public Health Service Act (42 U.S.C. 
300x–2), including such centers meeting such 
criteria as in effect on the day before the date 
of enactment of this Act; and 
(B) federally qualified community mental 
health clinics certified pursuant to section 223 
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of the Protecting Access to Medicare Act of 
2014 (Public Law 113–93), as amended by sec-
tion 505. 
(2) SCOPE.—In preparing the report under sub-
section (a), the Institute of Medicine (or, if applica-
ble, other appropriate entity) shall examine licens-
ing, certification, service definitions, claims payment, 
billing codes, and financial auditing requirements 
used by the Office of Management and Budget, the 
Centers for Medicare & Medicaid Services, the 
Health Resources and Services Administration, the 
Substance Abuse and Mental Health Services Ad-
ministration, the Office of the Inspector General of 
the Department of Health and Human Services, 
State Medicaid agencies, State departments of 
health, State departments of education, and State 
and local juvenile justice and social service agencies 
to— 
(A) establish an estimate of the combined 
nationwide cost of complying with such require-
ments, in terms of both administrative funding 
and staff time; 
(B) establish an estimate of the per capita 
cost to each center or clinic described in sub-
paragraph (A) or (B) of paragraph (1) to com-
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ply with such requirements, in terms of both 
administrative funding and staff time; and 
(C) make administrative and statutory rec-
ommendations to Congress (which recommenda-
tions may include a uniform methodology) to 
reduce the paperwork burden experienced by 
centers and clinics described in subparagraph 
(A) or (B) of paragraph (1). 
SEC. 104. ADVISORY COUNCIL ON GRADUATE MEDICAL 
EDUCATION. 
Section 762(b) of the Public Health Service Act (42 
U.S.C. 294o(b)) is amended— 
(1) by redesignating paragraphs (4) through 
(6) as paragraphs (5) through (7), respectively; and 
(2) by inserting after paragraph (3) the fol-
lowing: 
‘‘(4) the Assistant Secretary for Mental Health 
and Substance Use Disorders;’’. 
TITLE II—GRANT REFORM AND 
RESTRUCTURING 
SEC. 201. NATIONAL MENTAL HEALTH POLICY LABORA-
TORY. 
(a) IN GENERAL.— 
(1) ESTABLISHMENT.—The Assistant Secretary 
for Mental Health and Substance Use Disorders 
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shall establish, within the Office of the Assistant 
Secretary, the National Mental Health Policy Lab-
oratory (in this section referred to as the 
‘‘NMHPL’’), to be headed by a Director. 
(2) DUTIES.—The Director of the NMHPL 
shall— 
(A) identify, coordinate, and implement 
policy changes and other trends likely to have 
the most significant impact on mental health 
services and monitor their impact; 
(B) collect information from grantees 
under programs established or amended by this 
Act and under other mental health programs 
under the Public Health Service Act, including 
grantees that are States receiving funds under 
a block grant under part B of title XIX of the 
Public Health Service Act (42 U.S.C. 300x et 
seq.); 
(C) evaluate and disseminate to such 
grantees evidence-based practices and services 
delivery models using the best available science 
shown to be cost-effective while enhancing the 
quality of care furnished to individuals; 
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(D) establish standards for the appoint-
ment of scientific peer-review panels to evaluate 
grant applications; and 
(E) establish standards for grant programs 
under subsection (b). 
(3) EVIDENCE-BASED PRACTICES AND SERVICE 
DELIVERY
MODELS.—In selecting evidence-based 
best practices and service delivery models for evalua-
tion and dissemination under paragraph (2)(C), the 
Director of the NMHPL— 
(A) shall give preference to models that 
improve— 
(i) the coordination between mental 
health and physical health providers; 
(ii) the coordination among such pro-
viders and the justice and corrections sys-
tem; and 
(iii) the cost effectiveness, quality, ef-
fectiveness, and efficiency of health care 
services furnished to individuals with seri-
ous mental illness, in mental health crisis, 
or at risk to themselves, their families, and 
the general public; and 
(B) may include clinical protocols and 
practices used in the Recovery After Initial 
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Schizophrenia Episode (RAISE) project and the 
North American Prodrome Longitudinal Study 
(NAPLS) of the National Institute of Mental 
Health. 
(4) DEADLINE FOR BEGINNING IMPLEMENTA-
TION.—The Director of the NMHPL shall begin im-
plementation of the duties described in this sub-
section not later than January 1, 2018. 
(5) CONSULTATION.—In carrying out the duties 
under this subsection, the Director of the NMHPL 
shall consult with— 
(A) representatives of the National Insti-
tute of Mental Health on organization, hiring 
decisions, and operations, initially and on an 
ongoing basis; 
(B) other appropriate Federal agencies; 
(C) clinical and analytical experts with ex-
pertise in medicine, psychiatric and clinical psy-
chological care, health care management, edu-
cation, corrections health care, and mental 
health court systems; and 
(D) other individuals and agencies as de-
termined appropriate by the Assistant Sec-
retary. 
(b) STANDARDS FOR GRANT PROGRAMS.— 
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(1) 
IN
GENERAL.—The 
Director 
of 
the 
NMHPL shall set standards for grant programs ad-
ministered by the Assistant Secretary, and the As-
sistant Secretary shall comply with such standards, 
including standards for— 
(A) the extent to which the grantee must 
have the capacity to implement the award; 
(B) the extent to which the grant plan sub-
mitted by the grantee as part of its application 
must explain how the grantee will help to pro-
vide comprehensive community mental health or 
substance use services to adults with serious 
mental illness and children with serious emo-
tional disturbances; 
(C) the extent to which the grantee must 
identify priorities, as well as strategies and per-
formance indicators to address those priorities 
for the duration of the grant; 
(D) the extent to which the grantee must 
submit statements on the extent to which the 
grantee is meeting annual program priorities 
with quantifiable, objective, and scientific tar-
gets, measures, and outcomes; 
(E) the extent to which grantees are ex-
pected to collaborate with other child-serving 
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systems such as child welfare, education, juve-
nile justice, and primary care systems; 
(F) the extent to which the grantee must 
collect and report data; 
(G) the extent to which the grantee must 
use evidence-based practices and the extent to 
which those evidence-based practices must be 
used with respect to a population similar to the 
population for which the evidence-based prac-
tices were shown to be effective; and 
(H) the extent to which a grantee, when 
possible, must have a control group. 
(2) PUBLIC
DISCLOSURE
OF
RESULTS.—The 
Director of the NMHPL— 
(A) shall make the standards under para-
graph (1), and the Director’s findings on com-
pliance by the Assistant Secretary and grantees 
with such standards, available to the public in 
a timely fashion; and 
(B) may establish requirements for States 
and other entities receiving funds through 
grants under programs established or amended 
by this Act and under other mental health pro-
grams under the Public Health Service Act, in-
cluding under a block grant under part B of 
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title XIX of the Public Health Service Act (42 
U.S.C. 300x et seq.), to collect information on 
evidence-based best practices and services deliv-
ery models selected under section 101(c)(2), as 
the Assistant Secretary determines necessary to 
monitor and evaluate such models. 
(c) STAFFING.— 
(1) COMPOSITION.—In selecting the staff of the 
NMHPL, the Director of the NMHPL, in consulta-
tion with the Director of the National Institute of 
Mental Health, shall ensure the following: 
(A) At least 20 percent of the staff shall— 
(i) have a doctoral degree in medicine 
or osteopathic medicine and clinical and re-
search experience in psychiatry; 
(ii) have graduated from an Accredi-
tation Council for Graduate Medical Edu-
cation-accredited psychiatric residency pro-
gram; and 
(iii) have an understanding of biologi-
cal, 
psychosocial, 
and 
pharmaceutical 
treatments of mental illness and substance 
use disorders. 
(B) At least 20 percent of the staff shall 
have a doctoral degree in psychology with— 
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(i) clinical and research experience re-
garding mental illness and substance use 
disorders; and 
(ii) an understanding of biological, 
psychosocial, and pharmaceutical treat-
ments of mental illness and substance use 
disorders. 
(C) At least 20 percent of the staff shall 
be professionals or academics with clinical or 
research expertise in substance use disorders 
and treatment. 
(D) At least 20 percent of the staff shall 
be professionals or academics with expertise in 
research design and methodologies. 
(2) CONGRESSIONAL APPOINTMENTS.—At least 
20 percent, or two, whichever is greater, of the 
members of the staff of the NMHPL shall be ap-
pointed by Congress. 
(d) REPORT ON QUALITY OF CARE.—Not later than 
1 year after the date of enactment of this Act, and every 
2 years thereafter, the Director of the NMHPL shall sub-
mit to the Congress a report on the quality of care fur-
nished through grant programs administered by the As-
sistant Secretary under the respective services delivery 
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models, including measurement of patient-level outcomes 
and public health outcomes such as— 
(1) reduced rates of suicide, suicide attempts, 
substance abuse, overdose, overdose deaths, emer-
gency psychiatric hospitalizations, emergency room 
boarding, incarceration, crime, arrest, victimization, 
homelessness, and joblessness; 
(2) rates of employment and enrollment in edu-
cational and vocational programs; and 
(3) such other criteria as the Director may de-
termine. 
(e) DEFINITION.—In this section, the term ‘‘emer-
gency room boarding’’ means the practice of admitting pa-
tients to an emergency department and holding them in 
the department until inpatient psychiatric beds become 
available. 
SEC. 202. INNOVATION GRANTS. 
(a) IN GENERAL.—The Assistant Secretary shall 
award grants to State and local governments, educational 
institutions, and nonprofit organizations for expanding a 
model that has been scientifically demonstrated to show 
promise, but would benefit from further applied research, 
for— 
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(1) enhancing the screening, diagnosis, and 
treatment of mental illness and serious mental ill-
ness; or 
(2) integrating or coordinating physical, mental 
health, and substance use services. 
(b) DURATION.—A grant under this section shall be 
for a period of not more than 2 years. 
(c) LIMITATIONS.—Of the amounts made available 
for carrying out this section for a fiscal year— 
(1) not more than one-third shall be awarded 
for use for primary prevention; and 
(2) not less than one-third shall be awarded for 
screening, diagnosis, treatment, or services, as de-
scribed in subsection (a), for individuals (or sub-
populations of individuals) who are below the age of 
18 when activities funded through the grant award 
are initiated. 
(d) GUIDELINES.—As a condition on receipt of an 
award under this section, an applicant shall agree to ad-
here to guidelines issued by the National Mental Health 
Policy Laboratory on research designs and data collection. 
(e) TERMINATION.—The Assistant Secretary may 
terminate any award under this section upon a determina-
tion that— 
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(1) the recipient is not providing information 
requested by the National Mental Health Policy 
Laboratory or the Assistant Secretary in connection 
with the award; or 
(2) there is a clear failure in the effectiveness 
of the recipient’s programs or activities funded 
through the award. 
(f) REPORTING.—As a condition on receipt of an 
award under this section, an applicant shall agree— 
(1) to report to the National Mental Health 
Policy Laboratory and the Assistant Secretary the 
results of programs and activities funded through 
the award; and 
(2) to include in such reporting any relevant 
data requested by the National Mental Health Policy 
Laboratory and the Assistant Secretary. 
(g) DEFINITION.—In this section, the term ‘‘primary 
prevention’’ means prevention that is designed to prevent 
a disease or condition from occurring among the general 
population without regard to identifying the presence of 
risk factors or symptoms in the population. 
(h) FUNDING.—Of the amounts made available to 
carry out sections 501, 509, 516, and 520A of the Public 
Health Service Act for a fiscal year, 5 percent of such 
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amounts are authorized to be used to carry out this sec-
tion. 
SEC. 203. DEMONSTRATION GRANTS. 
(a) GRANTS.—The Assistant Secretary shall award 
grants to States, counties, local governments, educational 
institutions, and private nonprofit organizations for the 
expansion, replication, or scaling of evidence-based pro-
grams across a wider area to enhance effective screening, 
early diagnosis, intervention, and treatment with respect 
to mental illness and serious mental illness, primarily by— 
(1) applied delivery of care, including training 
staff in effective evidence-based treatment; and 
(2) integrating models of care across specialties 
and jurisdictions. 
(b) DURATION.—A grant under this section shall be 
for a period of not less than 2 years and not more than 
5 years. 
(c) LIMITATIONS.—Of the amounts made available 
for carrying out this section for a fiscal year— 
(1) not less than half shall be awarded for 
screening, diagnosis, intervention, and treatment, as 
described in subsection (a), for individuals (or sub-
populations of individuals) who are below the age of 
26 when activities funded through the grant award 
are initiated; 
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(2) no amounts shall be made available for any 
program or project that is not evidence-based; 
(3) no amounts shall be made available for pri-
mary prevention; and 
(4) no amounts shall be made available solely 
for the purpose of expanding facilities or increasing 
staff at an existing program. 
(d) GUIDELINES.—As a condition on receipt of an 
award under this section, an applicant shall agree to ad-
here to guidelines issued by the National Mental Health 
Policy Laboratory on research designs and data collection. 
(e) TERMINATION.—The Assistant Secretary may 
terminate any award under this section upon a determina-
tion that— 
(1) the recipient is not providing information 
requested by the National Mental Health Policy 
Laboratory or the Assistant Secretary in connection 
with the award; or 
(2) there is a clear failure in the effectiveness 
of the recipient’s programs or activities funded 
through the award. 
(f) REPORTING.—As a condition on receipt of an 
award under this section, an applicant shall agree— 
(1) to report to the National Mental Health 
Policy Laboratory and the Assistant Secretary the 
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results of programs and activities funded through 
the award; and 
(2) to include in such reporting any relevant 
data requested by the National Mental Health Policy 
Laboratory and the Assistant Secretary. 
(g) FUNDING.—Of the amounts made available to 
carry out sections 501, 509, 516, and 520A of the Public 
Health Service Act for a fiscal year, 10 percent of such 
amounts are authorized to be used to carry out this sec-
tion. 
SEC. 204. EARLY CHILDHOOD INTERVENTION AND TREAT-
MENT. 
(a) GRANTS.—The Director of the National Mental 
Health Policy Laboratory (in this section referred to as 
the ‘‘NMHPL’’) shall award— 
(1) grants to eligible entities to initiate and un-
dertake, for eligible children, early childhood inter-
vention and treatment programs, and specialized 
preschool and elementary school programs, with the 
goal of preventing chronic and serious mental illness; 
(2) grants to not more than 3 eligible entities 
for studying the longitudinal outcomes of programs 
funded under paragraph (1) on eligible children who 
were treated 5 or more years prior to the enactment 
of this Act; and 
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(3) ensure that programs and activities funded 
through grants under this subsection are based on 
a sound scientific model that shows evidence and 
promise and can be replicated in other settings. 
(b) ELIGIBLE ENTITIES AND CHILDREN.—In this 
section: 
(1) ELIGIBLE ENTITY.—The term ‘‘eligible enti-
ty’’ means a nonprofit institution that— 
(A) is duly accredited by State mental 
health and education agencies, as applicable, for 
the treatment and education of children from 1 
to 10 years of age; and 
(B) provides services that include early 
childhood intervention and specialized preschool 
and elementary school programs focused on 
children whose primary need is a social or emo-
tional disability (in addition to any learning dis-
ability). 
(2) ELIGIBLE
CHILD.—The term ‘‘eligible 
child’’ means a child who is at least 0 years old and 
not more than 12 years old— 
(A) whose primary need is a social and 
emotional disability (in addition to any learning 
disability); 
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(B) who is at risk of developing serious 
mental illness and/or may show early signs of 
mental illness; and 
(C) who could benefit from early childhood 
intervention and specialized preschool or ele-
mentary school programs with the goal of pre-
venting or treating chronic and serious mental 
illness. 
(c) APPLICATION.—An eligible entity seeking a grant 
under subsection (a) shall submit to the Secretary an ap-
plication at such time, in such manner, and containing 
such information as the Secretary may require. 
(d) USE OF FUNDS FOR EARLY CHILDHOOD INTER-
VENTION AND TREATMENT PROGRAMS.—An eligible enti-
ty shall use amounts awarded under a grant under sub-
section (a)(1) to carry out the following activities: 
(1) Deliver (or facilitate) for eligible children 
treatment and education, early childhood interven-
tion, and specialized preschool and elementary school 
programs, including the provision of medically based 
child care and early education services. 
(2) Treat and educate eligible children, includ-
ing startup, curricula development, operating and 
capital needs, staff and equipment, assessment and 
intervention services, administration and medication 
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requirements, enrollment costs, collaboration with 
primary care physicians and psychiatrists, other re-
lated services to meet emergency needs of children, 
and communication with families and medical pro-
fessionals concerning the children. 
(3) Develop and implement other strategies to 
address identified treatment and educational needs 
of eligible children that have reliable and valid eval-
uation modalities built into assess outcomes based 
on sound scientific metrics as determined by the 
NMHPL. 
(e) USE OF FUNDS FOR LONGITUDINAL STUDY.—In 
conducting a study on longitudinal outcomes through a 
grant under subsection (a)(2), an eligible entity shall in-
clude an analysis of— 
(1) the individuals treated and educated; 
(2) the success of such treatment and education 
in avoiding the onset of serious mental illness or the 
preparation of such children for the care and man-
agement of serious mental illness; 
(3) any evidence-based best practices generally 
applicable as a result of such treatment and edu-
cational techniques used with such children; and 
(4) the ability of programs to be replicated as 
a best practice model of intervention. 
