(2) for awards under subsection (a)(2), shall be 
not more than 5 fiscal years. 
(i) MATCHING FUNDS.—The Secretary may not 
award a grant under this section to an eligible entity un-
less the eligible entity agrees, with respect to the costs to 
be incurred by the eligible entity in carrying out the activi-
ties 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) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$5,000,000 for each of fiscal years 2017 through 2021. 
SEC. 108. 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 Substance Abuse and Mental Health Services 
Administration, acting in collaboration with the Director 
of the National Institute of Mental Health, shall require 
States to obligate at least 5 percent of the amounts appro-
priated for a fiscal year under subsection (a) to support 
evidence-based programs that address the needs of individ-
uals with early serious mental illness or serious emotional 
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disturbance, including psychotic disorders, regardless of 
the age of individual onset. Such models shall translate 
evidence-based interventions and best available science 
into systems of care, such as through models such as— 
‘‘(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) ADDITIONAL PROGRAM REQUIREMENTS.— 
(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 subparagraph (A), as 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-
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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 or serious 
emotional disturbance.’’; 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 improved outcomes, 
such as reduction of rates of suicides, suicide 
attempts, substance abuse, overdose deaths, 
emergency 
hospitalizations, 
incarceration, 
crimes, arrest, victimization, homelessness, job-
lessness, medication nonadherence, and edu-
cation and vocational programs drop outs. The 
plan must also include a detailed list of services 
available for individuals with serious mental ill-
ness or serious emotional disturbance in each 
county or county equivalent. 
‘‘(C) The plan shall include a separate de-
scription of active programs that seek to engage 
individuals with serious mental illness in 
proactively making their own health care deci-
sions and enhancing communication among 
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themselves, their families, and their treatment 
providers by allowing for early intervention by 
reducing legal proceedings related to involun-
tary treatment. Such programs may include 
services that help develop psychiatric advanced 
directives.’’. 
(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 ‘‘, such as reduc-
tions in homelessness, emergency hospitaliza-
tion, incarceration, and unemployment’’ after 
‘‘targets’’; 
(C) in such subparagraph, by striking the 
period at the end and inserting ‘‘; and’’; and 
(D) by adding at the end the following new 
subparagraph: 
‘‘(B) an agreement by the State to report 
to the Secretary such data as may be required 
by the Secretary concerning— 
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‘‘(i) comprehensive community mental 
health services in the State; and 
‘‘(ii) public health outcomes for per-
sons with serious mental illness or serious 
emotional disturbance in the State, such as 
rates of suicides, suicide attempts, sub-
stance abuse, overdose deaths, emergency 
hospitalizations, incarceration, crimes, ar-
rest, victimization, homelessness, jobless-
ness, medication nonadherence, and edu-
cation and vocational programs drop 
outs.’’. 
(3) IMPLEMENTATION
OF
PLAN.—Subsection 
(d)(1) of section 1912 of the Public Health Service 
Act (42 U.S.C. 300x–1(d)(1)) is amended— 
(A) by striking ‘‘Except as provided’’ and 
inserting: 
‘‘(A) Except as provided’’; and 
(B) by adding at the end the following new 
subparagraph: 
‘‘(B) For individuals receiving treatment 
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 
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meets the conditions under paragraph (2) by the end 
of the first quarter of the subsequent fiscal year, an 
equally divided share of the funding under para-
graph (3). 
‘‘(2) CONDITIONS.—The Secretary shall define 
the conditions under which a State is eligible to re-
ceive the additional amount under paragraph (1). 
‘‘(3) AUTHORIZATION
OF
APPROPRIATIONS.— 
For purposes of this subsection, there is authorized 
to be appropriated $25,000,000 for each of fiscal 
years 2017 through 2021. Any amounts made avail-
able under paragraph (1) shall be in addition to the 
State’s block grant allocation.’’. 
(d) EVIDENCE-BASED SERVICES DELIVERY MOD-
ELS.—Section 1912 of the Public Health Service Act (42 
U.S.C. 300x–1) is amended by adding at the end the fol-
lowing new subsection: 
‘‘(e) EXPANSION OF MODELS.— 
‘‘(1) IN GENERAL.—Taking into account the re-
sults of evaluations of block grant programs, the 
Secretary may, as part of the program of block 
grants under this subpart, provide for expanded use 
across the Nation of evidence-based service delivery 
models by providers funded under such block grants, 
so long as— 
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‘‘(A) the Secretary 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; 
‘‘(B) the Secretary determines that such 
expansion would improve the quality of patient 
care; and 
‘‘(C) the 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. 
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‘‘(2) DEFINITION.—In this subsection, the term 
‘emergency room boarding’ means the practice of ad-
mitting patients to an emergency department and 
holding them in the department until inpatient psy-
chiatric beds become available.’’. 
(e) 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, so long as any carryover is spent 
within 3 years of the year in which the funding was pro-
vided.’’. 
(f) 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.— 
‘‘(1) IN GENERAL.—A funding agreement for a 
grant under section 1911 is that the State involved 
has in effect active programs that seek to engage in-
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dividuals with serious mental illness in comprehen-
sive services in order to avert relapse, repeated hos-
pitalizations, arrest, incarceration, suicide, and to 
provide the individuals with the opportunity to live 
in the least restrictive setting, through a comprehen-
sive program of evidence-based and culturally rel-
evant assertive outreach and engagement services fo-
cusing on individuals who are homeless, have co-oc-
curring disorders, are at risk for incarceration or re- 
incarceration, or have a history of treatment failure, 
including repeated hospitalizations or emergency 
room usage. 
‘‘(2) EVIDENCE-BASED
ASSERTIVE
OUTREACH 
AND ENGAGEMENT SERVICES.— 
‘‘(A) SAMHSA.—The Administrator of 
the Substance Abuse and Mental Health Serv-
ices Administration, in cooperation with the Di-
rector of the National Institute of Mental 
Health, shall develop— 
‘‘(i) a list of evidence-based culturally 
and linguistically relevant assertive out-
reach and engagement services; and 
‘‘(ii) criteria to be used to assess the 
scope and effectiveness of the approaches 
taken by such services, such as the ability 
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to provide same-day appointments for 
emergent situations. 
‘‘(B) TYPES
OF
ASSERTIVE
OUTREACH 
AND ENGAGEMENT SERVICES.—For purposes of 
paragraph (1), appropriate programs of evi-
dence-based assertive outreach and engagement 
services may include peer support programs; 
the Wellness Recovery Action Plan, Assertive 
Community Treatment, and Forensic Assertive 
Community Treatment of the Substance Abuse 
and Mental Health Services Administration; ap-
propriate supportive housing programs incor-
porating a Housing First model; and intensive, 
evidence-based approaches to early intervention 
in psychosis, such as the Recovery After an Ini-
tial Schizophrenia Episode model of the Na-
tional Institute of Mental Health and the Spe-
cialized Treatment Early in Psychosis pro-
gram.’’. 
SEC. 109. CHILDREN’S RECOVERY FROM TRAUMA. 
Section 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 through the period at 
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the end and inserting ‘‘developing and maintaining 
programs that provide for— 
‘‘(1) the continued operation of the National 
Child Traumatic Stress Initiative (referred to in this 
section as the ‘NCTSI’), which includes a coordi-
nating center, that focuses on the mental, behav-
ioral, and biological aspects of psychological trauma 
response, prevention of the long-term consequences 
of child trauma, and early intervention services and 
treatment to address the long-term consequences of 
child trauma; and 
‘‘(2) the development of knowledge with regard 
to evidence-based practices for identifying and treat-
ing mental, behavioral, and biological disorders of 
children and youth resulting from witnessing or ex-
periencing 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 
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(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’’; 
(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 
treatment and services for children and families served by 
the NCTSI grantees. 
‘‘(d) TRAINING.—The NCTSI coordinating center 
shall facilitate the coordination of training initiatives in 
evidence-based and trauma-informed treatments, interven-
tions, and practices offered to NCTSI grantees, providers, 
and partners. 
‘‘(e) DISSEMINATION
AND COLLABORATION.—The 
NCTSI coordinating center shall, as appropriate, collabo-
rate with— 
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‘‘(1) the Secretary, in the dissemination of evi-
dence-based and trauma-informed interventions, 
treatments, products, and other resources to appro-
priate stakeholders; and 
‘‘(2) appropriate agencies that conduct or fund 
research within the Department of Health and 
Human Services, for purposes of sharing NCTSI ex-
pertise, evaluation data, and other activities, as ap-
propriate. 
‘‘(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 
of a consensus review process. The Secretary shall include 
review criteria related to expertise and experience in child 
trauma and evidence-based 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 
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(7) in subsection (j) (as so redesignated), by 
striking ‘‘$50,000,000’’ and all that follows through 
‘‘2006’’ and inserting ‘‘$47,000,000 for each of fis-
cal years 2017 through 2021’’. 
SEC. 110. GARRETT LEE SMITH MEMORIAL ACT REAUTHOR-
IZATION. 
