I 117th CONGRESS 2d Session H. R. 7237 IN THE HOUSE OF REPRESENTATIVES March 28, 2022 Mr. Griffith (for himself, Ms. Tenney , Ms. Davids of Kansas , and Ms. Craig ) introduced the following bill; which was referred to the Committee on Energy and Commerce A BILL To amend the Public Health Service Act to reauthorize certain mental health, suicide prevention, and crisis care programs, and for other purposes.

1. Short title This Act may be cited as the Reauthorizing Evidence-based And Crisis Help Initiatives Needed to Generate Improved Mental Health Outcomes for Patients Act of 2022 or the REACHING Improved Mental Health Outcomes for Patients Act of 2022 . 2. Innovation for mental health (a) National Mental Health and Substance Use Policy Laboratory Section 501A of the Public Health Service Act ( 42 U.S.C. 290aa–0 ) is amended— (1) in subsection (e)(1), by striking Indian tribes or tribal organizations and inserting Indian Tribes or Tribal organizations ; (2) by striking subsection (e)(3); and (3) by adding at the end the following: (f) Authorization of appropriations To carry out this section, there is authorized to be appropriated $10,000,000 for each of fiscal years 2023 through 2027. . (b) Priority mental health needs of regional and national significance Section 520A of the Public Health Service Act ( 42 U.S.C. 290bb–32 ) is amended— (1) in subsection (a), by striking Indian tribes or tribal organizations and inserting Indian Tribes or Tribal organizations ; and (2) in subsection (f), by striking $394,550,000 for each of fiscal years 2018 through 2022 and inserting $599,036,000 for each of fiscal years 2023 through 2027 . (c) Integration incentive grants and cooperative agreements for supporting the improvement of integrated care for primary care and behavioral health care Section 520K of the Public Health Service Act ( 42 U.S.C. 290bb–42 ) is amended— (1) in subsection (g)(2), by striking Indian tribes or tribal organizations and inserting Indian Tribes or Tribal organizations ; and (2) in subsection (h), by striking $51,878,000 for each of fiscal years 2018 through 2022 and inserting $52,877,000 for each of fiscal years 2023 through 2027 . 3. Crisis care coordination (a) Strengthening community crisis response systems Section 520F of the Public Health Service Act ( 42 U.S.C. 290bb–37 ) is amended to read as follows: 520F. Strengthening community crisis response systems (a) In general The Secretary shall award competitive grants to State and local governments, Indian Tribes, and Tribal organizations to— (1) enhance community-based crisis response systems; and (2) implement strategies that improve care coordination, and referral to inpatient psychiatric facilities, crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, as appropriate, for adults with a serious mental illness, children with a serious emotional disturbance, or individuals with a substance use disorder. (b) Applications (1) In general To receive a grant under subsection (a), an entity shall submit to the Secretary an application, at such time, in such manner, and containing such information as the Secretary may require. (2) Community-based crisis response plan An application for a grant under subsection (a) shall include a plan for— (A) promoting integration and coordination between local public and private entities engaged in crisis response, which shall include first responders, law enforcement, emergency health care providers, primary care providers, court systems, health care payers, social service providers, and behavioral health providers; (B) developing memoranda of understanding with public and private entities to implement crisis response services; (C) addressing gaps in community resources for crisis intervention and prevention; (D) developing models for minimizing hospital readmissions, including through appropriate discharge planning; (E) developing, maintaining, or enhancing directories to collect, aggregate, and display information about local inpatient psychiatric facilities and crisis stabilization units, and residential community mental health and residential substance use disorder treatment facilities, to facilitate the identification and designation of such facilities and units for the temporary treatment of individuals in mental or substance use disorder crisis; and (F) including in such directories real-time information about— (i) the number of available beds at each facility or unit; (ii) the types of patients that may be admitted to each facility or unit; and (iii) any other information necessary to allow for the proper identification and designation of appropriate facilities or units for treatment of individuals in mental or substance use disorder crisis. (c) Evaluation An entity receiving a grant under subsection (a) shall submit to the Secretary, at such time, in such manner, and containing such information as the Secretary may reasonably require, a report, including an evaluation of the effect of such grant on— (1) local crisis response services and measures for individuals receiving crisis planning and early intervention supports; (2) individuals reporting improved functional outcomes; and (3) individuals receiving regular followup care following a crisis. (d) Authorization of appropriations There is authorized to be appropriated to carry out this section $12,500,000 for the period of fiscal years 2023 through 2027. . (b) Mental health awareness training grants (1) In general Section 520J of the Public Health Service Act ( 42 U.S.C. 290bb–41 ) is amended— (B) in subsection (b)(1), by striking Indian tribes, tribal organizations