I 
111TH CONGRESS 
1ST SESSION H. R. 3191 
To amend the Public Health Service Act to provide for integration of mental 
health services and mental health treatment outreach teams, and for 
other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 13, 2009 
Mr. KENNEDY (for himself, Ms. ROS-LEHTINEN, and Mr. DAVIS of Illinois) 
introduced the following bill; which was referred to the Committee on En-
ergy and Commerce 
A BILL 
To amend the Public Health Service Act to provide for 
integration of mental health services and mental health 
treatment outreach teams, and for other purposes. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Positive Aging Act of 
2009’’. 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00001
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
SEC. 2. DEMONSTRATION PROJECTS TO SUPPORT INTE-
GRATION OF MENTAL HEALTH SERVICES IN 
PRIMARY CARE SETTINGS. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.) is amended— 
(1) in section 520(b)— 
(A) in paragraph (14), by striking ‘‘and’’ 
after the semicolon; 
(B) in paragraph (15), by striking the pe-
riod at the end and inserting ‘‘; and’’; and 
(C) by adding at the end the following: 
‘‘(16) conduct the demonstration projects speci-
fied in section 520K.’’; and 
(2) by adding at the end the following: 
‘‘SEC. 520K. PROJECTS TO DEMONSTRATE INTEGRATION OF 
MENTAL HEALTH SERVICES IN PRIMARY 
CARE SETTINGS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Center for Mental Health Services, 
shall award grants to public and private nonprofit entities 
for projects to demonstrate ways of integrating mental 
health services for older adults into primary care settings, 
such as health centers receiving a grant under section 330 
(or determined by the Secretary to meet the requirements 
for receiving such a grant), other federally qualified health 
centers, primary care clinics, and private practice sites. 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00002
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
‘‘(b) REQUIREMENTS.—In order to be eligible for a 
grant under this section, the project to be carried out by 
the entity shall provide for collaborative care within a pri-
mary care setting, provided by licensed mental health pro-
fessionals with appropriate training and experience in the 
treatment of older adults, in which screening, assessment, 
and intervention services are combined into an integrated 
service delivery model, including— 
‘‘(1) screening services by a mental health pro-
fessional with at least a masters degree in an appro-
priate field of training; 
‘‘(2) referrals for necessary prevention, inter-
vention, follow-up care, consultations, and care plan-
ning oversight for mental health and other service 
needs, as indicated; and 
‘‘(3) adoption and implementation of evidence- 
based intervention and treatment protocols (to the 
extent such protocols are available) for mental dis-
orders prevalent in older adults including, but not 
limited to, mood and anxiety disorders, dementias of 
all kinds (including the behavioral and psychological 
symptoms of dementia), psychotic disorders, and 
substance-related disorders. 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00003
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
‘‘(c) 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; and 
‘‘(2) a variety of populations, including racial 
and ethnic minorities and low-income populations, 
are served by projects funded under this section. 
‘‘(d) DURATION.—A project may receive funding pur-
suant to a grant under this section for a period of up to 
3 years, with an extension period of 2 additional years 
at the discretion of the Secretary. 
‘‘(e) 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); and 
‘‘(2) agree to report to the Secretary standard-
ized clinical and behavioral data and other perform-
ance data necessary to evaluate patient outcomes 
and to facilitate evaluations across participating 
projects. 
‘‘(f) EVALUATION.—Not later than July 31 of the 
second calendar year after the date of enactment of this 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00004
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
section, and July 31 of every year thereafter, the Sec-
retary shall submit to Congress a report evaluating the 
projects receiving awards under this section for the year 
involved. 
‘‘(g) SUPPLEMENT, NOT SUPPLANT.—Funds made 
available under this section shall supplement, and not sup-
plant, other Federal, State, or local funds available to an 
entity to carry out activities described in this section. 
‘‘(h) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section for fiscal year 2010 
and each fiscal year thereafter.’’. 
SEC. 3. GRANTS FOR COMMUNITY-BASED MENTAL HEALTH 
TREATMENT OUTREACH TEAMS. 
