Title: 9–8–8 Implementation Act of 2022
Policy area: Health

Summary:
9-8-8 Implementation Act of 2022
This bill modifies provisions to increase access to behavioral health services, with a focus on crisis services and the 9-8-8 telecommunication system. (The 9-8-8 system provides callers with mental health or suicide crisis support and resources through the existing National Suicide Prevention Lifeline and is scheduled to take effect by July 16, 2022.)
The bill reauthorizes through FY2027 and revises the National Suicide Prevention Lifeline program and requires a national suicide prevention media campaign.
In addition, the Substance Abuse and Mental Health Services Administration (SAMHSA) must establish standards for a behavioral health crisis continuum of care that health care providers and communities may use in responding to individuals experiencing a behavioral health crisis. The continuum must include emergency treatment, stabilization, and related services. The bill expands Medicaid and other insurance coverage for such services.
The bill further expands Medicaid coverage for behavioral health services. This includes permanently allowing coverage of certain community-based mobile crisis services and exempting some short-term stabilization services from coverage restrictions that apply to institutions for mental diseases.
Additionally, the bill establishes (1) an office within SAMHSA to coordinate behavioral health activities; and (2) various grants, including a pilot program for mobile crisis care teams that respond to behavioral health crises rather than law enforcement and a capital improvement program for certain behavioral health facilities.
The bill also reauthorizes through FY2027 and expands certain workforce programs for behavioral health providers. It also addresses training for emergency services dispatchers and coordination of the 9-1-1 system with the 9-8-8 system.

[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[H.R. 7116 Introduced in House (IH)]

<DOC>






117th CONGRESS
  2d Session
                                H. R. 7116

   To provide for improvements in the implementation of the National 
          Suicide Prevention Lifeline, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 17, 2022

   Mr. Cardenas (for himself, Mr. Fitzpatrick, Ms. Matsui, Ms. Blunt 
  Rochester, Mr. Moulton, Mrs. Napolitano, Mr. Beyer, and Mr. Raskin) 
 introduced the following bill; which was referred to the Committee on 
  Energy and Commerce, and in addition to the Committees on Ways and 
Means, Armed Services, Veterans' Affairs, and Oversight and Reform, for 
a period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
   To provide for improvements in the implementation of the National 
          Suicide Prevention Lifeline, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    (a) Short Title.--This Act may be cited as the ``9-8-8 
Implementation Act of 2022''.
    (b) Table of Contents.--The table of contents for this Act is as 
follows:

Sec. 1. Short title.
   TITLE I--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

Sec. 101. Behavioral Health Crisis Coordinating Office.
Sec. 102. National suicide prevention lifeline program.
Sec. 103. Regional and local lifeline call center program.
Sec. 104. Evidence-based and best practice crisis care programs.
Sec. 105. Mental Health Crisis Response Partnership Pilot Program.
Sec. 106. National suicide prevention media campaign.
         TITLE II--HEALTH RESOURCES AND SERVICES ADMINISTRATION

Sec. 201. Health center capital grants.
Sec. 202. Expanding behavioral health workforce training programs.
         TITLE III--BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION

Sec. 301. Crisis response continuum of care.
Sec. 302. Coverage of crisis response services.
Sec. 303. Building the crisis continuum infrastructure.
Sec. 304. Incident reporting.
                     TITLE IV--MEDICAID AMENDMENTS

Sec. 401. Revisions to the State option to provide qualifying 
                            community-based mobile crisis intervention 
                            services and other services under State 
                            plans under the Medicaid program.
Sec. 402. Revisions to the IMD exclusion under Medicaid.
Sec. 403. Excellence in Mental Health and Addiction Treatment.

   TITLE I--SUBSTANCE ABUSE AND MENTAL HEALTH SERVICES ADMINISTRATION

SEC. 101. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.

    Part A of title V of the Public Health Service Act (42 U.S.C. 290aa 
et seq.) is amended by adding at the end the following:

``SEC. 506B. BEHAVIORAL HEALTH CRISIS COORDINATING OFFICE.

    ``(a) In General.--The Secretary, acting through the Assistant 
Secretary for Mental Health and Substance Use, shall establish an 
office to coordinate work relating to behavioral health crisis care 
across the operating divisions of the Department of Health and Human 
Services, including the Centers for Medicare & Medicaid Services and 
the Health Resources and Services Administration and external 
stakeholders.
    ``(b) Duty.--The office established under subsection (a) shall--
            ``(1) convene Federal, State, Tribal, local, and private 
        partners;
            ``(2) launch and manage Federal workgroups charged with 
        making recommendations regarding behavioral health crisis 
        financing, workforce, equity, data, and technology, program 
        oversight, public awareness, and engagement; and
            ``(3) support technical assistance, data analysis, and 
        evaluation functions in order to develop a crisis care system 
        to establish nationwide standards with the objective of 
        expanding the capacity of, and access to, local crisis call 
        centers, mobile crisis care, crisis stabilization, psychiatric 
        emergency services, and rapid post-crisis follow-up care 
        provided by--
                    ``(A) the National Suicide Prevention and Mental 
                Health Crisis Hotline and Response System;
                    ``(B) community mental health centers (as defined 
                in section 1861(ff)(3)(B) of the Social Security Act);
                    ``(C) certified community behavioral health 
                clinics, as described in section 223 of the Protecting 
                Access to Medicare Act of 2014; and
                    ``(D) other community mental health and substance 
                use disorder providers.
    ``(c) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section $10,000,000 for each of fiscal 
years 2023 through 2027.''.

SEC. 102. NATIONAL SUICIDE PREVENTION LIFELINE PROGRAM.

    (a) Authorization of Appropriations.--Section 520E-3(c) of the 
Public Health Service Act (290bb-36c(c)) is amended by inserting before 
the period at the end the following: ``, and $240,000,000 for each of 
fiscal years 2023 through 2027''.
    (b) Specialized Hotline for Underserved Populations.--Section 520E-
3 of the Public Health Service Act (290bb-36c) is amended--
            (1) in subsection (b)--
                    (A) in paragraph (2)--
                            (i) by inserting after ``suicide prevention 
                        hotline'' the following: ``, under the 
                        universal telephone number designated under 
                        section 251(e)(4) of the Communications Act of 
                        1934,''; and
                            (ii) by striking ``; and'' at the end and 
                        inserting a semicolon;
                    (B) in paragraph (3), by striking the period at the 
                end and inserting ``; and''; and
                    (C) by adding at the end the following:
            ``(4) providing for access by LGBTQ individuals, people of 
        color, and other underserved populations to specialized 
        services through a range of digital and technology approaches, 
        as determined by the Office of the Assistant Secretary.'';
            (2) by redesignating subsection (c) as subsection (d); and
            (3) by inserting after subsection (b) the following:
    ``(c) Consultation.--Wherever possible, the Office of the Assistant 
Secretary shall, in determining which approaches to use to provide 
specialized services under subsection (b)(4) to the populations 
described in such subsection, consult with organizations that have 
experience--
            ``(1) working with such populations; and
            ``(2) technological expertise in effective crisis response 
        using such digital and technology approaches.''.