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(f) REQUIREMENTS.—In carrying out this section, 
the Secretary shall ensure that each entity receiving a 
grant under subsection (a) maintains a written agreement 
with the Secretary, and provides regular written reports, 
as required by the Secretary, regarding the quality, effi-
ciency, and effectiveness of intervention and treatment for 
eligible children preventing or treating the development 
and onset of serious mental illness. 
(g) AMOUNT OF AWARDS.— 
(1) AMOUNTS FOR EARLY CHILDHOOD INTER-
VENTION
AND
TREATMENT
PROGRAMS.—The 
amount of an award to an eligible entity under sub-
section (a)(1) shall be not more than $600,000 per 
fiscal year. 
(2) AMOUNTS
FOR
LONGITUDINAL
STUDY.— 
The total amount of an award to an eligible entity 
under subsection (a)(2) (for one or more fiscal 
years) shall be not less than $1,000,000 and not 
greater than $2,000,000. 
(h) PROJECT TERMS.—The period of a grant— 
(1) for awards under subsection (a)(1), shall be 
not less than 3 fiscal years and not more than 10 
fiscal years; and 
(2) for awards under subsection (a)(2), shall be 
not more than 5 fiscal years. 
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(i) MATCHING
FUNDS.—The Director of the 
NMHPL may not award a grant under this section to an 
eligible entity unless the eligible entity agrees, with respect 
to the costs to be incurred by the eligible entity in carrying 
out the activities described in subparagraph (D), to make 
available non-Federal contributions (in cash or in kind) 
toward such costs in an amount equal to not less than 
10 percent of Federal funds provided in the grant. 
(j) DEFINITIONS.—In this section: 
(1) The term ‘‘emergency room boarding’’ 
means the practice of admitting patients to an emer-
gency department and holding them in the depart-
ment until inpatient psychiatric beds become avail-
able. 
(2) The term ‘‘primary prevention’’ means pre-
vention that is designed to prevent a disease or con-
dition from occurring among the general population 
without regard to identifying the presence of risk 
factors or symptoms in the population. 
(k) FUNDING.—Of the amounts made available to 
carry out part E of title V of the Public Health Service 
Act (42 U.S.C. 290ff et seq.) for each of fiscal years 2016 
through 2021, not more than 5 percent of such amounts 
are authorized to be appropriated to carry out this section. 
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SEC. 205. EXTENSION OF ASSISTED OUTPATIENT TREAT-
MENT GRANT PROGRAM FOR INDIVIDUALS 
WITH SERIOUS MENTAL ILLNESS. 
Section 224 of the Protecting Access to Medicare Act 
of 2014 (42 U.S.C. 290aa note) is amended— 
(1) in subsection (e), by striking ‘‘and 2018’’ 
and inserting ‘‘2018, 2019, and 2020’’; and 
(2) in subsection (g)— 
(A) in paragraph (1), by striking ‘‘2018’’ 
and inserting ‘‘2020’’; 
(B) in paragraph (2)— 
(i) by striking ‘‘$15,000,000’’ and in-
serting ‘‘$20,000,000’’; and 
(ii) by striking ‘‘2018’’ and inserting 
‘‘2020’’; and 
(C) by adding at the end the following: 
‘‘(3) ALLOCATION.—Of the funds made avail-
able to carry out this section for a fiscal year, the 
Secretary shall allocate— 
‘‘(A) 20 percent of such funds for existing 
assisted outpatient treatment programs; and 
‘‘(B) 80 percent of such funds for new as-
sisted outpatient treatment programs.’’. 
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SEC. 206. BLOCK GRANTS. 
(a) BEST PRACTICES IN CLINICAL CARE MODELS.— 
Section 1920 of the Public Health Service Act (42 U.S.C. 
300x–9) is amended by adding at the end the following: 
‘‘(c) BEST PRACTICES
IN CLINICAL CARE MOD-
ELS.—The Secretary, acting through the Director of the 
National Institute of Mental Health, shall obligate 5 per-
cent of the amounts appropriated for a fiscal year under 
subsection (a) for translating evidence-based (as defined 
in section 2 of the Helping Families in Mental Health Cri-
sis Act of 2015) interventions and best available science 
into systems of care, such as through models including— 
‘‘(1) the Recovery After an Initial Schizo-
phrenia Episode research project of the National In-
stitute of Mental Health; and 
‘‘(2) the North American Prodrome Longitu-
dinal Study.’’. 
(b) ADMINISTRATION OF BLOCK GRANTS BY ASSIST-
ANT SECRETARY.—Section 1911(a) of the Public Health 
Service Act (42 U.S.C. 300x) is amended by striking ‘‘act-
ing through the Director of the Center for Mental Health 
Services’’ and inserting ‘‘acting through the Assistant Sec-
retary for Mental Health and Substance Use Disorders’’. 
(c) ADDITIONAL PROGRAM REQUIREMENTS.— 
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(1) INTEGRATED SERVICES.—Subsection (b)(1) 
of section 1912 of the Public Health Service Act (42 
U.S.C. 300x–1(b)(1)) is amended— 
(A) by striking ‘‘The plan provides’’ and 
inserting: 
‘‘(A) The plan provides’’; 
(B) in the subparagraph (A) inserted by 
paragraph (1), in the second sentence, by strik-
ing ‘‘health and mental health services’’ and in-
serting ‘‘integrated physical and mental health 
services’’; 
(C) in such subparagraph (A), by striking 
‘‘The plan shall include’’ through the period at 
the end and inserting ‘‘The plan shall integrate 
and coordinate services to maximize the effi-
ciency, effectiveness, quality, coordination, and 
cost effectiveness of those services and pro-
grams to produce the best possible outcomes for 
those with serious mental illness.’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(B) The plan shall include a separate de-
scription of case management services and pro-
vide for activities leading to reduction of rates 
of suicides, suicide attempts, substance abuse, 
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overdose deaths, emergency hospitalizations, in-
carceration, crimes, arrest, victimization, home-
lessness, joblessness, medication nonadherence, 
and education and vocational programs drop 
outs. The plan must also include a detailed list 
of services available for eligible patients (as de-
fined in subsection (d)(3)) in each county or 
county equivalent, including assisted outpatient 
treatment.’’. 
(2) DATA
COLLECTION
SYSTEM.—Subsection 
(b)(2) of section 1912 of the Public Health Service 
Act (42 U.S.C. 300x–1(b)(2)) is amended— 
(A) by striking ‘‘The plan contains an esti-
mate of’’ and inserting the following: ‘‘The plan 
contains— 
‘‘(A) an estimate of’’; 
(B) in subparagraph (A), as inserted by 
paragraph (1), by inserting ‘‘, including reduc-
tions in homelessness, emergency hospitaliza-
tion, incarceration, and unemployment for eligi-
ble patients (as defined in subsection (d)(3)),’’ 
after ‘‘targets’’; 
(C) in such subparagraph, by striking the 
period at the end and inserting ‘‘; and’’; and 
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(D) by adding at the end the following new 
subparagraph: 
‘‘(B) an agreement by the State to report 
to the National Mental Health Policy Labora-
tory such data as may be required by the Sec-
retary concerning— 
‘‘(i) comprehensive community mental 
health services in the State; and 
‘‘(ii) public health outcomes for per-
sons with serious mental illness in the 
State, including rates of suicides, suicide 
attempts, 
substance 
abuse, 
overdose 
deaths, emergency hospitalizations, incar-
ceration, 
crimes, 
arrest, 
victimization, 
homelessness, joblessness, medication non- 
adherence, and education and vocational 
programs drop outs.’’. 
(3) IMPLEMENTATION
OF
PLAN.—Subsection 
(d) of section 1912 of the Public Health Service Act 
(42 U.S.C. 300x–1(d)) is amended— 
(A) in paragraph (1)— 
(i) by striking ‘‘Except as provided’’ 
and inserting: 
‘‘(A) Except as provided’’; and 
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(ii) by adding at the end the following 
new subparagraph: 
‘‘(B) For eligible patients receiving treat-
ment through funds awarded under a grant 
under section 1911, a State shall include in the 
State plan for the first year beginning after the 
date of the enactment of this subparagraph and 
each subsequent year, a de-individualized re-
port, containing information that is open source 
and de-identified, on the services provided to 
those individuals, including— 
‘‘(i) outcomes and the overall cost of 
such treatment provided; and 
‘‘(ii) county or county equivalent level 
data on such patient population, including 
overall costs and raw number data on rates 
of involuntary inpatient and outpatient 
commitment orders, suicides, suicide at-
tempts, substance abuse, overdose deaths, 
emergency hospitalizations, incarceration, 
crimes, arrest, victimization, homelessness, 
joblessness, medication non-adherence, and 
education and vocational programs drop 
outs.’’; and 
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(B) by adding at the end the following new 
paragraph: 
‘‘(3) DEFINITION.—In this subsection, the term 
‘eligible patient’ means an adult mentally ill person 
who— 
‘‘(A) may have a history of violence, incar-
ceration, or medically unnecessary hospitaliza-
tions; 
‘‘(B) without supervision and treatment, 
may be a danger to self or others in the com-
munity; 
‘‘(C) is substantially unlikely to voluntarily 
participate in treatment; 
‘‘(D) may be unable, for reasons other 
than indigence, to provide for any of the basic 
needs of such person, such as food, clothing, 
shelter, health, or safety; 
‘‘(E) with a history of mental illness or 
condition that is likely to substantially deterio-
rate if the person is not provided with timely 
treatment; 
‘‘(F) due to mental illness, lacks capacity 
to fully understand or lacks judgment to make 
informed decisions regarding his or her need for 
treatment, care, or supervision; and 
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‘‘(G) is likely to improve in mental health 
and reduce the symptoms of serious mental ill-
ness when in treatment.’’. 
(4) TREATMENT UNDER STATE LAW.— 
(A) IN
GENERAL.—Section 1912 of the 
Public Health Service Act (42 U.S.C. 300x–1) 
is amended by adding at the end the following 
new subsections: 
‘‘(e) ASSISTED OUTPATIENT TREATMENT UNDER 
STATE LAW.— 
‘‘(1) IN GENERAL.—A funding agreement for a 
grant under section 1911 is that the State involved 
has in effect a law under which a State court may 
order a treatment plan for an eligible patient that— 
‘‘(A) requires such patient to obtain out-
patient mental health treatment while the pa-
tient is living in a community; and 
‘‘(B) is designed to improve access and ad-
herence by such patient to intensive behavioral 
health services in order to— 
‘‘(i) avert relapse, repeated hos-
pitalizations, arrest, incarceration, suicide, 
property destruction, and violent behavior; 
and 
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‘‘(ii) provide such patient with the op-
portunity to live in a less restrictive alter-
native to incarceration or involuntary hos-
pitalization. 
‘‘(2) CERTIFICATION OF STATE COMPLIANCE.— 
A funding agreement described in paragraph (1) is 
effective only if the Assistant Secretary for Mental 
Health and Substance Use Disorders reviews the 
State law and certifies that it satisfies the criteria 
specified in such paragraph. 
‘‘(f) TREATMENT STANDARD UNDER STATE LAW.— 
‘‘(1) IN GENERAL.—A funding agreement for a 
grant under section 1911 is that— 
‘‘(A) the State involved has in effect a law 
under which, if a State court finds by clear and 
convincing evidence that an individual, as a re-
sult of mental illness, is a danger to self, is a 
danger to others, is persistently or acutely dis-
abled, or is gravely disabled and in need of 
treatment, and is either unwilling or unable to 
accept voluntary treatment, the court must 
order the individual to undergo inpatient or 
outpatient treatment; or 
‘‘(B) the State involved has in effect a law 
under which a State court must order an indi-
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vidual with a mental illness to undergo inpa-
tient or outpatient treatment, the law was in ef-
fect on the date of enactment of the Helping 
Families in Mental Health Crisis Act of 2015, 
and the Secretary finds that the law requires a 
State court to order such treatment across all 
or a sufficient range of the type of cir-
cumstances described in subparagraph (A). 
‘‘(2) DEFINITION.—For purposes of paragraph 
(1), the term ‘persistently or acutely disabled’ refers 
to a serious mental illness that meets all the fol-
lowing criteria: 
‘‘(A) If not treated, the illness has a sub-
stantial probability of causing the individual to 
suffer or continue to suffer severe and abnor-
mal mental, emotional, or physical harm that 
significantly impairs judgment, reason, behav-
ior, or capacity to recognize reality. 
‘‘(B) The illness substantially impairs the 
individual’s capacity to make an informed deci-
sion regarding treatment, and this impairment 
causes the individual to be incapable of under-
standing and expressing an understanding of 
the advantages and disadvantages of accepting 
treatment and understanding and expressing an 
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understanding of the alternatives to the par-
ticular treatment offered after the advantages, 
disadvantages, and alternatives are explained to 
that individual. 
‘‘(C) The illness has a reasonable prospect 
of being treatable by outpatient, inpatient, or 
combined inpatient and outpatient treatment.’’. 
(B) FUNDING INCREASE.—Section 1918 of 
the Public Health Service Act (42 U.S.C. 300x– 
7) is amended— 
(i) in subsection (a)(1), by striking 
‘‘subsection (b)’’ and inserting ‘‘sub-
sections (b) and (d)’’; and 
(ii) by adding at the end the following 
new subsection: 
‘‘(d) INCREASE FOR CERTAIN STATES.—With respect 
to fiscal year 2016 and each subsequent fiscal year, in the 
case of a State that has in effect a law described in sub-
section (e)(1) or subparagraph (A) or (B) of subsection 
(f)(1), the amount of the allotment of a State under sec-
tion 1911 shall be for such fiscal year the amount that 
would otherwise be determined, without application of this 
subsection, for such State for such fiscal year, increased 
by 2 percent.’’. 
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(5) 
EVIDENCE-BASED
SERVICES
DELIVERY 
MODELS.—Section 1912 of the Public Health Serv-
ice Act (42 U.S.C. 300x–1), as amended by para-
graph (4), is further amended by adding at the end 
the following new subsection: 
‘‘(g) EXPANSION OF MODELS.— 
‘‘(1) IN GENERAL.—Taking into account the re-
sults of evaluations under section 201(a)(2)(C) of 
the Helping Families in Mental Health Crisis Act of 
2015, the Assistant Secretary may, by rule, as part 
of the program of block grants under this subpart, 
provide for expanded use across the Nation of evi-
dence-based service delivery models by providers 
funded under such block grants, so long as— 
‘‘(A) the Assistant Secretary for Mental 
Health and Substance Use Disorders (in this 
subsection referred to as the ‘Assistant Sec-
retary’) determines that such expansion will— 
‘‘(i) result in more effective use of 
funds under such block grants without re-
ducing the quality of care; or 
‘‘(ii) improve the quality of patient 
care without significantly increasing spend-
ing; 
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‘‘(B) the Director of the National Institute 
of Mental Health determines that such expan-
sion would improve the quality of patient care; 
and 
‘‘(C) the Assistant Secretary determines 
that the change will— 
‘‘(i) significantly reduce severity and 
duration of symptoms of mental illness; 
‘‘(ii) reduce rates of suicide, suicide 
attempts, substance abuse, overdose, emer-
gency hospitalizations, emergency room 
boarding, incarceration, crime, arrest, vic-
timization, homelessness, or joblessness; or 
‘‘(iii) significantly improve the quality 
of patient care and mental health crisis 
outcomes without significantly increasing 
spending. 
‘‘(2) CONGRESSIONAL REVIEW.—Any rule pro-
mulgated pursuant to paragraph (1) is deemed to be 
a major rule subject to congressional review and dis-
approval under chapter 8 of title 5, United States 
Code. 
‘‘(3) DEFINITION.—In this subsection, the term 
‘emergency room boarding’ means the practice of ad-
mitting patients to an emergency department and 
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holding them in the department until inpatient psy-
chiatric beds become available.’’. 
(d) PERIOD FOR EXPENDITURE OF GRANT FUNDS.— 
Section 1913 of the Public Health Service Act (42 U.S.C. 
300x–2), as amended, is further amended by adding at 
the end the following: 
‘‘(d) 
PERIOD
FOR
EXPENDITURE
OF
GRANT 
FUNDS.—In implementing a plan submitted under section 
1912(a), a State receiving grant funds under section 1911 
may make such funds available to providers of services de-
scribed in subsection (b) for the provision of services with-
out fiscal year limitation.’’. 
(e) ACTIVE OUTREACH AND ENGAGEMENT.—Section 
1915 of the Public Health Service Act (42 U.S.C. 300x– 
4) is amended by adding at the end of the following: 
‘‘(c) ACTIVE OUTREACH AND ENGAGEMENT TO PER-
SONS WITH SERIOUS MENTAL ILLNESS.—A funding 
agreement for a grant under section 1911 is that the State 
involved has in effect active programs, including assisted 
outpatient treatment, to engage persons with serious men-
tal illness who are substantially unlikely to voluntarily 
seek treatment, in comprehensive services in order to avert 
relapse, repeated hospitalizations, arrest, incarceration, 
and suicide to provide the patient with the opportunity 
to live in the community through evidence-based (as de-
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fined in section 2 of the Helping Families in Mental 
Health Crisis Act of 2015) assertive outreach and engage-
ment services targeting individuals that are homeless, have 
co-occurring disorders, or have a history of treatment fail-
ure. The Assistant Secretary for Mental Health and Sub-
stance Use Disorders shall work with the Director of the 
National Institute of Mental Health to develop a list of 
such evidence-based (as defined in section 2 of the Helping 
Families in Mental Health Crisis Act of 2015) assertive 
outreach and engagement services, as well as criteria to 
be used to assess the scope and effectiveness of such ap-
proaches. These programs may include assistant out-
patient treatment programs under State law where State 
courts may order a treatment plan for an eligible patient 
that requires— 
‘‘(1) such patient to obtain outpatient mental 
health treatment while the patient is living in the 
community; and 
‘‘(2) a design to improve access and adherence 
by such patient to intensive mental health services.’’. 