(a) INTERAGENCY RESEARCH, TRAINING, AND TECH-
NICAL ASSISTANCE CENTERS.—Section 520C of the Pub-
lic Health Service Act (42 U.S.C. 290bb–34) is amend-
ed— 
(1) in subsection (d)— 
(A) in paragraph (1), by striking ‘‘youth 
suicide early intervention and prevention strate-
gies’’ and inserting ‘‘suicide early intervention 
and prevention strategies for all ages, particu-
larly for youth’’; 
(B) in paragraph (2), by striking ‘‘youth 
suicide early intervention and prevention strate-
gies’’ and inserting ‘‘suicide early intervention 
and prevention strategies for all ages, particu-
larly for youth’’; 
(C) in paragraph (3)— 
(i) by striking ‘‘youth’’; and 
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(ii) by inserting before the semicolon 
the following: ‘‘for all ages, particularly for 
youth’’; 
(D) in paragraph (4), by striking ‘‘youth 
suicide’’ and inserting ‘‘suicide for all ages, par-
ticularly among youth’’; 
(E) in paragraph (5), by striking ‘‘youth 
suicide early intervention techniques and tech-
nology’’ and inserting ‘‘suicide early interven-
tion techniques and technology for all ages, par-
ticularly for youth’’; 
(F) in paragraph (7)— 
(i) by striking ‘‘youth’’; and 
(ii) by inserting ‘‘for all ages, particu-
larly for youth,’’ after ‘‘strategies’’; and 
(G) in paragraph (8)— 
(i) by striking ‘‘youth suicide’’ each 
place that such appears and inserting ‘‘sui-
cide’’; and 
(ii) by striking ‘‘in youth’’ and insert-
ing ‘‘among all ages, particularly among 
youth’’; and 
(2) by amending subsection (e) to read as fol-
lows: 
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‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $5,988,000 for each of fiscal years 
2017 through 2021.’’. 
(b) YOUTH SUICIDE EARLY INTERVENTION
AND 
PREVENTION STRATEGIES.—Section 520E of the Public 
Health Service Act (42 U.S.C. 290bb–36) is amended— 
(1) in subsection (b), by striking paragraph (2) 
and inserting the following: 
‘‘(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 sentences, 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).’’; 
and 
(2) by striking subsection (m) and inserting the 
following: 
‘‘(m) AUTHORIZATION
OF APPROPRIATIONS.—For 
the purpose of carrying out this section, there is author-
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‘‘(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 2017 through 
2021.’’. 
SEC. 112. ADULT SUICIDE PREVENTION. 
(a) GRANTS.— 
(1) AUTHORITY.—The Administrator of the 
Substance Abuse and Mental Health Services Ad-
ministration (referred to in this section as the ‘‘Ad-
ministrator’’) may award grants to eligible entities 
in order to implement suicide prevention efforts 
amongst adults 25 and older. 
(2) PURPOSE.—The grant program under this 
section shall be designed to raise suicide awareness, 
establish referral processes, and improve clinical care 
practice standards for treating suicide ideation, 
plans, and attempts among adults. 
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(3) RECIPIENTS.—To be eligible to receive a 
grant under this section, an entity shall be a com-
munity-based primary care or behavioral health care 
setting, an emergency department, a State mental 
health agency, an Indian tribe, a tribal organization, 
or any other entity the Administrator deems appro-
priate. 
(4) NATURE
OF
ACTIVITIES.—The grants 
awarded under paragraph (1) shall be used to imple-
ment programs that— 
(A) screen for suicide risk in adults and 
provide intervention and referral to treatment; 
(B) implement evidence-based practices to 
treat individuals who are at suicide risk, includ-
ing appropriate follow-up services; and 
(C) raise awareness, reduce stigma, and 
foster open dialog about suicide prevention. 
(b) ADDITIONAL ACTIVITIES.—The Administrator 
shall— 
(1) evaluate the activities supported by grants 
awarded under subsection (a) in order to further the 
Nation’s understanding of effective interventions to 
prevent suicide in adults; 
(2) disseminate the findings from the evaluation 
as the Administrator considers appropriate; and 
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(3) provide appropriate information, training, 
and technical assistance to eligible entities that re-
ceive a grant under this section, in order to help 
such entities to meet the requirements of this sec-
tion, including assistance with— 
(A) selection and implementation of evi-
dence-based interventions and frameworks to 
prevent suicide, such as the Zero Suicide frame-
work; and 
(B) other activities as the Administrator 
determines appropriate. 
(c) DURATION.—A grant under this section shall be 
for a period of not more than 5 years. 
(d) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section $15,000,000 
for each of fiscal years 2017 through 2021. 
(2) USE OF CERTAIN FUNDS.—Of the funds ap-
propriated to carry out this section in any fiscal 
year, the lesser of 5 percent of such funds or 
$500,000 shall be available to the Administrator for 
purposes of carrying out subsection (b). 
SEC. 113. PEER REVIEW AND ADVISORY COUNCILS. 
(a) IN GENERAL.—Section 501 of the Public Health 
Service Act (42 U.S.C. 290aa) is amended— 
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(1) in subsection (i), as redesignated by section 
102, by inserting at the end the following: ‘‘For any 
such peer-review group reviewing a proposal or grant 
related to the treatment of mental illness, no fewer 
than half of the members of the group shall be expe-
rienced mental health providers.’’; and 
(2) in subsection (m), as redesignated by sec-
tion 102— 
(A) in paragraph (2), by striking ‘‘and’’ at 
the end; and 
(B) in paragraph (3), by striking the pe-
riod at the end and inserting ‘‘; and’’. 
(b) 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 fol-
lowing: 
‘‘(C) No fewer than one-third of the mem-
bers of an advisory council for the Center for 
Mental Health Services 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. 
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‘‘(D) The Secretary shall adopt a policy 
that ensures members of advisory councils do 
not have conflicts of interest with any program 
or grant about which the members are to ad-
vise.’’. 
(c) 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) that 
pertains to the treatment of mental illness shall be 
licensed and experienced mental health profes-
sionals.’’; 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 evidence 
indicating whether the intervention reduces symptoms, im-
proves medical or behavioral outcomes, or improves social 
functioning.’’. 
SEC. 114. ADULT TRAUMA. 
(a) GRANTS.— 
(1) AUTHORITY.—The Administrator of the 
Substance Abuse and Mental Health Services Ad-
ministration (referred to in this section as the ‘‘Ad-
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ministrator’’) may award grants to eligible entities 
in order to implement trauma-informed care in pri-
mary care and public health settings. 
(2) PURPOSE.—The grant program under this 
section shall be designed to facilitate and evaluate 
the impact of appropriate trauma screening and re-
sponses in primary care settings in order to further 
advance the Nation’s understanding of the need for 
addressing trauma in nonbehavioral health settings. 
(3) RECIPIENTS.—To be eligible to receive a 
grant under this section, an entity shall be a com-
munity-based, primary care setting, an academic re-
search setting in conjunction with primary care set-
tings, or any other entity the Administrator deems 
appropriate. 
(4) NATURE
OF
ACTIVITIES.—The grants 
awarded under paragraph (1) shall be used to imple-
ment programs that— 
(A) screen for trauma in adults, provide 
intervention and referral to treatment, and pro-
vide follow-up services, as appropriate; and 
(B) engage and involve trauma survivors, 
people receiving services, and family members 
receiving services in program design. 
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(5) PRACTITIONERS.—As a condition on receipt 
of a grant under paragraph (1), an entity shall 
agree that practitioners used to carry out any pro-
gram through the grant will be trained in interven-
tions that, as described in ‘‘SAMHSA’s Concept of 
Trauma and Guidance for a Trauma-Informed Ap-
proach’’, are— 
(A) based on the best available empirical 
evidence and science; 
(B) culturally appropriate; and 
(C) reflecting principles of a trauma-in-
formed approach. 
(b) ADDITIONAL ACTIVITIES.—The Director shall— 
(1) evaluate the activities supported by grants 
awarded under subsection (a) in order to further the 
Nation’s understanding of the need for, and com-
plexity of, addressing trauma in nonbehavioral 
health settings; 
(2) disseminate the findings from the evaluation 
as the Administrator considers appropriate; 
(3) provide appropriate information, training, 
and technical assistance to eligible entities that re-
ceive a grant under this section, in order to help 
such entities to meet the requirements of this sec-
tion, including assistance with— 
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(A) selection and implementation of cul-
turally appropriate, evidence-based interven-
tions that reflect the principles of trauma-in-
formed approach; 
(B) incorporating principles of peer sup-
port and trauma-informed care in hiring, super-
vision, and staff evaluation; 
(C) establishment of organizational prac-
tices and policies to support trauma-informed 
approaches to care; and 
(D) other activities as the Administrator 
determines appropriate. 
(c) DURATION.—A grant under this section shall be 
for a period of not more than 5 years. 
(d) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section $3,000,000 for 
each of fiscal years 2017 through 2021. 
(2) USE OF CERTAIN FUNDS.—Of the funds ap-
propriated to carry out this section in any fiscal 
year, the lesser of 5 percent of such funds or 
$500,000 shall be available to the Director for pur-
poses of carrying out subsection (b). 
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SEC. 115. REDUCING THE STIGMA OF SERIOUS MENTAL ILL-
NESS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services and the Secretary of Education shall or-
ganize a national awareness campaign involving public 
health organizations, advocacy groups for persons with se-
rious mental illness or serious emotional disturbance, and 
social media companies to assist secondary school students 
and postsecondary students in— 
(1) reducing the stigma associated with serious 
mental illness and serious emotional disturbance; 
(2) understanding how to assist an individual 
who is demonstrating signs of a serious mental ill-
ness or serious emotional disturbance; and 
(3) understanding the importance of seeking 
treatment from a physician, clinical psychologist, 
psychiatric nurse practitioner, or licensed mental 
health professional when a student believes the stu-
dent may be suffering from a serious mental illness, 
serious emotional disturbance, or behavioral health 
disorder. 