SEC. 103. REGIONAL AND LOCAL LIFELINE CALL CENTER PROGRAM.

    Part B of title V of the Public Health Service Act (42 U.S.C. 290bb 
et seq.) is amended by inserting after section 520E-4 (42 U.S.C. 290bb-
36d) the following:

``SEC. 520E-5. REGIONAL AND LOCAL LIFELINE CALL CENTER PROGRAM.

    ``(a) In General.--The Secretary shall award grants to crisis call 
centers described in section 302(c)(1) of the 9-8-8 National Suicide 
Prevention Lifeline Implementation Act of 2022 to--
            ``(1) purchase or upgrade call center technology;
            ``(2) provide for training of call center staff;
            ``(3) improve call center operations; and
            ``(4) hiring of call center staff.
    ``(b) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $441,000,000 for fiscal year 
2023, to remain available until expended.''.

SEC. 104. EVIDENCE-BASED AND BEST PRACTICE CRISIS CARE PROGRAMS.

    (a) In General.--Section 1912(b)(1) of the Public Health Service 
Act (42 U.S.C. 300x-1(b)(1)) is amended--
            (1) in subparagraph (A)--
                    (A) by redesignating clauses (vi) and (vii) as 
                clauses (vii) and (viii), respectively; and
                    (B) by inserting after clause (v), the following:
                            ``(vi) include a description of how the 
                        State supports evidenced-based and best 
                        practice programs that address the crisis care 
                        needs of individuals with serious mental 
                        illness, and children with serious emotional 
                        disturbances, that include at least one of the 
                        core components specified in subparagraph 
                        (F);''; and
            (2) by adding at the end the following:
                    ``(F) Core components for crisis care services.--
                The core components of a program referred to in 
                subparagraph (A)(vi) include the following:
                            ``(i) Crisis call centers.
                            ``(ii) 24/7 mobile crisis services.
                            ``(iii) Crisis stabilization programs 
                        offering acute care or subacute care in a 
                        hospital or appropriately licensed facility, 
                        with referrals to inpatient or outpatient care, 
                        as determined by the Assistant Secretary for 
                        Mental Health and Substance Use.''.
    (b) Set-Aside for Evidence-Based and Best Practice Crisis Care 
Services.--Section 1920 of the Public Health Service Act (42 U.S.C. 
300x-9) is amended--
            (1) in subsection (a), by striking ``be appropriated'' and 
        all that follows through ``2022.'' and inserting the following: 
        ``be appropriated--
            ``(1) $532,571,000 for each of fiscal years 2018 through 
        2022; and
            ``(2) $2,235,000,000 for each of fiscal years 2023 through 
        2027.''; and
            (2) by adding at the end the following:
    ``(d) Crisis Care.--
            ``(1) In general.--Except as provided in paragraph (3), a 
        State shall expend at least 10 percent of the allotment of the 
        State pursuant to a funding agreement under section 1911 for 
        each of fiscal years 2023 through 2027 to support programs 
        described in section 1912(b)(1)(A)(vi).
            ``(2) State flexibility.--In lieu of expending 10 percent 
        of the State's allotment for a fiscal year as required by 
        paragraph (1), a State may elect to expend not less than 20 
        percent of such amount by the end of two consecutive fiscal 
        years.
            ``(3) Funding contingency.--Paragraph (1) shall not apply 
        with respect to a fiscal year unless the amount made available 
        to carry out this section for that fiscal year exceeds the 
        amount appropriated to carry out this section for fiscal year 
        2021 by at least $37,257,100.
            ``(4) Waiver.--A State may, pursuant to a waiver granted by 
        the Secretary of any requirements under this subpart (including 
        requirements imposed by a funding agreement under section 
        1911), use funds set aside under this subsection to provide 
        services described in section 1912(b)(1)(A)(vi) to individuals 
        in such State who do not meet the criteria to be considered 
        with serious mental illness or children with serious emotional 
        disturbances.''.

SEC. 105. MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT PROGRAM.

    Title V of the Public Health Service Act is amended (42 U.S.C. 
290aa) by inserting after section 520F (42 U.S.C. 290bb-37) the 
following:

``SEC. 520F-1. MENTAL HEALTH CRISIS RESPONSE PARTNERSHIP PILOT PROGRAM.

    ``(a) In General.--The Secretary shall establish a pilot program 
under which the Secretary will award competitive grants to eligible 
entities to establish new, or enhance existing, mobile crisis response 
teams that divert the response for mental health and substance use 
crises from law enforcement to mobile crisis teams, as described in 
subsection (b).
    ``(b) Mobile Crisis Teams Described.--A mobile crisis team 
described in this subsection is a team of individuals--
            ``(1) that is available to respond to individuals in crisis 
        and provide immediate stabilization, referrals to community-
        based mental health and substance use disorder services and 
        supports, and triage to a higher level of care if medically 
        necessary;
            ``(2) which may include licensed counselors, clinical 
        social workers, physicians, paramedics, crisis workers, peer 
        support specialists, or other qualified individuals; and
            ``(3) which may provide support to divert behavioral health 
        crisis calls from the 9-1-1 system to the 9-8-8 system.
    ``(c) Priority.--In awarding grants under this section, the 
Secretary shall prioritize applications which account for the specific 
needs of the communities to be served, including children and families, 
veterans, rural and underserved populations, and other groups at 
increased risk of death from suicide or overdose.
    ``(d) Report.--
            ``(1) Initial report.--Not later than one year after the 
        date of the enactment of this section, the Secretary shall 
        submit to Congress a report on steps taken by eligible entities 
        as of such date of enactment to strengthen the partnerships 
        among mental health providers, substance use disorder treatment 
        providers, primary care physicians, mental health and substance 
        use crisis teams, and paramedics, law enforcement officers, and 
        other first responders.
            ``(2) Progress reports.--Not later than one year after the 
        date on which the first grant is awarded to carry out this 
        section, and for each year thereafter, the Secretary shall 
        submit to Congress a report on the grants made during the year 
        covered by the report, which shall include--
                    ``(A) data on the teams and people served by such 
                programs, including demographic information of 
                individuals served, volume and types of service 
                utilization, linkage to community-based resources and 
                diversion from law enforcement settings, data 
                consistent with the State block grant requirements for 
                continuous evaluation and quality improvement, and 
                other relevant data as determined by the Secretary; and
                    ``(B) the Secretary's recommendations and best 
                practices for--
                            ``(i) States and localities providing 
                        mobile crisis response and stabilization 
                        services for youth and adults; and
                            ``(ii) improvements to the program 
                        established under this section.
    ``(e) Eligible Entity.--In this section, the term `eligible entity' 
means each of the following:
            ``(1) Community mental health centers (as defined in 
        section 1861(ff)(3)(B) of the Social Security Act).
            ``(2) Certified community behavioral health clinics 
        described in section 223 of the Protecting Access to Medicare 
        Act of 2014.
            ``(3) An entity that operates citywide, Tribal-wide, or 
        county-wide crisis response systems, including cities, 
        counties, Tribes, or a department or agency of a city, county, 
        or Tribe, including departments or agencies of social services, 
        disability services, health services, public health, or mental 
        health and substance disorder services.
            ``(4) A program of the Indian Health Service, whether 
        operated by such Service, an Indian Tribe (as that term is 
        defined in section 4 of the Indian Health Care Improvement 
        Act), or by a Tribal organization (as that term is defined in 
        section 4 of the Indian Self-Determination and Education 
        Assistance Act) or a facility of the Native Hawaiian health 
        care systems authorized under the Native Hawaiian Health Care 
        Improvement Act.
            ``(5) A public, nonprofit, or other organization that--
                    ``(A) can demonstrate the ability of such 
                organization to effectively provide community-based 
                alternatives to law enforcement; and
                    ``(B) has a demonstrated involvement with the 
                identified communities to be served.
    ``(f) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $100,000,000 for each of fiscal 
years 2023 through 2027.''.