SEC. 207. WORKFORCE DEVELOPMENT. 
(a) TELEPSYCHIATRY AND PRIMARY CARE PHYSI-
CIAN TRAINING GRANT PROGRAM.— 
(1) IN GENERAL.—The Assistant Secretary of 
Mental Health and Substance Use Disorders (in this 
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subsection referred to as the ‘‘Assistant Secretary’’) 
shall establish a grant program (in this subsection 
referred to as the ‘‘grant program’’) under which the 
Assistant Secretary shall award to 10 eligible States 
(as described in paragraph (5)) grants for carrying 
out all of the purposes described in paragraphs (2), 
(3), and (4). 
(2) TRAINING PROGRAM FOR CERTAIN PRIMARY 
CARE PHYSICIANS.—For purposes of paragraph (1), 
the purpose described in this paragraph, with re-
spect to a grant awarded to a State under the grant 
program, is for the State to establish a training pro-
gram to train primary care physicians in— 
(A) valid and reliable behavioral-health 
screening tools for violence and suicide risk, 
early signs of serious mental illness, and un-
treated substance abuse, including any stand-
ardized behavioral-health screening tools that 
are determined appropriate by the Assistant 
Secretary; 
(B) implementing the use of behavioral- 
health screening tools in their practices; 
(C) establishment of recommended inter-
vention and treatment protocols for individuals 
in mental health crisis, especially for individuals 
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whose illness makes them less receptive to men-
tal health services; and 
(D) implementing the evidence-based col-
laborative care model of integrated medical-be-
havioral health care in their practices. 
(3) PAYMENTS FOR MENTAL HEALTH SERVICES 
PROVIDED
BY
CERTAIN
PRIMARY
CARE
PHYSI-
CIANS.— 
(A) IN GENERAL.—For purposes of para-
graph (1), the purpose described in this para-
graph, with respect to a grant awarded to a 
State under the grant program, is for the State 
to provide, in accordance with this paragraph, 
in the case of a primary care physician who 
participates in the training program of the 
State establish pursuant to paragraph (2), pay-
ments to the primary care physician for services 
furnished by the primary care physician. 
(B) 
CONSIDERATIONS.—The 
Assistant 
Secretary, in determining the structure, quality, 
and form of payment under subparagraph (A) 
shall seek to find innovative payment systems 
which may take into account— 
(i) the nature and quality of services 
rendered; 
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(ii) the patients’ health outcome; 
(iii) the geographical location where 
services were provided; 
(iv) the acuteness of the patient’s 
medical condition; 
(v) the duration of services provided; 
(vi) the feasibility of replicating the 
payment model in other locations nation-
wide; and 
(vii) proper triage and enduring link-
age to appropriate treatment provider for 
subspecialty care in child or forensic 
issues; family crisis intervention; drug or 
alcohol rehabilitation; management of sui-
cidal or violent behavior risk, and treat-
ment for serious mental illness. 
(4) TELEHEALTH
SERVICES
FOR
MENTAL 
HEALTH DISORDERS.— 
(A) IN GENERAL.—For purposes of para-
graph (1), the purpose described in this para-
graph, with respect to a grant awarded to a 
State under the grant program, is for the State 
to provide, in the case of an individual fur-
nished items and services by a primary care 
physician during an office visit, for payment for 
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a consultation provided by a psychiatrist or psy-
chologist to such physician with respect to such 
individual through the use of qualified tele-
health technology for the identification, diag-
nosis, mitigation, or treatment of a mental 
health disorder if such consultation occurs not 
later than the first business day that follows 
such visit. 
(B) 
QUALIFIED
TELEHEALTH
TECH-
NOLOGY.—For purposes of subparagraph (A), 
the term ‘‘qualified telehealth technology’’, with 
respect to the provision of items and services to 
a patient by a health care provider, includes the 
use of interactive audio, audio-only telephone 
conversation, video, or other telecommuni-
cations technology by a health care provider to 
deliver health care services within the scope of 
the provider’s practice at a site other than the 
site where the patient is located, including the 
use of electronic media for consultation relating 
to the health care diagnosis or treatment of the 
patient. 
(5) ELIGIBLE STATE.— 
(A) IN GENERAL.—For purposes of this 
subsection, an eligible State is a State that has 
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submitted to the Assistant Secretary an appli-
cation under subparagraph (B) and has been 
selected under subparagraph (D). 
(B) APPLICATION.—A State seeking to 
participate in the grant program under this 
subsection shall submit to the Assistant Sec-
retary, at such time and in such format as the 
Assistant Secretary requires, an application 
that includes such information, provisions, and 
assurances as the Assistant Secretary may re-
quire. 
(C) MATCHING
REQUIREMENT.—The As-
sistant Secretary may not make a grant under 
the grant program unless the State involved 
agrees, with respect to the costs to be incurred 
by the State in carrying out the purposes de-
scribed in this subsection, to make available 
non-Federal contributions (in cash or in kind) 
toward such costs in an amount equal to not 
less than 20 percent of Federal funds provided 
in the grant. 
(D) SELECTION.—A State shall be deter-
mined eligible for the grant program by the As-
sistant Secretary on a competitive basis among 
States with applications meeting the require-
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ments of subparagraphs (B) and (C). In select-
ing State applications for the grant program, 
the Secretary shall seek to achieve an appro-
priate national balance in the geographic dis-
tribution of grants awarded under the grant 
program. 
(6) TARGET POPULATION.—In seeking a grant 
under this subsection, a State shall demonstrate how 
the grant will improve care for individuals with co- 
occurring behavioral health and physical health con-
ditions, vulnerable populations, socially isolated pop-
ulations, rural populations, and other populations 
who have limited access to qualified mental health 
providers. 
(7) LENGTH OF GRANT PROGRAM.—The grant 
program under this subsection shall be conducted for 
a period of 3 consecutive years. 
(8) PUBLIC
AVAILABILITY
OF
FINDINGS
AND 
CONCLUSIONS.—Subject to Federal privacy protec-
tions with respect to individually identifiable infor-
mation, the Assistant Secretary shall make the find-
ings and conclusions resulting from the grant pro-
gram under this subsection available to the public. 
(9) AUTHORIZATION OF APPROPRIATIONS.—Out 
of any funds in the Treasury not otherwise appro-
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priated, there is authorized to be appropriated to 
carry out this subsection, $3,000,000 for each of the 
fiscal years 2016 through 2020. 
(10) REPORTS.— 
(A) REPORTS.—For each fiscal year that 
grants are awarded under this subsection, the 
Assistant Secretary and the National Mental 
Health Policy Laboratory shall conduct a study 
on the results of the grants and submit to the 
Congress a report on such results that includes 
the following: 
(i) An evaluation of the grant pro-
gram outcomes, including a summary of 
activities carried out with the grant and 
the results achieved through those activi-
ties. 
(ii) Recommendations on how to im-
prove access to mental health services at 
grantee locations. 
(iii) An assessment of access to men-
tal health services under the program. 
(iv) An assessment of the impact of 
the demonstration project on the costs of 
the full range of mental health services (in-
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cluding inpatient, emergency and ambula-
tory care). 
(v) Recommendations on congres-
sional action to improve the grant. 
(vi) Recommendations to improve 
training of primary care physicians. 
(B) REPORT.—Not later than December 
31, 2018, the Assistant Secretary and the Na-
tional Mental Health Policy Laboratory shall 
submit to Congress and make available to the 
public a report on the findings of the evaluation 
under subparagraph (A) and also a policy out-
line on how Congress can expand the grant pro-
gram to the national level. 
(b) LIABILITY PROTECTIONS
FOR HEALTH CARE 
PROFESSIONAL VOLUNTEERS AT COMMUNITY HEALTH 
CENTERS AND FEDERALLY QUALIFIED COMMUNITY BE-
HAVIORAL HEALTH CLINICS.—Section 224 of the Public 
Health Service Act (42 U.S.C. 233) is amended by adding 
at the end the following: 
‘‘(q)(1) In this subsection, the term ‘federally quali-
fied community behavioral health clinic’ means— 
‘‘(A) a federally qualified community behavioral 
health clinic with a certification in effect under sec-
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tion 223 of the Protecting Access to Medicare Act 
of 2014; or 
‘‘(B) a community mental health center meeting 
the criteria specified in section 1913(c) of this Act. 
‘‘(2) For purposes of this section, a health care pro-
fessional volunteer at an entity described in subsection 
(g)(4) or a federally qualified community behavioral health 
clinic shall, in providing health care services eligible for 
funding under section 330 or subpart I of part B of title 
XIX to an individual, be deemed to be an employee of the 
Public Health Service for a calendar year that begins dur-
ing a fiscal year for which a transfer was made under 
paragraph (5)(C). The preceding sentence is subject to the 
provisions of this subsection. 
‘‘(3) In providing a health care service to an indi-
vidual, a health care professional shall for purposes of this 
subsection be considered to be a health professional volun-
teer at an entity described in subsection (g)(4) or at a 
federally qualified community behavioral health clinic if 
the following conditions are met: 
‘‘(A) The service is provided to the individual at 
the facilities of an entity described in subsection 
(g)(4), at a federally qualified community behavioral 
health clinic, or through offsite programs or events 
carried out by the center. 
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‘‘(B) The center or entity is sponsoring the 
health care professional volunteer pursuant to para-
graph (4)(B). 
‘‘(C) The health care professional does not re-
ceive any compensation for the service from the indi-
vidual or from any third-party payer (including re-
imbursement under any insurance policy or health 
plan, or under any Federal or State health benefits 
program), except that the health care professional 
may receive repayment from the entity described in 
subsection (g)(4) or the center for reasonable ex-
penses incurred by the health care professional in 
the provision of the service to the individual. 
‘‘(D) Before the service is provided, the health 
care professional or the center or entity described in 
subsection (g)(4) posts a clear and conspicuous no-
tice at the site where the service is provided of the 
extent to which the legal liability of the health care 
professional is limited pursuant to this subsection. 
‘‘(E) At the time the service is provided, the 
health care professional is licensed or certified in ac-
cordance with applicable law regarding the provision 
of the service. 
‘‘(4) Subsection (g) (other than paragraphs (3) and 
(5)) and subsections (h), (i), and (l) apply to a health care 
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professional for purposes of this subsection to the same 
extent and in the same manner as such subsections apply 
to an officer, governing board member, employee, or con-
tractor of an entity described in subsection (g)(4), subject 
to paragraph (5) and subject to the following: 
‘‘(A) The first sentence of paragraph (2) ap-
plies in lieu of the first sentence of subsection 
(g)(1)(A). 
‘‘(B) With respect to an entity described in sub-
section (g)(4) or a federally qualified community be-
havioral health clinic, a health care professional is 
not a health professional volunteer at such center 
unless the center sponsors the health care profes-
sional. For purposes of this subsection, the center 
shall be considered to be sponsoring the health care 
professional if— 
‘‘(i) with respect to the health care profes-
sional, the center submits to the Secretary an 
application meeting the requirements of sub-
section (g)(1)(D); and 
‘‘(ii) the Secretary, pursuant to subsection 
(g)(1)(E), determines that the health care pro-
fessional is deemed to be an employee of the 
Public Health Service. 
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‘‘(C) In the case of a health care professional 
who is determined by the Secretary pursuant to sub-
section (g)(1)(E) to be a health professional volun-
teer at such center, this subsection applies to the 
health care professional (with respect to services de-
scribed in paragraph (2)) for any cause of action 
arising from an act or omission of the health care 
professional occurring on or after the date on which 
the Secretary makes such determination. 
‘‘(D) Subsection (g)(1)(F) applies to a health 
professional volunteer for purposes of this subsection 
only to the extent that, in providing health services 
to an individual, each of the conditions specified in 
paragraph (3) is met. 
‘‘(5)(A) Amounts in the fund established under sub-
section (k)(2) shall be available for transfer under sub-
paragraph (C) for purposes of carrying out this subsection 
for health professional volunteers at entities described in 
subsection (g)(4). 
‘‘(B) Not later than May 1 of each fiscal year, the 
Attorney General, in consultation with the Secretary, shall 
submit to the Congress a report providing an estimate of 
the amount of claims (together with related fees and ex-
penses of witnesses) that, by reason of the acts or omis-
sions of health care professional volunteers, will be paid 
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pursuant to this subsection during the calendar year that 
begins in the following fiscal year. Subsection (k)(1)(B) 
applies to the estimate under the preceding sentence re-
garding health care professional volunteers to the same 
extent and in the same manner as such subsection applies 
to the estimate under such subsection regarding officers, 
governing board members, employees, and contractors of 
entities described in subsection (g)(4). 
‘‘(C) Not later than December 31 of each fiscal year, 
the Secretary shall transfer from the fund under sub-
section (k)(2) to the appropriate accounts in the Treasury 
an amount equal to the estimate made under subpara-
graph (B) for the calendar year beginning in such fiscal 
year, subject to the extent of amounts in the fund. 
‘‘(6)(A) This subsection takes effect on October 1, 
2017, except as provided in subparagraph (B). 
‘‘(B) Effective on the date of the enactment of this 
subsection— 
‘‘(i) the Secretary may issue regulations for car-
rying out this subsection, and the Secretary may ac-
cept and consider applications submitted pursuant to 
paragraph (4)(B); and 
‘‘(ii) reports under paragraph (5)(B) may be 
submitted to the Congress.’’. 
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(c) MINORITY FELLOWSHIP PROGRAM.—Title V of 
the Public Health Service Act (42 U.S.C. 290aa et seq.), 
as amended, is further amended by adding at the end the 
following: 
‘‘PART K—MINORITY FELLOWSHIP PROGRAM 
‘‘SEC. 597. FELLOWSHIPS. 
‘‘(a) IN GENERAL.—The Secretary shall maintain a 
program, to be known as the Minority Fellowship Pro-
gram, under which the Secretary awards fellowships, 
which may include stipends, for the purposes of— 
‘‘(1) increasing behavioral health practitioners’ 
knowledge of issues related to prevention, treatment, 
and recovery support for mental and substance use 
disorders among racial and ethnic minority popu-
lations; 
‘‘(2) improving the quality of mental and sub-
stance use disorder prevention and treatment deliv-
ered to ethnic minorities; and 
‘‘(3) increasing the number of culturally com-
petent behavioral health professionals who teach, ad-
minister, conduct services research, and provide di-
rect mental health or substance use services to un-
derserved minority populations. 
‘‘(b) TRAINING COVERED.—The fellowships under 
subsection (a) shall be for postbaccalaureate training (in-
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cluding for master’s and doctoral degrees) for mental 
health professionals, including in the fields of psychiatry, 
nursing, social work, psychology, marriage and family 
therapy, and substance use and addiction counseling. 
‘‘(c) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $6,000,000 for each of fiscal years 2016 through 
2020.’’. 
(d) NATIONAL HEALTH SERVICE CORPS.— 
(1) DEFINITIONS.— 
(A) PRIMARY HEALTH SERVICES.—Section 
331(a)(3)(D) of the Public Health Service Act 
(42 U.S.C. 254d(a)(3)) is amended by inserting 
‘‘(including pediatric mental health subspecialty 
services)’’ after ‘‘pediatrics’’. 
(B) BEHAVIORAL
AND
MENTAL
HEALTH 
PROFESSIONALS.—Clause 
(i) 
of 
section 
331(a)(3)(E)(i) of the Public Health Service 
Act (42 U.S.C. 254d(a)(3)(E)(i)) is amended 
by inserting ‘‘(and pediatric subspecialists 
thereof)’’ before the period at the end. 
(C) HEALTH
PROFESSIONAL
SHORTAGE 
AREA.—Section 332(a)(1) of the Public Health 
Service Act is amended by inserting ‘‘(including 
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children and adolescents)’’ after ‘‘population 
group’’. 
(D) 
MEDICAL
FACILITY.—Section 
332(a)(2)(A) of the Public Health Service Act 
is amended by inserting ‘‘medical residency or 
fellowship training site for training in child and 
adolescent psychiatry,’’ before ‘‘facility operated 
by a city or county health department,’’. 
(2) ELIGIBILITY TO PARTICIPATE IN LOAN RE-
PAYMENT PROGRAM.—Section 338A(b)(1)(B) of the 
Public Health Service Act (42 U.S.C. 254l– 
1(b)(1)(B)) is amended by inserting ‘‘, including any 
physician child and adolescent psychiatry residency 
or fellowship training program’’ after ‘‘be enrolled in 
an approved graduate training program in medicine, 
osteopathic medicine, dentistry, behavioral and men-
tal health, or other health profession’’. 
(e) CRISIS INTERVENTION GRANTS FOR POLICE OF-
FICERS AND FIRST RESPONDERS.— 
(1) GRANTS.—The Assistant Secretary may 
award grants to provide specialized training to law 
enforcement officers, corrections officers, para-
medics, emergency medical services workers, and 
other first responders (including village public safety 
officers (as defined in section 247 of the Indian Arts 
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and Crafts Amendments Act of 2010 (42 U.S.C. 
3796dd note)))— 
(A) to recognize individuals who have men-
tal illness and how to properly intervene with 
individuals with mental illness; and 
(B) to establish programs that enhance the 
ability of law enforcement agencies to address 
the mental health, behavioral, and substance 
use problems of individuals encountered in the 
line of duty. 