(b) DATA COLLECTION.—The Secretary of Health 
and Human Services shall evaluate the program under 
subsection (a) on public health to determine whether the 
program has made an impact on public health, such as 
reducing mortality rates of persons with serious mental 
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illness or serious emotional disturbance, the prevalence of 
serious mental illness and serious emotional disturbance, 
physician and clinical psychological visits, and emergency 
room visits for psychiatric services. 
(c) SECONDARY SCHOOL DEFINED.—For purposes of 
this section, the term ‘‘secondary school’’ has the meaning 
given the term in section 9101 of the Elementary and Sec-
ondary Education Act of 1965 (20 U.S.C. 7801). 
(d) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there is authorized to be appropriated 
$1,000,000 for each of fiscal years 2017 through 2021. 
SEC. 116. REPORT ON MENTAL HEALTH AND SUBSTANCE 
ABUSE TREATMENT IN THE STATES. 
(a) IN GENERAL.—Not later than 18 months after 
the date of enactment of this Act, and not less than every 
2 years thereafter, the Secretary of Health and Human 
Services shall submit to the Congress and make available 
to the public a report on mental health and substance use 
treatment in the States, including the following: 
(1) A detailed report on how Federal mental 
health and substance use treatment funds are used 
in each State including: 
(A) The numbers of individuals with men-
tal illness, serious mental illness, serious emo-
tional disturbance, substance use disorders, or 
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co-occurring disorders who are served with Fed-
eral funds. 
(B) The types of programs made available 
to individuals with mental illness, serious men-
tal illness, substance use disorders, or co-occur-
ring disorders. 
(2) 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 be-
havioral medicine, and improve outcomes for individ-
uals with mental illness or substance use disorders. 
(3) A statistical report of outcome measures in 
each State, for individuals with mental illness, seri-
ous mental illness, substance use disorders, and co- 
occurring disorders, such as— 
(A) rates of suicide, suicide attempts, sub-
stance abuse, overdose, overdose deaths, health 
outcomes, emergency psychiatric hospitaliza-
tions, and emergency room boarding; and 
(B) arrests, incarcerations, victimization, 
homelessness, joblessness, employment, and en-
rollment in educational or vocational programs. 
(b) DEFINITION.—In this subsection, the term 
‘‘emergency room boarding’’ means the practice of admit-
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ting patients to an emergency department and holding 
them in the department until inpatient psychiatric beds 
become available. 
SEC. 117. MENTAL HEALTH FIRST AID TRAINING GRANTS. 
Section 520J of the Public Health Service Act (42 
U.S.C. 290bb–41) is amended to read as follows: 
‘‘SEC. 520J. MENTAL HEALTH FIRST AID TRAINING GRANTS. 
‘‘(a) GRANTS.—The Secretary, acting through the 
Administrator, shall award grants to States, political sub-
divisions of States, Indian tribes, tribal organizations, and 
nonprofit private entities to initiate and sustain mental 
health first aid training programs. 
‘‘(b) PROGRAM REQUIREMENTS.— 
‘‘(1) IN GENERAL.—To be eligible for funding 
under subsection (a), a mental health first aid train-
ing program shall— 
‘‘(A) be designed to train individuals in the 
categories listed in paragraph (2) to accomplish 
the objectives described in paragraph (3); 
‘‘(B) ensure that training is conducted by 
trainers 
that 
are 
properly 
licensed 
and 
credentialed by nonprofit entities as designated 
by the Secretary; and 
‘‘(C) include— 
‘‘(i) at a minimum— 
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‘‘(I) a core live training course 
for individuals in the categories listed 
in paragraph (2) on the skills, re-
sources, and knowledge to assist indi-
viduals in crisis to connect with ap-
propriate local mental health care 
services; 
‘‘(II) training on mental health 
resources, including the location of 
community mental health centers de-
scribed in section 1913(c), in the 
State and local community; and 
‘‘(III) training on action plans 
and protocols for referral to such re-
sources; and 
‘‘(ii) where feasible, continuing edu-
cation and updated training for individuals 
in the categories listed in paragraph (2). 
‘‘(2) CATEGORIES
OF
INDIVIDUALS
TO
BE 
TRAINED.—The categories of individuals listed in 
this paragraph are the following: 
‘‘(A) Emergency services personnel and 
other first responders. 
‘‘(B) Police officers and other law enforce-
ment personnel. 
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‘‘(C) Teachers and school administrators. 
‘‘(D) Human resources professionals. 
‘‘(E) Faith community leaders. 
‘‘(F) Nurses and other primary care per-
sonnel. 
‘‘(G) Students enrolled in an elementary 
school, a secondary school, or an institution of 
higher education. 
‘‘(H) The parents of students described in 
subparagraph (G). 
‘‘(I) Veterans. 
‘‘(J) Other individuals, audiences or train-
ing populations as determined appropriate by 
the Secretary. 
‘‘(3) OBJECTIVES OF TRAINING.—To be eligible 
for funding under subsection (a), a mental health 
first aid training program shall be designed to train 
individuals in the categories listed in paragraph (2) 
to accomplish each of the following objectives (as ap-
propriate for the individuals to be trained, taking 
into consideration their age): 
‘‘(A) Safe de-escalation of crisis situations. 
‘‘(B) Recognition of the signs and symp-
toms of mental illness, including such common 
psychiatric conditions as schizophrenia, bipolar 
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disorder, major clinical depression, and anxiety 
disorders. 
‘‘(C) Timely referral to mental health serv-
ices in the early stages of developing mental 
disorders in order to— 
‘‘(i) avoid more costly subsequent be-
havioral health care; and 
‘‘(ii) enhance the effectiveness of men-
tal health services. 
‘‘(c) DISTRIBUTION
OF
AWARDS.—In awarding 
grants under this section, the Secretary shall— 
‘‘(1) ensure that grants are equitably distrib-
uted among the geographical regions of the United 
States; and 
‘‘(2) pay particular attention to the mental 
health training needs of populations and target audi-
ences residing in rural areas. 
‘‘(d) APPLICATION.—A State, political subdivision of 
a State, Indian tribe, tribal organization, or nonprofit pri-
vate entity that desires a grant under this section shall 
submit an application to the Secretary at such time, in 
such manner, and containing such information as the Sec-
retary may require, including a plan for the rigorous eval-
uation of activities that are carried out with funds received 
under such grant. 
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‘‘(e) EVALUATION.—A State, political subdivision of 
a State, Indian tribe, tribal organization, or nonprofit pri-
vate entity that receives a grant under this section shall 
prepare and submit an evaluation to the Secretary at such 
time, in such manner, and containing such information as 
the Secretary may reasonably require, including an evalua-
tion of activities carried out with funds received under 
such grant and a process and outcome evaluation. 
‘‘(f) AUTHORIZATION
OF
APPROPRIATIONS.—To 
carry out this section, there are authorized to be appro-
priated $20,000,000 for each of fiscal years 2017 through 
2021.’’. 
SEC. 118. ACUTE CARE BED REGISTRY GRANT FOR STATES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Administrator of the 
Substance Abuse and Mental Health Services Administra-
tion, shall award grants to State mental health agencies 
to develop and administer, or maintain an existing, real- 
time Internet-based bed registry described in subsection 
(b), to collect, aggregate, and display information about 
available beds in public and private inpatient psychiatric 
facilities and public and private residential crisis stabiliza-
tion units, and residential community mental health and 
residential substance abuse treatment facilities to facili-
tate the identification and designation of facilities for the 
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temporary treatment of individuals in psychiatric or sub-
stance abuse crisis. 
(b) REGISTRY REQUIREMENTS.—A bed registry de-
scribed in this subsection is a registry that— 
(1) includes descriptive information for every 
public and private inpatient psychiatric facility, 
every public and private residential crisis stabiliza-
tion unit, and residential community mental health 
and residential substance abuse facility in the State 
involved, including contact information for the facil-
ity or unit; 
(2) provides real-time information about the 
number of beds available at each facility or unit and, 
for each available bed, the type of patient that may 
be admitted, the level of security provided, and any 
other information that may be necessary to allow for 
the proper identification of appropriate facilities for 
treatment of individuals in psychiatric or substance 
abuse crisis; and 
(3) allows employees and designees of commu-
nity mental health and substance abuse service pro-
viders, employees of inpatient psychiatric facilities, 
public and private residential crisis stabilization 
units, or residential substance abuse treatment fa-
cilities, and health care providers working in an 
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emergency room of a hospital or clinic or other facil-
ity rendering emergency medical care to perform 
searches of the registry to identify available beds 
that are appropriate for the treatment of individuals 
in psychiatric crisis or substance abuse crisis. 
(c) AUTHORIZATION OF APPROPRIATIONS.—To carry 
out this section, there are authorized to be appropriated 
$15,000,000 for each of fiscal years 2017 through 2021. 