SEC. 106. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.

    Subpart 3 of part B of title V of the Public Health Service Act (42 
U.S.C. 290bb-31 et seq.) is amended by adding at the end the following:

``SEC. 520N. NATIONAL SUICIDE PREVENTION MEDIA CAMPAIGN.

    ``(a) National Suicide Prevention Media Campaign.--
            ``(1) In general.--Not later than the date that is 3 years 
        after the date of the enactment of this Act, the Secretary, in 
        consultation with the Assistant Secretary for Mental Health and 
        Substance Use and the Director of the Centers for Disease 
        Control and Prevention (referred to in this section as the 
        `Director'), shall conduct a national suicide prevention media 
        campaign (referred to in this section as the `national media 
        campaign'), for purposes of--
                    ``(A) preventing suicide in the United States;
                    ``(B) educating families, friends, and communities 
                on how to address suicide and suicidal thoughts, 
                including when to encourage individuals with suicidal 
                risk to seek help; and
                    ``(C) increasing awareness of suicide prevention 
                resources of the Centers for Disease Control and 
                Prevention and the Substance Abuse and Mental Health 
                Services Administration (including the suicide 
                prevention hotline maintained under section 520E-3, any 
                suicide prevention mobile application of the Centers 
                for Disease Control and Prevention or the Substance 
                Abuse Mental Health Services Administration, and other 
                support resources determined appropriate by the 
                Secretary).
            ``(2) Additional consultation.--In addition to consulting 
        with the Assistant Secretary and the Director under this 
        section, the Secretary shall consult with, as appropriate, 
        State, local, Tribal, and territorial health departments, 
        primary health care providers, hospitals with emergency 
        departments, mental and behavioral health services providers, 
        crisis response services providers, paramedics, law 
        enforcement, suicide prevention and mental health 
        professionals, patient advocacy groups, survivors of suicide 
        attempts, and representatives of television and social media 
        platforms in planning the national media campaign to be 
        conducted under paragraph (1).
    ``(b) Target Audiences.--
            ``(1) Tailoring advertisements and other communications.--
        In conducting the national media campaign under subsection 
        (a)(1), the Secretary may tailor culturally competent 
        advertisements and other communications of the campaign across 
        all available media for a target audience (such as a particular 
        geographic location or demographic) across the lifespan.
            ``(2) Targeting certain local areas.--The Secretary shall, 
        to the maximum extent practicable, use amounts made available 
        under subsection (f) for media that targets certain local areas 
        or populations at disproportionate risk for suicide.
    ``(c) Use of Funds.--
            ``(1) Required uses.--
                    ``(A) In general.--The Secretary shall, if 
                reasonably feasible with the funds made available under 
                subsection (f), carry out the following, with respect 
                to the national media campaign:
                            ``(i) Testing and evaluation of 
                        advertising.
                            ``(ii) Evaluation of the effectiveness of 
                        the national media campaign.
                            ``(iii) Operational and management 
                        expenses.
                            ``(iv) The creation of an educational 
                        toolkit for television and social media 
                        platforms to use in discussing suicide and 
                        raising awareness about how to prevent suicide.
                    ``(B) Specific requirements.--
                            ``(i) Testing and evaluation of 
                        advertising.--In testing and evaluating 
                        advertising under subparagraph (A)(i), the 
                        Secretary shall test all advertisements after 
                        use in the national media campaign to evaluate 
                        the extent to which such advertisements have 
                        been effective in carrying out the purposes of 
                        the national media campaign.
                            ``(ii) Evaluation of effectiveness of 
                        national media campaign.--In evaluating the 
                        effectiveness of the national media campaign 
                        under subparagraph (A)(ii), the Secretary 
                        shall--
                                    ``(I) take into account the number 
                                of unique calls that are made to the 
                                suicide prevention hotline maintained 
                                under section 520E-3 and assess whether 
                                there are any State and regional 
                                variations with respect to the capacity 
                                to answer such calls;
                                    ``(II) take into account the number 
                                of unique encounters with suicide 
                                prevention and support resources of the 
                                Centers for Disease Control and 
                                Prevention and the Substance Abuse and 
                                Mental Health Services Administration 
                                and assess engagement with such suicide 
                                prevention and support resources;
                                    ``(III) assess whether the national 
                                media campaign has contributed to 
                                increased awareness that suicidal 
                                individuals should be engaged, rather 
                                than ignored; and
                                    ``(IV) take into account such other 
                                measures of evaluation as the Secretary 
                                determines are appropriate.
            ``(2) Optional uses.--The Secretary may use amounts made 
        available under subsection (f) for the following, with respect 
        to the national media campaign:
                    ``(A) Partnerships with professional and civic 
                groups, community-based organizations, including faith-
                based organizations, and Federal agencies or Tribal 
                organizations that the Secretary determines have 
                experience in suicide prevention, including the 
                Substance Abuse and Mental Health Services 
                Administration and the Centers for Disease Control and 
                Prevention.
                    ``(B) Entertainment industry outreach, interactive 
                outreach, media projects and activities, the 
                dissemination of public information, news media 
                outreach, outreach through television programs, and 
                corporate sponsorship and participation.
    ``(d) Prohibitions.--None of the amounts made available under 
subsection (f) may be obligated or expended for any of the following:
            ``(1) To supplant Federal suicide prevention campaigns in 
        effect as of the date of the enactment of this section.
            ``(2) For partisan political purposes, or to express 
        advocacy in support of or to defeat any clearly identified 
        candidate, clearly identified ballot initiative, or clearly 
        identified legislative or regulatory proposal.
    ``(e) Report to Congress.--Not later than 18 months after 
implementation of the national media campaign has begun, the Secretary, 
in coordination with the Assistant Secretary and the Director, shall, 
with respect to the first year of the national media campaign, submit 
to Congress a report that describes--
            ``(1) the strategy of the national media campaign and 
        whether specific objectives of such campaign were accomplished, 
        including whether such campaign impacted the number of calls 
        made to lifeline crisis centers and the capacity of such 
        centers to manage such calls;
            ``(2) steps taken to ensure that the national media 
        campaign operates in an effective and efficient manner 
        consistent with the overall strategy and focus of the national 
        media campaign;
            ``(3) plans to purchase advertising time and space;
            ``(4) policies and practices implemented to ensure that 
        Federal funds are used responsibly to purchase advertising time 
        and space and eliminate the potential for waste, fraud, and 
        abuse; and
            ``(5) all contracts entered into with a corporation, a 
        partnership, or an individual working on behalf of the national 
        media campaign.
    ``(f) Authorization of Appropriations.--For purposes of carrying 
out this section, there is authorized to be appropriated $10,000,000 
for each of fiscal years 2022 through 2026.''.