(2) FUNDING.—Of the amounts made available 
to carry out sections 501, 509, 516, and 520A of the 
Public Health Service Act for a fiscal year, 5 per-
cent of such amounts are authorized to be used to 
carry out this subsection. 
SEC. 208. AUTHORIZED GRANTS AND PROGRAMS. 
(a) CHILDREN’S RECOVERY FROM TRAUMA.—Sec-
tion 582 of the Public Health Service Act (42 U.S.C. 
290hh–1) is amended— 
(1) in subsection (a), by striking ‘‘developing 
programs’’ and all that follows and inserting the fol-
lowing: ‘‘developing and maintaining programs that 
provide for— 
‘‘(1) the continued operation of the National 
Child Traumatic Stress Initiative (referred to in this 
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section as the ‘NCTSI’), which includes a coordi-
nating center, that focuses on the mental, behav-
ioral, and biological aspects of psychological trauma 
response; and 
‘‘(2) the development of knowledge with regard 
to evidence-based (as defined in section 2 of the 
Helping Families in Mental Health Crisis Act of 
2015) practices for identifying and treating mental, 
behavioral, and biological disorders of children and 
youth resulting from witnessing or experiencing a 
traumatic event.’’; 
(2) in subsection (b)— 
(A) by striking ‘‘subsection (a) related’’ 
and inserting ‘‘subsection (a)(2) (related’’; 
(B) by striking ‘‘treating disorders associ-
ated with psychological trauma’’ and inserting 
‘‘treating mental, behavioral, and biological dis-
orders associated with psychological trauma)’’; 
and 
(C) by striking ‘‘mental health agencies 
and programs that have established clinical and 
basic research’’ and inserting ‘‘universities, hos-
pitals, mental health agencies, and other pro-
grams that have established clinical expertise 
and research’’; 
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(3) by redesignating subsections (c) through (g) 
as subsections (g) through (k), respectively; 
(4) by inserting after subsection (b), the fol-
lowing: 
‘‘(c) CHILD OUTCOME DATA.—The NCTSI coordi-
nating center shall collect, analyze, and report NCTSI- 
wide child treatment process and outcome data regarding 
the early identification and delivery of evidence-based (as 
defined in section 2 of the Helping Families in Mental 
Health Crisis Act of 2015) treatment and services for chil-
dren and families served by the NCTSI grantees. 
‘‘(d) TRAINING.—The NCTSI coordinating center 
shall facilitate the coordination of training initiatives in 
evidence-based (as defined in section 2 of the Helping 
Families in Mental Health Crisis Act of 2015) and trau-
ma-informed treatments, interventions, and practices of-
fered to NCTSI grantees, providers, and partners. 
‘‘(e) DISSEMINATION.—The NCTSI coordinating 
center shall, as appropriate, collaborate with the Secretary 
in the dissemination of evidence-based and trauma-in-
formed interventions, treatments, products, and other re-
sources to appropriate stakeholders. 
‘‘(f) REVIEW.—The Secretary shall, consistent with 
the peer-review process, ensure that NCTSI applications 
are reviewed by appropriate experts in the field as part 
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of a consensus review process. The Secretary shall include 
review criteria related to expertise and experience in child 
trauma and evidence-based (as defined in section 2 of the 
Helping Families in Mental Health Crisis Act of 2015) 
practices.’’; 
(5) in subsection (g) (as so redesignated), by 
striking ‘‘with respect to centers of excellence are 
distributed equitably among the regions of the coun-
try’’ and inserting ‘‘are distributed equitably among 
the regions of the United States’’; 
(6) in subsection (i) (as so redesignated), by 
striking ‘‘recipient may not exceed 5 years’’ and in-
serting ‘‘recipient shall not be less than 4 years, but 
shall not exceed 5 years’’; and 
(7) in subsection (j) (as so redesignated), by 
striking ‘‘$50,000,000’’ and all that follows through 
‘‘2006’’ and inserting ‘‘$45,713,000 for each of fis-
cal years 2014 through 2018’’. 
(b) REDUCING THE STIGMA OF SERIOUS MENTAL 
ILLNESS.— 
(1) IN GENERAL.—The Secretary of Education, 
along with the Assistant Secretary for Mental 
Health and Substance Use Disorders, shall organize 
a national awareness campaign involving public 
health organizations, advocacy groups for persons 
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with serious mental illness, and social media compa-
nies to assist secondary school students and postsec-
ondary students in— 
(A) reducing the stigma associated with se-
rious mental illness; 
(B) understanding how to assist an indi-
vidual who is demonstrating signs of a serious 
mental illness; and 
(C) understanding the importance of seek-
ing treatment from a physician, clinical psychol-
ogist, or licensed mental health professional 
when a student believes the student may be suf-
fering from a serious mental illness or behav-
ioral health disorder. 
(2) DATA COLLECTION.—The Secretary of Edu-
cation shall— 
(A) evaluate the program under subsection 
(a) on public health to determine whether the 
program has made an impact on public health, 
including mortality rates of persons with seri-
ous mental illness, prevalence of serious mental 
illness, physician and clinical psychological vis-
its, emergency room visits; and 
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(B) submit a report on the evaluation to 
the National Mental Health Policy Laboratory 
created by title I of this Act. 
(3) SECONDARY SCHOOL DEFINED.—For pur-
poses of this section, the term ‘‘secondary school’’ 
has the meaning given the term in section 9101 of 
the Elementary and Secondary Education Act of 
1965 (20 U.S.C. 7801). 
(c) GARRETT LEE SMITH REAUTHORIZATION.— 
(1) SUICIDE PREVENTION TECHNICAL ASSIST-
ANCE CENTER.—Section 520C of the Public Health 
Service Act (42 U.S.C. 290bb–34) is amended to 
read as follows: 
‘‘SEC. 520C. SUICIDE PREVENTION TECHNICAL ASSISTANCE 
CENTER. 
‘‘(a) PROGRAM AUTHORIZED.—The Assistant Sec-
retary for Mental Health and Substance Use Disorders 
shall award a grant for the operation and maintenance 
of a research, training, and technical assistance resource 
center to provide appropriate information, training, and 
technical assistance to States, political subdivisions of 
States, federally recognized Indian tribes, tribal organiza-
tions, institutions of higher education, public organiza-
tions, or private nonprofit organizations concerning the 
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prevention of suicide among all ages, particularly among 
groups that are at high risk for suicide. 
‘‘(b) RESPONSIBILITIES OF THE CENTER.—The cen-
ter operated and maintained under subsection (a) shall— 
‘‘(1) assist in the development or continuation 
of statewide and tribal suicide early intervention and 
prevention strategies for all ages, particularly among 
groups that are at high risk for suicide; 
‘‘(2) ensure the surveillance of suicide early 
intervention and prevention strategies for all ages, 
particularly among groups that are at high risk for 
suicide; 
‘‘(3) study the costs and effectiveness of state-
wide and tribal suicide early intervention and pre-
vention strategies in order to provide information 
concerning relevant issues of importance to State, 
tribal, and national policymakers; 
‘‘(4) further identify and understand causes 
and associated risk factors for suicide for all ages, 
particularly among groups that are at high risk for 
suicide; 
‘‘(5) analyze the efficacy of new and existing 
suicide early intervention and prevention techniques 
and technology for all ages, particularly among 
groups that are at high risk for suicide; 
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‘‘(6) ensure the surveillance of suicidal behav-
iors and nonfatal suicidal attempts; 
‘‘(7) study the effectiveness of State-sponsored 
statewide and tribal suicide early intervention and 
prevention strategies for all ages particularly among 
groups that are at high risk for suicide on the over-
all wellness and health promotion strategies related 
to suicide attempts; 
‘‘(8) promote the sharing of data regarding sui-
cide with Federal agencies involved with suicide 
early intervention and prevention, and State-spon-
sored statewide and tribal suicide early intervention 
and prevention strategies for the purpose of identi-
fying previously unknown mental health causes and 
associated risk factors for suicide among all ages 
particularly among groups that are at high risk for 
suicide; 
‘‘(9) evaluate and disseminate outcomes and 
best practices of mental health and substance use 
disorder services at institutions of higher education; 
and 
‘‘(10) conduct other activities determined ap-
propriate by the Secretary. 
‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
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to be appropriated $4,957,000 for each of the fiscal years 
2016 through 2020.’’. 
(2) YOUTH SUICIDE INTERVENTION AND PRE-
VENTION STRATEGIES.—Section 520E of the Public 
Health Service Act (42 U.S.C. 290bb–36) is amend-
ed to read as follows: 
‘‘SEC. 520E. YOUTH SUICIDE EARLY INTERVENTION AND 
PREVENTION STRATEGIES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Assistant Secretary, shall award grants or cooperative 
agreements to eligible entities to— 
‘‘(1) develop and implement State-sponsored 
statewide or tribal youth suicide early intervention 
and prevention strategies in schools, educational in-
stitutions, juvenile justice systems, substance use 
disorder programs, mental health programs, foster 
care systems, and other child and youth support or-
ganizations; 
‘‘(2) support public organizations and private 
nonprofit organizations actively involved in State- 
sponsored statewide or tribal youth suicide early 
intervention and prevention strategies and in the de-
velopment and continuation of State-sponsored 
statewide youth suicide early intervention and pre-
vention strategies; 
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‘‘(3) provide grants to institutions of higher 
education to coordinate the implementation of State- 
sponsored or tribal youth suicide early intervention 
and prevention strategies; 
‘‘(4) collect and analyze data on State-spon-
sored statewide or tribal youth suicide early inter-
vention and prevention services that can be used to 
monitor the effectiveness of such services and for re-
search, technical assistance, and policy development; 
and 
‘‘(5) assist eligible entities, through State-spon-
sored statewide or tribal youth suicide early inter-
vention and prevention strategies, in achieving tar-
gets for youth suicide reductions under title V of the 
Social Security Act. 
‘‘(b) ELIGIBLE ENTITY.— 
‘‘(1) DEFINITION.—In this section, the term 
‘eligible entity’ means— 
‘‘(A) a State; 
‘‘(B) a public organization or private non-
profit organization designated by a State to de-
velop or direct the State-sponsored statewide 
youth suicide early intervention and prevention 
strategy; or 
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‘‘(C) a federally recognized Indian tribe or 
tribal organization (as defined in the Indian 
Self-Determination and Education Assistance 
Act) or an urban Indian organization (as de-
fined in the Indian Health Care Improvement 
Act) that is actively involved in the development 
and continuation of a tribal youth suicide early 
intervention and prevention strategy. 
‘‘(2) LIMITATION.—In carrying out this section, 
the Secretary shall ensure that a State does not re-
ceive more than one grant or cooperative agreement 
under this section at any one time. For purposes of 
the preceding sentence, a State shall be considered 
to have received a grant or cooperative agreement if 
the eligible entity involved is the State or an entity 
designated by the State under paragraph (1)(B). 
Nothing in this paragraph shall be construed to 
apply to entities described in paragraph (1)(C). 
‘‘(c) PREFERENCE.—In providing assistance under a 
grant or cooperative agreement under this section, an eli-
gible entity shall give preference to public organizations, 
private nonprofit organizations, political subdivisions, in-
stitutions of higher education, and tribal organizations ac-
tively involved with the State-sponsored statewide or tribal 
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youth suicide early intervention and prevention strategy 
that— 
‘‘(1) provide early intervention and assessment 
services, including screening programs, to youth who 
are at risk for mental or emotional disorders that 
may lead to a suicide attempt, and that are inte-
grated with school systems, educational institutions, 
juvenile justice systems, substance use disorder pro-
grams, mental health programs, foster care systems, 
and other child and youth support organizations; 
‘‘(2) demonstrate collaboration among early 
intervention and prevention services or certify that 
entities will engage in future collaboration; 
‘‘(3) employ or include in their applications a 
commitment to evaluate youth suicide early interven-
tion and prevention practices and strategies adapted 
to the local community; 
‘‘(4) provide timely referrals for appropriate 
community-based mental health care and treatment 
of youth who are at risk for suicide in child-serving 
settings and agencies; 
‘‘(5) provide immediate support and informa-
tion resources to families of youth who are at risk 
for suicide; 
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‘‘(6) offer access to services and care to youth 
with diverse linguistic and cultural backgrounds; 
‘‘(7) offer appropriate postsuicide intervention 
services, care, and information to families, friends, 
schools, educational institutions, juvenile justice sys-
tems, substance use disorder programs, mental 
health programs, foster care systems, and other 
child and youth support organizations of youth who 
recently completed suicide; 
‘‘(8) offer continuous and up-to-date informa-
tion and awareness campaigns that target parents, 
family members, child care professionals, community 
care providers, and the general public and highlight 
the risk factors associated with youth suicide and 
the life-saving help and care available from early 
intervention and prevention services; 
‘‘(9) ensure that information and awareness 
campaigns on youth suicide risk factors, and early 
intervention and prevention services, use effective 
communication mechanisms that are targeted to and 
reach youth, families, schools, educational institu-
tions, and youth organizations; 
‘‘(10) provide a timely response system to en-
sure that child-serving professionals and providers 
are properly trained in youth suicide early interven-
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tion and prevention strategies and that child-serving 
professionals and providers involved in early inter-
vention and prevention services are properly trained 
in effectively identifying youth who are at risk for 
suicide; 
‘‘(11) provide continuous training activities for 
child care professionals and community care pro-
viders on the latest youth suicide early intervention 
and prevention services practices and strategies; 
‘‘(12) conduct annual self-evaluations of out-
comes and activities, including consulting with inter-
ested families and advocacy organizations; 
‘‘(13) provide services in areas or regions with 
rates of youth suicide that exceed the national aver-
age as determined by the Centers for Disease Con-
trol and Prevention; and 
‘‘(14) obtain informed written consent from a 
parent or legal guardian of an at-risk child before 
involving the child in a youth suicide early interven-
tion and prevention program. 
‘‘(d) REQUIREMENT FOR DIRECT SERVICES.—Not 
less than 85 percent of grant funds received under this 
section shall be used to provide direct services, of which 
not less than 5 percent shall be used for activities author-
ized under subsection (a)(3). 
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‘‘(e) CONSULTATION AND POLICY DEVELOPMENT.— 
‘‘(1) IN GENERAL.—In carrying out this sec-
tion, the Secretary shall collaborate with the Sec-
retary of Education and relevant Federal agencies 
and suicide working groups responsible for early 
intervention and prevention services relating to 
youth suicide. 
‘‘(2) CONSULTATION.—In carrying out this sec-
tion, the Secretary shall consult with— 
‘‘(A) State and local agencies, including 
agencies responsible for early intervention and 
prevention services under title XIX of the So-
cial Security Act, the State Children’s Health 
Insurance Program under title XXI of the So-
cial Security Act, and programs funded by 
grants under title V of the Social Security Act; 
‘‘(B) local and national organizations that 
serve youth at risk for suicide and their fami-
lies; 
‘‘(C) relevant national medical and other 
health and education specialty organizations; 
‘‘(D) youth who are at risk for suicide, 
who have survived suicide attempts, or who are 
currently receiving care from early intervention 
services; 
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‘‘(E) families and friends of youth who are 
at risk for suicide, who have survived suicide at-
tempts, who are currently receiving care from 
early intervention and prevention services, or 
who have completed suicide; 
‘‘(F) qualified professionals who possess 
the specialized knowledge, skills, experience, 
and relevant attributes needed to serve youth at 
risk for suicide and their families; and 
‘‘(G) third-party payers, managed care or-
ganizations, and related commercial industries. 
‘‘(3) POLICY DEVELOPMENT.—In carrying out 
this section, the Secretary shall— 
‘‘(A) coordinate and collaborate on policy 
development at the Federal level with the rel-
evant Department of Health and Human Serv-
ices agencies and suicide working groups; and 
‘‘(B) consult on policy development at the 
Federal level with the private sector, including 
consumer, medical, suicide prevention advocacy 
groups, and other health and education profes-
sional-based organizations, with respect to 
State-sponsored statewide or tribal youth sui-
cide early intervention and prevention strate-
gies. 
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‘‘(f) RULE
OF
CONSTRUCTION; RELIGIOUS
AND 
MORAL ACCOMMODATION.—Nothing in this section shall 
be construed to require suicide assessment, early interven-
tion, or treatment services for youth whose parents or 
legal guardians object based on the parents’ or legal 
guardians’ religious beliefs or moral objections. 
‘‘(g) EVALUATIONS AND REPORT.— 
‘‘(1) EVALUATIONS BY ELIGIBLE ENTITIES.— 
Not later than 18 months after receiving a grant or 
cooperative agreement under this section, an eligible 
entity shall submit to the Secretary the results of an 
evaluation to be conducted by the entity concerning 
the effectiveness of the activities carried out under 
the grant or agreement. 
‘‘(2) REPORT.—Not later than 2 years after the 
date of enactment of this section, the Secretary shall 
submit to the appropriate committees of Congress a 
report concerning the results of— 
‘‘(A) the evaluations conducted under 
paragraph (1); and 
‘‘(B) an evaluation conducted by the Sec-
retary to analyze the effectiveness and efficacy 
of the activities conducted with grants, collabo-
rations, and consultations under this section. 
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‘‘(h) RULE OF CONSTRUCTION; STUDENT MEDICA-
TION.—Nothing in this section shall be construed to allow 
school personnel to require that a student obtain any 
medication as a condition of attending school or receiving 
services. 
‘‘(i) PROHIBITION.—Funds appropriated to carry out 
this section, section 527, or section 529 shall not be used 
to pay for or refer for abortion. 