SEC. 119. OLDER ADULT MENTAL HEALTH GRANTS. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Cen-
ter for Mental Health Services, shall award grants, con-
tracts, or cooperative agreements to public and private 
nonprofit entities for projects that address the mental 
health needs of older adults, including programs to— 
(1) support the establishment and maintenance 
of interdisciplinary geriatric mental health specialist 
outreach teams in community settings where older 
adults reside or receive social services, in order to 
provide screening, referrals, and evidence-based 
intervention and treatment services, including serv-
ices provided by licensed mental health professionals; 
(2) develop and implement older adult suicide 
early intervention and prevention strategies in 1 or 
more settings that serve seniors, and collect and 
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analyze data on older adult suicide early intervention 
and prevention services for purposes of monitoring, 
research, and policy development; and 
(3) otherwise improve the mental health of 
older adults, as determined by the Secretary. 
(b) CONSIDERATIONS
IN AWARDING GRANTS.—In 
awarding grants under this section, the Secretary, to the 
extent feasible, shall ensure that— 
(1) projects are funded in a variety of geo-
graphic areas, including urban and rural areas; 
(2) a variety of populations, including racial 
and ethnic minorities and low-income populations, 
are served by projects funded under this section; and 
(3) older adult suicide intervention and preven-
tion programs are targeted towards areas with high 
older adult suicide rates. 
(c) APPLICATION.—To be eligible to receive a grant 
under this section, a public or private nonprofit entity 
shall— 
(1) submit an application to the Secretary (in 
such form, containing such information, and at such 
time as the Secretary may specify); 
(2) agree to report to the Secretary standard-
ized clinical and behavioral data or other perform-
ance data necessary to evaluate patient or program 
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outcomes and to facilitate evaluations across partici-
pating projects; and 
(3) demonstrate how such applicant will col-
laborate with other State and local public and pri-
vate nonprofit organizations. 
(d) DURATION.—A project may receive funding under 
a grant under this section for a period of up to 3 years, 
and such funding may be extended for a period of 2 addi-
tional years, at the discretion of the Secretary. 
(e) SUPPLEMENT, NOT SUPPLANT.—Funds made 
available under this section shall be used to supplement, 
and not supplant, other Federal, State, or local funds 
available to an entity to carry out activities described in 
this section. 
(f) REPORT.—Grantees under this section shall, be-
ginning with the end of the second year of the grant, sub-
mit yearly reports to the Secretary on the activities of the 
grantee in support of the grant and the latest performance 
data. Such reports shall contain recommendations as how 
to replicate the project funded through the grant. 
(g) DEFINITIONS.—In this section, the term ‘‘older 
adult’’ has the meaning given the term ‘‘older individual’’ 
in section 102 of the Older Americans Act of 1965 (42 
U.S.C. 3002). 
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(h) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$5,000,000 for each of fiscal years 2017 through 2021. 
TITLE II—INTERAGENCY SERI-
OUS MENTAL ILLNESS CO-
ORDINATING COMMITTEE 
SEC. 201. 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, in coordi-
nation with the Assistant Secretary, shall— 
‘‘(1) develop and annually update a summary of 
advances in serious mental illness research related to 
causes, prevention, treatment, early screening, diag-
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nosis or rule out, intervention, and access to services 
and supports for individuals with serious mental ill-
ness; 
‘‘(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 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 update every 5 years a stra-
tegic plan for the conduct and support of programs 
and services to assist individuals with serious mental 
illness, including— 
‘‘(A) a summary of the advances in serious 
mental illness research developed under para-
graph (1); 
‘‘(B) a list of the Federal programs and 
activities identified under paragraph (2); 
‘‘(C) an analysis of the efficiency, effective-
ness, quality, coordination, and cost-effective-
ness of Federal programs and activities relating 
to the prevention, diagnosis, treatment, or reha-
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bilitation of serious mental illness, including an 
accounting of the costs of such programs and 
activities 
with 
administrative 
costs 
disaggregated from the costs of services and 
care; and 
‘‘(D) a plan with recommendations— 
‘‘(i) for the coordination and improve-
ment of Federal programs and activities 
related to serious mental illness, including 
budgetary requirements; 
‘‘(ii) for improving outcomes for indi-
viduals with a serious mental illness in-
cluding appropriate benchmarks to meas-
ure progress on achieving improvements; 
‘‘(iii) for the mental health workforce; 
‘‘(iv) to disseminate relevant informa-
tion developed by the coordinating com-
mittee to the public, health care providers, 
social service providers, public health offi-
cials, courts, law enforcement, and other 
relevant groups; 
‘‘(v) to identify research needs, includ-
ing longitudinal studies of pediatric popu-
lations; and 
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‘‘(vi) for vulnerable and underserved 
populations, 
including 
pediatric 
popu-
lations, geriatric populations, and racial, 
ethnic, sexual, and gender minorities; and 
‘‘(6) submit to the Congress such strategic plan 
and any updates to such plan. 
‘‘(c) MEMBERSHIP.— 
‘‘(1) IN
GENERAL.—The Committee shall be 
composed of— 
‘‘(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 Director of the Indian Health 
Service; 
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‘‘(G) a member of the United States Inter-
agency Council on Homelessness; 
‘‘(H) the Administrator of the Centers for 
Medicare & Medicaid Service (or the Adminis-
trator’s designee); 
‘‘(I) the Secretary of Defense (or the Sec-
retary’s designee); 
‘‘(J) the Secretary of Education (or the 
Secretary’s designee); 
‘‘(K) the Secretary of Labor (or the Sec-
retary’s designee); 
‘‘(L) the Secretary of Veterans Affairs (or 
the Secretary’s designee); 
‘‘(M) the Commissioner of the Social Secu-
rity Administration (or the Commissioner’s des-
ignee); and 
‘‘(N) the additional members appointed 
under paragraph (2). 
‘‘(2) ADDITIONAL MEMBERS.—Not fewer than 
20 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 five such members shall be 
an individual in recovery from a diagnosis of se-
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rious mental illness who has benefited from 
medical treatment under the care of a licensed 
mental health professional; 
‘‘(B) at least three such members shall be 
a parent or legal guardian of an individual with 
a history of serious mental illness, including at 
least one of whom is the parent or legal guard-
ian of a child who has either attempted suicide 
or is incarcerated for a crime committed while 
experiencing a serious mental illness or serious 
emotional disturbance; 
‘‘(C) at least one such member shall be a 
representative of a leading research, advocacy, 
and service organization for individuals with se-
rious mental illness; 
‘‘(D) at least one such member shall be— 
‘‘(i) a licensed psychiatrist with expe-
rience treating serious mental illness; or 
‘‘(ii) a licensed clinical psychologist 
with experience treating serious mental ill-
ness; 
‘‘(E) at least one member shall be a li-
censed 
mental 
health 
counselor 
or 
psychotherapist; 
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‘‘(F) at least one member shall be a li-
censed clinical social worker; 
‘‘(G) at least one member shall be a li-
censed psychiatric nurse or nurse practitioner; 
‘‘(H) at least one member shall be a men-
tal health professional with a significant focus 
in his or her practice working with children and 
adolescents; 
‘‘(I) at least one member shall be a mental 
health professional who spends a significant 
concentration of his or her professional time or 
leadership practicing community mental health; 
‘‘(J) at least one member shall be a mental 
health professional with substantial experience 
working with mentally ill individuals who have 
a history of violence or suicide; 
‘‘(K) at least one such member shall be a 
State certified mental health peer specialist; 
‘‘(L) at least one member shall be a judge 
with experience adjudicating cases related to 
criminal justice and serious mental illness; 
‘‘(M) at least one member shall be a law 
enforcement officer with extensive experience in 
interfacing with psychiatric and psychological 
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disorders or individuals in mental health crisis; 
and 
‘‘(N) at least one member shall be a cor-
rections officer with extensive experience in 
interfacing with psychiatric and psychological 
disorders or individuals in mental health crisis. 
‘‘(d) REPORTS
TO CONGRESS.—Not later than 2 
years after the date of enactment of this Act, and every 
3 years thereafter, the Committee shall submit a report 
to the Congress— 
‘‘(1) evaluating the impact of projects address-
ing priority mental health needs of regional and na-
tional significance under sections 501, 509, 516, and 
520A including measurement of public health out-
comes 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; 
‘‘(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; 
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‘‘(2) formulating recommendations for the co-
ordination and improvement of Federal programs 
and activities that affect individuals with serious 
mental illness; 
‘‘(3) identifying any such programs and activi-
ties that are duplicative; and 
‘‘(4) summarizing all recommendations made, 
activities carried out, and results achieved pursuant 
to the workforce development strategy under section 
501. 
‘‘(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-
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. 
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‘‘(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. 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—There 
is authorized to be appropriated $1,000,000 to carry out 
the staffing functions under subsection (e)(1) for each of 
fiscal years 2017 through 2021.’’. 
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TITLE 
III—COMMUNICATIONS 
BETWEEN INDIVIDUALS, FAM-
ILIES, AND PROVIDERS 
SEC. 301. CLARIFICATION OF CIRCUMSTANCES UNDER 
WHICH DISCLOSURE OF PROTECTED HEALTH 
INFORMATION 
OF 
MENTAL 
ILLNESS 
PA-
TIENTS IS PERMITTED. 
The HITECH Act (title XIII of division A of Public 
Law 111–5) is amended by adding at the end of subtitle 
D of such Act (42 U.S.C. 17921 et seq.) the following: 
‘‘PART 3—IMPROVED PRIVACY AND SECURITY 
PROVISIONS FOR MENTAL ILLNESS PATIENTS 
‘‘SEC. 13431. CLARIFICATION OF CIRCUMSTANCES UNDER 
WHICH DISCLOSURE OF PROTECTED HEALTH 
INFORMATION IS PERMITTED. 