         TITLE II--HEALTH RESOURCES AND SERVICES ADMINISTRATION

SEC. 201. HEALTH CENTER CAPITAL GRANTS.

    Subpart 1 of part D of title III of the Public Health Service Act 
(42 U.S.C. 254b et seq.) is amended by adding at the end the following:

``SEC. 330O. HEALTH CENTER CAPITAL GRANTS.

    ``(a) In General.--The Secretary shall award grants to eligible 
entities for capital projects.
    ``(b) Eligible Entity.--In this section, the term `eligible entity' 
is an entity that is--
            ``(1) a health center funded under section 330, or in the 
        case of a Tribe or Tribal organization, eligible, to be awarded 
        without regard to the time limitation in subsection (e)(3) and 
        subsections (e)(6)(A)(iii), (e)(6)(B)(iii), and (r)(2)(B) of 
        such section; or
            ``(2) a mental health and substance use crisis receiving 
        and stabilization program and crisis call center described in 
        section 302(c)(1) of the 9-8-8 Implementation Act of 2022 that 
        have a working relationship with one or more local community 
        mental health and substance use organizations, community mental 
        health centers, and certified community behavioral health 
        clinics, or other local mental health and substance use care 
        providers, including inpatient and residential treatment 
        settings.
    ``(c) Use of Funds.--Amounts made available to a recipient of a 
grant or cooperative agreement pursuant to subsection (a) shall be used 
for crisis response program facility alteration, renovation, 
remodeling, expansion, construction, and other capital improvement 
costs, including the costs of amortizing the principal of, and paying 
interest on, loans for such purposes.
    ``(d) Authorization of Appropriations.--There are authorized to be 
appropriated to carry out this section $1,000,000,000, to remain 
available until expended.''.

SEC. 202. EXPANDING BEHAVIORAL HEALTH WORKFORCE TRAINING PROGRAMS.

    (a) National Health Service Corps.--Section 331(a)(3)(E)(i) of the 
Public Health Service Act (254d(a)(3)(E)(i)) is amended by striking 
``and psychiatrists'' and inserting ``psychiatrists and professionals 
who provide crisis management services (such as at a crisis call 
center, as part of a mobile crisis team, or through crisis receiving 
and stabilization program)''.
    (b) Minority Fellowship Program.--Section 597(b) of the Public 
Health Service Act (42 U.S.C. 290ll(b)) is amended by inserting 
``crisis management services (such as at a crisis call center, as part 
of a mobile crisis team, or through crisis receiving and stabilization 
program),'' after ``mental health counseling,''.
    (c) Behavioral Health Workforce Education and Training.--Section 
756 of the Public Health Service Act (42 U.S.C. 294e-1) is amended--
            (1) in subsection (a)--
                    (A) in paragraph (1), by inserting ``crisis 
                management (such as at a crisis call center, as part of 
                a mobile crisis team, or through crisis receiving and 
                stabilization program),'' after ``occupational 
                therapy,'';
                    (B) in paragraph (2), by inserting ``and providing 
                crisis management services (such as at a crisis call 
                center, as part of a mobile crisis team, or through 
                crisis receiving and stabilization program)'' after 
                ``treatment services,'';
                    (C) in paragraph (3), by inserting ``and providing 
                crisis management services (such as at a crisis call 
                center, as part of a mobile crisis team, or through 
                crisis receiving and stabilization program),'' after 
                ``behavioral health services''; and
                    (D) in paragraph (4), by inserting ``including for 
                the provision of crisis management services (such as at 
                a crisis call center, as part of a mobile crisis team, 
                or through crisis receiving and stabilization 
                program),'' after ``paraprofessional field'';
            (2) in subsection (d)(2), by inserting ``or that emphasize 
        training in crisis management and meeting the crisis needs of 
        diverse populations specified in (b)(2), including effective 
        outreach and engagement'' after ``partnerships''; and
            (3) by adding at the end the following:
    ``(g) Additional Funding.--
            ``(1) In general.--For each of fiscal years 2023 through 
        2027, in addition to funding made available under subsection 
        (f), there are authorized to be appropriated $15,000,000 for 
        workforce development for crisis management, as specified in 
        paragraphs (1) through (4) of subsection (a).
            ``(2) Priority.--In making grants for the purpose specified 
        in paragraph (1), the Secretary shall give priority to programs 
        demonstrating effective recruitment and retention efforts for 
        individuals and groups from different racial, ethnic, cultural, 
        geographic, religious, linguistic, and class backgrounds, and 
        different genders and sexual orientations, as specified in 
        subsection (b)(2).''.

         TITLE III--BEHAVIORAL HEALTH CRISIS SERVICES EXPANSION

SEC. 301. CRISIS RESPONSE CONTINUUM OF CARE.

    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 106, is further amended 
by adding at the end the following:

``SEC. 520O. CRISIS RESPONSE CONTINUUM OF CARE.