‘‘(j) PARENTAL CONSENT.—States and entities re-
ceiving funding under this section shall obtain prior writ-
ten, informed consent from the child’s parent or legal 
guardian for assessment services, school-sponsored pro-
grams, and treatment involving medication related to 
youth suicide conducted in elementary and secondary 
schools. The requirement of the preceding sentence does 
not apply in the following cases: 
‘‘(1) In an emergency, where it is necessary to 
protect the immediate health and safety of the stu-
dent or other students. 
‘‘(2) Other instances, as defined by the State, 
where parental consent cannot reasonably be ob-
tained. 
‘‘(k) RELATION TO EDUCATION PROVISIONS.—Noth-
ing in this section shall be construed to supersede section 
444 of the General Education Provisions Act, including 
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the requirement of prior parental consent for the disclo-
sure of any education records. Nothing in this section shall 
be construed to modify or affect parental notification re-
quirements for programs authorized under the Elementary 
and Secondary Education Act of 1965 (as amended by the 
No Child Left Behind Act of 2001; Public Law 107–110). 
‘‘(l) DEFINITIONS.—In this section: 
‘‘(1) EARLY INTERVENTION.—The term ‘early 
intervention’ means a strategy or approach that is 
intended to prevent an outcome or to alter the 
course of an existing condition. 
‘‘(2) EDUCATIONAL INSTITUTION; INSTITUTION 
OF HIGHER EDUCATION; SCHOOL.—The term— 
‘‘(A) ‘educational institution’ means a 
school or institution of higher education; 
‘‘(B) ‘institution of higher education’ has 
the meaning given such term in section 101 of 
the Higher Education Act of 1965; and 
‘‘(C) ‘school’ means an elementary or sec-
ondary school (as such terms are defined in sec-
tion 9101 of the Elementary and Secondary 
Education Act of 1965). 
‘‘(3) 
PREVENTION.—The 
term 
‘prevention’ 
means a strategy or approach that reduces the likeli-
hood or risk of onset, or delays the onset, of adverse 
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health problems that have been known to lead to sui-
cide. 
‘‘(4) YOUTH.—The term ‘youth’ means individ-
uals who are between 10 and 26 years of age. 
‘‘(m) AUTHORIZATION
OF APPROPRIATIONS.—For 
the purpose of carrying out this section, there are author-
ized to be appropriated $29,738,000 for each of the fiscal 
years 2016 through 2020.’’. 
(3) SUICIDE
PREVENTION
FOR
YOUTH.—Sec-
tion 520E–1 of the Public Health Service Act (42 
U.S.C. 290bb–36a) is amended— 
(A) by amending the section heading to 
read as follows: ‘‘SUICIDE PREVENTION FOR 
YOUTH’’; and 
(B) by striking subsection (n) and insert-
ing the following: 
‘‘(n) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated such sums as may be necessary for 
each of fiscal years 2016 through 2020.’’. 
(4) MENTAL
HEALTH
AND
SUBSTANCE
USE 
DISORDERS
SERVICES
AND
OUTREACH
ON
CAM-
PUS.—Section 520E–2 of the Public Health Service 
Act (42 U.S.C. 290bb–36b) is amended to read as 
follows: 
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‘‘SEC. 520E–2. MENTAL HEALTH AND SUBSTANCE USE DIS-
ORDERS SERVICES ON CAMPUS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Center for Mental Health Services and 
in consultation with the Secretary of Education, shall 
award grants on a competitive basis to institutions of 
higher education to enhance services for students with 
mental health or substance use disorders and to develop 
best practices for the delivery of such services. 
‘‘(b) USES OF FUNDS.—Amounts received under a 
grant under this section shall be used for 1 or more of 
the following activities: 
‘‘(1) The provision of mental health and sub-
stance use disorder services to students, including 
prevention, promotion of mental health, voluntary 
screening, early intervention, voluntary assessment, 
treatment, and management of mental health and 
substance use disorder issues. 
‘‘(2) The provision of outreach services to notify 
students about the existence of mental health and 
substance use disorder services. 
‘‘(3) Educating students, families, faculty, staff, 
and communities to increase awareness of mental 
health and substance use disorders. 
‘‘(4) The employment of appropriately trained 
staff, including administrative staff. 
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100 
‘‘(5) The provision of training to students, fac-
ulty, and staff to respond effectively to students with 
mental health and substance use disorders. 
‘‘(6) The creation of a networking infrastruc-
ture to link colleges and universities with providers 
who can treat mental health and substance use dis-
orders. 
‘‘(7) Developing, supporting, evaluating, and 
disseminating evidence-based and emerging best 
practices. 
‘‘(c) IMPLEMENTATION OF ACTIVITIES USING GRANT 
FUNDS.—An institution of higher education that receives 
a grant under this section may carry out activities under 
the grant through— 
‘‘(1) college counseling centers; 
‘‘(2) college and university psychological service 
centers; 
‘‘(3) mental health centers; 
‘‘(4) psychology training clinics; 
‘‘(5) institution of higher education supported, 
evidence-based, mental health and substance use dis-
order programs; or 
‘‘(6) any other entity that provides mental 
health and substance use disorder services at an in-
stitution of higher education. 
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101 
‘‘(d) APPLICATION.—To be eligible to receive a grant 
under this section, an institution of higher education shall 
prepare and submit to the Secretary an application at 
such time and in such manner as the Secretary may re-
quire. At a minimum, such application shall include the 
following: 
‘‘(1) A description of identified mental health 
and substance use disorder needs of students at the 
institution of higher education. 
‘‘(2) A description of Federal, State, local, pri-
vate, and institutional resources currently available 
to address the needs described in paragraph (1) at 
the institution of higher education. 
‘‘(3) A description of the outreach strategies of 
the institution of higher education for promoting ac-
cess to services, including a proposed plan for reach-
ing those students most in need of mental health 
services. 
‘‘(4) A plan, when applicable, to meet the spe-
cific mental health and substance use disorder needs 
of veterans attending institutions of higher edu-
cation. 
‘‘(5) A plan to seek input from community 
mental health providers, when available, community 
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102 
groups and other public and private entities in car-
rying out the program under the grant. 
‘‘(6) A plan to evaluate program outcomes, in-
cluding a description of the proposed use of funds, 
the program objectives, and how the objectives will 
be met. 
‘‘(7) An assurance that the institution will sub-
mit a report to the Secretary each fiscal year con-
cerning the activities carried out with the grant and 
the results achieved through those activities. 
‘‘(e) 
SPECIAL
CONSIDERATIONS.—In 
awarding 
grants under this section, the Secretary shall give special 
consideration to applications that describe programs to be 
carried out under the grant that— 
‘‘(1) demonstrate the greatest need for new or 
additional mental and substance use disorder serv-
ices, in part by providing information on current ra-
tios of students to mental health and substance use 
disorder health professionals; and 
‘‘(2) demonstrate the greatest potential for rep-
lication. 
‘‘(f) REQUIREMENT OF MATCHING FUNDS.— 
‘‘(1) IN GENERAL.—The Secretary may make a 
grant under this section to an institution of higher 
education only if the institution agrees to make 
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103 
available (directly or through donations from public 
or private entities) non-Federal contributions in an 
amount that is not less than $1 for each $1 of Fed-
eral funds provided under the grant, toward the 
costs of activities carried out with the grant (as de-
scribed in subsection (b)) and other activities by the 
institution to reduce student mental health and sub-
stance use disorders. 
‘‘(2) DETERMINATION
OF
AMOUNT
CONTRIB-
UTED.—Non-Federal contributions required under 
paragraph (1) may be in cash or in kind. Amounts 
provided by the Federal Government, or services as-
sisted or subsidized to any significant extent by the 
Federal Government, may not be included in deter-
mining the amount of such non-Federal contribu-
tions. 
‘‘(3) WAIVER.—The Secretary may waive the 
application of paragraph (1) with respect to an insti-
tution of higher education if the Secretary deter-
mines that extraordinary need at the institution jus-
tifies the waiver. 
‘‘(g) REPORTS.—For each fiscal year that grants are 
awarded under this section, the Secretary shall conduct 
a study on the results of the grants and submit to the 
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104 
Congress a report on such results that includes the fol-
lowing: 
‘‘(1) An evaluation of the grant program out-
comes, including a summary of activities carried out 
with the grant and the results achieved through 
those activities. 
‘‘(2) Recommendations on how to improve ac-
cess to mental health and substance use disorder 
services at institutions of higher education, including 
efforts to reduce the incidence of suicide and sub-
stance use disorders. 
‘‘(h) DEFINITIONS.—In this section: 
‘‘(1) The term ‘evidence-based’ has the meaning 
given to such term in section 2 of the Helping Fami-
lies in Mental Health Crisis Act of 2015. 
‘‘(2) The term ‘institution of higher education’ 
has the meaning given such term in section 101 of 
the Higher Education Act of 1965. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there are authorized 
to be appropriated $4,975,000 for each of fiscal years 
2016 through 2020.’’. 
(5) SUICIDE LIFELINE.—Subpart 3 of part B 
of title V of the Public Health Service Act is amend-
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105 
ed by inserting after section 520E–2 of such Act (42 
U.S.C. 290bb–36b), as amended, the following: 
‘‘SEC. 520E–3. NATIONAL SUICIDE PREVENTION LIFELINE 
PROGRAM. 
‘‘(a) IN GENERAL.—The Secretary shall maintain the 
National Suicide Prevention Lifeline program, including 
by— 
‘‘(1) coordinating a network of crisis centers 
across the United States for providing suicide pre-
vention and crisis intervention services to individuals 
seeking help at any time, day or night; 
‘‘(2) maintaining a suicide prevention hotline to 
link callers to local emergency, mental health, and 
social services resources; and 
‘‘(3) consulting with the Secretary of Veterans 
Affairs to ensure that veterans calling the suicide 
prevention hotline have access to a specialized vet-
erans’ suicide prevention hotline. 
‘‘(b) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $8,000,000 for each of fiscal years 2016 through 
2020.’’. 
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106 
TITLE III—INTERAGENCY SERI-
OUS MENTAL ILLNESS CO-
ORDINATING COMMITTEE 
SEC. 301. INTERAGENCY SERIOUS MENTAL ILLNESS CO-
ORDINATING COMMITTEE. 
Title V of the Public Health Service Act, as amended 
by section 101, is further amended by inserting after sec-
tion 501 of such Act the following: 
‘‘SEC. 501A. INTERAGENCY SERIOUS MENTAL ILLNESS CO-
ORDINATING COMMITTEE. 
‘‘(a) ESTABLISHMENT.—The Assistant Secretary for 
Mental Health and Substance Use Disorders (in this sec-
tion referred to as the ‘Assistant Secretary’) shall estab-
lish a committee, to be known as the Interagency Serious 
Mental Illness Coordinating Committee (in this section re-
ferred to as the ‘Committee’), to assist the Assistant Sec-
retary in carrying out the Assistant Secretary’s duties. 
‘‘(b) RESPONSIBILITIES.—The Committee shall— 
‘‘(1) develop and annually update a summary of 
advances in serious mental illness research related to 
causes, prevention, treatment, early screening, diag-
nosis or rule out, intervention, and access to services 
and supports for individuals with serious mental ill-
ness; 
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107 
‘‘(2) monitor Federal activities with respect to 
serious mental illness; 
‘‘(3) make recommendations to the Assistant 
Secretary regarding any appropriate changes to such 
activities, including recommendations to the Director 
of NIH with respect to the strategic plan developed 
under paragraph (5); 
‘‘(4) make recommendations to the Assistant 
Secretary regarding public participation in decisions 
relating to serious mental illness; 
‘‘(5) develop and annually update a strategic 
plan for advancing— 
‘‘(A) public utilization of effective mental 
health services; and 
‘‘(B) compliance with treatment; 
‘‘(6) develop and annually update a strategic 
plan for the conduct of, and support for, serious 
mental illness research, including proposed budg-
etary requirements; and 
‘‘(7) submit to the Congress such strategic plan 
and any updates to such plan. 
‘‘(c) MEMBERSHIP.— 
‘‘(1) IN
GENERAL.—The Committee shall be 
composed of— 
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108 
‘‘(A) the Assistant Secretary for Mental 
Health and Substance Use Disorders (or the 
Assistant Secretary’s designee), who shall serve 
as the Chair of the Committee; 
‘‘(B) the Director of the National Institute 
of Mental Health (or the Director’s designee); 
‘‘(C) the Attorney General of the United 
States (or the Attorney General’s designee); 
‘‘(D) the Director of the Centers for Dis-
ease Control and Prevention (or the Director’s 
designee); 
‘‘(E) the Director of the National Insti-
tutes of Health (or the Director’s designee); 
‘‘(F) the directors of such national re-
search institutes of the National Institutes of 
Health as the Assistant Secretary for Mental 
Health and Substance Use Disorders deter-
mines appropriate (or their designees); 
‘‘(G) a member of the United States Inter-
agency Council on Homelessness; 
‘‘(H) representatives, appointed by the As-
sistant Secretary, of Federal agencies that are 
outside of the Department of Health and 
Human Services and serve individuals with seri-
ous mental illness, including representatives of 
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109 
the Bureau of Indian Affairs, the Department 
of Defense, the Department of Education, the 
Department of Housing and Urban Develop-
ment, the Department of Labor, the Depart-
ment of Veterans Affairs, and the Social Secu-
rity Administration; 
‘‘(I) 4 members, of which— 
‘‘(i) 1 shall be appointed by the 
Speaker of the House of Representatives; 
‘‘(ii) 1 shall be appointed by the mi-
nority leader of the House of Representa-
tives; 
‘‘(iii) 1 shall be appointed by the ma-
jority leader of the Senate; and 
‘‘(iv) 1 shall be appointed by the mi-
nority leader of the Senate; and 
‘‘(J) the additional members appointed 
under paragraph (2). 
‘‘(2) ADDITIONAL MEMBERS.—Not fewer than 
14 members of the Committee, or 1⁄3 of the total 
membership of the Committee, whichever is greater, 
shall be composed of non-Federal public members to 
be appointed by the Assistant Secretary, of which— 
‘‘(A) at least one such member shall be an 
individual in recovery from a diagnosis of seri-
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112 
‘‘(N) at least one member shall be a cor-
rections officer. 
‘‘(d) REPORTS TO CONGRESS.—Not later than 1 year 
after the date of enactment of this Act, and every 2 years 
thereafter, the Committee shall submit a report to the 
Congress— 
‘‘(1) analyzing the efficiency, effectiveness, 
quality, coordination, and cost effectiveness of Fed-
eral programs and activities relating to the preven-
tion of, or treatment or rehabilitation for, mental 
health or substance use disorders, including an ac-
counting of the costs of such programs and activi-
ties, with administrative costs disaggregated from 
the costs of services and care provided; 
‘‘(2) evaluating the impact on public health of 
projects addressing priority mental health needs of 
regional and national significance under sections 
501, 509, 516, and 520A including measurement of 
public health outcomes such as— 
‘‘(A) reduced rates of suicide, suicide at-
tempts, substance abuse, overdose, overdose 
deaths, emergency hospitalizations, emergency 
room boarding, incarceration, crime, arrest, vic-
timization, homelessness, and joblessness; 
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113 
‘‘(B) increased rates of employment and 
enrollment in educational and vocational pro-
grams; and 
‘‘(C) such other criteria as may be deter-
mined by the Assistant Secretary; 
‘‘(3) formulating recommendations for the co-
ordination and improvement of Federal programs 
and activities described in paragraph (2); 
‘‘(4) identifying any such programs and activi-
ties that are duplicative; and 
‘‘(5) summarizing all recommendations made, 
activities carried out, and results achieved pursuant 
to the workforce development strategy under section 
501(b)(9) of the Public Health Service Act, as 
amended by section 101. 
‘‘(e) ADMINISTRATIVE SUPPORT; TERMS OF SERV-
ICE; OTHER PROVISIONS.—The following provisions shall 
apply with respect to the Committee: 
‘‘(1) The Assistant Secretary shall provide such 
administrative support to the Committee as may be 
necessary for the Committee to carry out its respon-
sibilities. 
‘‘(2) Members of the Committee appointed 
under subsection (c)(2) shall serve for a term of 4 
years, and may be reappointed for one or more addi-
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114 
tional 4-year terms. Any member appointed to fill a 
vacancy for an unexpired term shall be appointed for 
the remainder of such term. A member may serve 
after the expiration of the member’s term until a 
successor has taken office. 
‘‘(3) The Committee shall meet at the call of 
the chair or upon the request of the Assistant Sec-
retary. The Committee shall meet not fewer than 2 
times each year. 
‘‘(4) All meetings of the Committee shall be 
public and shall include appropriate time periods for 
questions and presentations by the public. 
‘‘(f) SUBCOMMITTEES; ESTABLISHMENT AND MEM-
BERSHIP.—In carrying out its functions, the Committee 
may establish subcommittees and convene workshops and 
conferences. Such subcommittees shall be composed of 
Committee members and may hold such meetings as are 
necessary to enable the subcommittees to carry out their 
duties.’’. 
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115 
TITLE IV—HIPAA AND FERPA 
CAREGIVERS 
SEC. 401. PROMOTING APPROPRIATE TREATMENT FOR 
MENTALLY ILL INDIVIDUALS BY TREATING 
THEIR 
CAREGIVERS 
AS 
PERSONAL 
REP-
RESENTATIVES FOR PURPOSES OF HIPAA 
PRIVACY REGULATIONS. 