Subpart 3 of part B of title V of the Public Health 
Service Act (42 U.S.C. 290bb–31 et seq.), as amended by 
section 2, is further amended by adding at the end the 
following: 
‘‘SEC. 520L. GRANTS FOR COMMUNITY-BASED MENTAL 
HEALTH TREATMENT OUTREACH TEAMS. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Director of the Center for Mental Health Services, 
shall award grants to public or private nonprofit entities 
that are community-based providers of geriatric mental 
health services, to support the establishment and mainte-
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00005
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
nance by such entities of interdisciplinary geriatric mental 
health outreach teams in community settings where older 
adults reside or receive social services. Entities eligible for 
such grants include— 
‘‘(1) mental health service providers of a State 
or local government; 
‘‘(2) outpatient programs of private, nonprofit 
hospitals; 
‘‘(3) community mental health centers meeting 
the criteria specified in section 1913(c); and 
‘‘(4) other community-based providers of mental 
health services. 
‘‘(b) REQUIREMENTS.—To be eligible to receive a 
grant under this section, an entity shall— 
‘‘(1) adopt and implement, for use by its mental 
health outreach team, evidence-based intervention 
and treatment protocols (to the extent such proto-
cols are available) for mental disorders prevalent in 
older adults including, but not limited to, mood and 
anxiety disorders, dementias of all kinds (including 
the behavioral and psychological symptoms of de-
mentia), psychotic disorders, and substance-related 
disorders, relying to the greatest extent feasible on 
protocols that have been developed— 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00006
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
‘‘(A) by or under the auspices of the Sec-
retary; or 
‘‘(B) by academicians; 
‘‘(2) provide screening for mental disorders, di-
agnostic services, referrals for treatment, and case 
management and coordination through such teams; 
and 
‘‘(3) coordinate and integrate the services pro-
vided by such team with the services of social serv-
ice, mental health, and medical providers at the site 
or sites where the team is based in order to— 
‘‘(A) improve patient outcomes; and 
‘‘(B) to assure, to the maximum extent 
feasible, the continuing independence of older 
adults who are residing in the community. 
‘‘(c) COOPERATIVE ARRANGEMENTS WITH SITES 
SERVING AS BASES FOR OUTREACH.—An entity receiving 
a grant under this section may enter into an agreement 
with a person operating a site at which a geriatric mental 
health outreach team of the entity is based, including— 
‘‘(1) senior centers; 
‘‘(2) adult day care programs; 
‘‘(3) assisted living facilities; and 
‘‘(4) recipients of grants to provide services to 
older adults under the Older Americans Act of 1965, 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00007
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
under which such person provides (and is reim-
bursed by the entity, out of funds received under the 
grant, for) any supportive services, such as transpor-
tation and administrative support, that such person 
provides to an outreach team of such entity. 
‘‘(d) 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; and 
‘‘(2) a variety of populations, including racial 
and ethnic minorities and low-income populations, 
are served by projects funded under this section. 
‘‘(e) APPLICATION.—To be eligible to receive a grant 
under this section, an entity shall— 
‘‘(1) submit an application to the Secretary (in 
such form, containing such information, at such 
time as the Secretary may specify); and 
‘‘(2) agree to report to the Secretary standard-
ized clinical and behavioral data and other perform-
ance data necessary to evaluate patient outcomes 
and to facilitate evaluations across participating 
projects. 
‘‘(f) COORDINATION.—The Secretary shall provide 
for appropriate coordination of programs and activities re-
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00008
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
ceiving funds pursuant to a grant under this section with 
programs and activities receiving funds pursuant to grants 
under section 520K and sections 381, 422, and 423 of 
the Older Americans Act of 1965. 
‘‘(g) EVALUATION.—Not later than July 31 of the 
second calendar year after the date of enactment of this 
section, and July 31 of every year thereafter, the Sec-
retary shall submit to Congress a report evaluating the 
projects receiving awards under this section for such year. 