    ``(a) In General.--The Secretary shall establish standards for a 
continuum of care for use by health care providers and communities in 
responding to individuals, including children and adolescents, 
experiencing mental health crises, substance related crises, and crises 
arising from co-occurring disorders (referred to in this section as the 
`crisis response continuum').
    ``(b) Requirements.--
            ``(1) Scope of standards.--The standards established under 
        subsection (a) shall define--
                    ``(A) minimum requirements of core crisis services, 
                as determined by the Secretary, to include requirements 
                that each entity that furnishes such services should--
                            ``(i) not require prior authorization from 
                        an insurance provider nor referral from a 
                        health care provider prior to the delivery of 
                        services;
                            ``(ii) serve all individuals regardless of 
                        age or ability to pay;
                            ``(iii) operate 24 hours a day, 7 days a 
                        week, and provide care to all individuals; and
                            ``(iv) provide care and support through 
                        resources described in paragraph (2)(A) until 
                        the individual has been stabilized or transfer 
                        the individual to the next level of crisis 
                        care; and
                    ``(B) psychiatric stabilization, including the 
                point at which a case may be closed for--
                            ``(i) individuals screened over the phone; 
                        and
                            ``(ii) individuals stabilized on the scene 
                        by mobile teams.
            ``(2) Identification of essential functions.--The Secretary 
        shall identify the essential functions of each service in the 
        crisis response continuum, which shall include at least the 
        following:
                    ``(A) Identification of resources for referral and 
                enrollment in continuing mental health, substance use, 
                or other human services relevant for the individual in 
                crisis where necessary.
                    ``(B) Delineation of access and entry points to 
                services within the crisis response continuum.
                    ``(C) Development of and adherence to protocols and 
                agreements for the transfer and receipt of individuals 
                to and from other segments of the crisis response 
                continuum segments as needed, and from outside 
                referrals including health care providers, law 
                enforcement, EMS, fire, education institutions, and 
                community-based organizations.
                    ``(D) Description of the qualifications of crisis 
                services staff, including roles for physicians, 
                licensed clinicians, case managers, and peers (in 
                accordance with State licensing requirements or 
                requirements applicable to Tribal health 
                professionals).
                    ``(E) Requirements for the convening of 
                collaborative meetings of crisis response service 
                providers, first responders, such as paramedics and law 
                enforcement, and community partners (including National 
                Suicide Prevention Lifeline or 9-8-8 call centers, 9-1-
                1 public service answering points, and local mental 
                health and substance use disorder treatment providers) 
                operating in a common region for the discussion of case 
                management, best practices, and general performance 
                improvement.
            ``(3) Service capacity and quality standards.--Such 
        standards shall include definitions of--
                    ``(A) adequate volume of services to meet 
                population need;
                    ``(B) appropriate timely response; and
                    ``(C) capacity to meet the needs of different 
                patient populations who may experience a mental health 
                or substance use crisis, including children, families, 
                and all age groups, cultural and linguistic minorities, 
                individuals with co-occurring mental health and 
                substance use disorders, individuals with cognitive 
                disabilities, individuals with developmental delays, 
                and individuals with chronic medical conditions and 
                physical disabilities.
            ``(4) Oversight and accreditation.--The Secretary shall 
        designate entities charged with the oversight and accreditation 
        of entities within the crisis response continuum.
            ``(5) Implementation timeframe.--Not later than 1 year 
        after the date of enactment of this title, the Secretary shall 
        establish the standards under this section.
            ``(6) Data collection and evaluations.--
                    ``(A) In general.--The Secretary, directly or 
                through grants, contracts, or interagency agreements, 
                shall collect data and conduct evaluations with respect 
                to the provision of services and programs offered on 
                the crisis response continuum for purposes of assessing 
                the extent to which the provision of such services and 
                programs meet certain objectives and outcomes measures 
                as determined by the Secretary. Such objectives shall 
                include--
                            ``(i) a reduction in reliance on law 
                        enforcement response to individuals in crisis 
                        who would be more appropriately served by a 
                        mobile crisis team capable of responding to 
                        mental health and substance related crises;
                            ``(ii) a reduction in boarding or extended 
                        holding of patients in emergency room 
                        facilities who require further psychiatric 
                        care, including care for substance use 
                        disorders;
                            ``(iii) evidence of adequate access to 
                        crisis care centers and crisis bed services; 
                        and
                            ``(iv) evidence of adequate linkage to 
                        appropriate post-crisis care and longitudinal 
                        treatment for mental health or substance use 
                        disorder when relevant.
                    ``(B) Rulemaking.--The Secretary shall carry out 
                this subsection through notice and comment rulemaking, 
                following a request for information from stakeholders.
    ``(c) Components of Crisis Response Continuum.--The crisis response 
continuum consists of at least the following components:
            ``(1) Crisis call centers.--Regional clinically managed 
        crisis call centers that provide telephonic crisis intervention 
        capabilities. Such centers should meet National Suicide 
        Prevention Lifeline operational guidelines regarding suicide 
        risk assessment and engagement and offer air traffic control-
        quality coordination of crisis care in real-time.
            ``(2) Mobile crisis response team.--Teams of providers that 
        are available to reach any individual in the service area in 
        their home, workplace, school, physician's office or outpatient 
        treatment setting, or any other community-based location of the 
        individual in crisis in a timely manner.
            ``(3) Crisis receiving and stabilization facilities.--
        Subacute inpatient facilities and other facilities specified by 
        the Secretary that provide short-term observation and crisis 
        stabilization services to all referrals, including the 
        following services:
                    ``(A) 23-hour crisis stabilization services.--A 
                direct care service that provides individuals in severe 
                distress with up to 23 consecutive hours of supervised 
                care to assist with deescalating the severity of their 
                crisis or need for urgent care in a subacute inpatient 
                setting.
                    ``(B) Short-term crisis residential services.--A 
                direct care service that assists with deescalating the 
                severity of an individual's level of distress or need 
                for urgent care associated with a substance use or 
                mental health disorder in a residential setting.
            ``(4) Mental health and substance use urgent care 
        facilities.--Ambulatory services available 12-24 hours per day, 
        7 days a week, where individuals experiencing crisis can walk 
        in without an appointment to receive crisis assessment, crisis 
        intervention, medication, and connection to continuity of care.
            ``(5) Additional facilities and providers.--The Secretary 
        shall specify additional facilities and health care providers 
        as part of the crisis response continuum, as the Secretary 
        determines appropriate.
    ``(d) Relationship to State Law.--
            ``(1) In general.--Subject to paragraph (2), the standards 
        established under this section are minimum standards and 
        nothing in this section may be construed to preclude a State 
        from establishing additional standards, so long as such 
        standards are not inconsistent with the requirements of this 
        section or other applicable law.
            ``(2) Waiver or modification.--The Secretary shall 
        establish a process under which a State may request a waiver or 
        modification of a standard established under this section.''.

SEC. 302. COVERAGE OF CRISIS RESPONSE SERVICES.