(a) CAREGIVER ACCESS TO INFORMATION.—In ap-
plying section 164.502(g) of title 45, Code of Federal Reg-
ulations, to an individual with serious mental illness an 
exception for disclosure of specific limited protected health 
information shall be provided if all of the following criteria 
are met for the disclosure by a physician (as defined in 
paragraphs (1) and (2) of section 1861(r) of the Social 
Security Act (42 U.S.C. 1395x(r))) or other licensed men-
tal health or health care professional to an identified re-
sponsible caregiver: 
(1) Such disclosure is for information limited to 
the diagnoses, treatment plans, appointment sched-
uling, medications, and medication-related instruc-
tions, but not including any personal psychotherapy 
notes. 
(2) Such disclosure is necessary to protect the 
health, safety, or welfare of the individual or general 
public. 
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116 
(3) The information to be disclosed will be ben-
eficial to the treatment of the individual if that indi-
vidual has a co-occurring acute or chronic medical 
illness. 
(4) The information to be disclosed is necessary 
for the continuity of treatment of the medical condi-
tion or mental illness of the individual. 
(5) The absence of such information or treat-
ment will contribute to a worsening prognosis or an 
acute medical condition. 
(6) The individual by nature of the severe men-
tal illness has or has had a diminished capacity to 
fully understand or follow a treatment plan for their 
medical condition or may become gravely disabled in 
absence of treatment. 
(b) TRAINING.—In applying section 164.530 of title 
45, Code of Federal Regulations, the training described 
in paragraph (b)(1) of such section shall include training 
with respect to the disclosure of information to a caregiver 
of an individual pursuant to subsection (a). 
(c) AGE
OF
MAJORITY.—In applying section 
164.502(g) of title 45, Code of Federal Regulations, not-
withstanding 
any 
other 
provision 
of 
law, 
an 
unemancipated minor shall be an individual under the age 
of 18 years. 
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117 
(d) PROVIDER ACCESS TO INFORMATION.—Health 
care providers may listen to information or review medical 
history provided by family members or other caregivers 
who may have concerns about the health and well-being 
of the patient, so the health care provider can factor that 
information into the patient’s care. 
(e) DEFINITIONS.—For purposes of this section: 
(1) COVERED ENTITY.—The term ‘‘covered en-
tity’’ has the meaning given such term in section 
106.103 of title 45, Code of Federal Regulations. 
(2) PROTECTED HEALTH INFORMATION.—The 
term ‘‘protected health information’’ has the mean-
ing given such term in section 106.103 of title 45, 
Code of Federal Regulations. 
(3) CAREGIVER.—The term ‘‘caregiver’’ means, 
with respect to an individual with a serious mental 
illness— 
(A) an immediate family member of such 
individual; 
(B) an individual who assumes primary re-
sponsibility for providing a basic need of such 
individual; 
(C) a personal representative of the indi-
vidual as determined by the law of the State in 
which such individual resides; 
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118 
(D) can establish a longstanding involve-
ment and is responsible with the individual with 
a serious mental illness and the health care of 
the individual; and 
(E) excludes an individual with a docu-
mented history of abuse. 
(4) INDIVIDUAL WITH A SERIOUS MENTAL ILL-
NESS.—The term ‘‘individual with a serious mental 
illness’’ means, with respect to the disclosure to a 
caregiver of protected health information of an indi-
vidual, an individual who— 
(A) is 18 years of age or older; and 
(B) has, within one year before the date of 
the disclosure, been evaluated, diagnosed, or 
treated for a mental, behavioral, or emotional 
disorder that— 
(i) is determined by a physician to be 
of sufficient duration to meet diagnostic 
criteria specified within the Diagnostic and 
Statistical Manual of Mental Disorders; 
and 
(ii) results in functional impairment 
of the individual that substantially inter-
feres with or limits one or more major life 
activities of the individual. 
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119 
Such term includes an individual with autism 
spectrum disorder or other developmental dis-
ability if such individual has a co-occurring 
mental illness. 
SEC. 402. CAREGIVERS PERMITTED ACCESS TO CERTAIN 
EDUCATION RECORDS UNDER FERPA. 
Section 444 of the General Education Provisions Act 
(20 U.S.C. 1232g) is amended by adding at the end the 
following new subsection: 
‘‘(k) DISCLOSURES TO CAREGIVERS.— 
‘‘(1) IN GENERAL.—With respect to a student 
who is 18 years of age or older, an educational agen-
cy or institution may disclose to the caregiver of the 
student, without regard to whether the student has 
explicitly provided consent to the agency or institu-
tion for the disclosure of the student’s education 
record, the education record of such student if a 
physician (as defined in paragraphs (1) and (2) of 
section 1861(r) of the Social Security Act), psycholo-
gist, or other recognized mental health professional 
or paraprofessional acting in his or her professional 
or paraprofessional capacity, or assisting in that ca-
pacity reasonably believes such disclosure to the 
caregiver is necessary to protect the health, safety, 
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120 
or welfare of such student or the safety of one or 
more other individuals. 
‘‘(2) DEFINITIONS.—In this subsection: 
‘‘(A) CAREGIVER.—The term ‘caregiver’ 
means, with respect to a student, a family 
member or immediate past legal guardian who 
assumes a primary responsibility for providing 
a basic need of such student (such as a family 
member or past legal guardian of the student 
who has assumed the responsibility of co-sign-
ing a loan with the student). 
‘‘(B) 
EDUCATION
RECORD.—Notwith-
standing subsection (a)(4)(B), the term ‘edu-
cation record’ shall include a record described 
in clause (iv) of such subsection.’’. 
SEC. 403. CONFIDENTIALITY OF RECORDS. 
Section 543(e) of the Public Health Service Act (42 
U.S.C. 290dd–2(e)) is amended— 
(1) in paragraph (1), by striking ‘‘; or’’ and in-
serting a semicolon; 
(2) in paragraph (2), by striking the period and 
inserting ‘‘; or’’; and 
(3) after paragraph (2), by inserting the fol-
lowing: 
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121 
‘‘(3) within accountable care organizations de-
scribed in section 1899 of the Social Security Act 
(42 U.S.C. 1395jjj), health information exchanges 
(as defined for purposes of section 3013), health 
homes (as defined in section 1945(h)(3) of such Act 
42 U.S.C. 1396w–4(h)(3)), or other integrated care 
arrangements (in existence before, on, or after the 
date of the enactment of this paragraph) involving 
the interchange of electronic health records (as de-
fined in section 13400 of division A of Public Law 
111–5) (42 U.S.C. 17921(5)) containing information 
described in subsection (a) for purposes of attaining 
interoperability, improving care coordination, reduc-
ing health care costs, and securing or providing pa-
tient safety.’’. 
TITLE V—MEDICARE AND 
MEDICAID REFORMS 
SEC. 501. ENHANCED MEDICAID COVERAGE RELATING TO 
CERTAIN MENTAL HEALTH SERVICES. 
(a) MEDICAID COVERAGE
OF MENTAL HEALTH 
SERVICES AND PRIMARY CARE SERVICES FURNISHED ON 
THE SAME DAY.— 
(1) IN GENERAL.—Section 1902(a) of the So-
cial Security Act (42 U.S.C. 1396a(a)) is amended 
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122 
by inserting after paragraph (77) the following new 
paragraph: 
‘‘(78) not prohibit payment under the plan for 
a mental health service or primary care service fur-
nished to an individual at a community mental 
health center meeting the criteria specified in section 
1913(c) of the Public Health Service Act or a feder-
ally qualified health center (as defined in section 
1861(aa)(3)) for which payment would otherwise be 
payable under the plan, with respect to such indi-
vidual, if such service were not a same-day quali-
fying service (as defined in subsection (ll));’’. 
(2) SAME-DAY
QUALIFYING
SERVICES
DE-
FINED.—Section 1902 of the Social Security Act (42 
U.S.C. 1396a) is amended by adding at the end the 
following new subsection: 
‘‘(ll) SAME-DAY QUALIFYING SERVICES DEFINED.— 
For purposes of subsection (a)(78), the term ‘same-day 
qualifying service’ means— 
‘‘(1) a primary care service furnished to an in-
dividual by a provider at a facility on the same day 
a mental health service is furnished to such indi-
vidual by such provider (or another provider) at the 
facility; and 
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123 
‘‘(2) a mental health service furnished to an 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.’’. 
(b) STATE OPTION TO PROVIDE MEDICAL ASSIST-
ANCE FOR CERTAIN INPATIENT PSYCHIATRIC SERVICES 
TO NONELDERLY ADULTS.—Section 1905 of the Social 
Security Act (42 U.S.C. 1396d) is amended— 
(1) in subsection (a)— 
(A) in paragraph (16)— 
(i) by striking ‘‘effective’’ and insert-
ing ‘‘(A) effective’’; and 
(ii) by inserting before the semicolon 
at the end the following: ‘‘, (B) qualified 
inpatient psychiatric hospital services (as 
defined in subsection (h)(3)) for individ-
uals over 21 years of age and under 65 
years of age, and (C) psychiatric residen-
tial treatment facility services (as defined 
in subsection (h)(4)) for individuals over 
21 years of age and under 65 years of 
age’’; and 
(B) in the subdivision (B) that follows 
paragraph (29), by inserting ‘‘(other than serv-
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124 
ices described in subparagraphs (B) and (C) of 
paragraph (16) for individuals described in such 
subparagraphs)’’ after ‘‘patient in an institution 
for mental diseases’’; and 
(2) in subsection (h), by adding at the end the 
following new paragraphs: 
‘‘(3) For purposes of subsection (a)(16)(B), the term 
‘qualified inpatient psychiatric hospital services’ means, 
with respect to individuals described in such subsection, 
services described in subparagraphs (A) and (B) of para-
graph (1) that are furnished in an acute care psychiatric 
unit in a State-operated psychiatric hospital or a psy-
chiatric hospital (as defined section 1861(f)) if such unit 
or hospital, as applicable, has a facilitywide average (de-
termined on an annual basis) length of stay of less than 
30 days. 
‘‘(4) For purposes of subsection (a)(16)(C), the term 
‘psychiatric residential treatment facility services’ means, 
with respect to individuals described in such subsection, 
services described in subparagraphs (A) and (B) of para-
graph (1) that are furnished in a psychiatric residential 
treatment facility (as defined in section 484.353 of title 
42, Code of Federal Regulations, as in effect on December 
9, 2013).’’. 
(c) REPORT.— 
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(1) IN GENERAL.—The Assistant Secretary for 
Mental Health and Substance Use Disorders shall 
report on the impact of the amendments made by 
subsection (b) on the funds made available by States 
for inpatient psychiatric hospital care and for com-
munity-based mental health services. Such study 
shall include an assessment of each of the following: 
(A) The amount of funds expended annu-
ally by States on short-term, acute inpatient 
psychiatric hospital care. 
(B) The amount of funds expended annu-
ally on short-term, acute inpatient psychiatric 
hospital care through disproportionate share 
hospital payments under section 1923 of the 
Social Security Act (42 U.S.C. 1396r–4). 
(C) The reduction in the amount of funds 
described in subparagraph (A) that is attrib-
utable to the amendments made by subsection 
(b). 
(D) The reduction in the amount of funds 
described in subparagraph (B) that is attrib-
utable to the amendment made by such sub-
section. 
(E) The total amount of the reductions de-
scribed in subparagraphs (C) and (D). 
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(2) DEFINITION OF SHORT-TERM, ACUTE INPA-
TIENT PSYCHIATRIC HOSPITAL CARE.—For purposes 
of paragraph (1), the term ‘‘short-term, acute inpa-
tient psychiatric hospital care’’ means care that is 
provided in either— 
(A) an acute-care psychiatric unit with an 
average annual length of stay of fewer than 30 
days that is operated within a psychiatric hos-
pital operated by a State; or 
(B) a psychiatric hospital with an average 
annual length of stay of fewer than 30 days. 
(3) REPORT.—Not later than two years after 
the date of the enactment of this Act, such Assistant 
Secretary shall submit a report to Congress on the 
results of the study described in paragraph (1), in-
cluding recommendations with respect to strategies 
that can be used to reinvest in community-based 
mental health services funds equal to the total 
amount of the reductions described in paragraph 
(1)(E). 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraphs (2) 
and (3), the amendments made by this section shall 
apply to items and services furnished after the first 
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127 
day of the first calendar year that begins after the 
date of the enactment of this section. 
(2) CERTIFICATION OF NO INCREASED SPEND-
ING.—The amendments made by this section shall 
not be effective unless the Chief Actuary of the Cen-
ters for Medicare & Medicaid Services certifies that 
the inclusion of qualified inpatient psychiatric hos-
pital services and psychiatric residential treatment 
facility services (as those terms are defined in sec-
tion 1905(h) of the Social Security Act (42 U.S.C. 
1396d(h))) furnished to nonelderly adults as medical 
assistance under section 1905(a) of the Social Secu-
rity Act (42 U.S.C. 1396d(a)), as amended by sub-
section (a), would not result in any increase in net 
program spending under title XIX of such Act. 
(3) EXCEPTION FOR STATE LEGISLATION.—In 
the case of a State plan under title XIX of the So-
cial Security Act, which the Secretary of Health and 
Human Services determines requires State legisla-
tion in order for the respective plan to meet any re-
quirement imposed by amendments made by this 
section, the respective plan shall not be regarded as 
failing to comply with the requirements of such title 
solely on the basis of its failure to meet such an ad-
ditional requirement before the first day of the first 
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128 
calendar quarter beginning after the close of the 
first regular session of the State legislature that be-
gins after the date of enactment of this section. For 
purposes of the previous sentence, in the case of a 
State that has a 2-year legislative session, each year 
of the session shall be considered to be a separate 
regular session of the State legislature. 
SEC. 502. ACCESS TO MENTAL HEALTH PRESCRIPTION 
DRUGS UNDER MEDICARE AND MEDICAID. 
(a) COVERAGE OF PRESCRIPTION DRUGS USED TO 
TREAT MENTAL HEALTH DISORDERS UNDER MEDI-
CARE.—Section 1860D–4(b)(3)(G) of the Social Security 
Act (42 U.S.C. 1395w–104(b)(3)(G)) is amended— 
(1) in clause (i)(I), by striking ‘‘in the cat-
egories’’ and inserting ‘‘in the categories and classes 
of drugs specified in subclauses (II) and (IV) of 
clause (iv) and in other categories’’; 
(2) in clause (i)(II), by inserting ‘‘, for cat-
egories and classes of drugs other than the cat-
egories and classes of drugs specified in subclauses 
(II) and (IV) of clause (iv),’’ before ‘‘exceptions’’; 
(3) in clause (ii)(I), by inserting at the end the 
following new sentence: ‘‘For purposes of the pre-
vious sentence, the categories and classes of drugs 
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129 
specified in subclauses (II) and (IV) of clause (iv) 
shall be deemed to be of clinical concern.’’; and 
(4) in clause (iv), in the matter preceding sub-
clause (I), by inserting ‘‘(and in the case of cat-
egories and classes of drugs specified in subclauses 
(II) and (IV), before, on, and after the Secretary es-
tablishes such criteria)’’ after ‘‘clause (ii)(II)’’. 
(b) COVERAGE OF PRESCRIPTION DRUGS USED TO 
TREAT MENTAL HEALTH DISORDERS UNDER MED-
ICAID.— 
(1) IN GENERAL.—Section 1927(d) of the So-
cial Security Act (42 U.S.C. 1396r–8(d)) is amend-
ed by adding at the end the following new para-
graph: 
‘‘(8) ACCESS
TO
MENTAL
HEALTH
DRUGS.— 
With respect to covered outpatient drugs used for 
the treatment of a mental health disorder, including 
major depression, bipolar (manic-depressive) dis-
order, panic disorder, obsessive-compulsive disorder, 
schizophrenia, and schizoaffective disorder, a State 
shall not exclude from coverage or otherwise restrict 
access to such drugs other than pursuant to a prior 
authorization program that is consistent with para-
graph (5).’’. 
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130 
(2) MEDICAID
MANAGED
CARE
ORGANIZA-
TIONS.—Section 1932(b) of the Social Security Act 
(42 U.S.C. 1396u–2(b)) is amended by adding at 
the end the following new paragraph: 
‘‘(9) COVERAGE OF PRESCRIPTION DRUGS USED 
TO TREAT MENTAL HEALTH DISORDERS.—Each con-
tract with a managed care entity under section 
1903(m) or under section 1905(t)(3) shall require 
coverage of all covered outpatient drugs used for the 
treatment of a mental health disorder, in accordance 
with section 1927(d)(8).’’. 
SEC. 503. ELIMINATION OF 190-DAY LIFETIME LIMIT ON 
COVERAGE OF INPATIENT PSYCHIATRIC HOS-
PITAL SERVICES UNDER MEDICARE. 
(a) IN GENERAL.—Section 1812 of the Social Secu-
rity Act (42 U.S.C. 1395d) is amended— 
(1) in subsection (b)— 
(A) in paragraph (1), by adding ‘‘or’’ at 
the end; 
(B) in paragraph (2), by striking ‘‘; or’’ at 
the end and inserting a period; and 
(C) by striking paragraph (3); and 
(2) in subsection (c), by striking ‘‘or in deter-
mining the 190-day limit under subsection (b)(3)’’. 
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(b) EFFECTIVE DATE; CERTIFICATION OF NO IN-
CREASED SPENDING.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by subsection (a) shall apply 
to items and services furnished on or after January 
1, 2016. 