‘‘(a) IN GENERAL.—Not later than one year after the 
date of enactment of this section, the Secretary shall pro-
mulgate final regulations clarifying the circumstances 
under which, consistent with the standards governing the 
privacy and security of individually identifiable health in-
formation promulgated by the Secretary under sections 
262(a) and 264 of the Health Insurance Portability and 
Accountability Act of 1996, health care providers and cov-
ered entities may disclose the protected health information 
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of patients with a mental illness, including for purposes 
of— 
‘‘(1) communicating with a patient’s family, 
caregivers, friends, or others involved in the pa-
tient’s care, including communication about treat-
ments, side effects, risk factors, and the availability 
of community resources; 
‘‘(2) communicating with family or caregivers 
when the patient is an adult; 
‘‘(3) communicating with the parent or care-
giver of a patient who is a minor; 
‘‘(4) considering the patient’s capacity to agree 
or object to the sharing of their information; 
‘‘(5) communicating and sharing information 
with a patient’s family or caregivers when— 
‘‘(A) the patient consents; or 
‘‘(B) the patient does not consent, but the 
patient lacks the capacity to agree or object and 
the communication or sharing of information is 
in the patient’s best interest; 
‘‘(6) involving a patient’s family members, 
friends, or caregivers, or others involved in the pa-
tient’s care in the patient’s care plan, including 
treatment and medication adherence, in dealing with 
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patient failures to adhere to medication or other 
therapy; 
‘‘(7) listening to or receiving information from 
family members or caregivers about their loved ones 
receiving mental illness treatment; 
‘‘(8) communicating with family members, care-
givers, law enforcement, or others when the patient 
presents a serious and imminent threat of harm to 
self or others; and 
‘‘(9) communicating to law enforcement and 
family members or caregivers about the admission of 
a patient to receive care at a facility or the release 
of a patient who was admitted to a facility for an 
emergency psychiatric hold or involuntary treatment. 
‘‘(b) COORDINATION.—The Secretary shall carry out 
this section in coordination with the Director of the Office 
for Civil Rights within the Department of Health and 
Human Services. 
‘‘(c) CONSISTENCY WITH GUIDANCE.—The Secretary 
shall ensure that the regulations under this section are 
consistent with the guidance entitled ‘HIPAA Privacy 
Rule and Sharing Information Related to Mental Health’, 
issued by the Department of Health and Human Services 
on February 20, 2014.’’. 
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SEC. 302. DEVELOPMENT AND DISSEMINATION OF MODEL 
TRAINING PROGRAMS. 
(a) INITIAL PROGRAMS AND MATERIALS.—Not later 
than one year after promulgating final regulations under 
section 13431 of the HITECH Act, as added by section 
301, the Secretary of Health and Human Services (in this 
section referred to as the ‘‘Secretary’’) shall develop and 
disseminate— 
(1) a model program and materials for training 
health care providers (including physicians, emer-
gency medical personnel, psychologists, counselors, 
therapists, behavioral health facilities and clinics, 
care managers, and hospitals) regarding the cir-
cumstances under which, consistent with the stand-
ards governing the privacy and security of individ-
ually identifiable health information promulgated by 
the Secretary under sections 262(a) and 264 of the 
Health Insurance Portability and Accountability Act 
of 1996, the protected health information of patients 
with a mental illness may be disclosed with and 
without patient consent; 
(2) a model program and materials for training 
lawyers and others in the legal profession on such 
circumstances; and 
(3) a model program and materials for training 
patients and their families regarding their rights to 
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protect and obtain information under the standards 
specified in paragraph (1). 
(b) PERIODIC UPDATES.—The Secretary shall— 
(1) periodically review and update the model 
programs and materials developed under subsection 
(a); and 
(2) disseminate the updated model programs 
and materials. 
(c) CONTENTS.—The programs and materials devel-
oped under subsection (a) shall address the guidance enti-
tled ‘‘HIPAA Privacy Rule and Sharing Information Re-
lated to Mental Health’’, issued by the Department of 
Health and Human Services on February 20, 2014. 
(d) COORDINATION.—The Secretary shall carry out 
this section in coordination with the Director of the Office 
for Civil Rights within the Department of Health and 
Human Services, the Administrator of the Substance 
Abuse and Mental Health Services Administration, the 
Administrator of the Health Resources and Services Ad-
ministration, and the heads of other relevant agencies 
within the Department of Health and Human Services. 
(e) INPUT OF CERTAIN ENTITIES.—In developing the 
model programs and materials required by subsections (a) 
and (b), the Secretary shall solicit the input of relevant 
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national, State, and local associations, medical societies, 
and licensing boards. 
(f) FUNDING.—There is authorized to be appro-
priated to carry out this section $5,000,000 for fiscal year 
2017 and $25,000,000 for the period of fiscal years 2018 
through 2023. 
SEC. 303. MODERNIZING PRIVACY PROTECTIONS. 
Not later than two years after the date of the enact-
ment of this Act, the Secretary of Health and Human 
Services shall issue a final rule modernizing the privacy 
protections under section 543 of the Public Health Service 
Act (42 U.S.C. 290dd–2). 
SEC. 304. IMPROVING COMMUNICATION WITH INDIVID-
UALS, FAMILIES, AND PROVIDERS. 
(a) GRANTS.— 
(1) AUTHORITY.—The Secretary of Health and 
Human Services, acting through the Administrator 
of the Substance Abuse and Mental Health Services 
Administration, shall award grants to eligible enti-
ties for the implementation of pilot programs de-
signed to enhance care and promote recovery by sup-
porting communication between individuals in treat-
ment, their families, providers, and other individuals 
involved in their care. 
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(2) RECIPIENTS.—To be eligible to receive a 
grant under this section, an entity shall be a State, 
county, city, tribe, tribal organization, institutions of 
higher education, public organization, or private 
nonprofit organizations. 
(3) NATURE
OF
ACTIVITIES.—The grants 
awarded under paragraph (1) shall be used to imple-
ment evidence-based or innovative programs, such as 
Adapted or Open Dialogue, that enhance care and 
promote recovery by supporting communities be-
tween individuals and those involved in their treat-
ment, care, and support. 
(b) ADDITIONAL ACTIVITIES.—The Secretary shall— 
(1) evaluate the activities supported by grants 
awarded under subsection (a) in order to further the 
Nation’s understanding of effective communication 
strategies between individuals with mental illness 
and their families and health care providers; 
(2) disseminate the findings from the evaluation 
as the Secretary considers appropriate; 
(3) make recommendations for scaling up suc-
cessful models across the country, including in pub-
licly funded programs; and 
(4) other activities as the Secretary determines 
appropriate. 
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(c) DURATION.—A grant under this section shall be 
for a period of not more than 5 years. 
(d) AUTHORIZATION OF APPROPRIATIONS.— 
(1) IN GENERAL.—There is authorized to be 
appropriated to carry out this section $2,000,000 for 
each of fiscal years 2017 through 2021. 
(2) USE OF CERTAIN FUNDS.—Of the funds ap-
propriated to carry out this section in any fiscal 
year, no more than 5 percent shall be available to 
the Secretary for the purposes of carrying out sub-
section (b). 
TITLE 
IV—IMPROVING 
MED-
ICAID AND MEDICARE MEN-
TAL HEALTH SERVICES 
Subtitle A—Medicaid Provisions 
SEC. 401. 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.—Section 1902 of the Social Security Act 
(42 U.S.C. 1396a) is amended— 
(1) in subsection (a), by inserting after para-
graph (77) the following new paragraph: 
‘‘(78) in the case of a State that does not have 
in effect (as of the date of the enactment of this 
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paragraph) under its State plan a payment method-
ology that allows for full reimbursement of all same- 
day qualifying services through a single payment, 
not prohibit payment under the plan for a mental 
health service or primary care service furnished 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 federally qualified 
health center (as defined in section 1861(aa)(3)) for 
which payment would otherwise be payable under 
the plan, with respect to such individual, if such 
service were not a same-day qualifying service (as 
defined in subsection (ll));’’; and 
(2) by adding at the end the following new sub-
section: 
‘‘(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 
‘‘(2) a mental health service furnished to an in-
dividual by a provider at a facility on the same day 
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a primary care service is furnished to such individual 
by such provider (or another provider) at the facil-
ity.’’. 
(b) PROVIDING FULL-RANGE OF EPSDT SERVICES 
TO CHILDREN IN IMDS.—Section 1905(h) of the Social 
Security Act (42 U.S.C. 1396d(h)) is amended by adding 
at the end the following new paragraph: 
‘‘(3) Such term includes the full-range of early and 
periodic screening, diagnostic, and treatment services (as 
defined in subsection (r)).’’. 
(c) OPTIONAL LIMITED COVERAGE OF INPATIENT 
SERVICES FURNISHED IN INSTITUTIONS FOR MENTAL 
DISEASES.—Section 1903(m)(2) of the Social Security 
Act (42 U.S.C. 1396b(m)(2)) is amended by adding at the 
end the following new subparagraph: 
‘‘(I)(i) Notwithstanding the limitation specified in the 
subdivision (B) following paragraph (29) of section 
1905(a), beginning on the date of the enactment of this 
subparagraph, a State may provide, as part of the monthly 
capitated payment made by the State under this title to 
a medicaid managed care organization or a prepaid inpa-
tient health plan (as defined in section 438.2 of title 42, 
Code of Federal Regulations (or any successor regula-
tion)), for payment for limited inpatient psychiatric hos-
pital services provided by such organization or health plan, 
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at the option of the individual receiving such services, in 
lieu of services covered under the State plan during the 
month for which the payment is made. 