    (a) Coverage Under the Medicare Program.--
            (1) In general.--Section 1861(s)(2) of the Social Security 
        Act (42 U.S.C. 1395x(s)(2)) is amended--
                    (A) in subparagraph (GG), by striking ``and'' at 
                the end;
                    (B) in subparagraph (HH), by striking the period at 
                the end and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(II) crisis response services as defined in 
                subsection (lll);''.
            (2) Crisis response services defined.--Section 1861 of the 
        Social Security Act (42 U.S.C. 1395x) is amended by adding at 
        the end the following new subsection:
    ``(lll) Crisis Response Services.--
            ``(1) In general.--The term `crisis response services' 
        means mental health or substance use services that are 
        furnished by a mobile crisis response team, a crisis receiving 
        and stabilization facility, mental health or substance use 
        urgent care facility, or other appropriate provider, as 
        determined by the Secretary, to an individual, including 
        children and adolescents, experiencing a mental health or 
        substance use crisis. Such term includes services identified by 
        the Secretary as part of the crisis response continuum of care 
        under section 302 of the Behavioral Health Crisis Services 
        Expansion Act.
            ``(2) Definitions.--In this subsection, the terms `mobile 
        crisis response team', `crisis receiving and stabilization 
        facility', and `mental health and substance use urgent care 
        facility' have the meaning given those terms for purposes of 
        such section 302.''.
            (3) Payment.--
                    (A) In general.--Section 1833(a)(1) of the Social 
                Security Act (42 U.S.C. 1395l(a)(1)) is amended--
                            (i) by striking ``and (DD)'' and inserting 
                        ``(DD)''; and
                            (ii) by inserting before the semicolon at 
                        the end the following: ``and (EE) with respect 
                        to crisis response services described in 
                        section 1861(s)(2)(II), the amounts paid shall 
                        be 80 percent of the lesser of the actual 
                        charge for the service or the amount determined 
                        under the payment basis established under 
                        section 1834(z)''.
                    (B) Establishment of payment basis.--Section 1834 
                of the Social Security Act (42 U.S.C. 1395m) is amended 
                by adding at the end the following new subsection:
    ``(z) Payment for Crisis Response Services.--The Secretary shall 
establish a payment basis determined appropriate by the Secretary with 
respect to crisis response services (as defined in section 1861(lll)) 
furnished by a provider of services or supplier.''.
            (4) Ambulance transport of individuals in crisis.--
                    (A) In general.--Section 1834(l) of the Social 
                Security Act (42 U.S.C. 1395m(l)) is amended by adding 
                at the end the following new paragraph:
            ``(18) Transportation of individuals in crisis.--With 
        respect to ambulance services furnished on or after the date 
        that is 3 years after the date of the enactment of the 
        Behavioral Health Crisis Services Expansion Act, the 
        regulations described in section 1861(s)(7) shall provide 
        coverage under such section for ambulance and other qualified 
        emergency transport services to transport an individual 
        experiencing a mental health or substance crisis to an 
        appropriate facility, such as a community mental health center 
        (as defined in section 1861(ff)(3)(B)) or other facility or 
        provider identified by the Secretary as part of the crisis 
        response continuum of care under section 203 of the Behavioral 
        Health Crisis Services Expansion Act, as appropriate, for 
        crisis response services described in section 
        1861(s)(2)(II).''.
                    (B) Conforming amendment.--Section 1861(s)(7) of 
                such Act (42 U.S.C. 1395x(s)(7)) is amended by striking 
                ``section 1834(l)(14)'' and inserting ``paragraphs (14) 
                and (18) of section 1834(l)''.
            (5) Effective date.--The amendments made by this subsection 
        shall apply to services furnished on or after the date that is 
        3 years after the date of the enactment of this Act.
    (b) Mandatory Coverage of Crisis Response Services Under the 
Medicaid Program.--Title XIX of the Social Security Act (42 U.S.C. 1396 
et seq.) is amended--
            (1) in section 1902(a)(10)(A), in the matter preceding 
        clause (i), by striking ``and (30)'' and inserting ``(30), and 
        (31)''; and
            (2) in section 1905--
                    (A) in subsection (a)--
                            (i) in paragraph (30), by striking ``; 
                        and'' and inserting a semicolon;
                            (ii) by redesignating paragraph (31) as 
                        paragraph (32); and
                            (iii) by inserting the following paragraph 
                        after paragraph (30):
            ``(31) crisis response services (as defined in section 
        1861(lll)); and''.
            (3) Presumptive eligibility determination by crisis 
        response service providers.--Section 1902(a)(47)(B) of the 
        Social Security Act (42 U.S.C. 1396a(a)(47)(B)) is amended by 
        inserting ``or provider of crisis response services (as defined 
        in section 1861(lll))'' after ``any hospital''.
            (4) Effective date.--
                    (A) In general.--Except as provided in subparagraph 
                (B), the amendments made by this section shall take 
                effect on the date that is 3 years after the date of 
                the enactment of this Act.
                    (B) Delay permitted if state legislation 
                required.--In the case of a State plan under title XIX 
                of the Social Security Act (42 U.S.C. 1396 et seq.) 
                which the Secretary of Health and Human Services 
                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 this section, the State plan shall 
                not be regarded as failing to comply with the 
                requirements of such title solely on the basis of the 
                failure of the plan to meet such additional 
                requirements before the first day of the first calendar 
                quarter beginning after the close of the first regular 
                session of the State legislature 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 such session 
                shall be deemed to be a separate regular session of the 
                State legislature.
    (c) Essential Health Benefits.--Section 1302(b)(1)(E) of the 
Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)(E)) 
is amended by inserting ``and crisis response services (as defined in 
section 1861(lll) of the Social Security Act)'' before the period.
    (d) Group Health Plans and Health Insurance Issuers.--
            (1) In general.--Section 2707 of the Public Health Service 
        Act (42 U.S.C. 300gg-6) is amended by adding at the end the 
        following:
    ``(e) Crisis Response Services.--A group health plan or a health 
insurance issuer offering group or individual health insurance coverage 
shall ensure that such coverage includes crisis response services (as 
defined in section 1861(lll) of the Social Security Act).''.
            (2) Application to grandfathered plans.--Section 
        1251(a)(4)(A) of the Public Health Service Act (42 U.S.C. 
        18011(a)(4)(A)) is amended by adding at the end the following 
        new clause:
                            ``(v) Section 2707(e) (relating to coverage 
                        of crisis response services).''.
    (e) Tricare Coverage.--
            (1) In general.--The Secretary of Defense shall provide 
        coverage under the TRICARE program for crisis response 
        services, as defined in section 1861(lll) of the Social 
        Security Act (42 U.S.C. 1395x) (as amended by section 303).
            (2) Tricare program defined.--In this section, the term 
        ``TRICARE program'' has the meaning given the term in section 
        1072 of title 10, United States Code.
    (f) Reimbursement for Crisis Response Services for Veterans.--
Section 1725(f)(1) of title 38, United States Code, is amended, in the 
matter preceding subparagraph (A), by inserting ``, including crisis 
response services (as defined in subsection (lll) of section 1861 of 
the Social Security Act (42 U.S.C. 1395x)),'' after ``services''.
    (g) Coverage Under FEHB.--
            (1) In general.--Section 8902 of title 5, United States 
        Code, is amended by adding at the end the following:
    ``(p) Each contract for a plan under this chapter shall require the 
carrier to provide coverage for crisis response services, as that term 
is defined in subsection (lll) of section 1861 of the Social Security 
Act (42 U.S.C. 1395x).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall apply beginning with respect to the third contract year 
        for chapter 89 of title 5, United States Code, that begins on 
        or after the date that is 3 years after the date of enactment 
        of this Act.
    (h) Coverage Under CHIP.--Section 2103(c)(5) of the Social Security 
Act (42 U.S.C. 1397cc(c)(5)) is amended--
            (1) in subparagraph (A), by striking ``and'' at the end;
            (2) in subparagraph (B), by striking the period and 
        inserting ``; and''; and
            (3) by adding at the end the following new subparagraph:
                    ``(C) beginning on the date that is 3 years after 
                the date of the enactment of this subparagraph, crisis 
                response services (as defined in section 1861(lll)).''.