(2) CERTIFICATION OF NO INCREASED SPEND-
ING.—The amendments made by subsection (a) shall 
not be effective unless the Chief Actuary of the Cen-
ters for Medicare & Medicaid Services certifies that 
such amendments will not result in any increase in 
net Federal expenditures under title XVIII of the 
Social Security Act. 
SEC. 504. MODIFICATIONS TO MEDICARE DISCHARGE PLAN-
NING REQUIREMENTS. 
Section 1861(ee) of the Social Security Act (42 
U.S.C. 1395x(ee)) is amended— 
(1) in paragraph (1), by inserting ‘‘and, in the 
case of a psychiatric hospital or a psychiatric unit 
(as described in the matter following clause (v) of 
section 1886(d)(1)(B)), if it also meets the guide-
lines and standards established by the Secretary 
under paragraph (3)’’ before the period at the end; 
and 
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(2) by adding at the end the following new 
paragraph: 
‘‘(3) The Secretary shall develop guidelines and 
standards, in addition to those developed under paragraph 
(2), for the discharge planning process of a psychiatric 
hospital or a psychiatric unit (as described in the matter 
following clause (v) of section 1886(d)(1)(B)) in order to 
ensure a timely and smooth transition to the most appro-
priate type of and setting for posthospital or rehabilitative 
care. The Secretary shall issue final regulations imple-
menting such guidelines and standards not later than 24 
months after the date of the enactment of this paragraph. 
The guidelines and standards shall include the following: 
‘‘(A) The hospital or unit must identify the 
types of services needed upon discharge for the pa-
tients being treated by the hospital or unit. 
‘‘(B) The hospital or unit must— 
‘‘(i) identify organizations that offer com-
munity services to the community that is served 
by the hospital or unit and the types of services 
provided by the organizations; and 
‘‘(ii) must make demonstrated efforts to 
establish connections, relationships, and part-
nerships with such organizations. 
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‘‘(C) The hospital or unit must arrange (with 
the participation of the patient and of any other in-
dividuals selected by the patient for such purpose) 
for the development and implementation of a dis-
charge plan for the patient as part of the patient’s 
overall treatment plan from admission to discharge. 
Such discharge plan shall meet the requirements de-
scribed in subparagraphs (G) and (H) of paragraph 
(2). 
‘‘(D) The hospital or unit shall coordinate with 
the patient (or assist the patient with) the referral 
for posthospital or rehabilitative care and as part of 
that referral the hospital or unit shall include trans-
mitting to the receiving organization, in a timely 
manner, appropriate information about the care fur-
nished to the patient by the hospital or unit and rec-
ommendations for posthospital or rehabilitative care 
to be furnished to the patient by the organization.’’. 
SEC. 505. DEMONSTRATION PROGRAMS TO IMPROVE COM-
MUNITY MENTAL HEALTH SERVICES. 
Section 223 of the Protecting Access to Medicare Act 
of 2014 (Public Law 113–93; 128 Stat. 1077) is amended 
to read as follows: 
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‘‘SEC. 223. DEMONSTRATION PROGRAMS TO IMPROVE COM-
MUNITY MENTAL HEALTH SERVICES. 
‘‘(a) CRITERIA FOR CERTIFIED COMMUNITY BEHAV-
IORAL HEALTH CLINICS TO PARTICIPATE
IN DEM-
ONSTRATION PROGRAMS.— 
‘‘(1) PUBLICATION.—Not later than September 
1, 2015, the Secretary shall publish criteria for a 
clinic to be certified by a State as a certified com-
munity behavioral health clinic for purposes of par-
ticipating in a demonstration program conducted 
under subsection (d). 
‘‘(2) REQUIREMENTS.—The criteria published 
under this subsection shall include criteria with re-
spect to the following: 
‘‘(A) STAFFING.—Staffing requirements, 
including criteria that staff have diverse dis-
ciplinary backgrounds, have necessary State-re-
quired license and accreditation, and are cul-
turally and linguistically trained to serve the 
needs of the clinic’s patient population. 
‘‘(B) AVAILABILITY AND ACCESSIBILITY OF 
SERVICES.—Availability and accessibility of 
services, including crisis management services 
that are available and accessible 24 hours a 
day, the use of a sliding scale for payment, and 
no rejection for services or limiting of services 
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on the basis of a patient’s ability to pay or a 
place of residence. 
‘‘(C) CARE COORDINATION.—Care coordi-
nation, including requirements to coordinate 
care across settings and providers to ensure 
seamless transitions for patients across the full 
spectrum of health services including acute, 
chronic, and behavioral health needs. Care co-
ordination requirements shall include partner-
ships or formal contracts with the following: 
‘‘(i) Federally-qualified health centers 
(and as applicable, rural health clinics) to 
provide Federally-qualified health center 
services (and as applicable, rural health 
clinic services) to the extent such services 
are not provided directly through the cer-
tified community behavioral health clinic. 
‘‘(ii) Inpatient psychiatric facilities 
and substance use detoxification, post-de-
toxification step-down services, and resi-
dential programs. 
‘‘(iii) Other community or regional 
services, supports, and providers, including 
schools, child welfare agencies, juvenile and 
criminal justice agencies and facilities, In-
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dian Health Service youth regional treat-
ment centers, State-licensed and nationally 
accredited child placing agencies for thera-
peutic foster care service, and other social 
and human services. 
‘‘(iv) Department of Veterans Affairs 
medical centers, independent outpatient 
clinics, drop-in centers, and other facilities 
of the Department as defined in section 
1801 of title 38, United States Code. 
‘‘(v) Inpatient acute care hospitals 
and hospital outpatient clinics. 
‘‘(D) SCOPE OF SERVICES.—Provision (in 
a manner reflecting person-centered care) of the 
following services which, if not available directly 
through the certified community behavioral 
health clinic, are provided or referred through 
formal relationships with other providers: 
‘‘(i) Crisis mental health services, in-
cluding 24-hour mobile crisis teams, emer-
gency crisis intervention services, and cri-
sis stabilization. 
‘‘(ii) Screening, assessment, and diag-
nosis, including risk assessment. 
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‘‘(iii) Patient-centered treatment plan-
ning or similar processes, including risk as-
sessment and crisis planning. 
‘‘(iv) Outpatient mental health and 
substance use services. 
‘‘(v) Outpatient clinic primary care 
screening and monitoring of key health in-
dicators and health risk. 
‘‘(vi) Targeted case management. 
‘‘(vii) Psychiatric rehabilitation serv-
ices. 
‘‘(viii) Peer support and counselor 
services and family supports. 
‘‘(ix) 
Intensive, 
community-based 
mental health care for members of the 
Armed Forces and veterans, particularly 
those members and veterans located in 
rural areas, provided the care is consistent 
with minimum clinical mental health guide-
lines promulgated by the Veterans Health 
Administration including clinical guidelines 
contained in the Uniform Mental Health 
Services Handbook of such Administration. 
‘‘(E) QUALITY AND OTHER REPORTING.— 
Reporting of encounter data, clinical outcomes 
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data, quality data, and such other data as the 
Secretary requires. 
‘‘(F) ORGANIZATIONAL AUTHORITY.—Cri-
teria that a clinic be a non-profit or part of a 
local government behavioral health authority or 
operated under the authority of the Indian 
Health Service, an Indian tribe or tribal organi-
zation pursuant to a contract, grant, coopera-
tive agreement, or compact with the Indian 
Health Service pursuant to the Indian Self-De-
termination Act (25 U.S.C. 450 et seq.), or an 
urban Indian organization pursuant to a grant 
or contract with the Indian Health Service 
under title V of the Indian Health Care Im-
provement Act (25 U.S.C. 1601 et seq.). 
‘‘(b) GUIDANCE ON DEVELOPMENT OF PROSPECTIVE 
PAYMENT SYSTEM FOR TESTING UNDER DEMONSTRA-
TION PROGRAMS.— 
‘‘(1) IN GENERAL.—Not later than September 
1, 2015, the Secretary, through the Administrator of 
the Centers for Medicare & Medicaid Services, shall 
issue guidance for the establishment of a prospective 
payment system that shall only apply to medical as-
sistance for mental health services furnished by a 
certified community behavioral health clinic partici-
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pating in a demonstration program under subsection 
(d). 
‘‘(2) REQUIREMENTS.—The guidance issued by 
the Secretary under paragraph (1) shall provide 
that— 
‘‘(A) no payment shall be made for inpa-
tient care, residential treatment, room and 
board expenses, or any other nonambulatory 
services, as determined by the Secretary; and 
‘‘(B) no payment shall be made to satellite 
facilities of certified community behavioral 
health clinics if such facilities are established 
after the date of enactment of this Act. 
‘‘(c) PLANNING GRANTS.— 
‘‘(1) IN GENERAL.—Not later than January 1, 
2016, the Secretary shall award planning grants to 
States for the purpose of developing proposals to 
participate in time-limited demonstration programs 
described in subsection (d). 
‘‘(2) USE OF FUNDS.—A State awarded a plan-
ning grant under this subsection shall— 
‘‘(A) solicit input with respect to the devel-
opment of such a demonstration program from 
patients, providers, and other stakeholders; 
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‘‘(B) certify clinics as certified community 
behavioral health clinics for purposes of partici-
pating in a demonstration program conducted 
under subsection (d); and 
‘‘(C) establish a prospective payment sys-
tem for mental health services furnished by a 
certified community behavioral health clinic 
participating in a demonstration program under 
subsection (d) in accordance with the guidance 
issued under subsection (b). 
‘‘(d) DEMONSTRATION PROGRAMS.— 
‘‘(1) IN GENERAL.—Not later than September 
1, 2017, the Secretary shall select States to partici-
pate in demonstration programs that are developed 
through planning grants awarded under subsection 
(c), meet the requirements of this subsection, and 
represent a diverse selection of geographic areas, in-
cluding rural and underserved areas. 
‘‘(2) APPLICATION REQUIREMENTS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
solicit applications to participate in demonstra-
tion programs under this subsection solely from 
States awarded planning grants under sub-
section (c). 
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‘‘(B) REQUIRED INFORMATION.—An appli-
cation for a demonstration program under this 
subsection shall include the following: 
‘‘(i) The target Medicaid population 
to be served under the demonstration pro-
gram. 
‘‘(ii) A list of participating certified 
community behavioral health clinics. 
‘‘(iii) Verification that the State has 
certified a participating clinic as a certified 
community behavioral health clinic in ac-
cordance with the requirements of sub-
section (b). 
‘‘(iv) A description of the scope of the 
mental health services available under the 
State Medicaid program that will be paid 
for under the prospective payment system 
tested in the demonstration program. 
‘‘(v) Verification that the State has 
agreed to pay for such services at the rate 
established under the prospective payment 
system. 
‘‘(vi) Such other information as the 
Secretary may require relating to the dem-
onstration program including with respect 
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to determining the soundness of the pro-
posed prospective payment system. 
‘‘(3) NUMBER AND LENGTH OF DEMONSTRA-
TION PROGRAMS.—Not more than 10 States shall be 
selected for 4-year demonstration programs under 
this subsection. 
‘‘(4) REQUIREMENTS
FOR
SELECTING
DEM-
ONSTRATION PROGRAMS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
give preference to selecting demonstration pro-
grams where participating certified community 
behavioral health clinics— 
‘‘(i) provide the most complete scope 
of 
services 
described 
in 
subsection 
(a)(2)(D) to individuals eligible for medical 
assistance under the State Medicaid pro-
gram; 
‘‘(ii) will improve availability of, ac-
cess to, and participation in, services de-
scribed in subsection (a)(2)(D) to individ-
uals eligible for medical assistance under 
the State Medicaid program; 
‘‘(iii) will improve availability of, ac-
cess to, and participation in assisted out-
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patient mental health treatment in the 
State; or 
‘‘(iv) demonstrate the potential to ex-
pand available mental health services in a 
demonstration area and increase the qual-
ity of such services without increasing net 
Federal spending. 
‘‘(5) PAYMENT FOR MEDICAL ASSISTANCE FOR 
MENTAL
HEALTH
SERVICES
PROVIDED
BY
CER-
TIFIED
COMMUNITY
BEHAVIORAL
HEALTH
CLIN-
ICS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
pay a State participating in a demonstration 
program under this subsection the Federal 
matching percentage specified in subparagraph 
(B) for amounts expended by the State to pro-
vide medical assistance for mental health serv-
ices described in the demonstration program ap-
plication 
in 
accordance 
with 
paragraph 
(2)(B)(iv) that are provided by certified com-
munity behavioral health clinics to individuals 
who are enrolled in the State Medicaid pro-
gram. Payments to States made under this 
paragraph shall be considered to have been 
under, and are subject to the requirements of, 
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section 1903 of the Social Security Act (42 
U.S.C. 1396b). 
‘‘(B) FEDERAL MATCHING PERCENTAGE.— 
The Federal matching percentage specified in 
this subparagraph is with respect to medical as-
sistance described in subparagraph (A) that is 
furnished— 
‘‘(i) to a newly eligible individual de-
scribed in paragraph (2) of section 1905(y) 
of the Social Security Act (42 U.S.C. 
1396d(y)), the matching rate applicable 
under paragraph (1) of that section; and 
‘‘(ii) to an individual who is not a 
newly eligible individual (as so described) 
but who is eligible for medical assistance 
under the State Medicaid program, the en-
hanced FMAP applicable to the State. 
‘‘(C) LIMITATIONS.— 
‘‘(i) IN GENERAL.—Payments shall be 
made under this paragraph to a State only 
for mental health services— 
‘‘(I) that are described in the 
demonstration program application in 
accordance with paragraph (2)(B)(iv); 
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‘‘(II) for which payment is avail-
able under the State Medicaid pro-
gram; and 
‘‘(III) that are provided to an in-
dividual who is eligible for medical as-
sistance under the State Medicaid 
program. 
‘‘(ii) 
PROHIBITED
PAYMENTS.—No 
payment shall be made under this para-
graph— 
‘‘(I) for inpatient care, residen-
tial treatment, room and board ex-
penses, or any other nonambulatory 
services, as determined by the Sec-
retary; or 
‘‘(II) with respect to payments 
made to satellite facilities of certified 
community behavioral health clinics if 
such facilities are established after the 
date of enactment of this Act. 
‘‘(6) WAIVER
OF
STATEWIDENESS
REQUIRE-
MENT.—The 
Secretary 
shall 
waive 
section 
1902(a)(1) of the Social Security Act (42 U.S.C. 
1396a(a)(1)) (relating to statewideness) as may be 
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necessary to conduct demonstration programs in ac-
cordance with the requirements of this subsection. 
‘‘(7) ANNUAL REPORTS.— 
‘‘(A) IN GENERAL.—Not later than 1 year 
after the date on which the first State is se-
lected for a demonstration program under this 
subsection, and annually thereafter, the Sec-
retary shall submit to Congress an annual re-
port on the use of funds provided under all 
demonstration programs conducted under this 
subsection. Each such report shall include— 
‘‘(i) an assessment of access to com-
munity-based mental health services under 
the Medicaid program in the area or areas 
of a State targeted by a demonstration 
program compared to other areas of the 
State; 
‘‘(ii) an assessment of the quality and 
scope of services provided by certified com-
munity behavioral health clinics compared 
to community-based mental health services 
provided in States not participating in a 
demonstration program under this sub-
section and in areas of a demonstration 
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State that are not participating in the 
demonstration program; and 
‘‘(iii) an assessment of the impact of 
the demonstration programs on the Fed-
eral and State costs of a full range of men-
tal health services (including inpatient, 
emergency and ambulatory services). 
‘‘(B) RECOMMENDATIONS.—Not later than 
December 31, 2021, the Secretary shall submit 
to 
Congress 
recommendations 
concerning 
whether the demonstration programs under this 
section should be continued, expanded, modi-
fied, or terminated. 
‘‘(e) DEFINITIONS.—In this section: 
‘‘(1) FEDERALLY-QUALIFIED HEALTH CENTER 
SERVICES; FEDERALLY-QUALIFIED HEALTH CENTER; 
RURAL HEALTH CLINIC SERVICES; RURAL HEALTH 
CLINIC.—The terms ‘Federally-qualified health cen-
ter services’, ‘Federally-qualified health center’, 
‘rural health clinic services’, and ‘rural health clinic’ 
have the meanings given those terms in section 
1905(l) of the Social Security Act (42 U.S.C. 
1396d(l)). 
‘‘(2) ENHANCED FMAP.—The term ‘enhanced 
FMAP’ has the meaning given that term in section 
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2105(b) of the Social Security Act (42 U.S.C. 
1397dd(b)) but without regard to the second and 
third sentences of that section. 
‘‘(3) SECRETARY.—The term ‘Secretary’ means 
the Secretary of Health and Human Services. 
‘‘(4) STATE.—The term ‘State’ has the mean-
ing given such term for purposes of title XIX of the 
Social Security Act (42 U.S.C. 1396 et seq.). 
‘‘(f) FUNDING.— 
‘‘(1) IN GENERAL.—Out of any funds in the 
Treasury not otherwise appropriated, there is appro-
priated to the Secretary— 
‘‘(A) for purposes of carrying out sub-
sections (a), (b), and (d)(7), $2,000,000 for fis-
cal year 2014; and 
‘‘(B) for purposes of awarding planning 
grants under subsection (c), $25,000,000 for 
fiscal year 2016. 
‘‘(2) 
AVAILABILITY.—Funds 
appropriated 
under paragraph (1) shall remain available until ex-
pended.’’. 
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TITLE 
VI—RESEARCH 
BY 
NA-
TIONAL INSTITUTE OF MEN-
TAL HEALTH 
SEC. 601. INCREASE IN FUNDING FOR CERTAIN RESEARCH. 