‘‘(ii) In this subparagraph, the term ‘limited inpatient 
psychiatric hospital services’ means the services described 
in subparagraphs (A) and (B) of section 1905(h)(1)— 
‘‘(I) that are furnished to individuals over 21 
years of age and under 65 years of age in an institu-
tion for mental diseases (as defined in section 
1905(i)) that is an inpatient hospital facility or a 
sub-acute care facility providing crisis residential 
services (as defined by the Secretary); and 
‘‘(II) for which the length of stay in such an in-
stitution is for a short-term stay of not more than 
15 days during the month for which the capitated 
payment referred to in clause (i) is made.’’. 
(d) EFFECTIVE DATE.— 
(1) IN GENERAL.—Subject to paragraph (2), 
the amendments made by subsections (a) and (b) 
shall apply to items and services furnished after the 
date of the enactment of this section. 
(2) 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-
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tion in order for the respective plan to meet any re-
quirement imposed by amendments made by sub-
sections (a) and (b), 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 additional requirement before the first day 
of the first calendar quarter beginning after the 
close of the first regular session of the State legisla-
ture that begins after the date of enactment of this 
Act. For purposes of the previous sentence, in the 
case of a State that has a 2-year legislative session, 
each year of the session shall be considered to be a 
separate regular session of the State legislature. 
SEC. 402. EXTENSION AND EXPANSION OF DEMONSTRA-
TION PROGRAMS TO IMPROVE COMMUNITY 
MENTAL HEALTH SERVICES. 
Paragraph (3) of section 223(d) of the Protecting Ac-
cess to Medicare Act of 2014 (Public Law 113–93; 128 
Stat. 1077) is amended to read as follows: 
‘‘(3) NUMBER AND LENGTH OF DEMONSTRA-
TION PROGRAMS.— 
‘‘(A) IN GENERAL.—Except as provided in 
subparagraphs (B) and (C), not more than 8 
States shall be selected for 2-year demonstra-
tion programs under this subsection. 
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‘‘(B) THREE-YEAR EXTENSION.—A State 
selected to participate in the demonstration 
project under this subsection shall, upon the re-
quest of the State, be permitted to continue to 
participate in the demonstration project for an 
additional 3-year period, if the Secretary makes 
the determination specified in subparagraph 
(D) with respect to the State. The Secretary 
shall provide each such State with notice of that 
determination. 
‘‘(C) 
EXPANSION
TO
ADDITIONAL 
STATES.— 
‘‘(i) IN
GENERAL.—The Secretary 
may expand the number of eligible States 
participating in the demonstration project, 
if, with respect to any such State, the Sec-
retary makes the determination specified in 
subparagraph (D). The period of the par-
ticipation of any such eligible State in the 
demonstration project shall end on Decem-
ber 31, 2022, regardless of the date on 
which the State begins participating in the 
demonstration project. 
‘‘(ii) NOTIFICATION.—The Secretary 
shall provide each State that applies to be 
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added to the demonstration project under 
this subsection with notice of the deter-
mination under subparagraph (D) and the 
standards used to make such determina-
tion. 
‘‘(D) DETERMINATION.—The determina-
tion specified in this subparagraph is that the 
Secretary determines that, in the case of a re-
quest under subparagraph (B) or an expansion 
of the demonstration project under subpara-
graph (C)— 
‘‘(i) the continued participation of a 
State in the demonstration project under 
this subsection or an expansion of the 
project to any additional State (as applica-
ble) will measurably improve access to, and 
participation in, services described in sub-
section (a)(2)(D) by individuals eligible for 
medical assistance under the State Med-
icaid program; and 
‘‘(ii) any such State is in full compli-
ance with the reporting requirements 
under paragraph (7) and any quality re-
porting requirements established by the 
Secretary.’’. 
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SEC. 403. TERMS FOR EXTENSION AND EXPANSION OF MED-
ICAID 
EMERGENCY 
PSYCHIATRIC 
DEM-
ONSTRATION PROJECT. 
Section 2707(f)(4) of the Patient Protection and Af-
fordable Care Act (42 U.S.C. 1396a note; Public Law 
111–148), as amended by section 2(c) of the Improving 
Access to Emergency Psychiatric Care Act (Public Law 
114–97), is amended by striking subparagraph (C). 
SEC. 404. COMMUNITY-BASED MENTAL HEALTH SERVICES 
MEDICAID OPTION FOR CHILDREN IN OR AT 
RISK OF PSYCHIATRIC RESIDENTIAL TREAT-
MENT. 
Section 1915(c) of the Social Security Act (42 U.S.C. 
1396n(c)) is amended— 
(1) in paragraph (1)— 
(A) in the first sentence, by striking ‘‘or a 
nursing facility or intermediate care facility for 
the mentally retarded’’ and inserting ‘‘, nursing 
facility, intermediate care facility for the men-
tally retarded, or psychiatric residential treat-
ment facility’’; and 
(B) in the second sentence, by striking ‘‘or 
intermediate care facility for the mentally re-
tarded’’ and inserting ‘‘intermediate care facil-
ity for the mentally retarded, or psychiatric res-
idential treatment facility’’; 
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(2) in paragraph (2)— 
(A) in subparagraph (B)— 
(i) in clause (i), by striking ‘‘or serv-
ices in an intermediate care facility for the 
mentally retarded’’ and inserting ‘‘services 
in an intermediate care facility for the 
mentally retarded, or services in a psy-
chiatric residential treatment facility’’; and 
(ii) in the matter following clause (iii), 
by striking ‘‘or services in an intermediate 
care facility for the mentally retarded’’ and 
inserting ‘‘services in an intermediate care 
facility for the mentally retarded, or serv-
ices in a psychiatric residential treatment 
facility’’; and 
(B) in subparagraph (C)— 
(i) by striking ‘‘or intermediate care 
facility for the mentally retarded’’ and in-
serting ‘‘intermediate care facility for the 
mentally retarded, or psychiatric residen-
tial treatment facility’’; and 
(ii) by striking ‘‘or services in an in-
termediate care facility for the mentally re-
tarded’’ and inserting ‘‘services in an inter-
mediate care facility for the mentally re-
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tarded, or services in a psychiatric residen-
tial treatment facility’’; 
(3) in paragraph (7)(A), by striking ‘‘or inter-
mediate care facilities for the mentally retarded’’ 
and inserting ‘‘intermediate care facilities for the 
mentally retarded, or psychiatric residential treat-
ment facilities’’; and 
(4) by adding at the end the following new 
paragraph: 
‘‘(11) For purposes of this subsection, the term ‘psy-
chiatric residential treatment facility’ has the meaning 
given such term in section 483.352 of title 42, Code of 
Federal Regulations (or any successor regulation).’’. 
SEC. 405. EXPANSION OF CMMI AUTHORITY TO SUPPORT 
MAJOR MENTAL ILLNESS PROJECTS IN MED-
ICAID. 
Section 1115A(b)(2)(B) of the Social Security Act 
(42 U.S.C. 1315a(b)(2)(B)) is amended by adding at the 
end the following new clause: 
‘‘(xxv) Focusing primarily on title 
XIX, preventing major mental illness and 
substance use disorders and reducing the 
impact of long-term mental illness and 
substance use disorders among children, 
adolescents, pregnant women, and adults 
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through multi-level treatment including but 
not limited to outreach, clinical assessment 
and mental health services, and supported 
education and employment.’’. 
SEC. 406. MEDICAID DATA AND REPORTING. 
(a) GUIDANCE ON REPORTING MEDICAID MENTAL 
HEALTH SCREENING AND TREATMENT FOR YOUTH.— 
The Secretary of Health and Human Services shall de-
velop guidance for the annual reporting by States of men-
tal health screening provided to children eligible for med-
ical assistance for early and periodic screening, diagnostic, 
and treatment services under title XIX of the Social Secu-
rity Act. Such guidance shall be provided in the form of 
a modification of the CMS 416 Annual EPSDT Participa-
tion Report in a manner so that the report includes infor-
mation on the number of children under 12 years of age, 
and the number of individuals who are at least 12 years 
of age but not older than 21 years of age, who receive 
mental health screening services, the number of such chil-
dren and individuals who are referred for mental health 
treatment, and the number of such children and individ-
uals who are receive treatment for mental health condi-
tions under such title. 
(b) MACPAC.—Section 1900(b)(6) of the Social Se-
curity Act (42 U.S.C. 1396(b)(6)) is amended— 
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(1) by striking ‘‘MACPAC shall consult’’ and 
inserting the following: 
‘‘(A) IN GENERAL.—MACPAC shall con-
sult’’; and 
(2) by adding at the end the following new sub-
paragraph: 
‘‘(B) REVIEW AND REPORTS REGARDING 
BEHAVIORAL
HEALTH
PROVIDER
REIMBURSE-
MENT.— 
‘‘(i) IN
GENERAL.—MACPAC shall 
survey selected State Medicaid programs’ 
behavioral health provider reimbursement 
rates and beneficiary utilization of behav-
ioral health services and shall submit an 
annual report to Congress regarding such 
review. 