SEC. 303. BUILDING THE CRISIS CONTINUUM INFRASTRUCTURE.

    (a) Additional Amounts for Mental Health Block Grant.--Section 1920 
of the Public Health Service Act (42 U.S.C. 300x-9) is amended by 
adding at the end the following:
    ``(d) Support for Crisis Response Services Infrastructure.--
            ``(1) In general.--In addition to amounts made available 
        under subsection (a), there are authorized to be appropriated 
        such sums as are necessary for each of fiscal years 2022, 2023, 
        and 2024, for purposes of supporting the infrastructure needed 
        to provide crisis response services (as defined in section 
        1861(lll) of the Social Security Act) in the States, which may 
        include training and continuing education, and administrative 
        expenses with respect to the provision of such services.
            ``(2) Allotments.--Each fiscal year for which amounts are 
        appropriated under paragraph (1), the Secretary shall allot to 
        each State that receives a grant under section 1911 for the 
        fiscal year an amount that bears the same relationship to the 
        total amount appropriated under paragraph (1) for the fiscal 
        year that the amount received by the State under section 
        1911(a) for the fiscal year bears to the total amount 
        appropriated under subsection (a) for the fiscal year.
    ``(e) Technical Assistance.--The Secretary shall provide to States 
technical assistance regarding the provision of crisis response 
services, as defined in section 1861(lll) of the Social Security Act, 
including guidance on how States may blend Medicaid funds available to 
States under title XIX of the Social Security Act and funds available 
to States under the community mental health services block grant 
program under this subpart and the substance abuse prevention and 
treatment block grant program under subpart II to provide such 
services.
    ``(f) Clearinghouse of Best Practices.--The Secretary shall develop 
and maintain a publicly available clearinghouse of best practices for 
the successful operation of each segment of the system for providing 
crisis response services (as defined in section 1861(lll) of the Social 
Security Act) and the integration of such best practices into the 
provision of such services. The clearinghouse shall be updated 
annually.
    ``(g) Rule of Construction.--With respect to funds allocated under 
the crisis care set-aside authorized under (a), the provisions 
contained in 1912(b)(1)(A)(vi) shall not apply.''.

SEC. 304. INCIDENT REPORTING.

    (a) Establishment of Protocol Panel.--The Secretary of Health and 
Human Services (referred to in this section as the ``Secretary''), in 
consultation with the Attorney General, shall convene a panel for the 
purposes of making recommendations for training and protocol for 9-1-1 
dispatchers to respond appropriately to individuals experiencing a 
behavioral health crisis based on the characteristics of the incident 
and the needs of the caller.
    (b) Panelists.--The Secretary shall appoint individuals to serve 
staggered 10-year terms on the panel established under subsection (a). 
Such individuals shall include--
            (1) psychiatrists;
            (2) paramedics and other emergency medical services 
        personnel;
            (3) law enforcement officers and 9-1-1 dispatchers;
            (4) representatives from each segment of the crisis 
        response continuum, as described in section 302, including 9-8-
        8 dispatchers;
            (5) individuals who have received services under such 
        crisis response continuum, including individuals under the age 
        of 18;
            (6) members of underserved communities including ethnic and 
        racial minority groups and sexual orientation and gender 
        minority groups;
            (7) representatives from Tribes or Tribal organizations; 
        and
            (8) other individuals, as the Secretary determines 
        appropriate.
    (c) Recommendations.--
            (1) Topics.--In issuing recommendations under this section, 
        the panel shall consider--
                    (A) connecting 9-1-1 callers to crisis care 
                services instead of responding with law enforcement 
                officers;
                    (B) integrating the 9-8-8 system into the 9-1-1 
                system, or transferring calls from the 9-1-1 system to 
                the 9-8-8 system as appropriate; and
                    (C) a process for identifying 9-1-1 callers who may 
                be experiencing psychiatric symptoms or a mental health 
                crisis, substance use crisis, or co-occurring crisis 
                and evaluating the level of need of such callers, as 
                defined by relevant, standardized assessment tools such 
                as the Level of Care Utilization System (LOCUS), the 
                Child and Adolescent Level of Care Utilization System 
                (CALOCUS), and the American Society of Addiction 
                Medicine (ASAM) Criteria.
            (2) Updates.--The panel shall update recommendations issued 
        under this section not less frequently than every 5 years.

                     TITLE IV--MEDICAID AMENDMENTS

SEC. 401. REVISIONS TO THE STATE OPTION TO PROVIDE QUALIFYING 
              COMMUNITY-BASED MOBILE CRISIS INTERVENTION SERVICES AND 
              OTHER SERVICES UNDER STATE PLANS UNDER THE MEDICAID 
              PROGRAM.

    (a) In General.--Section 1947 of the Social Security Act (42 U.S.C. 
1396w-6) is amended--
            (1) in subsection (a)--
                    (A) by striking ``for qualifying community-based 
                mobile crisis intervention services'' and inserting 
                ``for--
            ``(1) qualifying community-based mobile crisis intervention 
        services;
            ``(2) regional and local lifeline call center operations; 
        and
            ``(3) programs for the purpose receiving and stabilization 
        individuals (including beds in homes and facilities for such 
        purpose).''; and
                    (B) by striking ``during the 5-year period'';
            (2) in subsection (c)--
                    (A) by striking ``85 percent.'' and inserting the 
                following: ``85 percent, and for medical assistance for 
                items described in paragraphs (2) and (3) of subsection 
                (a) furnished during such quarter shall be equal to 85 
                percent.''; and
                    (B) by striking ``occurring during the period 
                described in subsection (a) that a State'' and 
                inserting ``in which a State provides medical 
                assistance for qualifying community-based mobile crisis 
                intervention services under this section and'';
            (3) in subsection (e), by adding at the end at the 
        following new sentence: ``There is appropriated, out of any 
        funds in the Treasury not otherwise appropriated, $5,000,000 to 
        the Secretary for the purposes described in the preceding 
        sentence to remain available until expended.''; and
            (4) in subsection (d)(2)--
                    (A) in subparagraph (A), by striking ``for the 
                fiscal year preceding the first fiscal quarter 
                occurring during the period described in subsection 
                (a)'' and inserting ``for the fiscal year preceding the 
                first fiscal quarter in which the State provides 
                medical assistance for qualifying community-based 
                mobile crisis intervention services under this 
                section''; and
                    (B) in subparagraph (B), by striking ``occurring 
                during the period described in subsection (a)'' and 
                inserting ``occurring during a fiscal quarter''.
    (b) Effective Date.--The amendments made by subsection (a) shall 
take effect as if included in the enactment of the American Rescue Plan 
Act of 2021 (Public Law 117-2).