Section 402A(a) of the Public Health Service Act (42 
U.S.C. 282a(a)) is amended by adding at the end the fol-
lowing: 
‘‘(3) FUNDING FOR THE BRAIN INITIATIVE AT 
THE NATIONAL INSTITUTE OF MENTAL HEALTH.— 
‘‘(A) FUNDING.—In addition to amounts 
made available pursuant to paragraphs (1) and 
(2), there are authorized to be appropriated to 
the National Institute of Mental Health for the 
purpose described in subparagraph (B)(ii) 
$40,000,000 for each of fiscal years 2016 
through 2020. 
‘‘(B) PURPOSES.—Amounts appropriated 
pursuant to subparagraph (A) shall be used ex-
clusively for the purpose of conducting or sup-
porting— 
‘‘(i) research on the determinants of 
self- and other directed-violence in mental 
illness, including studies directed at reduc-
ing the risk of self harm, suicide, and 
interpersonal violence; or 
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‘‘(ii) brain research through the Brain 
Research through Advancing Innovative 
Neurotechnologies Initiative.’’. 
TITLE 
VII—BEHAVIORAL 
HEALTH INFORMATION TECH-
NOLOGY 
SEC. 701. EXTENSION OF HEALTH INFORMATION TECH-
NOLOGY ASSISTANCE FOR BEHAVIORAL AND 
MENTAL HEALTH AND SUBSTANCE ABUSE. 
Section 3000(3) of the Public Health Service Act (42 
U.S.C. 300jj(3)) is amended by inserting before ‘‘and any 
other category’’ the following: ‘‘behavioral and mental 
health 
professionals 
(as 
defined 
in 
section 
331(a)(3)(E)(i)), a substance abuse professional, a psy-
chiatric hospital (as defined in section 1861(f) of the So-
cial Security Act), a community mental health center 
meeting the criteria specified in section 1913(c), a residen-
tial or outpatient mental health or substance use treat-
ment facility,’’. 
SEC. 702. EXTENSION OF ELIGIBILITY FOR MEDICARE AND 
MEDICAID 
HEALTH 
INFORMATION 
TECH-
NOLOGY IMPLEMENTATION ASSISTANCE. 
(a) PAYMENT INCENTIVES FOR ELIGIBLE PROFES-
SIONALS UNDER MEDICARE.—Section 1848 of the Social 
Security Act (42 U.S.C. 1395w–4) is amended— 
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(1) in subsection (a)(7)— 
(A) in subparagraph (E), by adding at the 
end the following new clause: 
‘‘(iv) ADDITIONAL ELIGIBLE PROFES-
SIONAL.—The term ‘additional eligible pro-
fessional’ means a clinical psychologist pro-
viding qualified psychologist services (as 
defined in section 1861(ii)).’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(F) APPLICATION TO ADDITIONAL ELIGI-
BLE
PROFESSIONALS.—The Secretary shall 
apply the provisions of this paragraph with re-
spect to an additional eligible professional in 
the same manner as such provisions apply to an 
eligible professional, except in applying sub-
paragraph (A)— 
‘‘(i) in clause (i), the reference to 
2015 shall be deemed a reference to 2020; 
‘‘(ii) in clause (ii), the references to 
2015, 2016, and 2017 shall be deemed ref-
erences to 2020, 2021, and 2022, respec-
tively; and 
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‘‘(iii) in clause (iii), the reference to 
2018 shall be deemed a reference to 
2023.’’; and 
(2) in subsection (o)— 
(A) in paragraph (5), by adding at the end 
the following new subparagraph: 
‘‘(D) 
ADDITIONAL
ELIGIBLE
PROFES-
SIONAL.—The term ‘additional eligible profes-
sional’ means a clinical psychologist providing 
qualified psychologist services (as defined in 
section 1861(ii)).’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(6) APPLICATION
TO
ADDITIONAL
ELIGIBLE 
PROFESSIONALS.—The Secretary shall apply the 
provisions of this subsection with respect to an addi-
tional eligible professional in the same manner as 
such provisions apply to an eligible professional, ex-
cept in applying— 
‘‘(A) paragraph (1)(A)(ii), the reference to 
2016 shall be deemed a reference to 2021; 
‘‘(B) paragraph (1)(B)(ii), the references 
to 2011 and 2012 shall be deemed references to 
2016 and 2017, respectively; 
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‘‘(C) paragraph (1)(B)(iii), the references 
to 2013 shall be deemed references to 2018; 
‘‘(D) paragraph (1)(B)(v), the references 
to 2014 shall be deemed references to 2019; 
and 
‘‘(E) paragraph (1)(E), the reference to 
2011 shall be deemed a reference to 2016.’’. 
(b) ELIGIBLE HOSPITALS.—Section 1886 of the So-
cial Security Act (42 U.S.C. 1395ww) is amended— 
(1) in subsection (b)(3)(B)(ix), by adding at the 
end the following new subclause: 
‘‘(V) The Secretary shall apply 
the provisions of this subsection with 
respect to an additional eligible hos-
pital 
(as 
defined 
in 
subsection 
(n)(6)(C)) in the same manner as 
such provisions apply to an eligible 
hospital, except in applying— 
‘‘(aa) subclause (I), the ref-
erences to 2015, 2016, and 2017 
shall be deemed references to 
2020, 2021, and 2022, respec-
tively; and 
‘‘(bb) subclause (III), the 
reference 
to 
2015 
shall 
be 
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154 
deemed a reference to 2020.’’; 
and 
(2) in subsection (n)— 
(A) in paragraph (6), by adding at the end 
the following new subparagraph: 
‘‘(C) ADDITIONAL ELIGIBLE HOSPITAL.— 
The term ‘additional eligible hospital’ means an 
inpatient hospital that is a psychiatric hospital 
(as defined in section 1861(f)).’’; and 
(B) by adding at the end the following new 
paragraph: 
‘‘(7) APPLICATION
TO
ADDITIONAL
ELIGIBLE 
HOSPITALS.—The Secretary shall apply the provi-
sions of this subsection with respect to an additional 
eligible hospital in the same manner as such provi-
sions apply to an eligible hospital, except in apply-
ing— 
‘‘(A) paragraph (2)(E)(ii), the references 
to 2013 and 2015 shall be deemed references to 
2018 and 2020, respectively; and 
‘‘(B) paragraph (2)(G)(i), the reference to 
2011 shall be deemed a reference to 2016.’’. 
(c) MEDICAID PROVIDERS.—Section 1903(t) of the 
Social Security Act (42 U.S.C. 1396b(t)) is amended— 
(1) in paragraph (2)(B)— 
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155 
(A) in clause (i), by striking ‘‘, or’’ at the 
end and inserting a semicolon; 
(B) in clause (ii), by striking the period at 
the end and inserting a semicolon; and 
(C) by inserting after clause (ii) the fol-
lowing new clauses: 
‘‘(iii) a public hospital that is principally a 
psychiatric hospital (as defined in section 
1861(f)); 
‘‘(iv) a private hospital that is principally 
a psychiatric hospital (as defined in section 
1861(f)) and that has at least 10 percent of its 
patient volume (as estimated in accordance with 
a methodology established by the Secretary) at-
tributable to individuals receiving medical as-
sistance under this title; 
‘‘(v) a community mental health center 
meeting the criteria specified in section 1913(c) 
of the Public Health Service Act; or 
‘‘(vi) a residential or outpatient mental 
health or substance use treatment facility 
that— 
‘‘(I) is accredited by the Joint Com-
mission on Accreditation of Healthcare Or-
ganizations, the Commission on Accredita-
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156 
tion of Rehabilitation Facilities, the Coun-
cil on Accreditation, or any other national 
accrediting agency recognized by the Sec-
retary; and 
‘‘(II) has at least 10 percent of its pa-
tient volume (as estimated in accordance 
with a methodology established by the Sec-
retary) attributable to individuals receiving 
medical assistance under this title.’’; and 
(2) in paragraph (3)(B)— 
(A) in clause (iv), by striking ‘‘; and’’ at 
the end and inserting a semicolon; 
(B) in clause (v), by striking the period at 
the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following new 
clause: 
‘‘(vi) clinical psychologist providing quali-
fied psychologist services (as defined in section 
1861(ii)), if such clinical psychologist is prac-
ticing in an outpatient clinic that— 
‘‘(I) is led by a clinical psychologist; 
and 
‘‘(II) is not otherwise receiving pay-
ment under paragraph (1) as a Medicaid 
provider described in paragraph (2)(B).’’. 
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157 
(d) MEDICARE ADVANTAGE ORGANIZATIONS.—Sec-
tion 1853 of the Social Security Act (42 U.S.C. 1395w– 
23) is amended— 
(1) in subsection (l)— 
(A) in paragraph (1)— 
(i) by inserting ‘‘or additional eligible 
professionals (as described in paragraph 
(9))’’ after ‘‘paragraph (2)’’; and 
(ii) by inserting ‘‘and additional eligi-
ble professionals’’ before ‘‘under such sec-
tions’’; 
(B) in paragraph (3)(B)— 
(i) in clause (i) in the matter pre-
ceding subclause (I), by inserting ‘‘or an 
additional eligible professional described in 
paragraph (9)’’ after ‘‘paragraph (2)’’; and 
(ii) in clause (ii)— 
(I) in the matter preceding sub-
clause (I), by inserting ‘‘or an addi-
tional eligible professional described in 
paragraph 
(9)’’ 
after 
‘‘paragraph 
(2)’’; and 
(II) in subclause (I), by inserting 
‘‘or an additional eligible professional, 
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158 
respectively,’’ after ‘‘eligible profes-
sional’’; 
(C) in paragraph (3)(C), by inserting ‘‘and 
additional eligible professionals’’ after ‘‘all eligi-
ble professionals’’; 
(D) in paragraph (4)(D), by adding at the 
end the following new sentence: ‘‘In the case 
that a qualifying MA organization attests that 
not all additional eligible professionals of the 
organization are meaningful EHR users with 
respect to an applicable year, the Secretary 
shall apply the payment adjustment under this 
paragraph based on the proportion of all such 
additional eligible professionals of the organiza-
tion that are not meaningful EHR users for 
such year.’’; 
(E) in paragraph (6)(A), by inserting 
‘‘and, as applicable, each additional eligible pro-
fessional described in paragraph (9)’’ after 
‘‘paragraph (2)’’; 
(F) in paragraph (6)(B), by inserting 
‘‘and, as applicable, each additional eligible hos-
pital described in paragraph (9)’’ after ‘‘sub-
section (m)(1)’’; 
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(G) in paragraph (7)(A), by inserting 
‘‘and, as applicable, additional eligible profes-
sionals’’ after ‘‘eligible professionals’’; 
(H) in paragraph (7)(B), by inserting 
‘‘and, as applicable, additional eligible profes-
sionals’’ after ‘‘eligible professionals’’; 
(I) in paragraph (8)(B), by inserting ‘‘and 
additional eligible professionals described in 
paragraph (9)’’ after ‘‘paragraph (2)’’; and 
(J) by adding at the end the following new 
paragraph: 
‘‘(9) ADDITIONAL ELIGIBLE PROFESSIONAL DE-
SCRIBED.—With respect to a qualifying MA organi-
zation, an additional eligible professional described 
in this paragraph is an additional eligible profes-
sional (as defined for purposes of section 1848(o)) 
who— 
‘‘(A)(i) is employed by the organization; or 
‘‘(ii)(I) is employed by, or is a partner of, 
an entity that through contract with the organi-
zation furnishes at least 80 percent of the enti-
ty’s Medicare patient care services to enrollees 
of such organization; and 
‘‘(II) furnishes at least 80 percent of the 
professional services of the additional eligible 
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160 
professional covered under this title to enrollees 
of the organization; and 
‘‘(B) furnishes, on average, at least 20 
hours per week of patient care services.’’; and 
(2) in subsection (m)— 
(A) in paragraph (1)— 
(i) by inserting ‘‘or additional eligible 
hospitals (as described in paragraph (7))’’ 
after ‘‘paragraph (2)’’; and 
(ii) by inserting ‘‘and additional eligi-
ble hospitals’’ before ‘‘under such sec-
tions’’; 
(B) in paragraph (3)(A)(i), by inserting 
‘‘or additional eligible hospital’’ after ‘‘eligible 
hospital’’; 
(C) in paragraph (3)(A)(ii), by inserting 
‘‘or an additional eligible hospital’’ after ‘‘eligi-
ble hospital’’ in each place it occurs; 
(D) in paragraph (3)(B)— 
(i) in clause (i), by inserting ‘‘or an 
additional eligible hospital described in 
paragraph (7)’’ after ‘‘paragraph (2)’’; and 
(ii) in clause (ii)— 
(I) in the matter preceding sub-
clause (I), by inserting ‘‘or an addi-
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161 
tional eligible hospital described in 
paragraph 
(7)’’ 
after 
‘‘paragraph 
(2)’’; and 
(II) in subclause (I), by inserting 
‘‘or an additional eligible hospital, re-
spectively,’’ after ‘‘eligible hospital’’; 
(E) in paragraph (4)(A), by inserting ‘‘or 
one or more additional eligible hospitals (as de-
fined in section 1886(n)), as appropriate,’’ after 
‘‘section 1886(n)(6)(A))’’; 
(F) in paragraph (4)(D), by adding at the 
end the following new sentence: ‘‘In the case 
that a qualifying MA organization attests that 
not all additional eligible hospitals of the orga-
nization are meaningful EHR users with re-
spect to an applicable period, the Secretary 
shall apply the payment adjustment under this 
paragraph based on the methodology specified 
by the Secretary, taking into account the pro-
portion of such additional eligible hospitals, or 
discharges from such hospitals, that are not 
meaningful EHR users for such period.’’; 
(G) in paragraph (5)(A), by inserting 
‘‘and, as applicable, each additional eligible hos-
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162 
pital described in paragraph (7)’’ after ‘‘para-
graph (2)’’; 
(H) in paragraph (5)(B), by inserting 
‘‘and additional eligible hospitals, as applica-
ble,’’ after ‘‘eligible hospitals’’; 
(I) in paragraph (6)(B), by inserting ‘‘and 
additional eligible hospitals described in para-
graph (7)’’ after ‘‘paragraph (2)’’; and 
(J) by adding at the end the following new 
paragraph: 
‘‘(7) ADDITIONAL
ELIGIBLE
HOSPITAL
DE-
SCRIBED.—With respect to a qualifying MA organi-
zation, an additional eligible hospital described in 
this paragraph is an additional eligible hospital (as 
defined in section 1886(n)(6)(C)) that is under com-
mon corporate governance with such organization 
and serves individuals enrolled under an MA plan of-
fered by such organization.’’. 
TITLE VIII—SAMHSA REAUTHOR-
IZATION AND REFORMS 
Subtitle A—Organization and 
General Authorities 
SEC. 801. IN GENERAL. 
Section 501 of the Public Health Service Act (42 
U.S.C. 290aa) is amended— 
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(1) in subsection (h), by inserting at the end 
the following: ‘‘For any such peer-review group re-
viewing a proposal or grant related to mental illness, 
no fewer than half of the members of the group shall 
have a medical degree, or a corresponding doctoral 
degree in psychology and clinical experience.’’; and 
(2) in subsection (l)— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; 
(B) in paragraph (3), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(4) At least 60 days before awarding a grant, 
cooperative agreement, or contract, the Assistant 
Secretary shall give written notice of the award to 
the Committee on Energy and Commerce of the 
House of Representatives and the Committee on 
Health, Education, Labor, and Pensions of the Sen-
ate.’’. 
SEC. 802. ADVISORY COUNCILS. 
Paragraph (3) of section 502(b) of the Public Health 
Service Act (42 U.S.C. 290aa–1(b)) is amended by adding 
at the end the following: 
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‘‘(C) No fewer than half of the members of 
an advisory council shall be mental health care 
providers with— 
‘‘(i) experience in mental health re-
search or treatment; and 
‘‘(ii) expertise in the fields on which 
they are advising. 
‘‘(D) None of the appointed members may 
have at any point been a recipient of any grant, 
or participated in any program, about which the 
members are to advise. 
‘‘(E) None of the appointed members may 
be related to anyone who has been a recipient 
of any grant, or participated in any program, 
about which the members are to advise. 
‘‘(F) None of the appointed members may 
have a financial interest in any grant or pro-
gram with respect to which they advise, or re-
ceive funding separately through the Office of 
Assistant Secretary. 
‘‘(G) Each advisory committee must in-
clude at least one member of the National Insti-
tute of Mental Health and one member from 
any Federal agency that has a program serving 
a similar population.’’. 
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165 
SEC. 803. PEER REVIEW. 
Section 504 of the Public Health Service Act (42 
U.S.C. 290aa–3) is amended— 
(1) by adding at the end of subsection (b) the 
following: ‘‘At least half of the members of any peer- 
review group established under subsection (a) shall 
have a degree in medicine, or a corresponding doc-
toral degree in psychology, or be a licensed mental 
health professional. Before awarding a grant, coop-
erative agreement, or contract, the Secretary shall 
provide a list of the members of the peer-review 
group responsible for reviewing the award 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 
(2) by adding at the end the following: 
‘‘(e) SCIENTIFIC CONTROLS AND STANDARDS.—Peer 
review under this section shall ensure that any research 
concerning an intervention is based on scientific controls 
and standards indicating whether the intervention reduces 
symptoms, improves medical or behavioral outcomes, and 
improves social functioning.’’. 
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