‘‘(ii) REQUIRED
REPORT
INFORMA-
TION.—Each such report regarding behav-
ioral health services shall include selected 
data relating to— 
‘‘(I) beneficiary behavioral health 
service encounters; and 
‘‘(II) the amount of Medicaid be-
havioral health provider reimburse-
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ment rates and the sources for such 
rates. 
‘‘(iii) DATA.—Notwithstanding any 
other provision of law, the Secretary regu-
larly shall provide MACPAC with— 
‘‘(I) the most recent State re-
ports and most recent independent 
certified audits submitted under sec-
tion 1923(j); 
‘‘(II) 
cost 
reports 
submitted 
under title XVIII; and 
‘‘(III) 
such 
other 
data 
as 
MACPAC may request, 
for purposes of conducting the reviews and 
preparing and submitting the annual re-
ports required under this subparagraph.’’. 
SEC. 407. AT-RISK YOUTH MEDICAID PROTECTION. 
(a) IN GENERAL.—Section 1902 of the Social Secu-
rity Act (42 U.S.C. 1396a), as amended by section 401, 
is further amended— 
(1) in subsection (a)— 
(A) by striking ‘‘and’’ at the end of para-
graph (80); 
(B) by striking the period at the end of 
paragraph (81) and inserting ‘‘; and’’; and 
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(C) by inserting after paragraph (81) the 
following new paragraph: 
‘‘(82) provide that— 
‘‘(A) the State shall not terminate (but 
may suspend) eligibility for medical assistance 
under a State plan for an individual who is an 
eligible juvenile (as defined in subsection 
(mm)(2)) because the juvenile is an inmate of 
a public institution (as defined in subsection 
(mm)(3)); 
‘‘(B) the State shall automatically restore 
eligibility for such medical assistance to such an 
individual upon the individual’s release from 
any such public institution, unless (and until 
such date as) there is a determination that the 
individual no longer meets the eligibility re-
quirements for such medical assistance; and 
‘‘(C) the State shall process any applica-
tion for medical assistance submitted by, or on 
behalf of, a juvenile who is an inmate of a pub-
lic institution notwithstanding that the juvenile 
is such an inmate.’’; and 
(2) by adding at the end the following new sub-
section: 
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‘‘(mm) JUVENILE; ELIGIBLE JUVENILE; PUBLIC IN-
STITUTION.—For purposes of subsection (a)(82) and this 
subsection: 
‘‘(1) JUVENILE.—The term ‘juvenile’ means an 
individual who is— 
‘‘(A) under 19 years of age (or such higher 
age as the State has elected under section 
475(8)(B)(iii)); or 
‘‘(B) 
is 
described 
in 
subsection 
(a)(10)(A)(i)(IX). 
‘‘(2) ELIGIBLE JUVENILE.—The term ‘eligible 
juvenile’ means a juvenile who is an inmate of a 
public institution and was eligible for medical assist-
ance under the State plan immediately before be-
coming an inmate of such a public institution or who 
becomes eligible for such medical assistance while an 
inmate of a public institution. 
‘‘(3) INMATE OF A PUBLIC INSTITUTION.—The 
term ‘inmate of a public institution’ has the meaning 
given such term for purposes of applying the sub-
division (A) following paragraph (29) of section 
1905(a), taking into account the exception in such 
subdivision for a patient of a medical institution.’’. 
(b) NO CHANGE IN EXCLUSION FROM MEDICAL AS-
SISTANCE
FOR INMATES
OF PUBLIC INSTITUTIONS.— 
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Nothing in this section shall be construed as changing the 
exclusion from medical assistance under the subdivision 
(A) following paragraph (29) of section 1905(a) of the So-
cial Security Act (42 U.S.C. 1396d(a)), including any ap-
plicable restrictions on a State submitting claims for Fed-
eral financial participation under title XIX of such Act 
for such assistance. 
(c) EFFECTIVE DATE.— 
(1) IN GENERAL.—Except as provided in para-
graph (2), the amendments made by subsection (a) 
shall apply to eligibility of juveniles who become in-
mates of public institutions on or after the date that 
is 1 year after the date of the enactment of this Act. 
(2) RULE
FOR
CHANGES
REQUIRING
STATE 
LEGISLATION.—In the case of a State plan for med-
ical assistance under title XIX of the Social Security 
Act which the Secretary of Health and Human Serv-
ices determines requires State legislation (other than 
legislation appropriating funds) in order for the plan 
to meet the additional requirements imposed by the 
amendments made by subsection (a), the State plan 
shall not be regarded as failing to comply with the 
requirements of such title solely on the basis of its 
failure to meet these additional requirements before 
the first day of the first calendar quarter beginning 
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100 
after the close of the first regular session of the 
State legislature that begins after the date of the en-
actment of this Act. For purposes of the previous 
sentence, in the case of a State that has a 2-year 
legislative session, each year of such session shall be 
deemed to be a separate regular session of the State 
legislature. 
Subtitle B—Medicare Provisions 
SEC. 411. ELIMINATION OF 190-DAY LIFETIME LIMIT ON 
COVERAGE OF INPATIENT PSYCHIATRIC HOS-
PITAL SERVICES UNDER MEDICARE. 
Section 1812 of the Social Security 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)’’. 
SEC. 412. MODIFICATIONS TO MEDICARE DISCHARGE PLAN-
NING REQUIREMENTS. 
Section 1861(ee) of the Social Security Act (42 
U.S.C. 1395x(ee)) is amended— 
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101 
(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 (4)’’ before the period at the end; 
and 
(2) by adding at the end the following new 
paragraph: 
‘‘(4) 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, taking into account variations in posthospital care 
access, including mental health professional shortage 
areas designated by the Health Resources and Services 
Administration. The Secretary shall issue final regulations 
implementing such guidelines and standards not later than 
24 months after the date of the enactment of this para-
graph. The guidelines and standards shall include the fol-
lowing: 
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102 
‘‘(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) make demonstrated efforts to estab-
lish connections, relationships, and partnerships 
with such organizations. 
‘‘(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 
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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.’’. 
Subtitle C—Provisions Related to 
Medicaid and Medicare 
SEC. 421. REPORTS ON MEDICAID AND MEDICARE PART D 
FORMULARY AND APPEALS PRACTICES WITH 
RESPECT TO COVERAGE OF MENTAL HEALTH 
DRUGS. 
(a) MEDICAID.— 
(1) IN
GENERAL.—Not later than one year 
after the date of the enactment of this Act, the 
Comptroller General of the United States shall sub-
mit to Congress a report that, with respect to men-
tal health drugs, describes the practices of the State 
with respect to the following (for both such drugs 
furnished on a fee-for-service basis and through 
Medicaid managed care organizations): 
(A) The establishment of formularies and 
preferred drugs lists. 
(B) The appeal of any coverage determina-
tion. 
(2) MENTAL HEALTH DRUG DEFINED.—In this 
section, the term ‘‘mental health drug’’ means a cov-
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104 
ered outpatient drug (as defined in section 1927(k) 
of the Social Security Act (42 U.S.C. 1396r–8(k))) 
that— 
(A) is approved or licensed under section 
505 of the Federal Food, Drug, and Cosmetic 
Act (21 U.S.C. 355) or section 351 of the Pub-
lic Health Service Act (42 U.S.C. 262) to be 
used for the treatment of a mental health dis-
order, including major depression, bipolar 
(manic-depressive) disorder, panic disorder, ob-
sessive-compulsive disorder, schizophrenia, and 
schizoaffective disorder; and 
(B) is covered under the State plan under 
title XIX of the Social Security Act (42 U.S.C. 
1396 et seq.) (or under a waiver of such plan). 
(b) MEDICARE.— 
(1) STUDY.— 
(A) IN GENERAL.—The Inspector General 
of the Department of Health and Human Serv-
ices shall conduct a study that examines, with 
respect to the Medicare program established 
under title XVIII of the Social Security Act (42 
U.S.C. 1395 et seq.), the extent to which Medi-
care part D appeals-related processes are trans-
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parent, fair, effective, and in compliance with 
existing statutory and regulatory requirements. 
(B) INCLUDED
ELEMENTS
OF
STUDY.— 
The study required under paragraph (1) shall 
include— 
(i) an identification, with respect to a 
two-year period beginning not earlier than 
January 1, 2010, of— 
(I) the number of grievances, re-
considerations, and independent re-
views and appeals pursuant to Medi-
care part D appeals-related processes 
that were lodged, requested, or other-
wise filed during such period by part 
D eligible individuals who were en-
rolled in prescription drug plans of-
fered by PDP sponsors under part D 
of title XVIII of the Social Security 
Act (42 U.S.C. 1395 et seq.); and 
(II) with respect to such griev-
ances, reconsiderations, and inde-
pendent reviews and appeals that were 
so lodged, requested, or otherwise 
filed during such period by such indi-
viduals, the number of such griev-
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106 
ances, reconsiderations, and inde-
pendent reviews and appeals that were 
decided in favor of such individuals; 
and 
(ii) an examination of the extent to 
which Medicare part D appeals-related 
processes, with respect to grievances, re-
considerations, and independent reviews 
and appeals that relate to benefits for psy-
chiatric medications under such part, are 
transparent, fair, effective, and in compli-
ance with existing statutory and regulatory 
requirements. 
(2) REPORT.—Not later than one year after the 
date of the enactment of this Act, such Inspector 
General shall submit to Congress a report on the re-
sults of the study described in subsection (a), includ-
ing the recommendations of such Inspector General, 
if any, for improvements that can be made to Medi-
care part D appeals-related processes. 
