II 117th CONGRESS 2d Session S. 4498 IN THE SENATE OF THE UNITED STATES June 23, 2022 Mr. Casey introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To expand the availability of mental, emotional, and behavioral health services under the Medicaid program, and for other purposes.

1. Short title This Act may be cited as the Kids’ Mental Health Improvement Act . 2. Table of contents The table of contents for this Act is as follows: Sec. 1. Short title. Sec. 2. Table of contents. Sec. 3. Guidance to States on supporting mental, emotional, and behavioral health services, and on the availability of telehealth under Medicaid. Sec. 4. Ensuring children receive timely access to care. 3. Guidance to States on supporting mental, emotional, and behavioral health services, and on the availability of telehealth under Medicaid (a) Mental, emotional, and behavioral health services Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall issue guidance to States on how to expand the provision of mental, emotional, and behavioral health services covered by State plans (or waivers of such plans) under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ), including a description of best practices for effective programs, service provision for underserved communities, recruitment and retention of providers, and supporting the delivery of such services in schools and other community settings. (b) Telehealth services Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall issue guidance to States on best practices to sustain and enhance the availability of telehealth services covered by State plans (or waivers of such plans) under title XIX of the Social Security Act ( 42 U.S.C. 1396 et seq. ). 4. Ensuring children receive timely access to care (a) Guidance to States on flexibilities to ensure provider capacity To provide pediatric mental, emotional, and behavioral crisis care Not later than 1 year after the date of enactment of this Act, the Secretary of Health and Human Services shall provide guidance to States on existing flexibilities for hospitals and other providers under applicable laws, regulations, and guidance to support children in crisis or in need of intensive mental, emotional or behavioral health services. (b) Mandated report to Congress regarding barriers to repurposing of beds, space, and staff To address pediatric behavioral health needs (1) In general Not later than 120 days after the date of enactment of this Act, the Secretary of Health and Human Services shall submit to the Congress a report with respect to regulatory and legal barriers to care across the crisis continuum that identifies solutions to facilitate flexibility for children's hospitals and other providers of mental, emotional, or behavioral health services. (2) Requirements In preparing a report under this subsection, the Secretary of Health and Human Services shall include in such report— (A) a comprehensive list of laws, regulations, and guidance impacting children’s hospitals’ and other providers' ability to repurpose immediately beds, space, and staff for children in need of mental, emotional, or behavioral health services, including a description of the rationale for each policy and corresponding actions required to repurpose such beds, space, and staff; and (B) recommendations on how children’s hospitals and other providers can immediately expand access to mental, emotional, and behavioral health services while also ensuring high quality and safety. (c) Ensuring consistent review and State implementation of early and periodic screening, diagnostic, and treatment services Section 1905(r) of the Social Security Act ( 42 U.S.C. 1396d(r) ) is amended by adding at the end the following: The Secretary shall, not later than July 1, 2022, and not later than January 1 each year thereafter, review implementation of the requirements of this subsection by States as they pertain to behavioral health services for children, including services provided by a managed care entity, identify and disseminate best practices for ensuring comprehensive coverage of services, identify gaps and deficiencies in meeting Federal requirements, and provide guidance to States on addressing identified gaps and disparities and meeting Federal coverage requirements in order to ensure children, including children without a mental health diagnosis, have access to behavioral health services. .