SEC. 402. REVISIONS TO THE IMD EXCLUSION UNDER MEDICAID.

    (a) Shrinking of the IMD Exclusion Under Medicaid.--Section 
1905(a)(1) of the Social Security Act (42 U.S.C. 1396d(a)(1)) is 
amended by inserting ``, except for, services that, beginning the day 
after the date of the enactment of the 9-8-8 National Suicide 
Prevention Lifeline Implementation Act of 2022, are furnished in 
psychiatric acute care crisis beds administered by community behavioral 
health organizations certified under section 223 of the Protecting 
Access to Medicare Act of 2014, mental health centers that meet the 
criteria of section 1913(c) of the Public Health Service Act, crisis 
receiving and stabilization facilities (as defined in section 302(c)(3) 
of the 9-8-8 National Suicide Prevention Lifeline Implementation Act of 
2022) and the mental health and substance use urgent care facilities 
(as defined in section 302(c)(5) of such Act)''.
    (b) Guidance Relating to IMD Exclusion.--Not later than 180 days 
after the date of the enactment of this Act, the Secretary of Health 
and Human Services shall issue guidance that crisis stabilization units 
(as described in section 1905(a)(1) of the Social Security Act (42 
U.S.C. 1396d(a)(1)) are excluded from the prohibition specified in the 
parenthetical of paragraph (1) of section 1905(a) (relating to services 
in an institution for mental diseases), including the following 
facilities and services:
            (1) Subacute crisis receiving in inpatient or other 
        facilities specified by the Secretary that provide short-term 
        observation for all referrals to individuals in severe 
        distress, as further defined by the Secretary, with up to 23 
        consecutive hours of supervised care to assist with 
        deescalating the severity of a mental health or substance use 
        crisis or need for urgent care in a sub-acute inpatient 
        setting.
            (2) Short term crisis stabilization services assisting with 
        deescalating the severity of individuals in severe distress, as 
        defined by the Secretary, or need for urgent care associated 
        with a substance use or mental health disorder in an inpatient 
        or residential setting with reimbursement limited to 72 hours.
    (c) Reports on Crisis Stabilization Utilization.--Not later than 1 
year after the date of the enactment of this Act, the Secretary shall 
submit to the appropriate congressional committees of jurisdiction a 
report addressing the utilization of facility-based crisis services, 
including the number of patients served, type and duration of facility-
based services, linkage to community-based resources, and information 
on the total number of law enforcement drop-offs and other data 
relevant for diverting mental health and substance use disorder 
emergencies from law enforcement response.

SEC. 403. EXCELLENCE IN MENTAL HEALTH AND ADDICTION TREATMENT.

    (a) Expansion of Community Mental Health Services Demonstration 
Program.--Section 223 of the Protecting Access to Medicare Act of 2014 
(42 U.S.C. 1396a note) is amended--
            (1) in subsection (c), by adding at the end the following 
        new paragraph:
            ``(3) Planning grants for additional states.--In addition 
        to the planning grants awarded under paragraph (1), the 
        Secretary shall award planning grants to States (other than 
        States selected to conduct demonstration programs under 
        paragraphs (1) or (8) of subsection (d)) for the purpose of 
        developing proposals to participate in time-limited 
        demonstration programs described in subsection (d).'';
            (2) in subsection (d)--
                    (A) in paragraph (3), by striking ``Subject to 
                paragraph (8)'' and inserting ``Subject to paragraphs 
                (8) and (9)'';
                    (B) in paragraph (5)(C)(iii)(II), by inserting ``or 
                paragraph (9)'' after ``paragraph (8)'';
                    (C) in paragraph (7)--
                            (i) in subparagraph (A), by inserting 
                        ``through the year in which the last 
                        demonstration under this section ends'' after 
                        ``annually thereafter'';
                            (ii) in subparagraph (B)--
                                    (I) by striking ``December 31, 
                                2021'' and inserting ``September 30, 
                                2023''; and
                                    (II) by adding at the end the 
                                following new sentence: ``Such 
                                recommendations shall include data 
                                collected after 2019.''; and
                            (iii) by adding at the end the following 
                        new subparagraph:
                    ``(C) Final evaluation.--Not later than 18 months 
                after all demonstration programs under this section 
                have ended, the Secretary shall submit to Congress a 
                final evaluation of such programs.''; and
                    (D) by adding at the end the following new 
                paragraph:
            ``(9) Further additional programs.--In addition to the 
        States selected under paragraphs (1) and (8), the Secretary 
        shall select any State that submits an application that 
        includes such information as the Secretary shall require to 
        conduct a demonstration program that meets the requirements of 
        paragraph (2) and paragraphs (4) through (7) for 2 years or 
        through September 30, 2023, whichever is longer.''; and
            (3) in subsection (f)(1)(B), by inserting ``, and 
        $40,000,000 for fiscal year 2022'' before the period.
    (b) Certified Community Behavioral Health Clinic Expansion 
Grants.--Part D of title V of the Public Health Service Act (42 U.S.C. 
290dd et seq.) is amended by adding at the end the following:

``SEC. 553. CERTIFIED COMMUNITY BEHAVIORAL HEALTH CLINIC EXPANSION 
              GRANTS.

    ``(a) In General.--The Assistant Secretary shall award grants to 
communities and community organizations that meet the criteria for 
certified community behavioral health clinics under section 223(a) of 
the Protecting Access to Medicare Act A of 2014. Grants awarded under 
this subsection shall be for a period of not more than 5 years.
    ``(b) Technical Assistance.--The Assistant Secretary may provide 
appropriate information, training, and technical assistance through 
appropriate contract procedures to entities receiving grants under 
subsection (a), or to health or social service providers pursuing 
certified community behavioral health clinics status or partnering with 
certified community behavioral health clinics, State policymakers 
considering certified community behavioral health clinics 
implementation under the Medicaid program, and other stakeholders to 
facilitate successful implementation of the certification model.
    ``(c) Authorization of Appropriations.--
            ``(1) Grant program.--For purposes of awarding grants under 
        subsection (a), there is authorized to be appropriated 
        $500,000,000 for the period of fiscal years 2022 through 2024.
            ``(2) Technical assistance.--For purposes of carrying out 
        the technical assistance program under subsection (b), there 
        are authorized to be appropriated $5,000,000 for each of fiscal 
        years 2022 through 2026.''.
                                 <all>