(3) DEFINITIONS.—For purposes of this sec-
tion: 
(A) MEDICARE PART D APPEALS-RELATED 
PROCESSES.—The term ‘‘Medicare part D ap-
peals-related processes’’ means— 
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(i) grievance procedures provided by 
PDP sponsors pursuant to subsection (f) 
of section 1860D–4 of the Social Security 
Act (42 U.S.C. 1395w–104); 
(ii) reconsiderations provided by PDP 
sponsors pursuant to subsection (g) of 
such section; and 
(iii) independent reviews and appeals 
to which part D eligible individuals are en-
titled under subsection (h) of such section. 
(B) PART D TERMS.—The terms ‘‘part D 
eligible individual’’, ‘‘prescription drug plan’’, 
and ‘‘PDP sponsor’’ have the meanings given 
such terms by section 1840D–41 of the Social 
Security Act (42 U.S.C. 1395w–151). 
(c) ACCESS TO TREATMENTS FOR RESISTANT DE-
PRESSION
IN
THE
MEDICARE
AND
MEDICAID
PRO-
GRAMS.—Not later than one year after the date of the en-
actment of this Act, the Comptroller General of the United 
States shall submit to Congress a report that reviews— 
(1) access of available treatments for resistant 
depression under the Medicare program under title 
XVIII of the Social Security Act and the Medicaid 
program under title XIX of such Act; and 
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(2) the length of time to adopt, and processes 
for the adoption of, newly available treatment for re-
sistant depression for individuals entitled to benefits 
under part A of such title XVIII or enrolled under 
part B of such title and for individuals enrolled 
under a State plan under such title XIX. 
TITLE V—STRENGTHENING THE 
BEHAVIORAL HEALTH WORK-
FORCE AND IMPROVING AC-
CESS TO CARE 
SEC. 501. NATIONWIDE WORKFORCE STRATEGY. 
(a) IN GENERAL.—Not later than one year after the 
date of enactment of this Act, the Substance Abuse Men-
tal Health and Services Administration shall, submit to 
the Congress a report containing a nationwide strategy to 
increase the culturally aware behavioral health workforce 
and recruit professionals for the treatment of individuals 
with mental illness and substance use disorders. 
(b) DESIGN.—The nationwide strategy shall be de-
signed— 
(1) to encourage and incentivize students en-
rolled in accredited medical or osteopathic medical 
school to enter the specialty of psychiatry; 
(2) to promote greater research-oriented psy-
chiatrist residency training on evidence-based service 
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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 trained and culturally 
aware preventionists, health care practitioners, 
paraprofessionals, and peers; 
(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 most underserved by mental health and sub-
stance use professionals and the most in need of 
psychiatrists (including child and adolescent psychia-
trists), psychologists, psychiatric nurse practitioners, 
physician assistants, clinical social workers, mental 
health counselors, substance abuse counselors, peer- 
support specialists, recovery coaches, and other men-
tal health and substance use disorder professionals. 
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SEC. 502. REPORT ON BEST PRACTICES FOR PEER-SUP-
PORT 
SPECIALIST 
PROGRAMS, 
TRAINING, 
AND CERTIFICATION. 
(a) IN GENERAL.—Not later than 2 years after the 
date of enactment of this Act, the Secretary shall submit 
to the Congress and make publicly available a report on 
best practices and professional standards in States for— 
(1) establishing and operating health care pro-
grams using peer-support specialists; and 
(2) training and certifying peer-support special-
ists. 
(b) PEER-SUPPORT SPECIALIST DEFINED.—In this 
subsection, the term ‘‘peer-support specialist’’ means an 
individual who— 
(1) uses his or her lived experience of recovery 
from mental illness or substance abuse, plus skills 
learned in formal training, to facilitate support 
groups, and to work on a one-on-one basis, with in-
dividuals with a serious mental illness or a substance 
use disorder; 
(2) has benefited or is benefiting from mental 
health or substance use treatment services or sup-
ports; 
(3) provides non-medical services; and 
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(4) performs services only within his or her 
area of training, expertise, competence, or scope of 
practice. 
(c) CONTENTS.—The report under this section shall 
include information on best practices and standards with 
regard to the following: 
(1) Hours of formal work or volunteer experi-
ence related to mental health and substance use 
issues. 
(2) Types of peer support specialists used by 
different health care programs. 
(3) Types of peer specialist exams required. 
(4) Code of ethics. 
(5) Additional training required prior to certifi-
cation, including in areas such as— 
(A) ethics; 
(B) scope of practice; 
(C) crisis intervention; 
(D) State confidentiality laws; 
(E) Federal privacy protections, including 
under the Health Insurance Portability and Ac-
countability Act of 1996; and 
(F) other areas as determined by the Sec-
retary. 
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(6) Requirements to explain what, where, when, 
and how to accurately complete all required docu-
mentation activities. 
(7) Required or recommended skill sets, such as 
knowledge of— 
(A) risk indicators, including individual 
stressors, triggers, and indicators of escalating 
symptoms; 
(B) basic de-escalation techniques; 
(C) basic suicide prevention concepts and 
techniques; 
(D) indicators that the consumer may be 
experiencing abuse or neglect; 
(E) stages of change or recovery; 
(F) the typical process that should be fol-
lowed to access or participate in community 
mental health and related services; and 
(G) circumstances when it is appropriate 
to request assistance from other professionals 
to help meet the consumer’s recovery goals. 
(8) Requirements for continuing education. 
SEC. 503. ADVISORY COUNCIL ON GRADUATE MEDICAL 
EDUCATION. 
Section 762(b) of the Public Health Service Act (42 
U.S.C. 294o(b)) is amended— 
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(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;’’. 
SEC. 504. TELEPSYCHIATRY AND PRIMARY CARE PROVIDER 
TRAINING GRANT PROGRAM. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services shall establish a grant program (in this 
subsection referred to as the ‘‘grant program’’) under 
which the Secretary shall award to 10 eligible States (as 
described in subsection (e)) grants for carrying out all of 
the purposes described in subsections (b), (c), and (d). 
(b) TRAINING PROGRAM
FOR CERTAIN PRIMARY 
CARE PROVIDERS.—For purposes of subsection (a), the 
purpose described in this paragraph, with respect to a 
grant awarded to a State under the grant program, is for 
the State to establish a training program to train primary 
care providers in— 
(1) valid and reliable behavioral-health screen-
ing tools for violence and suicide risk, early signs of 
serious mental illness, and untreated substance 
abuse, including any standardized behavioral-health 
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screening tools that are determined appropriate by 
the Secretary; 
(2) implementing the use of behavioral-health 
screening tools in their practices; 
(3) establishment of recommended intervention 
and treatment protocols for individuals in mental 
health crisis, especially for individuals whose illness 
makes them less receptive to mental health services; 
and 
(4) implementing the evidence-based collabo-
rative care model of integrated medical-behavioral 
health care in their practices. 
(c) PAYMENTS
FOR MENTAL HEALTH SERVICES 
PROVIDED BY CERTAIN PRIMARY CARE PROVIDERS.— 
(1) IN GENERAL.—For purposes of subsection 
(a), the purpose described in this paragraph, with 
respect to a grant awarded to a State under the 
grant program, is for the State to provide, in ac-
cordance with this paragraph, in the case of a pri-
mary care physician who participates in the training 
program of the State establish pursuant to sub-
section (b), payments to the primary care providers 
for services furnished by the primary care providers. 
(2) CONSIDERATIONS.—The Secretary, in de-
termining the structure, quality, and form of pay-
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ment under paragraph (1) shall seek to find innova-
tive payment systems which may take into account— 
(A) the nature and quality of services ren-
dered; 
(B) the patients’ health outcome; 
(C) the geographical location where serv-
ices were provided; 
(D) the acuteness of the patient’s medical 
condition; 
(E) the duration of services provided; 
(F) the feasibility of replicating the pay-
ment model in other locations nationwide; and 
(G) proper triage and enduring linkage to 
appropriate treatment provider for subspecialty 
care in child or forensic issues; family crisis 
intervention; drug or alcohol rehabilitation; 
management of suicidal or violent behavior risk, 
and treatment for serious mental illness. 
(d) TELEHEALTH SERVICES FOR MENTAL HEALTH 
DISORDERS.— 
(1) IN GENERAL.—For purposes of subsection 
(a), the purpose described in this paragraph, 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 furnished items and services by 
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a primary care physician during an office visit, for 
payment for a consultation provided by a psychia-
trist or psychologist to such primary care provider 
with respect to such individual through the use of 
qualified telehealth technology for the identification, 
diagnosis, mitigation, or treatment of a mental 
health disorder if such consultation occurs not later 
than the first business day that follows such visit. 
(2) QUALIFIED TELEHEALTH TECHNOLOGY.— 
For purposes of paragraph (1), 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 tele-
communications technology by a health care provider 
to deliver health care services within the scope of the 
provider’s practice including the use of electronic 
media for consultation relating to the health care di-
agnosis or treatment of the patient. 
(e) ELIGIBLE STATE.— 
(1) IN GENERAL.—For purposes of this sub-
section, an eligible State is a State that has sub-
mitted to the Secretary an application under para-
graph (2) and has been selected under paragraph 
(4). 
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123 
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. 
‘‘(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. 
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