‘‘(h) SUPPLEMENT, NOT SUPPLANT.—Funds made 
available under this section shall supplement, and not sup-
plant, other Federal, State, or local funds available to an 
entity to carry out activities described in this section. 
‘‘(i) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated such sums as may be 
necessary to carry out this section for fiscal year 2010 
and each fiscal year thereafter.’’. 
SEC. 4. DESIGNATION OF DEPUTY DIRECTOR FOR OLDER 
ADULT MENTAL HEALTH SERVICES IN CEN-
TER FOR MENTAL HEALTH SERVICES. 
Section 520 of the Public Health Service Act (42 
U.S.C. 290bb–31) is amended— 
(1) by redesignating subsection (c) as sub-
section (d); and 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00009
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
(2) by inserting after subsection (b) the fol-
lowing: 
‘‘(c) DEPUTY DIRECTOR FOR OLDER ADULT MEN-
TAL
HEALTH
SERVICES
IN
CENTER
FOR
MENTAL 
HEALTH SERVICES.—The Director, after consultation 
with the Administrator, shall designate a Deputy Director 
for Older Adult Mental Health Services, who shall be re-
sponsible for the development and implementation of ini-
tiatives of the Center to address the mental health needs 
of older adults. Such initiatives shall include— 
‘‘(1) research on prevention and identification 
of mental disorders in the older adult population; 
‘‘(2) innovative demonstration projects for the 
delivery of community-based mental health services 
for older adults; 
‘‘(3) support for the development and dissemi-
nation of evidence-based practice models, including 
models to address substance-related disorders in 
older adults; and 
‘‘(4) development of model training programs 
for mental health professionals and caregivers serv-
ing older adults.’’. 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00010
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
SEC. 5. MEMBERSHIP OF ADVISORY COUNCIL FOR THE 
CENTER FOR MENTAL HEALTH SERVICES. 
Section 502(b)(3) of the Public Health Service Act 
(42 U.S.C. 290aa–1(b)(3)) is amended by adding at the 
end the following: 
‘‘(C) In the case of the advisory council for 
the Center for Mental Health Services, the 
members appointed pursuant to subparagraphs 
(A) and (B) shall include representatives of 
older adults or their families, and professionals 
with an expertise in geriatric mental health.’’. 
SEC. 6. PROJECTS OF NATIONAL SIGNIFICANCE TAR-
GETING 
SUBSTANCE 
ABUSE 
IN 
OLDER 
ADULTS. 
Section 509(b)(2) of the Public Health Service Act 
(42 U.S.C. 290bb–2(b)(2)) is amended by inserting before 
the period the following: ‘‘, and to providing treatment for 
older adults with substance-related disorders’’. 
SEC. 7. CRITERIA FOR STATE PLANS UNDER COMMUNITY 
MENTAL HEALTH SERVICES BLOCK GRANTS. 
(a) IN GENERAL.—Section 1912(b)(4) of the Public 
Health Service Act (42 U.S.C. 300x–2(b)(4)) is amended 
to read as follows: 
‘‘(4) TARGETED SERVICES TO OLDER INDIVID-
UALS, INDIVIDUALS WHO ARE HOMELESS, AND INDI-
VIDUALS LIVING IN RURAL AREAS.—The plan de-
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00011
Fmt 6652
Sfmt 6201
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS
scribes the State’s outreach to and services for older 
individuals, individuals who are homeless, and indi-
viduals living in rural areas, and how community- 
based services will be provided to these individuals.’’. 
(b) EFFECTIVE DATE.—The amendment made by 
subsection (a) shall apply to State plans submitted on or 
after the date that is 180 days after the date of enactment 
of this Act. 
Æ 
VerDate Nov 24 2008 
02:14 Jul 14, 2009
Jkt 079200
PO 00000
Frm 00012
Fmt 6652
Sfmt 6301
E:\BILLS\H3191.IH
H3191
jbell on DSKHWCL6B1PROD with BILLS