and inserting Indian Tribes, Tribal organizations ; (C) in paragraphs (4), (5), and (6) of subsection (b), by striking Indian tribe, tribal organization each place it appears and inserting Indian Tribe, Tribal organization ; and (D) in subsection (b)(7), by striking $14,693,000 for each of fiscal years 2018 through 2022 and inserting $24,963,000 for each of fiscal years 2023 through 2027 . (2) Technical corrections Section 520J(b) of the Public Health Service Act ( 42 U.S.C. 290bb–41(b) ) is amended— (A) in the heading of paragraph (2), by striking Emergency Services Personnel and inserting Emergency services personnel ; and (B) in the heading of paragraph (3), by striking Distribution of Awards and inserting Distribution of awards . (c) Adult suicide prevention Section 520L of the Public Health Service Act ( 42 U.S.C. 290bb–43 ) is amended— (1) in subsection (a)(2)— (A) by striking Indian tribe each place it appears and inserting Indian Tribe ; and (B) by striking tribal organization each place it appears and inserting Tribal organization ; and (2) in subsection (d), by striking $30,000,000 for the period of fiscal years 2018 through 2022 and inserting $30,000,000 for each of fiscal years 2023 through 2027 . 4. Treatment of serious mental illness (a) Assertive community treatment grant program (1) Technical amendment Section 520M(b) of the Public Health Service Act ( 42 U.S.C. 290bb–44(b) ) is amended by striking Indian tribe or tribal organization and inserting Indian Tribe or Tribal organization . (2) Report to Congress Section 520M(d)(1) of the Public Health Service Act ( 42 U.S.C. 290bb–44(d)(1) ) is amended by striking not later than the end of fiscal year 2021 and inserting not later than the end of fiscal year 2026 . (3) Authorization of appropriations Section 520M(e)(1) of the Public Health Service Act ( 42 U.S.C. 290bb–44(d)(1) ) is amended by striking $5,000,000 for the period of fiscal years 2018 through 2022 and inserting $9,000,000 for each of fiscal years 2023 through 2027 . (b) Assisted outpatient treatment 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: 520N. Assisted outpatient treatment grant program for individuals with serious mental illness (a) In general The Secretary shall award grants to eligible entities for assisted outpatient treatment programs for individuals with serious mental illness. (b) Consultation The Secretary shall carry out this section in consultation with the Director of the National Institute of Mental Health, the Attorney General of the United States, the Administrator of the Administration for Community Living, and the Assistant Secretary for Mental Health and Substance Use. (c) Selecting among applicants In awarding grants under this section, the Secretary— (1) may give preference to applicants that have not previously implemented an assisted outpatient treatment program; and (2) shall evaluate applicants based on their potential to reduce hospitalization, homelessness, incarceration, and interaction with the criminal justice system while improving the health and social outcomes of the patient. (d) Program requirements An assisted outpatient treatment program funded with a grant awarded under this section shall include— (1) evaluating the medical and social needs of the patients who are participating in the program; (2) preparing and executing treatment plans for such patients that— (A) include criteria for completion of court-ordered treatment if applicable; and (B) provide for monitoring of the patient’s compliance with the treatment plan, including compliance with medication and other treatment regimens; (3) providing for case management services that support the treatment plan; (4) ensuring appropriate referrals to medical and social services providers; (5) evaluating the process for implementing the program to ensure consistency with the patient’s needs and State law; and (6) measuring treatment outcomes, including health and social outcomes such as rates of incarceration, health care utilization, and homelessness. (e) Report Not later than the end of fiscal year 2027, the Secretary shall submit a report to the appropriate congressional committees on the grant program under this section. Such report shall include an evaluation of the following: (1) Cost savings and public health outcomes such as mortality, suicide, substance abuse, hospitalization, and use of services. (2) Rates of incarceration of patients. (3) Rates of homelessness of patients. (4) Patient and family satisfaction with program participation. (f) Definitions In this section: (1) The term assisted outpatient treatment means medically prescribed mental health treatment that a patient receives while living in a community under the terms of a law authorizing a State or local court to order such treatment. (2) The term eligible entity means a county, city, mental health system, mental health court, or any other entity with authority under the law of the State in which the entity is located to implement, monitor, and oversee an assisted outpatient treatment program. (g) Funding (1) Amount of grants (A) Maximum amount The amount of a grant under this section shall not exceed $1,000,000 for any fiscal year. (B) Determination Subject to subparagraph (A), the Secretary shall determine the amount of each grant under this section based on the population of the area to be served through the grant and an estimate of the number of patients to be served. (2) Authorization of appropriations There is authorized to be appropriated to carry out this section $22,000,000 for each of fiscal years 2023 through 2027. .